Conclusion:
The contract between the BMA and the Government on Out of Hours working for GPs accepts that medical practices in
particularly remote and isolated areas may not be able to opt out of the provision of Out of Hours medical cover.
NHS Highland has decided that, although Applecross is one of the most remote and isolated communities on mainland
Scotland, with extremely poor road access, they will impose a system which means that travelling times for Out of
Hours treatment are lengthy and outwith their own criteria.
It should be noted that the Bealach na Ba, which is the main access road to the Peninsula, is not safe to drive on
at any time while stressed or under pressure of time. It is, most certainly, not safe to drive when road or climatic
conditions are poor.
The nearest ambulance is based in Lochcarron and cannot reach Applecross patients in any time remotely approaching
Scottish Ambulance Service's target times. There is no midwifery or paramedical service available in Applecross which,
combined with excessive ambulance times, means that it is essential that the services of the local GP is available at
all times on the Peninsula.
To be effective, any Out of Hours service for Applecross will have to take into account not only the unique geographical
situation of the area, but also the demographics that show Applecross to be much more populous than the number of permanent
residents would suggest.
Applecross must, therefore, be considered to be one of the few areas meeting the exceptional circumstances
envisaged in the Out of Hours Contract and, until a suitable and sustainable solution can be provided, should, for the
foreseeable future, be unable to opt out - a straightforward solution to a difficult problem that is actively supported
by the local GP.
View images of the Bealach na Ba
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