Islands, GP practices and the Islay predicament

An Islay GP, Dr Chris Abell, has written to the islan’s celebrated newspaper, The Ileach, expressing serious concerns both about the decision taken by the Community Health Partnership to relocate the Bowmore GP Surgery to Islay Hospital and about the current GP provision for the sister islands of Islay and Jura.

The letter is committed but balanced, offering insights that require to be seriously addressed. It does not enter into the matter of the legal dispute now escalated between the owner of the Bowmore practice, Dr Latta and the Community Health Partnership.

The situation is of profound concern to islanders, with the most vulnerable patients, the elderly, now additionally suffering anxiety as to the nature of their future care.

The Bowmore practice serves 1200 island patients. Dr Abell feels, from an expertly informed position, that transferring that practice to the hospital can have nothing but an adverse impact on the services provided to practice patients  and to the entire island community by the hospital itself.

Dr Abell draws attention to the dangers of creeping familiarisation.  It is not hard to see that once the move is made and the necessary money spent on providing what would initially be a ‘temporary’ facility, its sheer presence at the hospital over time could slide into permanence, with its set up continuing as pretty ad hoc.

The big issue is the impact that the location of the practice at the hospital might make on the likelihood of attracting good – or even any- candidates to take up the vacant posts as GPs at the Bowmore practice. Dr Abel feels that the relocation of the practice will have little if any impact on this – for the negative reason that; ‘… the overall circumstances at the Bowmore practice were already deeply unattractive to potential GPs, as the failure to attract any interest at all from outside the island over the last 18 months has shown.’

His letter sets the general. context of this issue by noting that, at the moment, there are now no fewer than six vacant GP posts between Islay and Jura.

This is the heart of a matter of real concern to all remote island and mainland communities. Gp practices across such parts of Scotland are under threat when an incumbent GP retires or moves away.

We note from the report of the recent meeting of Islay Community Council – whom, the their peer council on Jura, Dr Abell rightly calls upon to take a very active role in leadership and representation – that an advertisement to recruit a GP is to be placed in the British Medical Journal and ‘other more Islay-specific press releases’.

We see two key issues here:

  • community ownership
  • imaginative recruitment strategies

Community ownership

In our view, community ownership is the way forwards in a community taking responsibility and carrying authority for the key services on which its sustainability depends.

With support from the community buy-out provisions of the Land Reform (Scotland) Act, communities have bought and control their own shop/post offices, filling stations and pubs.

Other vital services are primary schools, primary health care practices and care of the elderly.

Ownership of such services would be state supported but it would be down to the community to support and develop them, with pride in their achievements and control over their circumstances.

Islay is an island that has taken the lead in many initiatives – such as marine renewable energy. It is an inland that could and would enjoy pioneering in this new territory.

Inventive recruiting

Who is likely to want to be an island GP?

Doctors nearing retirement are one obvious target, with the prospect of an island life attractive at that stage of their careers.

But this route, by its nature and where it is successful, cannot be other than a delaying device because the same problem will recur in the short term.

Islands generally have two serious attractions for the right people:

  • land and water based outdoor activities
  • an idyllic set of circumstances for the early lives of children.

Islay has unique and fabulous activity opportunities – a sample of which includes:

  • cycling, with the enviable annual social cycling event, the Ride of the Falling Rain and with extreme cycling from the Islay Wilderness Guide;
  • walking – with long established groups and, again, with the annual Islay Walking Week drawing attention from far afield;
  • birding, with the glorious reserves of Loch Gruinart and Loch Indaal;
  • sea kayaking;
  • sea angling – and with island  business Stormcats, Scotland’s biggest GRP boat builder,  specialising in sea angling boats and running annual competitive events;
  • beach rugby – where else has an annual Eat Sand: Islay Beach Rugby contest attracting international players and club interest from far and wide;
  • golf – with an ambitious upgrade in train for the Machrie Hotel and its superb links course.

All of these sports have specialist magazines – in print and online – which will be read by doctors who are engaged in these activities.

The place to sell Islay to potential GPs is in places like this.

Then there are left field paces like The Lady. Once the journal of the upper classes looking for nannies and housekeepers, it is now also the province of middle class professionals looking for the domestic assistance that keeps their careers manageable.

Its recent editor was Rachel Johnson, Boris Johnson’s sister, equipped with the family’s flamboyance and who took The Lady so some pretty unladylike places – to enormous publicity. She and the publication have predictably parted company – but the awareness of its existence has been significantly widened.

What’s to be lost by talking to The Lady to see if they might be interested in running a feature on potential island life on Islay for doctors with outdoor interests and young families? As the medics look for new nannies and au pairs, some might just take five and think of a less pressured way of life in which they could spend more time with their children themselves and have fun into the bargain.

And Islay has an airport, its music festivals, its first class eating places, more world class and individualist single malt whiskies than a doctor should think about (but their guests would enjoy) – and a history that echoes down the ages before, with and since the Lords of the Isle and their seat at Finlaggan.

It simply HAS to be possible to find the right doctors for a place like this.

The failure of the Community Health Partnership to address the situation with authority, imagination and sensitivity rather than with the pragmatism underlying the current relocation, is a continuing matter of concern.

Dr Abell’s call for active engagement at leadership level by the Islay Community Council is a well taken point.

Note: The Ileach can be bought in hard copy form on the island or by online subscription to its pdf version here. It is unquestionably Argyll and Bute’s best local newspaper, with a wide spectrum of content. We are its enduring and admiring fans and we cannot recommend it highly enough.

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One Response to Islands, GP practices and the Islay predicament

  1. Truly excellent article based on Dr Abell’s letter to the Ileach. The advertisement for a GP has now been published in the BMJ and press releases sent to various newspapers. Islay Community Council has put together a terrific document, describing the potential lifestyle which could be enjoyed on Islay,as well as outlining the facilities and amenities on offer. This will be included in the NHS pack which will be sent to all applicants.

    BBC Reporting Scotland at 6.30pm on Friday 17th February will carry a piece by Eleanor Bradford including interviews with two of our current doctors.

    I will keep you informed of progress!

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