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GP Dispensing: Rural GPs across UK need a voice

Julie Griffiths talks to Scottish GPs who are urging the RCGP to establish a rural faculty.

Dumfries and Galloway GP Dr Gordon Baird believes it is time for remote and rural GPs to stand up and be counted. He is hoping to set up a rural faculty of the RCGP to help make that happen.

He believes that rural doctors need to come together from wherever they are in the UK to make their voices heard because their urban colleagues will not do it for them.

'If you fail to reflect and engage with people about the richness of what we do, we won't manage to sustain an important aspect of rural general practice,' he says.

Lack of resources
Dr Baird is chairman of the current rural practice sub-group of the RCGP. They feel that the forum has been a success, and it is time to take it to the next level.

'We've created an environment where rural issues can take their proper place in our college,' he explains. 'In rural practice, the difficulty we have is a lack of infrastructure. We have enthusiasm and innovation but we're doing it with inadequate local resources.'

He believes a faculty would need to be non-geographical so that it represents rural doctors no matter where they are in the country. He believes that there are aspects to general practice that are often particular only to those working in remote areas.

Better communication
Technology offers many opportunities for discussions to take place with emails and webcasts.

Dumfries and Galloway GP Dr Bernard Jones believes that a faculty would have an additional benefit of ensuring better representation of dispensing doctors.

'I don't think people understand how dispensing works and how different it is from a non-dispensing practice,' he says.

Making the decision
The UK is not the only country to have tussled with how to address the specific issues pertaining to rural medicine. The medical profession in Australia established a college for rural medicine in order to meet the needs of remote doctors.

Professor Richard Hays, head of the medical school at Keele University, was a rural doctor in Australia for many years.

He explains that the remoteness of parts of the country meant that rural medics had to turn their hand to many specialties, which had revalidation implications.

'I did lots of trauma, Caesarean sections and a limited amount of abdominal surgery. It was starting to look like doctors would spend 52 weeks of the year at re-certification events and none doing the job,' says Professor Hays.

He stressed that even there, the decision to set up a college did not come easily, and across the profession the view differed about whether it should happen at all.

'Even though this was the chosen solution for Australia, where remote populations can be much further from rural centres, it is not necessarily the right one for Britain,' he adds.

Professor Nigel Stott, emeritus professor of general practice with the University of Wales and Welsh council member of the RCGP is one GP who does not believe that rural doctors have enough similarities to make a faculty feasible.

He believes that it may be more fruitful to ensure urban and rural practice have shared clinical standards: 'We don't want a battle of surgeons and obstetricians and so on. We are dealing with standards for general practice and to ensure clinical standards we need a group that's tackling that.'

A spokeswoman from the RCGP says that debate on the viability of a faculty for rural medicine was ongoing. She estimated it would be another 18 months before a proposal was taken to RCGP council for consideration.

Anyone interested in getting involved in the proposed rural faculty should contact gordon.baird@nhs.net

The DDa
The DDA is the only organisation that ensures the views of dispensing practices are heard by the government and key negotiating bodies. We also provide telephone advice to members and essential updated information via our website, and email alerts. To find out more call Jeff Lee on (01751) 430835 or visit www.dispensingdoctor.org.uk

The DDA does not necessarily support or endorse the opinions or information contained on this page.

Interview with...
Name: Dr Kerry O'Conner
Location: Salisbury

I've been at my two-surgery practice for 20 years, and became a dispensing GP six years ago when a pharmacy in the village closed down.

We have eight doctors, four nurses and five dispensing staff. Six GPs and one nurse are partners. We have 8,700 patients, of whom a third are dispensing patients - all from our rural dispensing surgery.

Our inner-city surgery also has a dispensary to provide medicines for patients from our rural practice when they come to town. This was allowed when we first set it up, but would not be permitted now.

In my time as a dispensing GP, I have seen bar code scanning of medicines introduced - which has been a great help. Dedicated dispensers are now the norm, rather than asking receptionists to overlap their tasks.

I am not so delighted about the 2005 regulations that redrew the boundaries for pharmacies and dispensing practices, nor the Category M drug list and quick introduction of VAT for all dispensing practices.

The greatest threat to our dispensing practice is inflexibility. We cannot move, we cannot merge so we can not grow.

In my view, the greatest threat to dispensing in general is finding new young GPs to want to take rural partnerships

My advice to any GP thinking of joining a dispensing practice would be to ask themselves if it is somewhere they and their family want to live and work in, and could they get on with the doctors at the practice? Everything else can either be changed or doesn't matter.

Contact jacki Buist at GPdispensing@haymarket.com or (020) 8267 4865 with comments, or if you would like to be interviewed.

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