Lismore Facing Emergency Medical Cover Crisis 


 3 June 2006


Thursday 11th May was one of the best-attended Community Council meetings ever seen on Lismore.  Top of the agenda was the impending ‘opt out’ from out-of-hours services by the Port Appin GP practice (Dr. Iain McNicol and Dr. Kate Howlett), which serves the island. Dr. McNicol attended the meeting.


Despite pressure from Lismore community and from the Appin GPs over the last 15 months, Argyll and Bute Community Health Partnership and the Scottish Ambulance Service have so far been unable to propose a safe and effective alternative solution for emergency medical cover on the island.


Following an opt out by the Port Appin practice, the only out-of-hours access to a doctor for islanders would be via NHS 24 to the duty GP based in the hospital in Oban. Although this doctor is said to be available for home visits, the reality of the situation is that they would take several hours to attend a patient on Lismore and during that time, they would be unavailable to the thousands of others on the mainland who might be depending upon them.


The issue has been brought to a head by the recent withdrawal by NHS Board middle management of the 15 hours per week relief cover for the island’s nurse practitioner, without any consultation with the island community.  This was considered an insidious reduction, by the back door, of health care provision for Lismore.


The narrow strip of water dividing Lismore from the mainland has always prevented the ambulance service from accessing patients on the island and this

will continue to be the case in the absence of a rapid response vehicle ferry.  While helicopter evacuation could be an option if a helipad were provided, experience shows that it could take more than three hours to arrive. Until now, seriously ill patients have either been treated by the local GP in their own homes or depended upon a voluntarily arranged patient evacuation plan devised, organised and implemented by the doctor. 


In his closing remarks Dr McNicol suggested that the community might wish to press for their own GP, resident on the island, with an island surgery.  “You are being short changed compared to every other island,” he said, making it clear that despite a growing population, health provision was already shrinking.


The Community Council resolved to continue to press, at the highest levels, for a clinically safe and sustainable out-of-hours service, which would enable the Port Appin practice to opt out.  Meanwhile, islanders are left feeling vulnerable and anxious. 


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