I fully understand the need for evaluation. My concern for the past 18 months—it will continue to be a concern—is that phase 1 implementation has happened and we are risking rural and remote areas in terms of recruitment and retention of GPs, morbidity and continuing problems for patients.
Evaluation is really important, and it is good to hear that there is some understanding that there needs to be a more flexible approach in rural and remote areas. However, I want to know when that will happen, because the contract has already had a detrimental impact. For example, there are questions about the impact on mortality—I think that Dr Helene Irvine and Professor Wilson submitted information about that—and although there is no correlation, there are indicators out there that, in rural and remote areas, there are impacts on patients’ lives.
It is all very well talking about evaluation, but what concrete measures can be put in place so that we retain our GPs? It is wonderful to hear about multidisciplinary teams, but the practice of which I am a patient—I can only talk about my own experience—has no health visitor and no district nurse. We are reliant on somewhere else for health visitors and district nurses, let alone wonderful things such as mental health workers and other multidisciplinary team members.
I became interested in the issue because it is so difficult to live in a rural and remote area. Yes, we want multidisciplinary teams, but it is not practical or feasible in those areas. Therefore, if a GP or similar service is the best way forward, we need to hang on to GPs. If the multidisciplinary approach, which is a salami-sliced approach, is not going to work, how can we retain and recruit GPs? To me, it seems that the GP contract does not necessarily recognise the particular role that GPs have in such a community.
12:00
It is a fine-tuned thing. When I was in my 30s and I moved home, it was important to me that the schools were there. In retirement, it was important to me that the GP was there. I am a young, well person. I am concerned that, for my neighbours and other people in villages and communities like mine, access to healthcare will be difficult.
Earlier, I listened to witnesses in the first panel talk about social media and encouraging people to think about where else to go for healthcare. That is lovely, but I live in a village where information is passed on with a poster in a bus stop. The committee is discussing fine, high-level stuff. In urban communities, I understand the need to educate people to go to a pharmacy, but when the pharmacy is 40 minutes away and the bus runs only every three hours, it will be more difficult.
The situation should be evaluated, but I would like to see speedy responses. Our petition asked for that. To me, the remote and rural short-life working group was the slow life working group. We still seem to be in that situation.