Disruption campaign may be last resort for night call GPs

As GPs lock horns with the Government over out of hours calls, Stephen Naysmith considers the arguments and below shadows a Greenock doctor on night duty.

Family doctors are in dispute with the Govemment over payments for out-of- hours calls. and threatening disruptive action. Last week the annual

conference of the British Medical Association backed the use of sanctions if negotiations fail.

Irene Hamilton of the BMA argues that the offer on the table will benefit few GPs. but says the dispute isn't about money: ‘lt‘s about how much the Government is prepared to invest in the service. and fears that there could be a shortage of doctors if there isn‘t an improvement. Young doctors are not choosing general practise as a first option and many GPs are seeking early retirement' she says. t

A mixture of social change and abuse of the system has led to a huge increase in the demand Pttteed 0“ dOCtOtS‘ htght education campaign to help patients use call services. in particular. families live _ the System more responsibly Dr c thither apart and With an thereage th Karpasi doesn‘t think this is the answer. a single parent families there is less hack - ‘Who are you going to educate and UP for Young thOthet'S- 9 how'.’ Responsible people use it

(‘1.1\ [5 SMITH

Social change may be one of the factors that accounts for the increase in demand for night call services

According to Dr Mustafa Karpasi. of ; responsibly already Irresponsible On one recent night. Dr Karpasi was 1 problems. Greenock Health Centre. the system is people think it is their fight" called out nine times after midnight. ‘l 9.30pm The mother of a four-month- close to breakdown. ‘lfl was called out 2 Mike Nelson who ]t\:e;itt Glasgo“' would assume a call at that time would old babv bov. he has a couch and is twenty times a night to do life saving E guffch from Ctohn's disease. Regent” be for something life-threatening. but 1 screaming —' ‘Probablv thecvast bulk of work 1 would be delighted. but when ; oftet- a had reaction to his medication ' didn‘t have to write one prescription or our cans is for fractions children. 1 you end up delivering calamine lotion I doting the night‘ he had to watt {our dispense anything from my bag.‘ he i dispense Kalpol (a mild painkiller in to someone who has run out. peOple are : hourg for a doctor who never came. ‘1 $11)“? liquid form) two or three times a night.‘ just exploiting the system.‘ he says. : was feverish and delirious. My He believes most of the calls could 5 10.10pm An epileptic woman of 389has

Greenock Health Centre incorporates temperature was 105 and Inv flatmateS wait for the normal surgery the t diarrhoea and is vomiting ‘Vet-V few nine different medical practises and 3 called the doctor out at tthoht I 1pm“ he following day and 90 per cent could patients need to be seen :1! home. If boasts 33 GPs. It is the largest of its ! says. ‘They said someone would call make it in t0 the SUt‘get')’~ Open a“ night someone has an epileptic seizure it is kind in Europe. In 1980 with a list of i but they didn‘t and we phoned again an for emergencies. ! inavbe better that they Oct to the 60.000 patients they answered 3000 hour later. By this time l was shiK'CI‘ing 8pm Dr Karpasi and one colleague take hospital quickly.' ' c can} This Year» With 6000 fewer and shaking continuously. b over responsibility for all calls to the 11.23pm A woiiian of 35 complaining PattehtS they eXPeet ttS (teeters t0 tithe 5 ‘They told us someone would see us. Health Centre ofchest pain. ‘ln general people witlf 16.500 eatts- Dr Karl)“81 agrees that i but that other things like heart attacks 8.04pm A teenager calls. suffering from seem-c chesthiin also need to get into SOClat meters the Changed the f were taking priority. In the end we all dizzy spells hospital.‘ he says. b demands made 0“ (thetem- ‘SOthe ; just wanted to go to sleep. I felt a bit 8.20pm A 73-year-old woman with 11 .30pm ‘Hennhurn‘ is the reason PeOPte ea” YOU OUt at htght because i better anyway and it was after 3am pain in the ribs. ‘If patients have given by a 34-year-old woman for they can't afford a bus tare 0t 80 Pehee when we called back and told them not childcare problems or are old and needing a nith can. to the health centre during the da)’- We to come. I didn‘t mind not having a immobile then they can't be expected 23.35 A 22-year-old woman calls have a W 0f young 'hOthel'S Who deh't f doctor out. but 1 would have liked to to travel in to the surgery' he says. looking. not fora visit. btit for advice haVe the haek UP 0fthetr 0W" Patent-9 have had some advice. There wasn‘t 9.1511111 A 33-year-old. thirteen weeks from her GP.

th the‘PQSt the gmth W95 “Ways even anyone medically qualified pregnant with side and back pain. t It‘s now midnight. There are still eight there- The BMA ts caltthg for a” 1 answering the phones.‘ 9.17pm A two-year-old boy with eye l hours of the shift to go. 5

W now complete. Screen one closes on . ""0'93' PmteSt The Scotti-Sh CND tht'OttghOUt JtttY~ August tthtt Friday 141iin for extensive party is appealing for support at a series Scplcmbcl‘.

refurbishment and a fourth will be 0t “'eekt)’ Ptekettt OtttStde the Ft‘eheh I Gay Centre Glasgow’s gav and I New screen Cinema-goers in added in the autumn. Consulate in Randolph Crescent. lesbian community has t‘oun‘d a home in Glasgow will benefit from a third I British Shorts Fancy titeen minutes Edinburgh The ttrSt dethOhStrtttteth the heart of the cifv. In a historic move. screen at the Muirend Cannon. The of fame? This year the Drambuie again-“t Ft'eheh htteteat‘ teStthg th the planning permission has been granted new screen was refurbished at a cost of Edinburgh Film Festival is giving SOttth Pttett‘te‘ take-9 Ptttee 0" Ft'ttttt)’ t4 fora gay and lesbian communitv centre £40,000 and boasts a 90-seat capacity budding filmmakers the chance to show JUt)’ at tthtth- ‘We're toekthg tor in Di;oii Street behind St Enoch‘s and Dolby SR. Manager Jeremy off their work. The New British Expo anyone who wants a nuclear free world Square. A mix of coirimercial and Donald points out that the new screen (NBX) showcase will host open I tojoin our protest.’ explains Scottish 3 community spaces for the building.

1 CND's International Officer Dr Lynn including offices. shops and a cafe is

allows him to run major releases for t sessions for short films from the UK from 22_27 August. The sereeningst . Jamieson. The French government 1 planned for the centre. Refurbishment only open to those attendtng NBX‘ wt” announced its plans to carry out several t of the site will be financed by

he Shown to on exclusive ottthettee of atomic tests despite signing a non- frindraiscd resources and a capital grant lnous”), players from a“ over the proliferation treaty in May. ‘Numbers from Strathclvde Regional Council's world. A“ matenal must be fictional. arch .t [hill'llllp()l‘lillil as long as there's Social Strategy programme which

less than one year old and no more than a visible display of people s displeasure promotes equal opportunities. The

longer. ‘lt just shows that cinema is alive and kicking.‘ he says. ‘No matter how often it seems to be on its knees it always gets back up again.‘ The new screen opens on Friday at 3.30pm with a showing of Congo. Meanwhile. the

dipvg tosvards a four-screen Cinema in fifteen minutes long. Call Rachel of what they're doing to the world.’ : centre is due to open in November. I e or ers continues. Screens two and Davrson on 0131 228 4051 for more Says Dr Janucson. The picket continues j Contact Kim or Duncan on ()14] 227 three at the Pavilion in Galashiels are information. every Friday from 10am to 1 Iain 6936 for details. (Jim Byers)

The List 14-27 Jul 1995 5