Perthshire patients could face a round trip of up to 150 miles to see an out of hours GP or nurse this winter.
NHS Tayside intends to trial a new system, whereby patients will be expected to travel to Dundee, instead of the primary care emergency centre at Perth Royal Infirmary.
The “test of change” is scheduled to begin on November 1.
Under the plan, Perth and Kinross will also be left with just one GP available for out of hours home visits across the whole region.
The proposal was detailed in a message to GPs from the Out of Hours management team.
The email, seen by The Courier, links the move to NHS Tayside cost-cutting.
It notes: “We are in a challenging situation financially”.
And it says: “We are being asked to limit the overspend if there is a capacity to do so.”
A meeting to plan the next steps is due to be held later this month.
However, The Courier has been sent a copy of a letter to health secretary Michael Mathieson.
Signed by “a concerned Tayside OOHS clinician”, it calls on the Scottish Government to intervene.
Local GPs raise alarm over Perth out of hours care change
The writer says: “I can confirm, as a Perthshire resident myself, and as a hardworking clinician, that all colleagues are in utter shock at the huge safety risk the service is exposing us and our patients in the locality to.”
They provide examples of some of the distances which patients will have to travel to and from Dundee. These include 150 miles from Kinloch Rannoch, 110 miles from Aberfeldy and 80 miles from Crieff.
The letter goes on: “The service will likely return by saying if someone cannot attend they will be visited.
“But can they explain how one home visiting GP for the whole of Perthshire can provide this service safely at all?
“We already only have two GPs covering the whole of Perthshire which in itself is a huge risk.”
The Dundee out of hours GP service is based at Kings Cross Health and Community Care Centre.
Andrew Buist, chairman of the BMA’s Scottish general practitioners committee, agreed the proposal is “concerning”.
The Blairgowrie GP said he feared it would lead to a rise in the number of people attending the accident and emergency unit at Perth Royal Infirmary.
And he questioned the timing of the move.
“November 1 is a strange time of year to do a ‘test of change’,” he said.
“We know activity and demand increase over the winter months. So usually when people talk about winter planning in the health service, they mean ways to bolster care. What we are doing here is the exact opposite.
“You do worry. Patients are certainly going to be inconvenienced.”
NHS Tayside defends Perth out of hours GP move
A spokesperson for NHS Tayside said: “The Tayside OOHS has been reviewing how it delivers services for the people of Tayside.
“This is to ensure the service continues to meet clinical demand, remains safe for both patients and our workforce and is sustainable for the future.
“A test of change has been proposed by the OOHS team and they are continuing to engage with staff, partner services and the senior leadership team prior to any change being agreed and implemented.
“Any change to how the service is delivered will be clearly communicated to all relevant stakeholders.”
Responding on behalf of the Health Secretary, a Scottish Government spokesperson said: “While Scottish Ministers set the strategic policy for the NHS in Scotland, responsibility for service delivery rests locally with health boards.
“We expect the board to undertake the necessary steps to engage on this matter and to ensure a safe and sustainable out of hours service is provided for the local population.”
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