The cost of locum GPs is responsible for a half a million pound overspend in primary care in one area of Scotland.
A board meeting report said that the bill for locum GPs in Shetland was responsible for a projected £554,000, or 12%, overspend this year.
The report, presented to Shetland’s Integration Joint Board, also said that planned targets for efficiency savings in GP employed practices and out of hours are highly unlikely to be met.
Eight of 10 of the GP practices in Shetland are run by the health board, which employs staff directly.
Locum costs this financial year include £67,000 for Bixter, £130,000 for Whalsay, £157,000 for Yell, £137,000 for Unst and £18,000 in Lerwick.
Overall in 2017/18, NHS Shetland is expected to overspend by around £2.7m.
Plans for how to address the funding crisis in Shetland are being discussed but have not yet been made public.
Speaking at the meeting, board vice-chair and local councillor Allison Duncan said the £554,000 predicted overspend in primary care was a ‘horrendous amount of money’, and he questioned what more could be done to attract GPs to the isles.
‘I’ve said it before and I’ll say it again – we have to make a case to the Scottish Government, because locums are costing us an absolute fortune.’
Dr Dylan Murphy, a GP at the Lerwick Health Centre and Shetland LMC chair, said Shetland was facing the same recruitment and retention problems as anywhere else but with the additional pressures of its rural and remote location.
He added that there was no problem finding locum cover and that his practice was currently training four registrars, but finding permanent staff was becoming impossible.
‘There’s always been the odd vacancy in Shetland, a degree of change, but for the past three or four years, recruitment has been very difficult and now we don’t get any applicants at all.’
Dr Murphy added that they warned the health board that there would be a lot of doctors retiring who used to work 24/7 and it would not be straightforward to replace that singlehanded model.
‘The younger generation aren’t looking for that kind of job so we have to rethink how we do that.’
He said for the time being rural boards would just have to accept the higher costs of locums but there needed to be a ‘coherent vision’ for providing care in rural and remote areas.