It is, perhaps, the stuff of a successful TV series: a doctor comes to a remote, beautiful area, becoming embedded, even loved, in the local community.
Dutch-born Rachel Weldon travelled in 1990 to the Inner Hebrides island of Eigg with her new husband, painter Eric Weldon. From then on, she served the 200 people, or so living on Eigg and its even smaller neighbours of Muck, Rum and Canna, travelling between each in an inflatable rib, sometimes in force eight gales. Unusually for British GPs today, the Dutch doctor, known to locals by her married name, was available at all times, managing emergencies, such as mountaineering accidents on Eigg's An Sgúrr, on her own.
The locals were fond of her. She was kind, helpful, skilful, tolerant of their foibles and discreet in a community where privacy is hard to protect.
Last year, she died. Her place in the life of Eigg and the other islands has since been filled by a locum doctor, one of an increasing number needed to fill gaps among Highland GPs. Fifty miles from Eigg on the mainland, the 300-strong village of Acharacle lost its two doctors last year, when they left for opportunities further south.
Seven-doctor practice
Based in his practice in nearby Mallaig, Dr Ian Gartshore came up with a plan to establish a seven-doctor practice for West Locabher, serving Mallaig, Acharacle, Arisaig, Strontian and the islands.
However, recruitment has proven to be a nightmare, even though the posts pay £75,000 a year, plus a Highlands’ “golden hello” bonus of about £5,000.
In addition, outdoor-loving medics can enjoy one of the most beautiful parts of Britain, with superb outdoor pursuits, though one that can be crushingly remote for some.
In all, the doctors would care for 3,300 patients spread over 1,242 square miles, including Britain’s most remote pub, The Old Forge – reachable only by boat, or by walking 18 miles over hills.
Two advertising campaigns have failed, with just two hirings. "These are really good jobs, but we haven't got the package completely right, yet," says the National Health Service's Tracy Ligema.
Fears of a life always on call deters some, even if that is not the reality. Since 2004, NHS doctors have not provided out-of-hours services.
Older ones have become used it, while younger ones have never known otherwise. Gartshore’s plan includes on-call and weekend working, but is kept to an acceptable minimum, the NHS believes.
Reluctant initially to come to Eigg, Weldon soon fell in love with the island, taking a permanent post a year later, but she continually feared that the practice would be closed by the NHS.
The struggling reform plans do mean that decades of permanent service on Eigg by Weldon and the GPs who came before her, Chris Tiarks and Hector MacLean will, however, finally end. The islanders, along with the 34 on Rum, the 30 on Muck and the 15 on Canna "excluding the dogs and the sheep" have reluctantly come to accept that those days are gone, says independent councillor, Allan Henderson.
Despite the region’s beauty, Gartshore accepts that the Highlands are not for everyone: “There are a lot of people who cannot live without easy access to the internet and wi-fi at every location.”
Creature comforts, such luxury shopping, or high street coffee shops, “just don’t exist here”, he points out, while incomers need “to be able to adopt and fit into” the locals’ way of life.
Besides advertising in the national and trade press, Gartshore has given interviews to Scottish journalists and those elsewhere in a bid to spread the word, but to little avail. The problem is not just the working hours, or the isolation, says Henderson.
Other professionals
"Unfortunately, most of these people seem to marry other professionals. So the partner needs to want to come as well, but also has to find work and that makes it more difficult. We'll just have to get doctors to marry only doctors," he says.
However, Henderson is proud of his home: “We’ve great schools, with excellent academic records. Any doctor would be made to feel welcome. We’re respectful towards doctors around here.”
For Rachel Weldon, the journey to Eigg, and a life in medicine that was immortalised in a BBC Radio 4 series about the lives of rural GPs called GPs Who Need GPS, ended sadly.
In the middle of April last year she was disqualified from driving for being over the alcohol limit after she was stopped by a police checkpoint during a visit to the mainland.
Having reported herself to the General Medical Council, Weldon faced the prospect of an investigation into her fitness to practise. Just weeks later she took her own life.
"Rachel was a lovely person," said her friend and fellow doctor, Paul Kettle, "There was no substitute for her comical and penetrating conversation. We will miss her for all this but above all because we loved her. It was impossible not to."
