Communities in the west Highlands who have been without full-time GPs for nearly two years have expressed relief that two doctors will start next year.
However, there are still concerns that the recruits will work just two days a week with locums still required.
Patients of the Mallaig and Arisaig practice say there has been extreme anxiety facing the Covid pandemic without consistent cover.
Dr Iain Gartshore advised NHS Highland in January 2020 he was leaving at the end of March.
It followed the departure of Dr Katrina Geissel for another practice in the Highlands.
Two recent appointments
The health board advertised twice but was unable to secure a new provider for the practice under an independent general medical services (GMS) contract.
It also arranged for locum cover from April 1 that year.
It is claimed that two doctors were interviewed for the posts earlier in the year but were not employed as their business cases were not accepted.
Community representatives say they are unclear about the need for business cases and feel frustrated that full-time candidates were rejected on business grounds while apparently meeting medical criteria.
A recruitment campaign eventually led to the recent appointment of two GPs.
One will start in February 2022 and the other will follow in August, each working two days a week.
NHS Highland is to continue with the recruitment process, aiming to get additional GP or advanced nurse practitioner cover.
The practice has 1,800 patients with more during the summer with visitors to the area.
It extends from Mallaig north to the Knoydart peninsula, which is accessible only by boat, and south through the villages of Morar, Arisaig, Lochailort, Roshven and Glenuig.
Residents say by the time the first recruit takes up the post, the practice will have been without a regular GP for almost two years and feel “let down” by the process.
A joint comment from the three community councils in Mallaig, Morar and Arisaig praised the health centre and nursing staff in Mallaig who have managed “incredibly well” without a permanent GP.
But they have raised questions about future cover, given the new GPs will be working part-time.
‘People feel let down’
The communities say: “It is disappointing that full-time candidates have been rejected for the post and, instead, two part-time people are being taken on, which will still require reliance on locums.
“There are people in the community feeling very let down by the current situation.
“They have health problems and, seeing different doctors every few weeks who have different diagnoses and different solutions, is distressing and frustrating.
“Two doctors working two days each per week equals four days.
“As far back as anyone can remember we were able to have a doctor’s appointment every day of the working week.
“Will this now be reduced down to four days? If so, it will surely add extra waiting time for people to see a doctor.”
They say the situation at the practice was raised in 2018 when Dr Gartshore was the sole GP responsible for the practice when the second post was vacant for a number of months without it being filled.
At the time Dr Gartshore blamed NHS cuts for forcing his colleague, Dr Geissel, to quit and move to Ullapool.
He claimed a pot of NHS cash used to pay locums for holiday cover had dropped from £45,000 to £15,000 in the previous three years.
National advert did not attract interest
The communities also say the last GP based at Arisaig, Dr Shina Young, worked with NHS Highland to establish a community surgery which is no longer in use.
As several residents do not have cars, they feel the Arisaig facility should be used regularly.
A NHS spokesman said: “We worked closely with Dr Gartshore to advertise the practice at the time.
“Unfortunately, there was no interest in the national advert that was placed.
“The responsibility for the management of the practice then transferred to NHS Highland. (There were) two further national procurement processes but the applications received did not fulfil the criteria for holding a GMS contract and were therefore unsuccessful.
“Following a recent national recruitment campaign, two salaried GPs have been appointed to the practice.
“They will both be living within the local area and are invested in the local community. The practice will continue to be covered by locum GPs until the candidates are in post.
“In addition to the two GPs appointed to the practice, NHS Highland is also looking to advertise for an advanced practitioner to work as part of the team.”
Earlier this month, it was announced NHS Highland is to take over the Alness and Invergordon Medical Practice from April next year.
It said the practice has been unable to stabilise staffing since three GPs resigned earlier this year.