OUT-of-hours doctors' schemes in Settle, Bentham and Skipton could be under threat unless the Government reverses a decision to axe funding for rural services.

The Settle and Bentham service, set up a couple of years ago, is the most likely to be affected by the NHS decision to withdraw £164,000 funding for rural out-of-hours schemes across North Yorkshire.

The Skipton service, operated like North Craven by North Yorkshire Emergency Doctors, could also suffer.

Dr John Givens, medical secretary of the North Yorkshire Local Medical Committee told the Herald: "We set up the service in Settle on the basis that this money would be coming. That is an ongoing cost, which the Department of Health is aware of, and it is a totally dishonest manoeuvre on their part to withdraw it.

"It could seriously undermine the Settle scheme. Some of Skipton is urban and not as expensive, but it will have a knock-on effect," said Dr Givans, who was optimistic that a solution would be found.

The out of hours service operates at nights, weekends and bank holidays. Doctors from the co-operative take it in turns to be on duty and are based at Castleberg Hospital in Giggleswick for North Craven and Skipton General Hospital in Skipton.

Each service has a specially equipped vehicle and a driver on duty. Patients ring a central number and the duty doctor rings them back then decides whether a home visit, advice over the phone, or appointment at the out-of-hours centre is the most appropriate course of action.

However, Mark Cockerton, general manager of North Yorkshire Emergency Doctors, the largest GP out-of-hours co-operative in the country, reassured patients that services would continue.

"We have every intention of continuing to provide a high quality out-of-hours service throughout North Yorkshire and we trust that the problem will soon be sorted out," he said.

Doctors have welcomed the co-operative schemes because they reduce pressure on GPs. Previously each practice arranged its own out-of-hours cover which led to tired GPs being on call overnight then working all day. Rural surgeries were also experiencing difficulties in recruiting new doctors.

Settle GP Dr Eric Ward told the Herald: "I don't think it will happen. It is so serious a problem, I predict there will be a solution. It is being looked at very carefully. All is not lost and I am sure something will be sorted out.

"I don't think myself or my colleagues could really envisage going back to how we used to run out-of-hours. In hours workload and pressures seem to have increased and it is totally unrealistic to work all day and be expected to be on call at night on a frequent basis."

Dr David Pearson, of Skipton's Fisher Medical Centre, did not know any details. He said: "There is a big recruitment problem for GPs in very rural areas and one of the ways it is being addressed is good out-of-hours care. If that is jeopardised there will be a problem getting doctors and a problem for patient care."

Dr Givans added: "There is no question that GPs will be required to continue providing a service, and it will be the doctors who suffer."

Karen Lloyd, spokesman for the NHS Executive Northern and Yorkshire, said: "The Department of Health is committed to the continued improvement of out-of-hours services where this is most needed."

Skipton and Ripon MP David Curry has already been in touch with Health Secretary Alan Milburn calling for the reinstatement of the grant. Mr Curry said: "The withdrawal of the grant is outrageous."

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