Dr. Noreen Lineen-Curtis:

What will happen on Clare Island is that the person will get through to the nurse and she will ring me. She will assess the patient and will ring me. At the moment, due to the unavailability of out-of-hours cover, I am pretty much on duty 24-7. I had to get a locum to come here today. The difference in many rural communities with a small single-handed practice is that there is not enough out-of-hours cover, so the doctor is on duty a lot. There is nothing wrong with out-of-hours cover and it should be available. Nobody can be available 24-7. It is not possible and we cannot keep doing it long term. It is not sustainable but in a small rural community, it is often what happens. On the west coast, there are many practices where staff are on duty a lot of the time. Some GPs use a rota system and they cover for other practices. Of course, it is lovely to talk for people to talk to their own GP because he or she knows them better, but it is not always possible. Out-of-hours cover has to come into play, but it needs to be improved in many of the rural communities. It was brought in initially to try and improve the lot of rural GPs or single-handed practices in a rota system but, in fact, urban practices and centres have benefited most because there are more people involved in them. They do not have to take on as much of the workload. On Clare Island, someone will get me on the phone and I will hopefully advise him or her.