To ask the Scottish Executive what assessment has been made of the effects of the outcome of the negotiations on general practitioner contracts on the provision of GP services in the islands. (S1O-6581)

The new general medical services contract is subject to a ballot of general practitioners that will take place between mid-March and early April. During the negotiations, a working group was established to consider and assess specific remote and rural issues, including island issues. The group's findings have been reflected in the new contract, which addresses the needs of patients in remote and rural areas in a number of ways and promises to alleviate many of the pressures that currently exist in those settings.

I thank the minister for his reply, particularly for his point about pressure on island GP practices. Will he ensure that the negotiations reflect the difficulties in retaining doctors that the Lerwick doctors' practice and Shetland NHS Board are facing? Does he accept that the Lerwick practice is running with only 50 per cent of its recommended doctor work force? Given that recruitment and, crucially, retention are widespread difficulties for island and rural GP practices, will he consider measures, particularly out-of-hours cover, to help those areas?

I was sorry to hear that a further GP will leave the Lerwick practice at the end of June. I spoke to the chief executive of Shetland NHS Board about that today. She said that someone had been recruited to start in Lerwick in July. However, that will not lessen the problems that exist there. The new contract that has been agreed—subject to the ballot of GPs—will offer substantial opportunities not only for island areas, but for areas throughout Scotland. There will be a 33 per cent increase in primary care services. That is an important development, which is consistent with the messages of the "Partnership for Care" white paper about the importance of developing more services in primary care, particularly community health partnerships, which we emphasised during last week's debate.

Part of the new contract will be a statutory patient service guarantee. I am aware of the concerns about the provision of out-of-hours cover. However, other options are open to GPs, including not having to deliver that cover themselves, which are helpful in terms of GPs' work load and recruiting people into general practice. All patients will be guaranteed an out-of-hours service.

In the negotiations, are any special incentives being offered to attract GPs to work on islands? Will the minister consider offering travel warrants? The cost of travel is an aspect that makes people unwilling to live on an island, because they would be unable to afford to keep in touch with people on the mainland.

The agreed funding arrangements are responsive to the extra cost of delivering care in island areas. Indeed, the group to which I referred earlier included an Orkney GP, so particular account was taken of the islands. Funding for general practices on the islands will be increased and that will make the islands more attractive for GPs to work on in the future.