Life as a GP on Jura

Dr Martin Beastall describes how he and his wife, Dr Abby Beastall, became GPs in a close-knit community on the remote island of Jura.

How did you and your wife begin working on Jura?

I saw an item on the BBC news website about the Jura residents' Facebook campaign to find a doctor.

There had been no doctor on the island for two years and they were relying on locums.

My wife Abby and I moved here in January with our seven-month-old baby, Zoe. We are going to share the GP role when Abby returns from maternity leave in April.

What first attracted you to the idea of working there?

We spent our honeymoon on the west coast of Scotland and said we would like to work there.

It was a coincidence because it was just a passing thought then. I liked the idea of having my own island to look after.

It was definitely a lifestyle choice. The patient list is 80 times smaller than at my previous practice in Doncaster. We are very outdoorsy and it is a beautiful place to explore. We are basically sharing one job now, which means we can look after our baby without any extra childcare.

How does the healthcare system work on the island?

There is no other healthcare facility on the island, apart from two district nurses who work part-time and are based next door to the practice, at a progressive care centre, which is like sheltered accommodation.

There are about 190 residents on the island, who are all registered at the practice, which relies on a sizeable correction factor.

There are two part-time receptionists who are also dispensers because we have a pharmacy. It is a standard GMS contract, but the only difference is that we haven't opted out of out-of-hours. I am on call seven days a week, 24 hours a day.

If there is an emergency, I can go to it in my 4x4 and volunteers follow in an ambulance - basically a van with a stretcher in the back. There is no paramedic ambulance. I carry equipment such as a defibrillator and an ECG machine.

Dr Beastall's transport on the island

There is an air ambulance, which flies in from the Royal Alexandra Hospital in Paisley. This takes about half an hour to arrive if it is not already out somewhere else and the weather is OK. Often it is an RAF or Navy helicopter, and they can take a couple of hours to arrive because they are based further away.

There is a small 10-bed community hospital run by GPs on Islay, which is a five-minute ferry ride away from us. They have some visiting consultants doing outpatient clinics such as paediatric, psychiatric, and speech and language therapy. They don't have elective surgery.

They have an A&E but it is not quite what you would expect. There is an X-ray department, but it is only staffed in-hours.

What is a typical day like?

My day starts with coming in early to do paperwork and my first few appointments are normally blood tests because they get picked up by Royal Mail by 10.30am.

GP practice on the island of Jura

The rest of the morning is routine appointments, everything from vaccinations to warfarin tests.

There are a surprising number of patients with quite rare conditions. I treated Lyme disease for the first time, which is fairly common on the island because there are 5,000 deer.

After surgery closes, we do home visits, which are a bit different because of the terrain. People here are very responsible and only call when they really need help because they are used to coping with things. I usually know everyone who calls me.

What challenges do you face?

Adapting to the different ways of doing things here and being very self-sufficient. Even though I have colleagues on the next island who are very supportive, I still have to make a lot of decisions myself.

There is a practice manager, but she works on Islay and comes here for three hours a week. However, she is at the end of the phone or an email. There is lots of management work to do. At my previous practice, we had three managers. Here, I feel like I have a complete sense of ownership.

What do you like about Jura?

I love the lifestyle and the sense of community. People have been incredibly welcoming.

The wildlife here is like living in a nature reserve. There are seals, golden eagles, deer and adders.

The move is certainly for the long-term. There is a primary school on the island, which they are lucky to have. Even though we have only been here for two months, we already feel at home. It is a bustling community with a food and literature festival, and 12,000 tourists in the summer. As a GP, you are an important community figure.

Would you recommend it?

I would recommend it to anyone up for a challenge. I can't understand why the position was vacant for two years. Being on a small island makes you feel like a proper doctor. It reminds me why I went into medicine in the first place, to make a difference.

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