The move aims to reduce GPs' workload

The doctors from Dumfries and Galloway said they were "aghast" at the reforms, which they described as "unsafe".

Under the new GP contract, which came into effect this year, responsibility for all out-of-hours calls will shift to local health boards.

The measure aims to ease rural doctors' workload and encourage recruitment.

A total of 30 GPs wrote to the prime minister, the majority of them from Dumfries and Galloway, to outline their concerns.

All health boards must have their alternative arrangements in place by December.

However, the doctors in Dumfries and Galloway said they were aghast at the proposals being put forward.

Emergency calls

They said that the number of doctors on call out-of-hours would be reduced from about 20 to about five.

NHS 24 will handle calls and decide if patients need a doctor, an ambulance, or if their complaint can wait.

The Dumfries and Galloway doctors predicted that the ambulance service would not cope with the increase in emergency calls and warned that the care of the elderly and terminally ill would be compromised.

Wigtownshire GP Dr John MacDonald also said the new arrangements were not designed to respond to potentially life-threatening emergencies.

It has been able to provide a very safe service which has a high degree of patient satisfaction. Dr David Love

He said: "These emergencies are rare but they do happen and without an adequate means to respond to them I am very afraid that lives are going to be lost unnecessarily."

The British Medical Association (BMA) said that while emergency care must be adequate, it is possible for rural areas to manage with far fewer GPs on call.

Dr David Love, who represents GPs at the BMA, said the arrangements were already in place in the Borders and working.

He said: "We had similar misgivings several years ago when we changed from a system of doctors being called from their own practices to having a more-central based co-operative of doctors in the Borders, with coverage being provided by a much smaller number of GPs.

"But actual experience has shown that this has been a very effective arrangement.

"It has been able to provide a very safe service which has a high degree of patient satisfaction."

He said doctors were no longer prepared to work round-the-clock, seven days a week and it was not good for patients for GPs to work unreasonable hours.

Patients 'alarmed'

Health Minister Malcolm Chisholm said it was essential to cut the workload of doctors.

He said: "It is very difficult to recruit GPs into rural areas if we insist they work 24-hours-a-day. Also, in terms of the quality of care, it is not good that patients should be treated by exhausted over-worked doctors."

The proposals in Dumfries and Galloway were out to consultation, he said.

The Scottish National Party urged the health minister to address the doctors' concerns.

SNP health spokeswoman Shona Robison said: "Patients across rural Scotland will be alarmed at GPs warning that the level of planned out-of-hours cover is medically unsafe.