The BMA says the future of community hospitals is at risk

Family doctors provide cover on wards on top of running surgeries and many claim they are working during the day for as little as �1 per hour.

It has prompted more than 50 GPs to meet in Powys to discuss the issue.

The assembly government said it valued the GPs' work and had sought to reach agreement with the BMA.

The British Medical Association, after a meeting in Caersws on Wednesday, said 27 doctors in Monmouthshire would resign this month from Chepstow Community Hospital, while it added that some GPs had quit in Powys too.

The gathering follows a breakdown in talks over a Wales-wide deal to fund the service.

Many GPs find they are working for as little as �1 per hour Dr David Roberts

But Powys Local Health Board said GPs wanted to continue providing community hospital services.

John Jenkins, of BMA Cymru, said: "Most of the community hospitals in Wales are run by GPs.

"But if problems about pay and contracts are not solved soon then it's possible that some community hospitals could close."

Mr Jenkins added: "When responsibility for out of hours coverage transferred to local health boards doctors didn't have to do out of hours work, but they found that during the day they were being paid as little as �1 per hour and one doctor found he received just 48p per hour.

"We have neogotiated with the Welsh Assembly Government and it said we were to negotiate with the LHBs.

"The meeting in Caersws is designed to advise doctors what to do next."

Implications

Dr David Roberts, a GP from Llandysul, Ceredigion and chairman of Dyfed-Powys Local Medical Committee, said: "Some GPs who work in community hospitals don't seem to have contracts and others who do find that they are decades old.

"There are variations in terms and conditions of the contracts and many GPs find they are working for as little as �1 per hour."

A spokeswoman for the Welsh Assembly Government said it valued "very highly" the work carried out by GPs in community hospitals.

"We are aware that many GPs have given notice of their intent to discontinue working in community hospitals as a result of their revising their particular work commitments arising from the implementation of the new General Medical Council contract," she added.

"We have sought to reach agreement with the BMA on a framework of nationally agreed principles which could be applied across NHS Wales to GPs working in community hospitals."

A spokeswoman for Powys Local Health Board said the GPs' issue was "under review."

She added: "GPs in Powys want to continue providing community hospital services and they want to negotiate a framework in which to do that."

In a statement on the GPs' action in Monmouthshire, Gwent Healthcare NHS Trust said last month: "The GP-led out of hours for patients in Gwent will continue to be provided after September 2004.

"However, the implications of the new GMC contract are now extending to the medical cover provided to community hospitals.