 The BBC election bus in Machynlleth |
The BBC Wales assembly election bus is on the road bringing politicians to the people, and people to the politicians. The bus is spending the days up to polling on 3 May touring Wales.
In Machynlleth, Montgomeryshire and regional Mid and West Wales candidates met retired market gardener Margaret Teare, 58, from Llanbrynmair.
She is one of the Wales 60, a voters' group drawn up by the BBC, and asked what they would do to improve out-of-hours rural GP services.
Click on the links below for the candidates' responses, and for Mrs Teare's verdict on it all.
NERYS EVANS, PLAID CYMRU
 Nerys Evans |
Plaid fully recognises there have been problems with the GP out-of-hours service and these problems have been more acute in rural areas. Plaid Cymru is committed to developing primary care centres - called well-being centres - in communities across Wales, especially in rural areas where it's difficult to attract health professionals such as dentists to the area.
These well-being centres would be a place where people could access not just a doctor, but also primary care therapists such as nurses, dentists, physiotherapists and counsellors, so patients will be able to see the most relevant person for them.
Plaid strategy is to ensure high quality health provision as close to people's homes as possible unlike New Labour's centralisation approach, which is based on big urban centres which is not applicable for most of mid Wales.
MICK BATES, LIBERAL DEMOCRATS
 Mick Bates |
It's a very interesting question. There are some people who believe that the 24-hour service is adequate, in my opinion it is definitely not.
The whole system is absolutely inadequate, however it's almost impossible to change the GP contract, which brought in out-of-hours services. What the Welsh Liberal Democrats want to do is to have a first responder system for the out-of-hours service and this will be based on paramedics.
We've already seen the establishment of one first responder unit, with help from the St John Ambulance in Caersws (near Newtown). Here in Machynlleth we would have an extra paramedic who would provide the out-of-hours service as a first responder.
That doesn't necessarily mean you'll see a doctor straight away, but at least they would be able to give you direct, quick, personal service which at the moment has been lost by telephones, people not knowing where they're going, doctors from a distance being called out and, in some cases, not willing to travel, and patients in pain being asked to travel large distances.
GLYN DAVIES, CONSERVATIVE
 Glyn Davies |
The out-of-hours service is poor - very poor. It isn't good, we know that, so we would institute a fundamental review of the out-of-hours service, and particularly look at the mix of expertise available at different times.
There is always a cost element to everything and if you demand that a GP is always on call it's probably going to be difficult to fund, except in a limited number of a places. You need a fundamental review to make sure this service works and builds on the experience we've had, and that hasn't been that good in this part of Wales.
In this area I know roughly what the costs were of keeping an out-of-hours service based in Machynlleth, and they were massive and unsustainable. The most sensible way of dealing with this, including using the expertise of paramedics and the many other links we could use, is to establish a review of the service.
I can't go promising that we'd throw a lot of money at it because I think that would be unrealistic and you wouldn't believe me anyway.
BRUCE LAWSON, UK INDEPENDENCE PARTY
 Bruce Lawson |
The health service negotiated a new contract with the British Medical Association and it was amazed to find that their (the GPs) contract rate was only reduced by 6% in exchange for cutting out out-of-hours working.
They (the GPs) were quite prepared to give up between a fifth and a quarter of their contract for this concession. Out-of-hours services are of paramount importance, particularly to the elderly and those with young children, and must be fully funded.
UKIP would simply renegotiate the contract to ensure a better deal for patients and feel the recent deal negotiated represents a very unbusiness-like attitude by the health ministry. We feel the cost of the Welsh assembly and the European Union inevitably means there is less money for health services.
We believe the Welsh assembly costs approx �250m a year in Wales, a large portion of which could be made available for other services such as health, education and pensions. I think it's frustrating that the costs of the Welsh assembly are making our health provision poorer.
RACHEL MAYCOCK, LABOUR
 Rachel Maycock |
Labour continues to invest in health, we continue to improve primary care in rural areas, such as GPs, community nursing and pharmacists and we will continue to improve patient access.
It is important to provide more treatment in the community and as close to home as possible. In a border area like Montgomeryshire we need to make sure that patients needing health care don't fall through the gaps. So we will reform the out-of-hours GP service to make it easier for patients to access services in rural areas.
At the moment 93% of patients are seen within 24 hours and we will provide extra resources to help practices offer pre-booked appointments with a doctor of a patients' choice. Where there are problems we need to work with GP practices and local health boards to help them extend their surgery hours to evenings and weekends.
We will increase the number of salaried GPs, especially in rural areas like Montgomeryshire where the challenge of recruitment and retention is greatest. We will expand the range of treatments and therapies carried out in GP surgeries and increase the number of nurses qualified and able to prescribe medicines independently.
WALES 60 MEMBER MARGARET TEARE'S VERDICT
 Margaret Teare |
Plaid Cymru's idea of well-being centres is appealing. However, I am concerned that our small local hospitals are being closed.
Wouldn't it make more sense to keep the small hospitals open and redevelop them as well-being centres? But we still need a decent out-of-hours GP service.
I find it hard to believe that UKIP would be able to renegotiate GPs' contracts because their current deal is so good. They would be unlikely to make concessions if the contract is re-negotiated. I find UKIP's stance unrealistic, and it sounds like a bit of flannel.
The comments made by Labour don't make sense either. They make a general point about wanting to improve health, but there's no evidence that they have a strategy to solve the out-of-hours problem.
Mick Bates said the Lib Dems were looking at different ways of delivering the out-of-hours service and I like that.
Glyn Davies' idea of a review of the service also sounds promising. They all accept there's an out-of-hours problem, but the issue is far worse in rural areas.