Private GP facility in Londonderry being operated voluntarily to 'keep the NHS practise going'

Dr Black said his Abbey medical practice in the Bogside would be facing bankruptcy within six months if the doctors hadn’t agreed to see fee-paying patients in their free time – with all of the money being ploughed back into the NHS side of the business.

“All the money from those private patients will go back into the [NHS] practice. I won’t get paid, I won’t get a day in lieu – that is a voluntary piece of work that all of my partners are doing to keep the practice going,” Dr Black said.

“We have reached the point of no return, in terms of the funding and the workforce, and the workload within the NHS.

“We have inadequate funding … in my own practice we are losing money, and have been losing money, every month for the last 15 months.

“We have a very large overdraft and we had to take a second overdraft to pay a pay rise to our staff, because we were losing staff and no one would apply for the job because we weren’t paying the going rate.

“So, we have a financial crisis that will close us, in the next six months we will be bankrupt.

“We had to find an alternative source of funding, and the only one we could see was to open a parallel practice that would support and subsidise the NHS practice,” he told BBC Radio’s Good Morning Ulster programme.

“Yesterday, I spent all day seeing my NHS patients. I had 32 consultations yesterday, on Friday I had 43. Our safe working limit is 25 so I am exceeding that, nearly doubling it. That is really, really tough,” Dr Black added.

Meanwhile, a Co Antrim GP has warned that seeing a GP could soon become as difficult has accessing an NHS dentist.

Dr Ian Lalsingh of the Larne medical practice has become the 18th surgery to hand back its contract to the Department of Health.

Dr Lalsingh told BBC News NI that the five doctors at the practice was not enough to safely oversee 8,500 patients.

He said they would need to recruit at least one more GP partner before May or an alternative provider – possibly the local health trust – will be sought to provide the service.

"My worry is that general practice will collapse. That's my greatest worry – I see so many have handed back their contract and there will be more this year," Dr Lalsingh said.

"My biggest worry is that we would end up with a system that is similar to how the dentists operate now, that it's very difficult to get to see an NHS dentist."

Two surgeries in Larne merged last year to become the largest medical practice in the area, however, one GP has since resigned, meaning there are now too many patients for the remaining GP to safely oversee.

Dr Lalsing said handing back the contract is a last resort that no one wants to see happen.

Last month, Dr Black’s BMA colleague Dr Alan Stout said he had every confidence that the Londonderry GP would successfully transform his practice to the hybrid model.

“I would listen very carefully to the GP with 40 years of experience in perhaps the most challenging demography in the whole of the UK,” Dr Stout tweeted.

“If @TomblackBlack can’t make it work, no one can. This is the beginning of the end of the NHS as we know it.”