THERE are fears that thousands of people may not be offered out-of-hours GP cover if Local Health Boards (LHBs) continue to try to provide an all-Gwent service.

Monmouthshire health bosses believe separate arrangements for parts of the county, like Mon-mouth, Tintern, Usk and Raglan, may be necessary to ensure cover.

Under the new GP contract, responsibility for providing out-of-hours cover for nights, weekends and Bank Holidays switches from family doctors to LHBs.

Gwent's five LHBs - Newport, Torfaen, Blaenau Gwent, Caerphilly and Monmouthshire - want to develop a pan-Gwent solution where a provider, either a GP co-operative or a private company, serves the whole area by October 1 . But Monmouthshire LHB, which discusses the issue tomorrow, fears this is an increasingly risky strategy.

A report for the board states that although a united front of Gwent's LHBs have agreed to seek a pan-Gwent solution, "a number are beginning to realise they have differing local needs".

"Other LHBs are now recognising there is a possibility that if we can deliver a pan-Gwent solution, they will need to cross-subsidise less economically attractive areas (to providers), predominantly central Monmouthshire."

The report claims that with a pan-Gwent solution "the most significant risk is we will not be able to provide out-of-hours services for much of central Monmouth-shire using current and likely providers.

"Early indications are that providers are not interested in offering an affordable service, and whilst Chepstow, Caldicot, Magor and Aber-gavenny will probably be offered cover, Monmouth, Tintern, Usk, Raglan and the other smaller communities will not.

"If we force the issue of maintaining a united front, there are two likely outcomes: either any potential providers will withdraw their bids, or the collaboration will fragment, with individual LHBs seeking their own solutions."

Despite the report, Verona Nelmes, Monmouthshire council cabinet member for social services, who is on the management team of the Monmouthshire LHB, pledg-ed people will not be left without cover.

She said: "Whatever the conclusion we will not abandon our residents and leave them without access to a doctor.

"They may not be included in the same package as the rest of Monmouthshire but we will arrange suitable cover should we fail to ensure one provider covers the whole patch."