Escape to the country: challenges of a migrant population for the rural GP

> People move to rural locations such as the Orkney Islands seeking a change of environment and pace. However, there is a price to pay for the beautiful scenery and relative isolation. Migrants encounter limited emergency services and difficult access to consultant-led specialties; many find the loss of anonymity, removal from a familiar social network, and harsh winter weather challenging to their mental health. GPs in the Orkney Islands have a role in both advising new patients about unfamiliar services and assisting those who may be struggling in their new environment. An awareness of the potential problems encountered by a migrant population in a rural setting is a vital underlying aspect to the work of every rural GP consultation. Patients stumble into the waiting room, propelled by a passing icy squall raging outside. They are almost uniformly Caucasian, wearing warm, waterproof coats and practical shoes. But one speaks with a Cumbrian accent, and another clearly hails from the Home Counties; two more sound Scottish, but my gradually acclimatising ear picks up both a Glaswegian rumble and an Orcadian lilt. What does a migrant population mean at …