THERE were angry exchanges at St Paul's Hall last Wednesday night, when 300 patients gathered to grill health chief Barbara Smith about the fate of Marshfield Road Surgery.

The future of the surgery, near Chippenham town centre, has been hanging in the balance since October last year, when Dr Barney Williams withdrew from a contractual agreement to provide out-of- hours cover for his patients. He claimed that as the practice's sole doctor, he was unable to offer sufficient overnight care for his patients, 24 hours a day, 365 days a year.

But Kennet and North Wiltshire Primary Care Trust said the decision held him in breach of his contract and there were fears that the surgery would have to shut at the end of March, when Dr Williams' NHS contract ran out.

The Trust is currently providing out -of-hours cover for Dr Williams' patients at a cost, they claim, of up to £500 a night.

In March, the surgery was given a stay of execution following a deluge of letters and calls to the trust from Dr Williams' patients.

And while the PCT covers the cost of after hours cover at the surgery, the dispute has now been sent to arbitration and Dr Williams' future at the surgery is expected to be known in around six months.

But his patients are determined not to lose their doctor and met with Mrs Smith to emphasise the fact.

With tempers running high, the meeting on Wednesday evening saw Mrs Smith come up against some difficult questions from both patients and surgery staff.

Asked to give assurances about the future of the surgery, Mrs Smith refused to pre-empt the findings of the arbitration, but said she wanted the problem resolved as soon as possible. Two patients called for Mrs Smith's resignation, claiming she had the power to resolve the situation, but wouldn't.

And accused by one patient of not caring about the fate of the surgery, Mrs Smith was greeted with uproar when she admitted that she had never visited the practice.

She was also bombarded with questions about why Dr Williams has been barred from joining a doctors' co-operative, which covers out-of-hours care for other surgeries throughout north Wiltshire, but denied that the patients had become victims of a vendetta.

And later, when asked whether it was true that Dr Williams had been banned from following his patients into Chippenham Community Hospital, Mrs Smith confirmed that the doctor was no longer able to visit in-patients because of the dispute.

But she refuted some patients' claims that Dr Williams had been refused access to patients attending the minor injuries unit and pledged to investigate the claim further.

Mrs Smith said she recognised the value of the practice to its patients and wanted the matter resolved as quickly as possible.

She also pledged to visit the practice in two weeks, when she returned from holiday.

But she said she could not guarantee the future of the practice and urged patients to wait for the result of the arbitration, which is expected in around six months' time.

Last month, the PCT took the doctor to county court over a dispute about supplying notes.

The case was adjourned and the PCT withdrew from the case on grounds of the costs it would incur.

Dr Williams heralded the decision as a victory for him and his patients and an indication that he could not be taken to court for breaching his contract. But his patients fear the surgery's days may still be numbered and that they will eventually face the difficult task of joining Chippenham's other doctors' practices, which are already over-subscribed.