THE early symptoms of an impending crisis are quite apparent.

The UK population is predicted to increase by more than half over the coming decades.

If Tunbridge Wells was to follow the same trend then by 2090 the town's doctors and dentists will have to care for more than 50,000 additional patients, many of them elderly as life expectancy also increases.

Considering this date is 78 years away, many would consider it to be a long-term prognosis, but with a steadily-increasing population it is not a problem that can be dismissed as being distant.

Health professionals have differing views on what the cure could be, and practice manager Jo Hird, from The Rowan Tree Surgery, is worried.

She said: "If there are significantly more patients then we will inevitably need more doctors, but they have to be paid for.

"Unless there is enough money to pay for the right number of staff, patients could potentially suffer.

"The infrastructure here would struggle if the population increased significantly and the number of doctors didn't."

Many of Mrs Hird's colleagues in the medical profession are similarly concerned about how local healthcare will be delivered in the future.

Already staff say they work long hours to ensure patients are seen as promptly as possible.

Mrs Hird said NHS paperwork particularly eats into GPs' time. Furthermore they face a period of uncertainty as the Government looks to introduce Health Secretary Andrew Lansley's Health and Social Care Reform Bill, which will hand them control of their own surgeries.

Currently, doctors believe they are coping with demand and have stable patient lists. But faced with the pressures of a rising population and dwindling budgets, they are concerned cracks will begin to show.

Gill Orrin, practice manager of Greggswood Road Medical Centre and The Old Bakery Surgery in Speldhurst, said a population surge would force GP surgeries to call on their bosses at West Kent Primary Care Trust to consider building a new practice in Tunbridge Wells to meet growing demand.

Stephen Ingram, the associate director of primary care at the trust, insisted it was ready to meet any fresh challenges.

He said: "As the population grows and changes, so do the services we commission."

But healthcare watchdog Kent LINk governor John Ashelford said: "The idea that GPs are going to take on extra work structuring and delivering the services is a bit worrying.

"Resources will become stretched and we won't get a better package of services."

Mrs Hird agreed the healthcare reforms would increase doctors' workload.

She said: "It's always been a challenge to get patients seen when they want to be seen. It's not always that easy because we don't have a limitless supply of doctors and time.

"In the future we have a choice – either we take away patient contact time or we work longer hours. My doctors are very committed to ensuring that patient time is not compromised."

Mrs Orrin added: "The pressure is in meeting demand. There are certain times when demand will outstrip the number of appointments available and we have to review the situation on a daily basis, particularly at this time of year."

She said the future was "uncertain", but that patient care must not be compromised even if GPs take on additional work. She also wanted political reassurances that services would be monitored and regularly reviewed to ensure they can adapt to meet growing demand.

Health minister Earl Howe insisted the new health bill would "free up" frontline professionals and enable them to deliver a "world class service that puts patients at the heart of everything it does".

Meanwhile, one private dentist in Tunbridge Wells has criticised the way NHS dental care is provided.

Dentists bid for contracts from the trust, with successful practices then given a specific amount of work to do, measured in units. If a centre exceeds its quota it is not paid for the extra work while those falling short of the target are penalised.

Dr Sarah Dehdashty, who runs dental practice The Aspen Clinic, in Mount Ephraim, said the system was a "shambles". She said there was simply insufficient Government cash to pay for adequate dental care.

"The NHS funding can provide emergency treatment to fix a problem but there is not enough money to pay for regular check-ups which stop patients from having problems," she said.

"The Government should be clearer about that."

Dr Dehdashty said NHS dentists struggled to cope with the system and were "limited" by their contracts. NHS patients find it difficult to get appointments because practices have already reached their quota, she said.

Dr Nigel Carter, chief executive of the British Dental Health Foundation, said many dentists were "unhappy" with the system implemented in 2006.

But he insisted the changes had "increased local availability of dentists and patients should no longer have any difficulty in finding a dental practice to treat them".

Part Four next week: Burial grounds