Jim Hume, Scottish Liberal Democrat MSP for South Scotland and health spokesperson, has put further pressure on the SNP Health Secretary to tackle Scotland’s looming GP crisis.
Liberal Democrats are urging Health Secretary Shona Robison to publicly back the Royal College of GP’s strategy when she speaks at the organisation’s Annual Primary Care conference in Glasgow on Thursday (Thursday 1st October).
Chair of RCGP Scotland, Dr Miles Mack, has questioned whether the Scottish Government has a political strategy for general practice.
He highlighted figures showing that the funding share for general practice has fallen for the tenth year in a row. This is despite the number of consultations GP practices provide increasing by 11 percent in the same period to 24.2million.
RCGP warn that Scotland needs an additional 740 GPs by 2020 if it is to tackle the recruitment and retention crisis in primary care.
Commenting, Mr Hume said:
“The Health Secretary must use her speech to publicly back the Royal College of GP’s strategy for General Practice.
“The experts are warning that Scotland needs an additional 740 GPs by 2020 if it is to tackle the crisis facing GP services.
“Indeed in my own region, Dumfries and Galloway is facing this crisis right now with 12 post lysing vacant and an estimated loss of a quarter of GP posts over the next three years.
“Meanwhile, we continue to learn of cases across the country where a lack of GPs is forcing surgeries to stop accepting new patients and in the worst cases, dissolve entirely.
“Our survey showed that 99 percent of GPs who had heard of the SNP’s existing action did not think it was sufficient. It’s time the SNP face the facts and start listening to the experts. We are fully behind RCGP’s call for immediate action instead of the SNP’s usual promises for tomorrow, otherwise there is a real risk that seeing your GP could become a luxury.”
Notes to editors,
Mr Hume recently led a debate in the Scottish Parliament on GP services in September. His motion and speech shown below.
The text of Mr Hume’s motion is as follows:
Motion Number: S4M-13973
Lodged By: Jim Hume
Date Lodged: 18/08/2015
Title: ♦ Promoting Sustainable GP Recruitment
That the Parliament notes with concern the reported challenges facing GPs across Scotland, including a shortage in numbers in South Scotland; understands that the British Medical Association and the Royal College of General Practitioners Scotland have said that the country will need an additional 740 GPs by 2020 and that it is facing a recruitment crisis in general practice; believes that around 90% of patient contact with the NHS is through the primary care provided by GPs and that quality primary care is the bedrock of the NHS and a lifeline to many, particularly in remote and rural communities; further believes that the pressure on GPs is intolerable and that the situation at present is unsustainable, and notes the calls from Scotland's healthcare professionals for a full and frank debate on the future of primary care.
Please see below for a check against delivery version of Mr Hume’s speech, which is embargoed until delivery:
*Check against delivery*
Presiding Officer, I welcome fellow Members back for this first Members’ debate after this long recess. Unfortunately I have to bring to the attention of the Chamber the many issues surrounding the state of our General Practice as there has not been progress in either the numbers or the working conditions of our General Practitioners.
Scottish Liberal Democrats have taken a strong stance and have raised this issue many times, not least when my colleague Willie Rennie conducted a survey earlier this summer, which uncovered some truly disturbing facts about the mood of GPs and state of affairs in GP practices.
The issue of GP recruitment and the future of GP surgeries that are faced with a crisis is one that affects the heath of nearly everyone, as general practices deliver 90% of patient care in the NHS, yet receive less than 8% of NHS funding.
Naturally, this has hard-hitting consequences on GPs and the increasing demands they are facing, with increasingly shrinking budgets. Their funding has been facing a near-constant reduction since 2007, from 9.2% to 7.8% in 2013, whereby because of its stagnant funding it was further reduced by 1.2% because of inflation. That’s preventive amounts which the Government isn’t spending, while evidence suggests that investing in GP practice can save the NHS nearly £200 million per year by 2020.
In line with its 2020 Vision, the Government first pledged in November £40 million for primary care in 2015/2016, then said that £50 million will be spent through the Primary Care Fund over three years – that’s a reduction of £24 million per year from the amount that was originally announced.
One of those elements of the scheme, the Pharmacist Independent Prescribers promises to recruit 140 new pharmacists – that’s 10 pharmacists per health board. I don’t deny that it is a welcome start – but it’s the first step of a very long journey that we will need to make to ensure sustainability. Because when we are already seeing health boards taking over GP practices, we need to face the real numbers and see what the real issues are.
If the Government doesn’t reverse its spending cuts from where spending cuts are the most hazardous, we will be facing a 2020 crisis, and not a 2020 vision. The Royal College of General Practitioners has called on the Government to provide urgently a clear strategy for sustainably investing in Scottish general practice, and we back that call.
We also back the call from the British Medical Association which has raised a warning flag over recruitment. One third of GPs are currently considering retirement, while more than 1 in 10 are planning to move to part-time work. This will leave a number of practices unable to operate.
Presiding Officer, we need not look far into the future to see that this is a real problem, already facing us. 463 practices have at least one GP vacancy, while some have not been able to secure locum GPs for 15 days or more within 1 month period. Practices aren’t able to see as many patients as need to be seen; appointments are being slashed, waiting lists for registration are getting longer, and people are being sent elsewhere because of maximum capacity.
Presiding Officer, I want to stress the importance of this issue. The SNP Government has taken the GP services and risks turning them from an accessible, first-point of contact service for every Scot into almost a luxury service which many currently do not have access to. I want to point out how important it is for the Scottish Government to work constructively with GPs and listen to what they are saying, because it is currently at risk of violating the right to health for all Scots.
My colleague Willie Rennie’s GP survey speaks volumes. Almost 4 in ten practices find their workload unmanageable – they also say that this is their greatest challenge. What is most telling however is that more than half of the respondents want the Scottish Government’s Primary Care to be reduced or abolished.
But perhaps one of the most worrisome and discomforting facts was that one third of GPs answered the question of whether they would choose to become GPs again, with a negative answer.
Presiding officer, this raises many questions about the future of our GP services. Why is the Scottish Government not ensuring that the right amount of resources is being put where GPs think it’s important? Why are we seeing less GP trainees, with less retention across Scotland? Why are current GPs under so much stress and work pressures that many see their own health deteriorate?
When the Scottish Government enables GPs to put professionalism back to the profession, then many of these questions will surely have found their answer. If the Scottish Government wants to listen and implement some substantial solutions, there are a number of recommendations given both by the Royal College of GPs as well as the BMA.
Seeing an investment in the tools that GPs have in their disposal to lead the development of new models of care would enable them and empower them to provide better services to their patients. Whether it’s the newly announced investment of £500,000, which I welcome, into the program for improving outpatient services with better technology, or enabling GPs to work alongside Advanced Nurse Practitioners in their practices, it’s important to recognise the leading role that GPs are playing and must continue to play in communities. I urge the Government to continue with providing support and resources to ease the workloads and pressures of general practice.
This includes reducing the administrative burdens. We know that GPs currently work not only more hours than they should during a typical work day, but they are also responsible for the administrative work when the practice closes up for the day. Instead of being forced to do tasks not related to medical practice, GPs should instead be enabled to spend more time with their patients, have closer working relationships with other professions, and be able to face a good interface with other experts who are involved with their patients’ care.
Presiding Officer, I want to close by expressing once more my concern for the future of our general practice in Scotland. I hope that by listening to the facts today, the Scottish Government will decide to act to prevent this cornerstone of our healthcare from reaching breaking point.