Comment: ‘Don’t let basic care decline’

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Fine-sounding pledges on health service funding are one thing. But, as Edinburgh residents are finding out, GP access can be quite another.

Figures we reveal today show growing difficulties in the Capital over access to family doctors. Patients have frequently to wait between two and three weeks for a routine appointment and many having to travel across the city because their GP cannot take on new patients.

Evidence of pressure is indisputable and widespread. Almost a fifth of GP practices in the Lothian area have had to restrict their waiting lists. Some 25 practices have stopped accepting new patients. Three surgeries have been dissolved entirely and ten have asked NHS Lothian for help.

GP care – the mainstay of the health service and on which the public relies for everyday medical attention – is being hit by a combination of funding constraints and demographic pressures, with the Capital’s rising population inevitably bringing greater numbers of patients to surgeries. And it is not just a problem of more numbers. Patients are coming with increasingly complex conditions as they move into old age.

Funding shortage is part of the problem. Dr Miles Mack, chair of the Royal College of General Practitioners Scotland, says the pressure on GPs is a direct consequence of the lack of funding and attention given to general practice over the last decade. He tells of GPs struggling under the weight of their workload and colleagues leaving the profession because it is simply unsustainable for them.

The call for greater resources is understandable, though that in turn poses the question of where the extra money will come from within the NHS budget. The extra £8 billion pledged by the government also has to cover new facilities, buildings, equipment, medicines and rising staff costs, just to be able to meet the current levels of service.

All this suggests that changes may now be required in the way that GP care is provided, with nurses and pharmacists taking on more of the work. Without such change, the evidence suggests that extra help for GP care should be made a priority if the pressures are not to get worse. It cannot be right that basic provision for residents in Scotland’s capital is allowed to decline into a postcode lottery.