GP shortage challenging but '˜not in crisis', insists Shona Robison
Health Secretary Shona Robison has denied there is a crisis in general practice, despite evidence that some family doctors are facing 'inhumane' workloads.
Ms Robison told MSPs on Holyrood’s Health Committee that she accepts the shortage of GPs in Scotland is “very challenging”, but she refused to characterise it as a crisis.
Doctors earlier told the committee there is a “major problem” that is beginning to affect patient care.
Dr Alan McDevitt, chair of the British Medical Association’s Scottish general practitioners committee, said the latest figures show a 28.6% GP vacancy rate across Scotland, with the number of posts still vacant after six months up from 42 last year to 80 this year.
He said: “We’ve got very clear evidence now of a recruitment problem into general practice.
“The fact is many practices, because of that, are having to somewhat restrict the services they provide, so in terms of determining what the problems are we’re now seeing them very real and they’re actually beginning, I think, to affect patients and I think that’s when it becomes a crisis, when patient care begins to be affected by the numbers of GPs we have.”
Calling for increased investment in the specialism, he said: “I know how hard the public purse is stretched but this is an absolute requirement. If you want to fix this, if you want to have general practice for your families and mine, this requires investment now.”
He added: “Many of our colleagues just now say the workload is inhumane and they are deciding to get out of it one way or another, whether by going part-time or leaving the profession - 259 GPs under 50 have left the profession in the last five years, 200 of those were under 40 when they decided to get out.”
Dr Miles Mack, chair of the Scottish Council of the Royal College of General Practitioners, said the percentage of NHS funding going to general practice had fallen from 9.8% in 2005/06 to 7.4%.
He said that while GP headcount has increased by 7%, the number of whole time equivalent GPs has actually fallen by 2% in the last two years.
“It does seem that the workforce planning has gone awry, we’re not actually investing in the workforce in the place where we should have it,” he said.
Dr Mack also raised concerns about the “bad-mouthing” of general practice in medical schools, which he said was “severely damaging”.
Ms Robison was later twice pressed by Liberal Democrat MSP Alex Cole-Hamilton on whether she accepts there is a crisis in general practice.
She responded: “No, I would characterise it as being very challenging.
“What I’m focused on is coming up with a range of solutions that get us to a point where people want to go into general practice, stay in general practice, and work here in Scotland.
“That is not easy to resolve because it is partly about the perception of general practice, it is about how our medical schools work and perhaps some of the perception within medical schools of where general practice sits in regards to other specialities. So these are quite deep-rooted and complex issues, there is not one solution to them.”
Ms Robison said new models of care are being tested in every health board area, with the Government committed to increasing the share of NHS funding in primary care year-on-year throughout the parliament.
GP training places have been increased from 300 to 400 a year, with £2 million invested in GP recruitment and retention and more than £16 million allocated to recruit 140 pharmacists in general practice.
She said the Government is also looking at ways to boost the number of Scottish-domiciled medical students by increasing the number of undergraduate medical places by 50 from this year, and examining linking the payment of graduate fees to a commitment to work in the Scottish NHS.