HAVING read your article concerning the proposed GP contract starting in 2017 I am somewhat encouraged ("Doctors to give up key duties in shake-up", The Herald, May 21).
The proposed plan to remove certain aspects of care and administration from GPs' remit would suggest that finally it has been recognised that the current workload is unsustainable and cannot continue.
I note the proposed ending of practices directly employing their own staff. Should this be agreed I would go further and suggest that the current model of GPs being independent contractors is no longer fit for purpose and should be replaced by direct employment. Only by doing this can GPs be assured of properly defined terms and conditions of service allowing for sensible negotiated working hours, protected learning time for appraisal and revalidation, cover for holidays and illness - and possibly even lunch breaks.
A sensibly negotiated contract may make general practice attractive again to young doctors and rejuvenate older ones. A properly staffed service may allow for some extension of opening hours and even out of hours cover on a shift system (using the former cooperative model to manage demand appropriately) while maintaining a reasonable work life balance. The dysfunctional NHS 24 could be disbanded and its huge funding allocation could be redistributed within primary care.
A downside to this may be the end of the small practice as such a service will require large premises like Health Centres for economy of scale and best use of combined resources. Pams (Professions Allied to Medicine) and other ancillary services will need to be utilised to the full to cope with demand. Continuity of care is highly valued by patients and may be difficult to maintain.
Let us hope that the SNP Government continues in not following the disastrous change to primary care in England driven by political and ill-informed populist pressure and which does not promote a 24/7 service. It is unnecessary, impractical and totally unaffordable.
Let us not miss this opportunity to transform general practice for generations to come.
Dr David Mathie,
16 Sheepburn Road,
Uddingston.
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