DOCTORS are calling for patients to be charged if they miss a booked GP appointment in Scotland as concern escalates about the pressure on surgeries.

Demand for the Scottish Government to introduce fines for no-shows are among a list of measures put forward for discussion at what is expected to be a heated GP conference in Glasgow.

Family doctors are using the event to warn "general practice and the NHS may not survive" because "of the ever increasing demand and inadequate funding".

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The conference, which is due to be attended by Scottish Health Secretary Shona Robison and GPs from across the country, is also expected to hear that a recruitment crisis is

"putting great physical and emotional strain" on some doctors.

One motion to be put to the meeting of the British Medical Association's Scottish GP Committee (SGPC) says: "It is time for the GP body to have an honest and open discussion with patients and secondary (hospital) care colleagues as to what we can and cannot do, they need to be aware that general practice is already in crisis."

Dr Amy Small, a member of the BMA's Scottish GP Committee (SGCP) and a GP in Prestonpans, said: "Morale is really low. I look around at my own colleagues who are struggling. We have a really good supportive practice but I think just over the last few weeks everyone is getting to the point where we are beginning to weigh up all our options."

She said her practice had closed their list to newcomers last Spring having taken on 1500 extra patients in the last five years. There wasn't enough additional funding to recruit more GPs and, she said, when she was on maternity leave they were unable to find a replacement doctor.

Dr Small said they had closed their list to protect the service for existing patients, adding: "The people who will end up suffering most in all of this are the patients and that is what we do not want. Stressed doctors are inevitably going to make mistakes."

Some GP practices have already collapsed because vacancies for doctors could not be filled, forcing the health board to step in to run services. A fifth of training places for general practice in Scotland were left vacant last year and Dr Small said a huge percentage were considering retirement - at the last count 160 GPs in Scotland were over the age of 55.

Dr Small said the future of general practice and the NHS was in jeopardy "unless there is increased investment and they look at patient demand."

GPs, she said, were the "backstop for everything" with information on medication telling people to ring their GP after a few days, posters telling people to consult their GP, benefits assessments requiring GPs and patients turning to them about issues such as relationship problems because they did not have anywhere else to go. Dr Small said: "We cannot have the 'all you can eat' buffet we have at the moment."

GPs from Ayrshire and Arran have submitted a motion to the conference calling for patients to be fined if they miss their scheduled appointment.

The motion they have put to the conference says "a penalty should be introduced for patients who fail to attend pre-booked GP appointments without adequate notice or explanation". It continues to call on the SGPC to lobby the Scottish Government for the introduction of a charge to discourage such behaviour.

The conference is taking place in Clydebank on Friday March 11.