THE diagnosis is grim: there is a crisis in the training, recruitment and retention of doctors in Scotland and the situation is deteriorating. At the weekend, it was revealed that as many as 3,000 doctors are estimated to have left to work abroad since 2008, and now we are told that nearly a third of this year’s GP training places remain unfilled. If the GP service were a patient, could we feel confident about the long-term prognosis?

The latest figures are part of the Conservatives’ campaign on the health service but they are official NHS statistics and show just 275 of 402 GP training places have been filled after two rounds of recruitment, or 68 per cent of vacancies. This compares to England, where 84 per cent have been filled, and Wales, where the figure is 91 per cent.

Partly, the differences can be explained by the fact that 100 additional training places have been created in Scotland, but that is only a partial explanation. In reality, the latest news on GP recruitment only confirms what we already know which is that the service is in serious trouble.

In responding to the figures, Dr Alan McDevitt, the chair of BMA Scotland’s GP Committee, has pointed out that some improvement has been made on GP trainee recruitment in Scotland compared to the same stage last year and he is hopeful that the new GP contract, which is currently being negotiated with the Scottish Government, could make a difference. But he also acknowledges that not enough is being done to make becoming a GP an attractive career choice for young doctors.

To some extent, there is an issue with lecturers putting young doctors off the idea of becoming a GP, but the bigger problem is that students can see the reality. Yes, GPs are paid relatively well and few of them have to work evenings or weekends, but many GPs do not have the resources they need and are coping with the increasing burden of admin. The problem is reflected in the fact an increasing number of GP practices are being taken under direct health board control because there are no GPs to run them.

If the new GP contract is to come anywhere close to tackling these problems, then it will have to make the job more attractive and bearable, which means looking seriously at ways of reducing the workload – for instance, is there more that pharmacies could do to offer some of the services that are currently the responsibility of GPs? The day-to-day business and admin elements of a GP’s working life must also be reduced so they can concentrate on their patients.

The issue of funding also needs to be tackled. Some of the GPs who have been handing the running of their practices to the health boards say they have done so because the current funding has made it impossible for them to carry on. Nearly a third of this year’s training places remain unfilled partly because many young doctors do not want to be GPs. But it is also because they can see the GP service for what it really is: an essential part of the NHS that is starved of support, staff and money.