FOR some time now there has been serious concern over the recruitment and retention of GPs in Scotland. Nowhere has this been more acutely felt than in rural areas. For too long, newly qualified doctors have not only shunned many GP jobs, but efforts to fill vacancies in more remote areas has proved especially problematic.
The dangers of this are obvious given that GPs still constitute a vital frontline in our primary healthcare system. Such challenges are not unique to Scotland, of course, with the NHS across the UK having trouble attracting people to become GPs.
News yesterday then of a Scottish Government plan in collaboration with the British Medical Association (BMA) to recruit an extra 800 GPs over the next 10 years is to be welcomed.
While the scheme is a Scotland-wide one, funded to the tune of £7.5 million in 2018-19, support for all 160 of Scotland’s rural and remote practices will be given particular emphasis. There is no shortage of issues the scheme urgently needs to address. Among them are reducing GP workloads, re-establishing general practice as an attractive career choice, expanding remote and rural incentive schemes and relocation funds for doctors.
According to Health Secretary Shona Robison, the new contract will ensure that GPs are able to spend more time with patients and less time on bureaucracy. As might be expected in this new collaborative scheme Scotland’s BMA’s GP Committee (GPC), is also upbeat about the contract. Dr Alan McDevitt, chairman of the committee, is convinced that delivering 800 GPs adding to Scotland’s current tally of 4,900 is both a “sensible and realistic target for the years ahead”.
Not all GPs, however, are as convinced. Some rural doctors insist the proposals fail to recognise rural practices’ needs and could potentially strip away up to two-thirds of their core income. According to Dr David Hogg, chairman of the Rural GP Association of Scotland (RGPAS), any new contract that did not adequately recognise the inequalities or workload faced in rural areas, where 20 per cent of the Scottish population live, would be unacceptable.
The RGPAS also says more than one-third of its members report that the new contract would leave them facing losses of 40-69 per cent of their core funding, with 90 per cent of practices in the north of Scotland likely to see their allocations through the contract reduced by up to two-thirds. The crux of the matter, says the RGPAS is not the issue of GP pay and income, but about resource allocation. Both the Scottish Government and GPC rebut such criticisms, insisting that under the new proposed contract no GP practice in Scotland will lose any funding. The problem here is one of the devil being in the detail.
All parties now need to sit down and iron out any shortcomings and misreading of the new scheme. With more than one-third of GPs working in Scotland aged over 50, time is of the essence.
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