RURAL GPs should continue to offer vaccinations direct to patients in their practices, the Health Secretary has said.

Jeane Freeman said there was nothing in the new Scottish GP contract to stop family doctors continuing to provide routine vaccines themselves if they want.

It comes amid warnings from the profession that immunisation uptake for common viruses such as flu, meningitis and measles among elderly people and infants would fall in remote and rural areas under plans to transfer funding for the injections away from local doctors' surgeries back to health boards.

Critics said the system was suited to cities and the Central Belt, but would become patchy if patients on islands or rural communities were relying on NHS clinical teams who only visited the area occasionally.

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Concerns were also raised that people might not bother to be vaccinated at all if it meant travelling tens of miles to an NHS clinic.

The decision to remove vaccines from general practice was intended to help reduce doctors' workload, but rural GPs have complained that it is another example of the new contract being skewed in favour of urban Scotland.

Professor Phil Wilson, a GP and director of the Centre for Rural Health, said he could not "see a health board administered system being able to deliver immunisation rates as high as they are currently in rural areas", while Dr Miles Mack - a Dingwall-based GP and former chair of the Royal College of GPs Scotland - said he "did not understand" why the scheme had been negotiated, adding that "coverage will drop".

In an interview with the Herald, however, Ms Freeman insisted that the contract had been misunderstood and "was flexible".

She said: "The bulk of Scotland is rural. In those communities there is a tradition of working out for yourself how best to deliver services. I think sometimes we forget that.

"So we could have paid a bit more attention to whether or not the contract was flexible enough - or at least seen to be flexible enough - to achieve its core objectives regardless of whether you were in an urban or rural setting.

"I think the contract is flexible enough, but it wasn't seen to be. So in not being clear about that, we have rural GPs feeling that they've been ignored.

"If it makes sense for a group of GPs to continue to do vaccines, as opposed to that coming out centrally, the flexibility is there to continue to do vaccinations."

However, Ms Freeman rebuffed the repeated calls of the profession to increase general practice's share of the health budget to 11 per cent.

Back in 2005/6, general practice accounted for 9% of health spending, but by 2017/18 that had dwindled to 6.8%.

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The Scottish Government has pledged to raise spending for primary care as a whole to 11% by the end of the current parliament, in 2021, including an extra £250 million for general practice. However, its share of the health budget looks set to drop to around 5.5%.

Ms Freeman said: "Primary care is more than GP practices. Primary care also includes the advanced nurse practitioner, it includes NHS 24 for out-of-hours, the paramedic service, the pharmacy service that is lifting a huge amount of workload off the GP in repeat prescribing.

"That is why I commit 11% to primary care - but half of that is going into GP practice."

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Ms Freeman also said it was "not really fair or very sensible" to put health board staff in charge of major infrastructure projects.

It comes after a number of serious design flaws were uncovered in ventilation at the newly-built Queen Elizabeth University hospital in Glasgow and the Royal Hospital for Children and Young People in Edinburgh.

"They're not civil engineers, they're not architects, they're not builders," she said, adding that this was why she has commissioned the creation of a new expert body to take charge of future healthcare builds.

"It will bring together building expertise, microbiology expertise, it will be responsible for compliance with the latest standards, for quality assurance and testing, and for all aspects of contract compliance.

"I think of it like the grumpy old guy going round with a clipboard saying 'don't just show me the paperwork, switch it on and show me it works'. That's what that centre will do for all our major infrastructure builds."

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NHS Greater Glasgow and Clyde is suing Multiplex, the contractor which built the QEUH.

It follows a string of high-profile infection cases and deaths which have been linked to ventilation or contamination of the water supply.

Ms Freeman, who has been critical of the health board's handling of the crisis, said she expected them to publish the Aecom report outlining the legal advice they had received.

"I want that published," said Ms Freeman. "I don't want a report known about and not published. They're working on that now.

"They'll either get legal advice that says 'now you've lodged it you can publish the whole thing', or 'you need to take bits out because they would compromise the legal case'.

"If they have to take bits out before publishing, they need to make that clear."