Peter Christie (Letters, March 10) clearly can remember back a long way to when his general practice met all his needs – and regrets changes. Achieving continuity while maintaining accessibility has always been a tension in general practice. For some years, in most practices, good records and communication among a team has had to represent this continuity.
He deprecates the rise of profit-making GP services to plug a gap, but most GPs in the UK are essentially private practitioners, self-employed, but contracting with the NHS to serve the population registered with the practice. As a GP, I was "serving" patients but was there to make a profit and often stated "What's good for patients is good for profits".
There are several changes which have altered the service we now receive. For one, minor surgery in general practice is no longer tenable because of sterile room standards. Most primary care buildings simply don't have the facilities.
Sixty-two per cent of general practitioners in Scotland are female and tend to work fewer hours in the week than their male partners. Many men have followed suit, pacing themselves through a long career and perhaps contributing more time at home. Some GPs, me included, carried sessional responsibilities alongside care for patients. Input to medical management, clinic or ward work in hospitals, out of hours shifts, research and teaching and yes, sometimes work with commercial agencies, makes for variety and interest and are important contributions.
We are short of GPs, the whole time equivalent number has fallen in the last 10 years. In a medium-sized practice, being unable to recruit and being one GP down inevitably impacts on the service which can be provided. There is a 15% sickness absence rate among GPs; that's high.
The 2018 GP contract in Scotland provided salaried professionals to work in primary care – physiotherapists, mental health workers, advanced nurse practitioners and pharmacists. That is why receptionists are trained to ask patients on the phone about the reason they need attention, in order to offer them an alternative to a doctor when appropriate.
The Scottish Government (SG) is committed to putting more money into primary care and health boards are charged with achieving that also. Health boards and integration joint boards virtually all are overspent and struggling to achieve balanced budgets for next year. No progress there.
An imaginative SG plan to promote recruitment and retention begun last year carries forward 25 elements, all worked out with the profession. Each bit makes good sense but will it in total make a dent in the shortage and soon?
We know that the Covid pandemic, its aftermath and an ageing population with more chronic ill health and complexity has placed increasing demands on the service. GPs need time with patients and carers to meet those needs and 10-minute consultations are insufficient. That would produce more contented patients – and doctors. Providing that additional time needs more practitioners as indeed many European countries have.
Philip Gaskell (retired GP), Drymen.
Read more letters
- What on earth have they done to our GP practices?
- Politicians have traduced women. Thank goodness the tide is turning
Toilet trouble
Alexander McKay (Letters, March 13) claims it is “common sense” to demand that biological males be banned from female toilets and changing areas. Has he ever considered the implications of this if rigidly enforced? For instance, if there is a blockage in the pipes or a light bulb needing replacing in a female toilet or changing area, would it mean that the toilets will have to be closed off until a female plumber or electrician becomes available? Good luck with that.
He also declares that special interest groups should not be pandered to. So it looks like the disabled are being kicked into the long grass again. At present there are no separate male and female wheelchair toilets in any public or private building in Scotland that I am aware of. So can he explain how he intends to remedy that to meet his demands?
Similarly, thousands of small businesses like takeaways have a shared toilet if there are fewer than five employees. Under his proposal they will have to provide an additional toilet or else employ only staff of one sex, which in itself would be a breach of employment law. Either way it would render many of these businesses unviable.
Further, can he advise if a man and wife working from home will now require to have separate toilets to comply with both his edict and the workplace regulations?
Put simply, his proposal would create economic carnage amongst small and medium-sized enterprises and put a sizeable chunk of an already struggling sector of the Scottish economy into freefall. In what way, shape, or form is this “common sense”?
Robert Menzies, Falkirk.
A task for GB Energy
The Agenda article on GB Energy ("GB Energy likely to bring added benefits", The Herald, March 14) contained not a single reference to the collapse of the SNP Heat in Buildings Bill due to Scottish taxpayers being unable to underwrite the massive debt to decarbonise our homes.
There was also silence over the debt that will arise from the addendum to the SNP energy paper that was meant to install 25GW of hydrogen-fuelled gas turbine generators. Add on the cost of electrolysis plant, leak-proof storage vessels and associated pipe work and the debt will be at least three times that for the decarbonisation project. Just who is expected to repay such a debt or does it mean a massive cut to the budget of the Scottish NHS?
The primary task that Ed Miliband needs to assign to GB Energy is to reduce the unit price of electricity (27p per unit) to match that of gas (7p per unit).
Ian Moir, Castle Douglas.
When mum knew best
Allan Sutherland’s recollection of an expression frequently on the lips of his parents’ generation (Letters, March 14), reminded me of one my late mum was inclined to trot out whenever a celebrity, or more often than not, a politician fell from grace. With the smallest of frowns, she would say “I never liked the look of him!”. In those days, it was usually a "him". Nowadays, it’s pretty well 50/50, and in recent weeks, in the wake of tides of self-justification, I find I’ve been using it a lot.
Robert Love, Glasgow.
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