Doctors issue 'distress' plea to Scottish patients: 'Write to your MSPs over NHS in crisis'
By Joseph Anderson
Published 25th May 2024
The unprecedented step comes as GP surgeries across the country face closure
Senior doctors have issued a “distress call” to patients in a bid to help keep GP practices open, following what they have branded a “cultural and systematic neglect of general practice” by the Scottish Government.
The Lothian Local Medical Committee (LMC), the body representing GPs in Lothian, has told patients to contact their MSPs, saying it is the only way to resolve a “critical situation with less money, less doctors and less staff”.
In an open letter to patients obtained by The Scotsman, titled ‘Why are your GP practices now unable to do everything they once were?’, doctors said they were now facing closures due to the crippling financial pressures of running a GP surgery in Scotland.
It comes as health secretary Neil Gray is set to face questions in a crunch session at Holyrood on Wednesday on the future of the NHS, with maintaining GP practices set to feature heavily in the discussion.
The LMS letter outlines a £1.6 million hike in facilities’ bills, a delay in a promised new funding model that better reflects GPs' workloads, the axing of Government funding for non-GP staff pay rises, the cancellation of funding for new build premises and the withdrawal of sustainability loans.
“General practice across the country has been struggling for years,” the letter reads. “However, it has now reached a critical situation with less money, less doctors and less staff to meet the growing needs of the Scottish population. So how did we get here?
“In 2017, the Scottish Government recognised this and promised to introduce a new contract, starting in 2018 and to be fully implemented within three years. At the time, the-then health secretary Shona Robison MSP said ‘we equally recognised the fundamental challenges faced by general practice, not least growing workload and increasing risk’.
“Unfortunately, for the first time in the history of the NHS, large parts of this contract have not been implemented. Even worse, when health boards haven’t been able to spend the money that they were given to employ additional pharmacists and other professionals to support general practice, the money has had to be returned to the Scottish Government rather than being able to be spent supporting your local practice.”
The letter added: "All GPs want to deliver the highest quality of care for patients in a timely manner, but the cultural and systematic neglect of general practice has led to a workload and workforce crisis.”
In Scotland, GP practice numbers have dwindled, while the number of patients registered with GP practices has soared, leading to frustrated patients and overworked GPs looking to leave the profession.The latest Public Health Scotland (PHS) figures show the number of patients registered with GP practices has continued to rise year on year, increasing by 7.1 per cent since 2013. Meanwhile, the number of patients aged 65 and over, who are far more likely to need medical assistance than other age groups, has increased by 19.3 per cent since 2013.
In the same period, the number of practices in Scotland has dropped by almost 10 per cent, from 994 to 897 since 2013.
The Royal College of General Practitioners (RCGP) said “it’s no surprise” that GPs in Scotland were asking the Scottish Government “to properly value the contribution of general practice”.
“Fundamentally, more GPs and greater investment are crucial to the future stability of general practice and the NHS as a whole,” an RCGP spokesperson said.
"RCGP Scotland is working closely with the Scottish Government to deliver solutions to retain our experienced existing GPs, as well as on ways to attract the best into the profession and to empower international medical graduates to settle as part of the Scottish GP workforce. Capital investment to ensure premises are fit for purpose and can accommodate this growing workforce is essential."
Jackie Baillie, Scottish Labour's spokesperson for health, said: "When you're worried about your health, the first number you call is your local GP and we know that NHS staff are working flat out to try to get patients in the door. But this crippling rent hike means GP practices are crumbling from the inside out while the government fails to act.
“At the same time, SNP funding cuts are leaving GPs high and dry. These rent hikes and funding cuts are pulling the rug under our vital GP surgeries in the midst of a cost-of-living crisis. The fact Lothian's GPs are now issuing a distress call asking patients to contact their MSPs should be an alarm bell for everyone who cares about our NHS.
"John Swinney's Government should stop treating GPs with contempt and instead work with them to create the health safety net we all need."
A spokesperson for the Scottish Government said it “greatly values” general practice and “wants to ensure GP practices have the support they need”.
“Scotland has a higher number of GPs per head than the rest of the UK, and a record 1,200 trainee GPs coming through the training system in Scotland,” the spokesperson said.
“We are fully committed to increasing the number of GPs in Scotland and have invested over £1.2 billion in General Medical Services in 2023/24 to ensure more people get the right care in the right place at the right time.”
The LMS letter outlines a £1.6 million hike in facilities’ bills, a delay in a promised new funding model that better reflects GPs' workloads, the axing of Government funding for non-GP staff pay rises, the cancellation of funding for new build premises and the withdrawal of sustainability loans.
“General practice across the country has been struggling for years,” the letter reads. “However, it has now reached a critical situation with less money, less doctors and less staff to meet the growing needs of the Scottish population. So how did we get here?
“In 2017, the Scottish Government recognised this and promised to introduce a new contract, starting in 2018 and to be fully implemented within three years. At the time, the-then health secretary Shona Robison MSP said ‘we equally recognised the fundamental challenges faced by general practice, not least growing workload and increasing risk’.
“Unfortunately, for the first time in the history of the NHS, large parts of this contract have not been implemented. Even worse, when health boards haven’t been able to spend the money that they were given to employ additional pharmacists and other professionals to support general practice, the money has had to be returned to the Scottish Government rather than being able to be spent supporting your local practice.”
The letter added: "All GPs want to deliver the highest quality of care for patients in a timely manner, but the cultural and systematic neglect of general practice has led to a workload and workforce crisis.”
In Scotland, GP practice numbers have dwindled, while the number of patients registered with GP practices has soared, leading to frustrated patients and overworked GPs looking to leave the profession.The latest Public Health Scotland (PHS) figures show the number of patients registered with GP practices has continued to rise year on year, increasing by 7.1 per cent since 2013. Meanwhile, the number of patients aged 65 and over, who are far more likely to need medical assistance than other age groups, has increased by 19.3 per cent since 2013.
In the same period, the number of practices in Scotland has dropped by almost 10 per cent, from 994 to 897 since 2013.
The Royal College of General Practitioners (RCGP) said “it’s no surprise” that GPs in Scotland were asking the Scottish Government “to properly value the contribution of general practice”.
“Fundamentally, more GPs and greater investment are crucial to the future stability of general practice and the NHS as a whole,” an RCGP spokesperson said.
"RCGP Scotland is working closely with the Scottish Government to deliver solutions to retain our experienced existing GPs, as well as on ways to attract the best into the profession and to empower international medical graduates to settle as part of the Scottish GP workforce. Capital investment to ensure premises are fit for purpose and can accommodate this growing workforce is essential."
Jackie Baillie, Scottish Labour's spokesperson for health, said: "When you're worried about your health, the first number you call is your local GP and we know that NHS staff are working flat out to try to get patients in the door. But this crippling rent hike means GP practices are crumbling from the inside out while the government fails to act.
“At the same time, SNP funding cuts are leaving GPs high and dry. These rent hikes and funding cuts are pulling the rug under our vital GP surgeries in the midst of a cost-of-living crisis. The fact Lothian's GPs are now issuing a distress call asking patients to contact their MSPs should be an alarm bell for everyone who cares about our NHS.
"John Swinney's Government should stop treating GPs with contempt and instead work with them to create the health safety net we all need."
A spokesperson for the Scottish Government said it “greatly values” general practice and “wants to ensure GP practices have the support they need”.
“Scotland has a higher number of GPs per head than the rest of the UK, and a record 1,200 trainee GPs coming through the training system in Scotland,” the spokesperson said.
“We are fully committed to increasing the number of GPs in Scotland and have invested over £1.2 billion in General Medical Services in 2023/24 to ensure more people get the right care in the right place at the right time.”
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