By Bill Heaney
Everyone seems to think GP surgeries are closed and that face-to-face appointments with their doctor are no longer possible, Dumbarton MSP Jackie Baillie told the Scottish Parliament this week.
Labour’s health spokesperson said that while the extent of the crisis that is being experienced by the NHS, with services struggling to meet demand and waiting lists at a record high, the GP service was the poor relation in all this.
She added: “Much of the attention so far has focused on acute care in our hospitals and with emergency services, but the truth is that, if we are to resolve some of those problems, we need to mobilise and resource primary care.
“We all value our GPs. In fact, we value the entire primary care team—practice nurses, health visitors, dentists, pharmacists, and optometrists. They all do an important job in preventing and dealing with ill health, but they are often the first and most enduring contact in a patient’s journey.
“It is unfortunate that the messaging from the Government has so far been confused, suggesting that somehow GP surgeries have been closed.
Alexandria Health Centre in grounds of Vale of Leven Hospital.
“In fact, GPs and their teams have been working really hard. They are the ones at the vaccination centres, helping colleagues in hospitals with Covid patients, all while dealing with their own patients.
“Primary care has adapted and evolved, and yes, there might be more telephone or virtual consultations, but if someone needs to be seen, they should be given a face-to-face consultation.
“I recognise that parents want the reassurance of a face-to-face consultation with their GP. Clinically, it is important, as some conditions need to be seen to be diagnosed, so virtual consultations should not be the default.
“However, GPs are operating to Scottish Government guidance, which wants a model of telephone consultations first. That has not changed, so it is ultimately up to the Government, and transferring blame to GPs is neither right nor appropriate.”
Ms Bailie, pictured right, added: “Although I recognise the frustration that is felt by people over their access to a range of services, that is never a reason to be abusive to staff, who are doing their very best to help us to keep safe.
“We all need to acknowledge the failure of the [SNP] Government to support staff in primary care.
“That is not just a pandemic problem; it has been building for the past 14 years of the SNP’s mismanagement of the health service.
“The NHS recovery plan fails to address the pressure on staff, and the lack of a coherent workforce plan to build capacity to match demand is more than disappointing; it is a dereliction of duty.
Nurses are under real pressure, exhausted and working all hours.
“During the previous parliamentary session, a promise was made to recruit an additional 800 GPs, but there is an urgent need for them now, not in 2027.
“Many are retiring early because they feel burnt out. What progress has been made on that? Multidisciplinary teams in GP practices were also promised, but progress on that has been, at best, extremely patchy.
“There are simply not enough physiotherapists or pharmacists in general practice. That is another pre-pandemic promise that has not been fulfilled. Mental health workers are also unlikely to be in place until 2026, which is five years from now.
“Pharmacists have a contribution to make to NHS recovery, but the Government appears to be resistant to the opportunity, and I hope that that is not the case.
“If the Government extended the pharmacy first service, pharmacists could be the first port of call for many people.
“They could help with diagnostic testing to reduce antibiotic use, and deal with blood pressure, type 2 diabetes, and cholesterol testing.
“That would help to alleviate some of the load on GPs. Equally they could play a key part in helping with the management of those who have long-term conditions.
“Pharmacists could provide pharmaceutical care and create the capacity for GPs to focus on acute presentation and reduce hospital admissions. More of that needs to be happening, so that we use appropriately the entire primary care team.”
Ms Baillie then turned to the situation with dentists.
Dental appointments – there is mixed messaging from the Government.
She said: “Patients are told that dentists are open for business, but Government guidance means that they are able to offer appointments to only a small number of patients.
“More and more people are going private. In effect, the Government is privatising the dental service by the back door.
“We all value the primary care team, which has GPs at its heart. I think that primary care is key to the recovery of the NHS, but it needs to be resourced.
“So far, the SNP has failed to do so adequately.
“It is true that we need to remobilise and that patients want more face-to-face consultations, but the Government needs to be honest and manage expectation.
“Above all, it needs to resource GPs and primary care so that they can play their full part in the recovery of the NHS. As the BMA said, ‘we are open for business, but it’s not business as usual’.”
She asked parliament to recognise the important contribution that GPs have made throughout the COVID-19 pandemic, including stepping up to support colleagues in acute care and administering vaccinations across the country.
And to express regret for the Scottish Government’s failure to remedy the alarming shortage of GPs and staff in the wider primary care team, with the current workforce feeling overworked and undervalued, all of which will severely undermine a sustainable future for primary care in Scotland.
People waiting hours on end for an ambulance. The British Red Cross providing humanitarian aid to ambulances at Scotland’s biggest hospital. The worst A&E wait times. A Health Secretary whose advice is for people to “think twice” about getting the help they need.