The Scotsman caught up with The Democrat story today ((Saturday).
By Bill Heaney
Patients from Dalreoch to Dalmonach and across West Dunbartonshire are sick to death of telephones ringing out when they call their GP’s surgery for an appointment on a Monday morning.
On any day of the week in fact and being told by an under-paid, over-worked receptionist that they can’t get an appointment for days or maybe even weeks on end.
Labour leader Anas Sarwar told First Minister Nicola Sturgeon on Thursday that it was not so much the patients but the doctors who were feeling the pressure of all this.
He told the Scottish Parliament: “This week, the British Medical Association in Scotland sounded an alarm about the state of GP practices across the country. The BMA says that practices are struggling with vacancies and that GPs are ‘exhausted, burnt out and cannot see the light at the end of the tunnel’.
“People across the country are sick of phone lines ringing out when they call their GP first thing in the morning. Does the First Minister agree with BMA Scotland and accept its criticism that this Government is not doing enough to tackle the GP crisis?”
First Minister Nicola Sturgeon told him: “I accept what the BMA says about the pressure on our GPs. The national health service as a whole is under very significant pressure—greater pressure, perhaps, than at any time in the history of the NHS.
Anas Sarwar and Nicola Sturgeon who clashed over GP services.
“That is true for those who work in our acute sector and it is also true for those who work in primary care, including GPs, so I absolutely accept those comments from the BMA.
“That, of course, is exactly why—starting from a base where we already have proportionately higher staffing in the NHS in Scotland than in other parts of the United Kingdom, and proportionately higher funding for our NHS—we have a target of recruiting 800 additional GPs in headcount terms over the next few years. So far, since 2017, we have recruited 277 of them.
“In addition, we are supporting the wider primary care team. In recent times, we have recruited over 3,000 primary care multidisciplinary team members to help with the pressure on GPs, and NHS Pharmacy First Scotland has provided almost three million consultations across its network.
“We continue to take action to support not only GPs but the wider teams in which GPs operate, and it is right and proper that we do so.”
Anas Sarwar refused to accept this. He told MSPs: “The First Minister says that more GPs are being recruited and that she is listening to what the BMA has to say about the pressures that GPs face, but she is clearly not listening to what the BMA has to say about the recruitment crisis that we have in the national health service, which predates the pandemic.
“She talks about the 277 new GPs who have been recruited; the BMA is saying that we are 1,000 GPs short right now. That means unbearable pressure on existing GPs, and it means that many patients are unable to access a GP. On the First Minister’s target of 800 additional GPs, we are well short. The BMA has made it clear that missing the target would be’disastrous for Scotland and our patients’.
“At the same time, the First Minister has decided to cut the budget for primary care by £65 million. That cut means taking away the ability to recruit the health professionals that GP practices need to support their patients. Dr Buist says that the cut: ‘threatens to undermine practices, at the exact moment when we should be doing the opposite’.
“Will the First Minister reverse the cut, truly listen to the BMA and support Scotland’s NHS staff?”
Ms Sturgeon admitted these were important issues. She said: “I will address the budgetary issue first. I do not like the budget situation that the Scottish Government faces, but the hard reality is that, this year, our budget has been eroded to the tune of £1.7 billion because of inflation.
“Our budget is effectively fixed: we have no levers to increase the revenue that is available to us within this financial year, so we have to make very difficult decisions. We have been open about those decisions and, if any member thinks that we should make different ones, they can put the case to us. What they cannot do is magic up more money for this financial year.”
She added: “We have more GPs per head of population than other parts of the UK do, but we want to grow our GP workforce, which is why the target that I have spoken about and the progress that has been made against it is so important—as is the redesign and reform work that we are doing that relates to wider primary care teams. None of those things is easy. All of us acutely understand their impact on patients and the pressure on our NHS.
“We will continue to support people who work in our national health service, and we will try to recruit from overseas as much as we can, which is something that Labour, inexplicably, seems to have set its face against. We will continue to take steps to support our NHS during these tough times, because that is what it deserves and what the people of Scotland expect from us.”
However, Anas Sarwar refused to be fobbed off with arguments about what was happening elsewhere.
He said: “The First Minister wants to pretend that she has not been in government for 15 years and that she has not been in charge of setting the NHS’s budget for 15 years. Those problems predate the challenges with the budget and the inflation crisis. I recognise that there is an inflation crisis, which is why, when the Deputy First Minister [John Swinney] set out the emergency budget review two months ago, we said that we would work constructively with the Government if it opened the books. It has failed to do so; it would rather hide and play politics than do right by the people of Scotland.
“Those decisions have consequences. The Deputy First Minister called the £65 million cut for GP practices, which are already short staffed and under pressure, a ‘reprioritisation’.
“Let us call it what it is: a cut that is having devastating consequences for staff and patients. At the same time that he is cutting funds for GP practices, the health secretary is telling people to go to their GP instead of going to accident and emergency.
“That is another case of the SNP telling NHS staff to do more with less, leaving patients waiting longer to be seen, diagnosed and treated.
“The SNP has been in charge of our NHS for 15 years and there is a crisis in every part of it: our GP practices, our accident and emergency departments and our hospitals.
“Staff are crying out for help and patients are dying. Does the First Minister accept that it is the worst it has ever been, all happening on her and Humza Yousaf’s watch?”
The First Minister’s face drained and she looked like it was her who would need to call a doctor.
She said: “Nothing that I have said today, or at any time, takes away from the fact that the management of the NHS is a responsibility of mine and of my Government. I accept that absolutely and I take that responsibility seriously. Is the pressure on the NHS greater than it has been at any time in its history? Yes, it is—and I think that I said that myself earlier.
“The pressure that the NHS faces has been significantly exacerbated by the pandemic, but there are other factors at play, such as the changing demographic of our population. Governments have to work through those significant challenges.
“The fact of the matter is that, although management of the NHS is our responsibility, the amount that we are able to invest in the national health service is determined by funding decisions that are taken at Westminster—funding decisions of the kind that are being set out in the House of Commons as we speak.
The First Minister told him: “Anybody can say that we should do things differently, but they cannot deny the reality. Even within that reality, Scotland has proportionately higher funding for our national health service than have other parts of the UK and Scotland has higher staffing levels. That is the measure of the priority that this Government gives, and always will give, to the national health service.”
Vale of Leven and Clydebank health centres in West Dunbartonshire.