GP surgeries in Dumbarton, Helensburgh, Clydebank and Alexandria.
By Bill Heaney
Scottish Labour will end the early morning rush for on-the-day GP appointments and bring back the family doctor by renegotiating the GP contract, the party has announced.
Set in a wider package of reform in primary care, with GPs at the heart of the service, patients will be able to book advance appointments and be seen within 48 hours under the renegotiated terms.
Announcing the measures before conference, the party pledged to open negotiations on a revised GP contract within the first hundred days of a Scottish Labour government at Holyrood.
The measures will improve triaging so patients can be treated quicker and more efficiently, and offer greater continuity of care for patients with frailty or chronic conditions.
While the 2018 GP contract was well intentioned with the aim being to modernise primary care services, it has simply failed to deliver.
For example, the SNP Government promised to train and recruit 800 more GPs by 2027, but it failed to deliver on this commitment – instead, there are 222 fewer whole-time equivalent GPs in Scotland compared to a decade ago.
And while the contract introduced multi-disciplinary support staff to take the burden off GPs, it failed to create the appropriate management structures to deploy them efficiently.
The SNP has also paused its GP Sustainability Loan Scheme and cut the Primary Care Improvement Fund.
In contrast, Scottish Labour has a long term commitment to raise the proportion of the health budget spent in primary care, so it is fit for the future.
“The result is that too often patients who need help from their GP surgery are left on hold only to be told there are no appointments left.
“Scottish Labour will renegotiate the GP contract so it delivers for patients and GPs and ensures that anyone who needs to can be seen within 48 hours.
“Our NHS needs a new direction and Scottish Labour is ready to deliver it.”
In summary, the 2018 GP Contract was supposed to modernise primary care services and help GPs to support patients with increasingly complex needs. However, it has failed to live up to this ambitious billing due to a failure of delivery by the SNP government.
Scottish Labour is determined to address these issues as a matter of priority. That is why within the first 100 days of a Scottish Labour government we will open negotiations on a new GP contract, moving towards a new future for GP services in Scotland, fit for the 21st century.
This will be a negotiation with GPs, but Scottish Labour has clear objectives for any future contract. As well as ensuring GPs are equipped to meet current and future need we will improve access for patients. That is why as part of the negotiation Scottish Labour will be clear that there has to be:
- A reinstatement of advance booking and an end to the system that in many places sees an 8am rush for on-the-day appointments and patients stuck in a hold call cycle, just to get the care they need.
- The guarantee that patients can be seen by GPs and Primary Care within 48 hours. This will require improved triage of patients and scheduling of appointments so that patients are not left with the only option being phone tomorrow or attend A&E.
- A plan to improve continuity of care. We know how valuable consistency and continuity is for patients and so we will have the overall aim of returning to the model of the family doctor.
- Measures to empower and incentivise GPs to help Scots to live healthier lives and support the prevention agenda, which we know GPs want to deliver.
The 2018 Contract
There a number of changes within the 2018 Contract that have had unintended consequences and will need to be addressed in renegotiation, including:
- Changes to the management of staff within the wider MDT
- The organisation and delivery of vaccination programmes, particularly in rural areas
- The future of the primary care and GP estate.
All of these issues, and the support required from government to deliver our objectives, will be included within the wider renegotiation.
GMS Contract: 2018
The current GP contract has failed to deliver fully on properly funding general practice and the future sustainability of GP premises, as well as reducing workforce burnout and redesigning services to take the pressure off GP practices.
In December 2017, then-Health Secretary Shona Robison announced that the Scottish Government would increase the number of GPs in Scotland by at least 800 over the next ten years.
BMA Scotland has captured the scale of the sustainability crisis in GP practice in Scotland.
|
Year |
Total patient list |
WTE GPs |
Patients per WTE GP |
|
2024 |
6,017,284 |
3,453 |
1,743 |
|
2013 |
5,568,304 |
3,675 |
1,515 |
|
change |
448,980 |
-222 |
227 |
Source: General Practice Workforce Survey 2024; General practice demographics (Sept 2024); General Practice – GP practice list sizes 2013 to 2023