GP plan failing to deliver for patients and people report finding it more difficult to access care

Health centres in Dumbarton, Alexandria, Helensburgh and Clydebank failing to deliver for patients.

By Bill Heaney

A Scottish Government agreement with GPs to improve general practice has failed to deliver on several of its commitments.

The 2018 General Medical Service (GMS) contract aimed to address the financial pressures and growing workloads facing GPs, and to improve patients’ access to care. However, seven years on:

the estimated number of whole-time equivalent GPs has fallen

pressure on general practice has increased

proposals to support GP teams with more nurses, physiotherapists and other specialists have moved more slowly than planned

and people report finding it more difficult to access care.

The Scottish Government has not set out how it intends to invest in general practice over the medium-term. And it is unlikely to hit its target of 800 more GPs by 2027. Spending on general practice as a proportion of overall NHS spending has fallen slightly in recent years. And between 2021/22 and 2023/24 spending decreased by 6 per cent in real terms, putting more pressure on GP practices.

National data for primary care remains inadequate. There is a lack of robust information about general practice demand, workload, workforce, and quality of care. This limits the Scottish Government’s ability to say whether the GMS contract changes represent value for money or have improved patient care.

Stephen Boyle, left, Auditor General for Scotland, said: “The pandemic pushed back plans for general practice. But the new delivery deadlines that were put in place were missed, and there’s not been enough transparency about progress since then.

“The Scottish Government needs to clarify its plan for general practice and set out the actions, timescales and costs to deliver it.”

Commenting on the Audit Scotland report on GPs, Jackie Baillie, Scottish Labour’s Health spokesperson, said: “This damning report shows that the SNP Government is floundering when it comes to GPs.

“The SNP was supposed to increase the headcount number of GPs by at least 800 by 2027 — this report confirms the commitment will not be met. In fact there are 200 fewer full-time equivalent GPs today, having to deal with more patients and they are exhausted.

“Rather than providing a clear direction, the 2018 contract has disempowered GPs and betrayed the patients it was supposed to serve.

“Scottish Labour will renegotiate the GP contract and restore the family doctor so that patients get the primary care treatment they need.”

The report from the Auditor General for Scotland warns that the Scottish Government’s GP plan is failing to deliver, the estimated number of whole-time equivalent GPs has fallen, spending on general practice as a proportion of overall NHS spending has fallen in recent years.

Dumbarton MSP Jackie Baillie and LibDem leader Alex Cole Hamilton.

And that it is unlikely to hit its target of 800 more GPs by 2027 and proposals to support GP teams with more nurses, physiotherapists and other specialists have moved more slowly than planned.

Scottish Liberal democrat leader Alex Cole-Hamilton MSP said: “Right now, GPs feel burnt out, overwhelmed and under immense pressure. There’s no real incentive for them to stay and if the chance comes to leave, they’re keen to take it.

“Scottish Liberal Democrats have repeatedly urged SNP ministers to address the crisis in primary care. Our efforts have secured £14 million more for general practice but as this report makes clear there is a lot more that needs to be done.

“Now, the Scottish Government must ensure this money is spent on measures that will help, such as recruiting specialists in pharmacy, physiotherapy and mental health to work alongside GPs. That’s how we can ease their workloads, make it easier for them to see patients and get more people swift access to the local health care they need.”

While politicians and accountants are commenting on the situation, public opinion in Dumbarton is not letting the GPs themselves off lightly when it comes to the state we are in.

Complaints are commonplace at the Health Centre about having to telephone doctors’ surgeries atound 8am to make an appointment only to be told there are no doctors available at the times being sought by patients.

This is despite the fact that in recent history the Health and Social Care Practice, which is now chaired by a GP, sacked a doctor illegally – an employment appeals tribunal overturned their decision.

The HSCP refused even to look at a petition to reinstate the GP which was signed signed by more than 1,000 people. They didn’t even put it before their committee.

Then they re-allocated the sacked doctor’s patients to another practise – now headed up by a senior GP who doubles as chairman of the HCSP.

This practise frequently tells people that it can’t cope with the number of patient requests for appointments at a time convenient to them.

It has been known to have refused to make house calls to patients in emergency situations because they were “too busy” with their list of non emergency patients and and didn’t know the geography of the town.

Some patients are particularly dismayed at the fact that some doctors close their surgeries for lunch between 1 and 2pm because that is a time when most people manage to get away from work to see a doctor.