Scotland’s GPs threaten to strike in dispute with Government

Dumbarton Health Centre in Artizan and Vale of Leven Health centre (above).

By Bill Heaney

West Dunbartonshire and Argyll and Bute GPs are threatening to strike in a dispute with the Scottish Government that could cause chaos in local surgeries.

The British Medical Association, which represents doctors, says its members are at the end of their tether, with rising workloads and the inability to employ more staff to help.

They have seen their share of the NHS budget fall from 11 per cent to 6.2 per cent since 2008 and claim in real terms, because of inflation, this amounts to a 22.8 per cent cut.

Now they have decided enough is enough and are demanding movement on funding by the summer or they will enter into a formal dispute which could lead to strikes.

Dr Iain Morrison, chair of BMA Scotland’s GP Committee, said: “I have written to the Scottish Government and the Cabinet Secretary to put them on formal notice that we are heading towards formal dispute if we don’t see urgent action to address the funding imbalance we have at present.

Dr Iain Morrison, chair of the BMA

Scotland’s GP committee.

“We need to see definitive action by this summer. To address the historical inflation we are looking at a £290 million gap in our funding. That is just shy of approximately one per cent of the Scottish NHS budget so it is not huge money in the scheme of healthcare although it does sound quite a lot.

“Since 2008 our share of the NHS budget has fallen from 11 per cent down to 6.2 per cent and it’s looking like it’s going to fall further in this financial year.

“What that means is we are working harder than ever with less proportionate resources than ever before. The workload in general practice is growing year on year with increasing medical complexity with more patients, with more disease, with more treatment options – putting huge pressure on the system.

“We know general practice can operate much better than it is if we had adequate resourcing from government so we share the frustration many patients are currently feeling. We want to move away from a service that we are constantly apologising for to one we are privileged to deliver.”

Morrison said putting the government on notice gives “a time frame by which it can act to avoid that escalation”.

He added: “If we don’t see the urgent action required to move significant resources into general practice then we will declare a formal dispute and that will lead to a ballot of the profession for what kind of collective or industrial action we would consider.”

Morrison admitted: “It would have a major impact but to make it absolutely clear this is a last resort to protect general practice in its entirety and fundamentally people’s access to free universal healthcare.”

Asked if there could be an escalation to GPs going on strike, he responded: “Nothing would be off the table.”

Morrison said the drop in the share of the NHS purse has meant practices no longer have the resources to employ all the staff they need to run a GP service “as well as it can be”.

He added: “For many practices this means delays in phone calls being answered, difficulty accessing appointments in a timely fashion, failing to see the GP of their choice and as soon as they need to be seen.”

The Scottish Government pledged to provide an extra 800 GPs but in whole time equivalent terms there are fewer GPs now than when the promise was made.

Morrison said: “We have seen a growth in the number of patients every GP has on list size. There is one GP in Scotland for every 1725 people and that used to be 1500 people so that is over an extra 200 people to look after. That number is rising.

“As a profession we would like to see a commitment towards list sizes of 1000 and with that we would be able to deliver a huge amount – preventative agenda, bespoke healthcare plans, localised screening plans – huge potential for revolutionising how we approach healthcare in Scotland and get everyone living the most healthy they can be.”

He claimed a return to historic funding levels would see more people employed to provide care in a timely fashion and give doctors more time to handle more complex cases.

But he said: “Currently we are in this terrible situation where we are just fighting to function. We need to see resource transfer to firstly stablise the profession and then look towards a future where we reach our potential and deliver so much more within the community setting to give patients the best healthcare and outcomes they could experience.

“There is a huge amount of potential in terms of preventative medicine to get people as healthy as they can be before they’re unwell. That is a really difficult task to deliver with every GP firefighting day in, day out with the acutely unwell.

“A move towards more proactive care to prevent disease in the first place has been shown to offer a serious amount of economic benefit to the country.

“It has been shown £1 of investment in general practice returns £14 to the general economy. These are numbers the government should be paying very close attention to and making the right choice about delivering healthcare and preventative healthcare at a much earlier stage.”

Scottish Lib Dem leader Alex Cole-Hamilton, right, said: “GPs are on their knees and that is leading to conditions becoming more acute and people needing more costly interventions because they have had to wait longer.

“The possibility of strike action would be disastrous for the health of our community and Scottish ministers need to urgently come to the table.”

The Scottish Government said it was in dialogue with the BMA and “giving careful consideration” to the letter and welcomed “BMA’s collaborative approach”.

It said: “We have increased investment in general practice by £73.2million in the last financial year and are determined to increase the number of GPs in Scotland by 800, by 2027, with an additional 307 GPs added since 2017.

“Our renewed plan will ensure a greater proportion of new funding goes to primary and community care which will assist in supporting GPs.”

Commenting on the BMA Scotland’s new campaign to save primary care, Jackie Baillie, left, Scottish Labour’s Health spokesperson, said: “After 18 years, the SNP has run primary care into the ground.

“GPs are expected to deal with hundreds more patients than they were ten years ago — this is creating a doom loop of burnout and stress while patients wait on the end of the line.

“Yet rather than recruiting more GPs as promised, the SNP has delivered less.

“And even as patients join the 8am appointment queue, there are qualified GPs sitting on their hands because they can’t find work.

“Scottish Labour will restore the family doctor, invest in primary care and ensure patients can be seen in 48 hours so they get the care they need.

“The SNP government can’t even manage to deliver on its promise to hire 800 more GPs. In fact, there are less whole time equivalent GPs since that pledge was made according to Audit Scotland.

“Each full-time equivalent GP has on average 227 more patients than they did a decade ago.”