The cost-of-living crisis is hitting rural Scotland’s health care services harder and making it tougher to recruit doctors, a leading Highland GP warns.
Dingwall doctor Miles Mack said the north of Scotland has been the “canary in the mine” over the past decade for an NHS crisis which has still gone on to grip the entire country.
Dr Mack, a former chair of the Royal College of General Practitioners in Scotland, said there are no easy solutions to the “mess”.
He told the Press and Journal: “It’s going to be expensive to fix it. Any solutions which are put out there as being cost-free I think are unrealistic.”
A&E waiting times have worsened, many patients face a struggle to see their GP and nurses threatened to strike.
There have even been demands to draft in the Army to improve capacity and ensure services can continue to run.
SNP health chief Humza Yousaf has faced repeated calls to quit, including calls to explain himself over failures in north-east community care provision.
Mr Yousaf is expected to give a statement to the Scottish Parliament on January 10 to address the mounting challenges facing the NHS.
But Dr Mack said many of the problems gripping the country are nothing new.
He said: “Rural areas are the canary in the mine. We’ve had practices being taken over by health boards for many years.”
Recruitment problems
In November 2021, NHS Highland confirmed plans to take over Alness and Invergordon Medical Practice due to staffing shortages.
In August this year, an independent Western Isles GP practice was taken over by the NHS after their doctor announced his departure.
Dr Mack added: “It’s always been difficult to recruit doctors to work in rural areas.
“It only makes it more so as the cost of travel and cost of heating disproportionately hits rural areas.”
In November, top Inverness doctor Iain Kennedy, who chairs the BMA doctors’ union in Scotland, warned the NHS risks “sleepwalking” into a two-tier system where free healthcare is not available for all.
Dr Mack said that would be a “disaster” for the country, and admitted he is “pessimistic” about the future of the health service.
He said: “In the long-term, I can’t see that would be of any benefit. It would all cost every one of us a great deal more to use a private system.
‘Terrible situation’
“We’re in a terrible situation. I’m pessimistic that we’ll fix it unless we get a clear understanding that it needs to be funded in an adequate way.”
As a GP, Dr Mack believes solutions to the current crisis must go beyond simply chasing targets.
He said: “Concentrating on front door services is not going to be sufficient.
“It’s problems downstream which are just as important. Social care comes into this. It’s imperative to fix the lack of social care provision in the community.”
Is National Care Service value for money?
However, the veteran Highland GP doubts whether the SNP’s proposed National Care Service is the best way to do this.
He told us: “I’m pretty anxious about the proposals. Our experience from setting out new organisations is that it’s expensive and often has marginal benefits over improving existing systems.
“I think that’d be very sad if that was the only way we could perceive it as acceptable to increase resources put into social care.”
Conversation