Ministers lack clear vision on future of primary care, MSPs claim

MSPs on the Scottish Parliament's Health Committee suggested a number of steps could be taken to increase the number of family doctors
MSPs on the Scottish Parliament's Health Committee suggested a number of steps could be taken to increase the number of family doctors

The Scottish Government has no clear vision for the future of primary care, a Holyrood committee said, as it urged ministers to tackle the perception GPs are “second-class medics”.

MSPs on the Scottish Parliament’s Health Committee suggested a number of steps could be taken to increase the number of family doctors, including changing the “largely academic-based approach” medical schools have when selecting students.

The committee also called for efforts to be made to attract doctors who have left back into general practice and said it would welcome “golden handcuffs” deals to help keep medical students in Scotland after they graduate.

The MSPs said: “Overall, we consider there is an absence of a clear vision setting out what primary care should look like in the future.”

The committee has just completed a short inquiry into GP and primary care services, with MSPs raising their concerns in a letter to Health Secretary Shona Robison.

Committee convener Neil Findlay said: ” Concerns around GP recruitment, vacancy rates and the profession have been well rehearsed.

“This is why we wanted to take specific evidence on this issue to determine what else the Scottish Government needs to do to tackle this problem.

“What was clear was that within the medical profession general practitioners were viewed as second-class medics.

“This committee considers this issue so fundamental that unless it is addressed we don’t see how any attempts to boost recruitment can work.

“We also heard of real issues around retaining medical students who train in Scotland. More needs to be done to come up with ways to encourage students who study here to stay here and practice.”

During their inquiry, the committee heard that 25% to 30% of the work done by GPs could be dealt with by other professionals such as nurses and pharmacists, with MPs urging the Government to set out in detail how “they will ensure full co-operation and participation from GPs in the development and delivery of a true multi-disciplinary team partnership”.

Their letter also highlighted concerns about vacancy rates and the number and age of the current GP workforce.

” GP representatives spoke about perception and expectation of medical students having changed, suggesting general practice was now considered an unattractive option due to its negative portrayal,” the MSPs said.

“This is further co mpounded by the ‘badmouthing’ that goes on in medical schools which leads to GPs being viewed as second-class medics.”

While they said “s ome work was being undertaken to address this”, the MSPs stated: “Any attempts to boost recruitment are unlikely to be successful without first addressing the negative perception of general practice within medicine.”

The committee questioned if medical schools are “automatically reducing the potential pool of those desiring a career in general practice” by targeting academic high flyers.

To address this, the MSPs suggested ministers ” consider whether changes to the current largely academic-based approach might be beneficial in increasing numbers seeking to enter general practice”

They also suggested “efforts should be directed into attracting people to return to the profession and would welcome details of work being undertaken in Scotland”.

Dr Alan McDevitt, chair of the BMA’s Scottish GP committee, said: “The British Medical Association is currently negotiating a new contract for GPs in Scotland.

“This contract forms part of a wider vision of primary care that is based on an expanded multi-disciplinary team.

“That means more nurses, pharmacists, physios and other health professionals working in communities and able to treat the patients who could choose to see them but who currently go to their GPs in the first instance.

“Patients will continue to be able to access their GP but will have greater choice about who is most appropriate for their needs.

“This will help to alleviate the severe workload pressures that GPs are currently facing and which is one of the major reasons why practices across Scotland are facing severe difficulties in recruiting and retaining GPs.”

Ms Robison said: ” We’re working with doctors to transform primary care, backed by our commitment to increase the amount invested in primary care and GP services by £500 million by the end of this parliament.

“We have a clear shared vision on the future direction of GP services with the BMA, including the enhanced role GPs can play, which forms the bedrock of our negotiations towards a new GP contract.”

The Health Secretary added: ” NHS staffing is at a record high level and we’ve already increased GP numbers under this Government.

“But we are committed to going further as we transform our local health services to better-meet the needs of communities across Scotland.

“We’ve increased the number of GP training posts this year, leading to an increase of the numbers entering training by almost 20%.

“This is one of a number of initiatives we have introduced to grow our GP workforce, including making a career in general practice a more attractive option and funding initiatives to encourage established GPs to return to practice.

“We continue to work closely with NHS boards and are developing a national healthcare workforce Plan that will take full account of the future demand for safe and high-quality services for people across Scotland.”