Family doctors squeezed out by SNP budget, warns top GP

Scottish Government plans to reshape primary care will leave many members of the public without access to a GP, the Royal College of General Practitioners (RCGP) in Scotland has warned.

After scrutinising details of the provision for general practice in the latest draft budget, RCGP Scotland chair Dr Miles Mack said it was clear the Government deems general practice to be ‘dispensable’ in the new model of care.

A Primary Care Fund introduced last year – £45m of which is to be allocated this year – was designed to address immediate workload and recruitment issues and to pilot new models of primary care.

However in its response to RCGP Scotland, the Scottish Government admitted “the majority of this funding would not become part of a direct allocation to practices.”

Dr Mack said it confirmed his view that there was a deliberate policy of reducing the role of general practice.

“It is now clear that the Scottish Government’s true vision is one in which the public should expect to get by without GPs as their prime provider of care,” he said.

General practice is due to receive £13m extra in real terms in John Swinney’s budget but RCGP Scotland argues this is insufficient given the number of consultations has increased by 11 per cent in the last decade as the population ages.

The pilots of new models of care are to examine ways to deal with an increased demand by expanding the roles of other members of the primary team such as pharmacists or physios.

Mack says despite GPs attempting to be “constructive and optimistic” money is still being diverted into hospitals.

“When we have offered solutions and Scottish Government have responded positively we have been first to applaud them. However, when we see comparatively huge additional funding to secondary care, that again speaks to a strategy of service reduction,” he said.

Health secretary Shona Robison said the idea the role of the GP is being eroded is “wrong”.

“We are transforming primary care, including developing new ways of working with multi-disciplinary teams that elevate the role of GPs as medical experts in the community.

“Last week we announced a major project to test new ways of structuring primary care services in Inverclyde, which will be led by GPs,” she said.

The Scottish Government had agreed to abolish the bureaucratic QOF funding system and work continued towards a new GP contract in 2017, Robison added.

Labour public services spokesperson Dr Richard Simpson said contract negotiations without being clear about what general practice would look like was “a recipe for disaster”.

"This SNP government has no clear vision of primary care or the role of GPs for the medium to long term. Without such a vision backed by better funding general practice is condemned to continue the long slow decline it has experienced since the SNP took power,” he said.