BMA Audit Scotland report
Below is a direct excerpt from BMA Scotland’s own blog. You can view the article directly here.
General Practice is currently operating in the most challenging circumstances of a generation. Last week’s Audit Scotland report set out exactly why, in bleak detail.
But, at the BMA’s SGPC committee we continue to fight not just to guarantee the survival of our profession, but in the belief that something far better lies in the future.
We are making progress in persuading politicians of all parties, that if we are properly invested in and resourced, GPs can both stabilise the current position, and more than that, lead the recovery of our NHS from its current dire position.
To get to that point, it’s going to be a long road, and we’ll need your support, every step of the way. On that basis – we’ll keep you up to date with developments as much as we can. Keep reading for three key things from recent developments below.
Audit Scotland report
As already mentioned, this really was tough reading. In a forensic dismantling of failures to support GPs, it set out exactly why so many of our practices are desperately struggling to keep up with demand. It is absolutely in line with our message to the Scottish Government.
If you have time, please do read the full report. To summarise, it is clear beyond any doubt that the failure to invest directly into General Practice and fund the recruitment of GPs is taking its inevitable toll. After seven years, the 2018 GP contract has failed to create anywhere near the services and capacity promised to the profession by the Scottish Government. Given the rising demand from a growing and ageing population, with more complex health conditions, it means GPs are simply unable to provide the best possible service to their patients and the community.
Our full response is here and you may have seen the story on the front page of the Herald, or heard Dr Morrison on the BBC’s Good Morning Scotland programme on the morning the report was published.
The awful paradox, as we are consistently pointing out, is that we don’t have enough GPs in our practices, yet at the same time we face a GP unemployment crisis in many parts of Scotland.
Overall, this strengthens the argument we are making that GPs urgently need greater direct funding. That’s the only way we’ll actually get the number of GPs our local communities need.
National Insurance Increases
We have blogged before about National Insurance increases. Despite our warnings that these increases will mean cuts to services as practices desperately try to balance their books and remain sustainable, no funding to cover this rise has been forthcoming. And they officially come into force as of today (April 1) with bills on the way in due course.
We are definitive: any previous funding, including the £13.6 million announced by the Scottish Government at the SLMC conference has been to maintain GP services in their current state or make up for previous cuts. NO funding has been provided to cover this rise, which GPs are being asked to make up entirely from their practice’s income. Hence why it is so important that you look carefully at the BMA Business Guidance so you can assess what steps you need to take. Please consider that simultaneous implementation of the BMA Safe Workload Guidance as it would be wrong if any staff group were forced to work even harder to make up the shortfall.
Continuing to cut GP funding like this makes no sense for Government. Ultimately it will be patients who suffer when practices are forced to cut services. It will also inevitably cost money in the long run, as GPs are prevented from providing the level of service that is vital to keeping people out of the secondary care system.
None of this is GPs’ fault – so please don’t hesitate to explain the position to patients and the wider problems caused by the lack of resource to meet demand. Our materials to help support this will be out very shortly.
Cabinet Secretary meeting
Dr Morrison’s recent podcast, Talking General Practice with GP Online Magazine explained that the BMA’s Scottish GP Committee view is that the current direction of travel is leading us towards inevitable formal dispute with the Scottish Government and if there is no resolution, industrial action as a last resort. As difficult as this is to contemplate, the issues described above signal exactly why we are where we are. And this isn’t something that has happened overnight. The systematic deprioritisation of GP funding dates back at least a decade. Even the Scottish Government’s Operational Improvement Plan, published yesterday, after all the positive rhetoric did nothing to provide any more new support to GPs. The plan merely highlighted previously announced funding that will do nothing more than help us stand still. The lip service paid to shifting the balance of care is still not translating to action and it still seems to escape the Government that the ONLY way that will happen effectively will be through greater direct investment in GPs.
This approach simply can’t go on. Something must change, otherwise all the optimism we have for the future and potential of the profession will be thwarted. If general practice as the bedrock of the NHS crumbles under excessive demand, the consequences for the people we care for will be incredibly serious. We have already seen warnings that the NHS as we know it will struggle to see out another year. If GPs continue to be undermined, those predictions will come true even faster.
It was in this context that Dr Morrison met the Cabinet Secretary for Health, Neil Gray last week. It was a positive meeting, and the Scottish Government continues to make the right noises. On that basis we still hope dispute can be avoided. But time is running out, and that point was emphatically made in the meeting. Action must follow words. Direct investment in general practice to right the wrong of years of underfunding must be made urgently. We will continue to press Scottish Government for resolution as soon as possible, but meanwhile we are continuing to intensify our preparations for this difficult path. You can help in that by getting involved. If you are not a BMA member, join today. If you are a member, share this blog, highlight the Audit Scotland report, listen to the podcast and let people know why we have reached this point. The time to fight for the future of our profession and for the patients and communities we care for is upon us, and we need your support now more than ever. Together we can shape a better future for our patients and profession.
Dr Iain Morrison, Chair BMA SGPC, Dr Chris Black, Deputy Chair BMA SGPC and Dr Al Miles, Deputy Chair BMA SGPC
