Family doctors are seen as “dispensable” by a Scottish Government which is risking patient safety by failing to fund them properly, the Royal College of General Practitioners (Scotland) has warned.
The most recent cut in the proportion of NHS Scotland funding allocated to GPs outlined in John Swinney’s Budget has led to the RCGP Scotland claiming ministers are attempting to “erode” the role of GPs in family life.
Dr Miles Mack, chairman of the RCGP Scotland, said “patients have every right to worry” and added that the Budget would see the GPs waiting times “crisis” worsen.
GPs are alarmed that Mr Swinney’s Draft Budget for 2016-17 showed more evidence of money being shifted from family doctors in the community to the secondary care provided by specialists in hospitals.
The RCGP Scotland is worried by the GP recruitment crisis, as well as signs that ministers intend to move to a new model of care which will undermine the role of the GP.
Unveiling his Budget in December, Mr Swinney spoke of the “transformation” of health care. Many in the sector suspect that work currently carried out by GPs may be moved to other health professionals such as nurses or physiotherapists.
Of the £13 billion allocated to health, Mr Swinney allocated £722.8 million to GP services, a rise from £709.6m the previous year. However, GPs pointed out that the increase was a rise of just 0.1 per cent for a speciality that sees 90 per cent of patient contact with the NHS.
Moreover, the real terms percentage increase for general practice amounts to half that enjoyed by health boards – 1.9 per cent against 3.8 per cent.
According to the RCGP Scotland, GP budgets have fallen by more than £1bn in real terms over the past decade, while the number of consultations has risen by 11 per cent.
Dr Mack said: “The Scottish Government should be clear and open with the pubic. There appears to be a set strategy to erode or end the current role of the GP in family life.
“The constant direction of funding to secondary care suggest hospital treatment is preferred and the ‘2020 vision’ of ‘care at home or in a homely setting’ will remain only that. It appears that the Scottish Government views general practice as dispensable.
“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.
“We very much value and acknowledge the benefit of wider open access to other health professionals, but the pressures presented by changing demographics and resulting complexity cannot be safely, effectively or efficiently addressed solely by this model. Evidence clearly supports the effectiveness and importance of the expertise of general practitioners.”
Labour’s public services spokesman Richard Simpson, a former GP, agreed that the GP crisis would get worse.
He said: “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.”
But health secretary Shona Robison insisted: “The Scottish Government is committed to supporting and enhancing primary care and the work of GPs. To say the service is dispensable or that services are being eroded is wrong.
“Funding for GP services has increased each year under this government, rising from £704.61m in 2007-8 to £852.57m in 2014-15.
“In addition to this, investment has been made in other community services, such as the ambulance service and increasing health visitors, which has beneficial impact on general practice. Health boards also allocate funding from their central budget to primary care.”
She added: “We continue to work closely with stakeholders, like the BMA, to reduce workload and modernise the service. This includes working towards a brand new Scottish GP contract from 2017 that will make primary care services fit for the future.”