Primary care is getting worse – but more quickly in some parts than in others

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The latest news from the BMA about a worsening shortage of GPs in Scotland is hardly a surprise.

However, the crisis obscures an urgent question of social justice which no one responsible wants to talk about: the deterioration in primary care services is not being felt equally across Scotland.

Research shows that deprived communities always tend to suffer poorer provision than more affluent ones, and figures from Scotland bear this out.

Residents in these communities face a downward spiral of deprivation: struggles to access GP services reinforce existing health inequalities which in turn reinforce long-standing social and economic inequalities.

Last week a league table drawn from NHS Scotland’s Health and Care Experience Survey 2015/2016 revealed that the most deprived areas of Central Fife had the worst GP services by some way in the whole of Fife and Tayside.

Even local Labour MSP Alex Rowley, who has specialised in campaigning for improvements to the NHS, described GP shortages as a Fife-wide problem, ignoring the social injustice on his home turf in Cowdenbeath.

While politicians muck about with long-term plans for reorganising primary care or building fancy new health centres, residents in places like Lochgelly continue to struggle to be seen by their GPs within three days, or even get through to the surgery on the phone. This situation is set to get worse before it gets better.

Shona Robison’s £2 million investment in improving GP services will make precious little difference to the communities that need it most.

The causes of health inequalities may be complex but inequalities in primary care where clinical demand exceeds GP provision are simple to address: target resources to increase staffing and services in communities hardest hit by shortages.

If we can find the money to cover shortfalls in essential staff in schools and hospitals, we can do the same for GP surgeries.

This is why I have just launched a change.org petition (www.change.org/p/fife-s-most-deprived-communities-need-more-gps-now) calling on the Scottish Government, NHS Fife and Fife Council to set up an emergency taskforce.

It has a crystal-clear target: sort out the lack of GP services in Central Fife practices by getting their NHS Scotland Health and Care Experience measures up to the Fife/Tayside average within six months.

James Glen

Walker Street, Lochgelly

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