Scottish GPs warn ‘public must use NHS differently’

The British Medical Association (BMA) meeting in Clydebank heard that GPs faced an “overwhelming” workload that was expected to grow.

And they told health secretary Alex Neil that he should tell patients they need to use the NHS in a different way.

Mr Neil told doctors that the biggest challenges facing the NHS included funding pressures and the demands from a growing and ageing population.

His comments came as doctors last week told The Scotsman their workloads were reaching “saturation point”.

At yesterday’s meeting, Dr Dean Marshall, former chair of the BMA GPs committee in Scotland, challenged Mr Neil to face up to telling patients what the NHS could and could not offer them.

He said: “The demand from the public is rising and is unsustainable and not deliverable. No matter what resources you give us, we cannot deliver the amount of service that reaches demand.

“So, are you prepared to have that conversation with the public in Scotland and say it is not deliverable and they need to use the NHS in a different way?”

Mr Neil agreed that demand for health services needed to be managed much better. “Sometimes we generate a lot more demand ourselves by the things that we do,” he said.

Mr Neil said the demand caused by alcohol misuse was one area that needed tackled to reduce pressure on services,

“I think there are people phoning emergency services, or through their GP or NHS 24, where it is neither an emergency nor an accident. There’s loads of things we can do there,” added.

Dr Alan McDevitt, chair of the BMA’s GPs committee, said: “We have to find better ways of telling people how to best use the services. It is not about saying to people you can’t, but about saying this is when it is best to use the NHS.

“We want to make more use of internet information and that is already happening.”

He added: “I am not for saying to people who need us, don’t come and see us.

“But we do have to make sure if there are ways in which they could self-manage then they should and think twice, particularly out of hours, before contacting the NHS.”

Dr Andrew Buist, joint deputy chair of the Scottish GPs committee, said the public was no longer being educated about how to use services.

He said: “It is the other way – we encourage them to use services rather than educate them on how to use them properly.”

Dr Buist said telling people not to use services was not a vote-winner for politicians, which may be why it was not higher up the agenda.

In his speech to the delegates, Dr McDevitt said that the rising workload was not sustainable.

“I’ve seen the work piling up – we all have – but what I don’t see are the resources to sustain this workload,” he said.

“Something’s got to give and I do not want out-patients to suffer because general practice has reached saturation point.

“We need more GPs, more practice staff, better facilities and increased funding to ensure we can do the thing we do best – make patients’ health better.”