Leaders: Change is the prescription for Scotland’s GP service

GP budgets have fallen by more than �1 billion over the past decade. Picture: PA
GP budgets have fallen by more than �1 billion over the past decade. Picture: PA
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A vital piece of the NHS jigsaw, it must be made fit for purpose – but first we must ensure we know exactly what that purpose is.

The NHS is changing. Medicine is changing. New drugs are being discovered all of the time. People are living longer and surviving illnesses that they previously would not have survived.

In light of the changes, it is inevitable that the role of GPs iscoming up for debate. Yet warnings from the Royal College of General Practitioners (Scotland) that GPs are regarded as “dispensable” by the Scottish Government should be listened to if we are to create a service that is fit for the modern world.

They say that GP budgets have fallen by more than £1 billion in real terms over the past decade, while the number of consultations has risen by 11 per cent. Some GPs complain about time wasters who consult their doctor about every tiny ache and pain but they need to remember that the general public is not medically trained.

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In addition, while the internet is a minefield of hypochondriacs and worst case scenarios, it is also a place where patients can find information that could encourage them to get worrying symptoms checked out earlier – and potentially prevent a serious illness from developing.

There is no doubt that the GP system is in crisis. There are fewer GPs and many are set to retire in the near future. Survey show job satisfaction is at a low, making recruiting new doctors tough. Meanwhile, it is becoming increasingly difficult to get an appointment with a family doctor.

However, the system is vital. Statistics show that 90 per cent of contact with the NHS is with GPs. They have a general overview and are trained to know whether a problem needs further investigation or if it is likely to go away on its own.

Nobody really believes that GPs are dispensable or that they are not a good point of contact. They are often a vital doorway for other parts of the health service.

John Swinney’s draft budget for 2016-17 suggested that money could be shifted from family doctors in the community to the secondary care provided by specialists in hospitals – while other health professionals such as nurses and physiotherapists could carry out services previously provided by GPs.

There is no doubt that Scotland’s GP service needs to evolve to ensure it is suitable for modern life. People need to be able to see doctors when they need them and not just during daytime hours.

Valuable money is wasted by people visiting out-of-hours GPs at weekends, only to be told to see their own GP on Monday morning.

Patients must ensure that we do not hark back with nostalgia to a time when the family doctor service was something quite different – a dedicated GP who lived down the road, who saw several generations of the same family through childhood illnesses.

As a nation, we need to think about what kind of GP service we need. There is no doubt it needs to change and come more into line with the 21st century.

We need to protect GPs, but not without change. In short, we need a better GP service for Scotland – not a worse one.

Cities offer refugees most hope

Calls for refugees fleeing war-torn countries to be distributed evenly around Scotland are unlikely to be met.

While it is understandable that MSPs and local authority leaders with the highest concentrations of refugees, including Glasgow, feel they have shouldered the burden of new residents more than their counterparts elsewhere in the country, the idea that people can be dispersed as easily to remote and rural communities as they can to our biggest cities is wrong-headed.

Recent stories of refugees who have been placed by the Home Office on the Isle of Bute painted a glum picture, despite residents’ best efforts to welcome the newcomers.

Before the refugees’ arrival, the island had empty homes because there were few employment prospects for young people growing up there, many of whom have moved to the mainland in a bid to find work.

What chance, therefore, do Bute’s latest residents have of creating new, sustainable lives there for themselves and their families?

One criticism that is lobbed at refugees is that they are living off government handouts – something which the vast majority of them do not want to do. And the only way they can put a stop to that is to find work. And Scotland’s cities are where the most opportunities for work are located.

In addition, there is an infrastructure already in place, of organisations which can help new residents from overseas, as well as existing groups of migrants from the same culture, who can help them find their feet.

While it is a nice idea that refugees could be settled all over Scotland, it would defy common sense to do so.