Leading doctor warns new GP contract fails to meet needs of poor patients

Dr John Montgomery, right, the lead GP on the Govan SHIP, with practice manager Vince McGarry. Photograph: Nick Ponty
Dr John Montgomery, right, the lead GP on the Govan SHIP, with practice manager Vince McGarry. Photograph: Nick Ponty
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A leading doctor has spoken out against the decision to approve the new GP contract, saying it doesn’t go far enough in addressing the urgent needs of the most deprived people in Scotland.

Dr John Montgomery, from the flagship Govan SHIP (social and health integrated partnership) project, says the new contract meets “patient demand not need” and is calling for a separate committee to be set up to examine how best to treat the urban poor.

The project, which is now in its third year and funded by the Scottish Government, has had notable successes, leading to a decrease in emergency, outpatient and GP appointments. It works on a multidisciplinary approach which gives patients access to social workers and help with other issues including housing problems.

Dr Montgomery also said he was “personally shocked” by the low turn-out of 38.86 percent of GPs who voted on the new contract with just 29 per cent of doctors in Scotland approving the proposal to implement.

The concerns of doctors in the most deprived urban areas were matched by rural GPs with both parties unhappy over the allocation of funding.

Dr Montgomery said: “Just as the rural boys have done a very good job in having their concerns highlighted and addressed and there’s going to be a short-term working group I think we need exactly the same thing for practices that operate in urban deprived areas.

“It’s clear that the contract as it stands is designed to meet patient demand not need.

“We need to have some kind of mechanism outwith the national contract that will help us deal with the particular difficulties that we have in the urban deprived setting.

“The Scottish Government has stated that it wants to address health and inequality as a priority. The contract as it stands is not going to do that.

“It’s putting resources into areas that have greater numbers of elderly affluent patients. So, it’s not going to address the rural problems and it’s not going to address the issues we face with the urban deprived.”

On the polling turnout Dr Montgomery said there was now a situation where just over one in four of the profession voted in favour of the new contract.

He added: “I’m personally shocked at the low turn-out for something that is so important. I understand it’s a democracy and for those that voted it was clearly an overwhelmingly positive vote but it’s very disappointing that the turnout was so low and I’d be curious to know what the BMA thinks are some of the reasons for such a poor turnout. ”

Chair of BMA Scotland’s GP Committee Dr Alan McDevitt said: “The formula is only one aspect of the new contract and practices serving more deprived areas will see substantial improvements from other aspects of the contract such as the expansion of link workers and other healthcare professionals.”