Scotland’s primary care services are in the midst of a critical workforce supply problem that has led to patient demand exceeding our capacity on a daily basis, with Dr Andrew Buist, chair of the BMA’s Scottish GP Committee, issuing a stark warning that major issues must be addressed.
In his speech to the Scottish Local Medical Committee (SLMC) conference today, Dr Buist said the Scottish Government urgently needs a credible plan to get the new GP contract, which is now in its fourth year and was set back as a result of the COVID-19 pandemic, back on track.
In particular, he used his speech to focus on issues in delivering staff across a range of professions to work in practices and work as part of whole teams supporting and working closely with GPs.
He said: “Workforce supply across primary care is a problem, the new community services have been significantly held up by a lack of available healthcare workforce; this is something the Scottish Government urgently needs a credible plan to improve on.
“We need the physiotherapists, the pharmacists, the nurses who are all key parts of the multi-disciplinary teams we need in place if we are truly to deliver the vision the contract sets out. The pandemic has only underlined the importance of all professionals working closely to deliver the right care to patients from the right person – so we need proper strategic planning and a redoubled focus on delivering these staff to support practices across the country, and we need that urgently.”
Dr Buist added that the co-dependency between community health care and hospital care has never been so apparent in the wake of the pandemic restrictions. And he urged all politicians to engage in an open and honest discussion to set Scotland’s health service on the path to a more sustainable future.
He commented: “This pandemic has greatly disrupted our NHS. Waiting times for hospital investigations and treatments have rocketed, the pressures on social care are immense and, in many ways, they are currently the most pressing – because if care in the community fails, then hospitals cannot hope to function.
“That is why I believe it is so important when we think about health care as a society that our focus is not solely – or even primarily – on hospitals. It is going to take many years for the NHS to recover from the pandemic. Indeed, I am not convinced we will ever get back to where we were.
“The pandemic has exposed what many of us knew pre-pandemic – namely that our healthcare model and the way the system operated was unsustainable in the face of rising demand, caused at least in part by an ageing population. In world terms we are a wealthy country, but our resources are not unlimited. Pursuit of impossible targets within ever-more stretched budgets raises expectations that cannot be fulfilled, frustrating the public, burning out our workforce and leading in some cases to energies being invested in obstruction, diversion and a culture dominated by fear and blame.
“I believe we need to review what is we are trying to achieve through our health care system, and I call upon the Scottish Government – I urge them – to commit to deliver a genuine, open and honest conversation with the public and key stakeholders to build a realistic achievable vision of what we in Scotland can, and should, provide to our people within the constraints of care, free at the point of delivery. This could – and should in my view – be supported by convening, with cross-party support, an expert group to build this vision which I hope we can all commit to. Working together, we can build better care in the community and our hospitals for generations to come.”
In his closing remarks Dr Buist expressed his anxiety for general practice has never been greater.
He said: “GPs are a resilient group, but we are tired. The demands we are facing are huge and often beyond our capacity – I fear for the well-being of individuals trying to do their best and it not being enough. The government and the public must appreciate the GP service or they won’t know what they had until it’s gone – the independent contractor model has served the country well since the beginning of this NHS, but there are limits to which GPs can be exposed.”
Notes to editors
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.