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Scotland’s GPs work in the furthest northern part of the United Kingdom. In terms of health-care provision there are 14 health boards which vary in size. The largest is Greater Glasgow and Clyde, and there are smaller ones such as Shetland. There are various urban, remote and rural practices with huge varieties of patient populations, each with their attendant challenges.
Those who have heard of the ‘Glasgow effect’ and of the general practice-led supporting initiatives of ‘deep-end practices’ (also to be found in Lothian), know of the historical effects of deprivation with its concomitant co-morbidity and reduced life expectancy. Scotland still has the lowest life expectancy of all UK countries. With a population of 1.2 million in Greater Glasgow, life expectancy at birth is 71.6 years for men, nearly seven years below the national average of 78.2 years and 78 years for women, over four years below the national average of 82.3. This makes for big challenges for primary care. Of course, there are areas of deprivation in other parts of Scotland and these are obviously just as challenging.
I have now visited 12 (Shetland, Orkney, Highland, Grampian, Tayside, Forth Valley, Lothian, Borders, Greater Glasgow & Clyde, Dumfries & Galloway, Ayrshire & Arran & Lanarkshire) out of 14 of the Scottish health board local medical committees and have been privileged to hear their current successes, challenges and concerns. At some meetings I have met their sessional representatives. Some places have enough GPs due to encouraging training GPs and retaining them afterwards, as well as other factors. Some areas of Scotland are seen as attractive to work due to the proximity to university cities, cultural attractions or housing.
Sessional GPs care about their work-life balance for rest and recreation. The central Scotland belt has great motorway connections which means that travel can be relatively easy. However, other areas of Scotland are struggling to recruit both permanent members of staff and locums.
Scotland differs from England in that the rate of pay is lower, but the medical indemnity fees are also lower. One thing to keep in mind is that in order to work in a health board area you need to get on the individual performers’ lists and then you can be transferred to the others. There is no doubt, however, that if you wish to have the chance to live and work in some of the most stunning scenery in the UK, this is the place to come! It is a chance to get involved in small communities and participate in all sorts of sports (suitably clothed of course).
If you need a career-refresh, even as a short-term locum, think no further than Scotland.
Mary Anne L. Burrow is a member of the Sessional GPC subcommittee and regional representative for Scotland
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