The Scottish health secretary has pledged to put primary care ‘front and centre’ of the health service – and put it ahead of secondary care in terms of priority. 

Addressing the conference of Scottish LMCs in Clydebank (on Friday 1 December), Michael Matheson, the cabinet secretary for NHS recovery, health and social care, told GPs that he wanted an honest and open national discussion about the future of health services. ‘My view is that primary care will be critical to delivering an effective and sustainable healthcare system going forward, given the challenges we face.’ 

Mr Matheson said there was a need to deliver more investment into primary care – and acknowledged that this hadn’t happened. ‘It’s very clear that if we don’t change the health and care system we have, it’s unsustainable in its present form. We have to have to very open discussion about what the future shape of our health and care system is going to be. 

‘We need to start to redesign the system, where primary care is more of a central focus than secondary care. There’s a political challenge there and I’m not naïve enough to think there isn’t.’ 

Mr Matheson said he wanted to change design of the health service. ‘If I look at the way in which we design the healthcare system at the present moment, I largely see it in four different elements: the focus tends to be on secondary care, then primary care, then social care and then the patient. My view is that it should be patient, social care, primary care and then secondary care, but I’m not foolish enough to think I can change this overnight.’ 

Mr Matheson also affirmed his commitment to the independent contractor model of general practice, and said he wanted to see expansion of multi-disciplinary teams to reduce pressure on GPs and improve services to patients. ‘There is no political agenda to look at changing the independent contractor model – I’m not looking to do that, and I want to support you to deliver that, so please be reassured it’s not something I’m looking to try and change.’ 

Mr Matheson said that he wanted to attract more people into general practice and also to retain GPs in the profession. He pointed to an additional 35 GP training places this year, and said there had been progress in meeting the commitment of 800 additional GPs by 2027.