General Practitioner Access (Homeless People)

– in the Scottish Parliament on 24th October 2018.

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Photo of Bob Doris Bob Doris Scottish National Party

5. To ask the Scottish Government how it ensures that people who are homeless are not disadvantaged from accessing a general practitioner. (S5O-02463)

Photo of Jeane Freeman Jeane Freeman Scottish National Party

The Scottish Government published a guide for healthcare providers of general medical services on 20 September this year. The guidance clarifies that inability by a patient to provide identification or proof of address is not considered reasonable grounds to refuse or delay registering a patient. The guidance clarifies that practices can use agreed addresses such a homeless centre, a practice’s own address or “no fixed abode” to register a patient, and that street homelessness can be considered as residence in a practice area.

Photo of Bob Doris Bob Doris Scottish National Party

I have a constituent who is currently homeless and is, with her two children, temporarily staying with a friend. When her youngest child needed an appointment with a GP, it was refused, with homelessness cited as a reason. My office’s intervention secured an appointment.

Members will note that I have not named the practice publicly, which is because I would rather promote improved practice than shame the practice in this case. The vast majority of general practices fulfil their obligations, but how can the Scottish Government—yet again—remind general practices of their responsibilities? Are there any actions that could be taken regarding general practices that behave in such ways?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

We not only published the guidance but asked boards to ensure that it was circulated to all general practices, and we asked boards to follow that up. In addition, primary care performance improvement plans are coming forward, and I would look to ensure that general practices within primary care areas understand what the guidance is and abide by it.

If any member is aware of a situation such as that described by Mr Doris, I ask them to bring it to our attention as quickly as possible, so that we can address it as quickly as possible. I intend to raise the matter through our work with the health and social care partnerships and the Convention of Scottish Local Authorities to ensure not only that general practices know what the guidance is but that teams working with people who are homeless—as street teams or in whatever other fashion—are aware of it, too, and can advocate on behalf of those individuals’ rights.

Photo of Mary Fee Mary Fee Labour

Given the links between transmittable diseases, such as tuberculosis, and homelessness, how will the Scottish Government ensure that homeless people, including destitute and homeless asylum seekers, can reach out to health services, and thus prevent the spread of transmittable diseases?

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I am grateful to Ms Fee for that very important question. I draw her attention—not as a complete answer, but as part of one—to a practice here in the city of Edinburgh that I visited early in my time as cabinet secretary. In that practice, there are street homeless workers, housing workers, general practitioners, addiction workers and other support staff, all working as a single team. I am pleased to say that they will shortly move to new and more bespoke premises. That is an example of what we should see in other areas where there are significant numbers of homeless people. It is one that I am raising and trying to ensure is adopted elsewhere as part of the other work that I am talking about, which is about raising the pace and spreading good practice where we expect to see it.