Nationally, we are investing an additional £250 million in direct support for general practice by the end of this parliamentary period, delivering the new GP contract and delivering at least 800 more GPs over 10 years.
As I am sure Alexander Stewart knows, Scotland has more GPs per 100,000 of the population than the rest of the United Kingdom—the figure is 92 here, 73 in England, 70 in Wales and 71 in Northern Ireland.
In Fife, the health board that has specific local responsibility is taking a twofold approach: it is further developing its operational response to issues in practices as they emerge and, alongside that, it is taking a strategic look with a strategic group to ensure a co-ordinated approach across Fife to those practices that may need additional support. That involves working with GP representatives and the British Medical Association to explore both the implementation and impact of the new contract, and taking steps locally to increase the attractiveness of general practice, including capitalising on the Scottish graduate entry medicine programme course.
In my region, surgeries in Perthshire and Fife are either closing or are facing closure. In one case in Dunfermline, four GPs are looking after nearly 9,000 patients—that is completely unsustainable.
Audit Scotland recently indicated that the lack of workforce planning will mean that the recruitment of 800 new GPs will be fragmented and that
“for every GP that retires more than one will need to be trained and recruited to replace them.”
Therefore, the crisis is of the Government’s making. What urgent steps will the cabinet secretary take to rectify it?
Before I go on to answer that in detail, I point out to Alexander Stewart that part of the difficulty that GPs and others in our health service face are the pension changes that his party’s Westminster Government has forced on them, which for some means that it begins to cost them money to go to work. That is hardly a sensible and wise proposition from the UK Government, but then we are becoming increasingly used to that.
Mr Stewart will know—as will all members—that the point of the GP contract is to widen the multidisciplinary team to ensure that GPs can concentrate on those patients who need their particular skills for longer. Therefore that widening of those teams, along with recruitment and training of physiotherapists and pharmacists, pharmacological input and so on, is helping to manage the numbers that Mr Stewart has mentioned.
I take Audit Scotland’s report very seriously indeed. We have a number of initiatives to increase GP numbers. Presiding Officer, I am mindful of your exhortation not to take too long, so I will not mention them all, but I am sure that Mr Stewart knows about them. For medical undergraduates, there is the ScotGEM programme and increased GP training. Specific financial support is being given to GP practices, including those in rural areas. All those initiatives are designed to ensure that we manage that challenge as best we can. Only this morning, I discussed with one of Mr Stewart’s colleagues additional steps that we might take, and I stress that I am always open to hearing positive ideas that might come from any bench in the chamber.
The Cabinet Secretary for Health and Sport might have seen reports of concerns about the implementation of the new GP out-of-hours services model in St Andrews. The relationship between the healthcare partnership and local campaigners seems to have broken down and the campaigners now fear that the partnership is setting the model up to fail. Will the cabinet secretary investigate that important matter and provide some assistance?
I am grateful to Mr Rennie for raising that question. I would be very disappointed indeed if what seems to me to be a genuine, community-devised and community-led solution to problems with out-of-hours services provision in St Andrews is in any sense now in jeopardy, whether because relationships have broken down or for any other reason.
I will certainly look at the matter with some urgency and ensure that Mr Rennie and other members whose constituencies are affected are informed of what I uncover and the steps that we might take to resolve any difficulties that exist.
I say to Alexander Stewart that if he wishes to know what is going on with GP recruitment in Fife and the efforts that NHS Fife is making, he might wish to attend the quarterly meetings that NHS Fife holds with elected members. The cabinet secretary referred to the pensions fiasco that the UK Government has created in the health sector. I would have thought that it would be better for the member to seek to work with the Scottish Government and others to try to sort out the fiasco that the UK Government has created in that regard and for him constructively to support the strenuous efforts that NHS Fife is making to resolve the problem.