Primary Care

– in the Scottish Parliament on 11th December 2019.

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Photo of Richard Leonard Richard Leonard Labour

2. Does the First Minister agree with her Cabinet Secretary for Health and Sport that primary care is the “bedrock” of the health service?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

Yes, I do think that primary care is the bedrock of our health service. That, of course, is why the Scottish Government is taking action to invest more in primary care, and to invest a greater percentage of the health budget in primary care, in order to shift the balance away from acute and specialist healthcare and into the community.

Primary care is, of course, about much more than general practitioners, vital though they are. That is why we are promoting the multidisciplinary primary care team. There are big challenges for the health service, but it is really important work that we are determined to get on with.

Photo of Richard Leonard Richard Leonard Labour

An integral part of the new 2018 GP contract is

“The National Code of Practice for GP Premises”, which recommends that health boards reduce pressure on doctors by providing them with premises.

However, last week, GPs from the Maryfield medical centre in Dundee contacted me. They have for almost two years been embroiled in protracted negotiations over the transfer of their lease to NHS Tayside. Even though the health board started to run services from the medical centre more than a year ago, and even though the building has been assessed as being fit for purpose, NHS Tayside is still demanding that the GPs pay more than £100,000 for work that even the landlord deems to be completely unnecessary.

The doctors have told us that up to a third of general practices in Tayside might be facing the same situation. They have petitioned the Scottish Government for support, but nothing has been done. Does the First Minister think that that is acceptable? Will she listen to the GPs? Will she act to support them? Will she intervene?

The First Minister:

I am very happy to look into the specific issue that Richard Leonard has raised. I would have thought that lease negotiations would best be conducted between GPs and the heath board in question, but because Richard Leonard has raised the issue I will, of course, look into it.

We are investing heavily in supporting general practitioners and general practice. The number of GPs working in Scotland has risen. By 2021, we will have invested £50 million in our groundbreaking new GP premises sustainability loan scheme, which is aimed at securing general practice for the future. Practices are already being reimbursed with £41.5 million through the Primary Medical Services (Premises Development Grants, Improvement Grants and Premises Costs) Directions 2004. We support GPs and the premises in which they work.

As I said in my earlier answer, we want to support the multidisciplinary primary care team, which is why we are also supporting pharmacists and physiotherapists to work with GPs in order to ensure that people have the best care possible in the community.

I am happy to look into the particular case that Richard Leonard mentioned. However, generally speaking, the Scottish Government provides continued and growing support for GPs, who do a very difficult and challenging job.

Photo of Richard Leonard Richard Leonard Labour

The Maryfield medical centre wrote to me last week, at the same time as it wrote to the First Minister.

The truth is that general practice and primary care are under immense pressure right across the country. The British Medical Association has warned that there are workload pressures and that there is a GP shortage. The truth is that Scotland is in the grip of a GP crisis; the very survival of GP surgeries is at stake.

Incredibly, the Government still has no accurate and up-to-date information, so it has no idea how many full-time equivalent GPs there are in Scotland. It has no accurate and up-to-date information, so it has no idea how long patients are waiting to see a GP, but we all know that they are waiting too long.

Patients who need a GP appointment are being let down. GPs such as those in Dundee who need the First Minister’s support are being let down. After 12 years of her Government, Scotland is being let down. When will the First Minister finally recognise that Scotland is facing a GP crisis and that GPs and patients need a Government that is on their side?

The First Minister:

The most recent figures show that the number of GPs who are working in Scotland is 5,049, which is an increase on the previous year. Incidentally, there are significantly more GPs per head of population in Scotland than there are in England, and there are significantly more GPs per head of population in Scotland than there are in Wales, where the Labour Party is in Government.

Next year, we will double our primary care improvement fund from £55 million to £110 million specifically to help to accelerate the expansion of multidisciplinary teams. The most recent figures show that, since 2006, there has been a 17.3 per cent increase in the number of GP training places, and we are, as I said earlier, investing in GP premises.

Through all those and other things that I could talk about—including initiatives relating to rural recruitment and, of course, the new GP contract, which was supported heavily by the BMA—we are taking action to support GPs, and to ensure that they are at the heart of the jewel in the crown of the Scottish national health service, which is primary care.

Unlike Governments elsewhere in the UK—one of which is, of course, run by Labour—the Scottish Government is getting on with the job of facing up to the challenges in the NHS and bringing to bear the solutions that the people who work in our NHS and the patients who rely on it need. I had hoped that Labour would welcome that.