Primary Care

Part of the debate – in the Scottish Parliament on 3rd March 2021.

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Photo of Donald Cameron Donald Cameron Conservative

I record my thanks to my colleagues on the Health and Sport Committee for their work on the report, and to the committee clerks for their efforts in producing it. I also thank those who gave evidence. Broadly speaking, I feel that we have a report that can set in motion a wider debate on how we deliver primary care services in the future.

I have long been of the view that, when we discuss the future delivery of health and social care in general, we should look not only at the next five years but at the next 25 years. We, in the chamber, need to ask ourselves how we would like to see such services being delivered when we are older, and what national health service and social care service we want to leave for future generations.

The committee’s report covers a broad range of issues, including the general medical services contract, the future role of multidisciplinary teams and the status and purpose of integration joint boards going forward, to name but a few.

However, I will focus on the recommendations for general practice, which is an issue that the Scottish Conservatives have long believed needs to be debated properly and fully by Parliament. Before delving into some of the specific issues, I thank our doctors, nurses, ancillary staff, office staff and all those who work in general practice for their efforts during the Covid-19 pandemic--in particular, for their role in the vaccination roll-out.

One of the more important aspects of the pandemic with which we require to grapple is its long-term impact on the health service. For instance, does it mean that we should pause or accelerate the changes that are under way? In its response to the committee’s report, the Royal College of General Practitioners made a number of comments, including that it welcomes the

“focus on improving data sharing and technology within primary care ... which will bring huge benefits for patients and increase efficiency within the NHS.”

Both the RCGP and the British Medical Association welcomed the recommendation that the Scottish Government should devise

“an information campaign to inform the public on what their primary care service will look like, what they can expect and when”.

The RCGP stated that it would like to ensure that

“the target of increasing the GP workforce by 800 by 2027 is reached” and that it wanted to

“see workforce numbers across the primary care multidisciplinary team bolstered”.

I agree. Over the course of this parliamentary session, the Scottish Conservatives have consistently called for investment in additional GPs in order to address that particular aspect of the broader workforce crisis that we see in our NHS and social care services.

In particular, the committee report notes that

“more innovative approaches… were required to attract professionals to rural practices, where it was more difficult to recruit.”

I represent the Highlands and Islands, so that is a pertinent point for me, given the real difficulties of recruiting GPs in remote and island communities.

In addition to the need to recruit more GPs, current data shows that the number of GPs who are aged over 60 and approaching retirement is at a 10-year high. In 2020, some 250 GPs were over 60 years old, and from 2010 to 2020 the number of GP practices decreased by 9 per cent. Therefore, it is clear that there are multiple challenges in general practice that we need to address to ensure that it is properly staffed and supported and can meet the demands of a growing and ageing population.

Patently, there is more that we need to discuss and debate about the future delivery of primary care services. I am afraid that, undoubtedly, general practice is facing a workforce crisis, as are other areas of our NHS. It is also evident that existing ways of delivering primary care might not be financially sustainable.

We need a primary care system that keeps pace with modern life, that embraces technology and, above all, that is shaped around the needs of patients. That is something the Scottish Conservatives will continue to focus on as we move forward.