General Practice (Independent Contractor Model)

– in the Scottish Parliament at on 31 May 2023.

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Photo of Claire Baker Claire Baker Labour

2. To ask the Scottish Government how it is supporting the continuation of the independent contractor model in general practice. (S6O-02301)

Photo of Michael Matheson Michael Matheson Scottish National Party

The Scottish Government remains committed to supporting general practice, and the independent contractor model is a key part of that. I recently met the chair of the British Medical Association’s Scottish general practitioners committee to reaffirm that. The 2018 GP contract that was agreed with the BMA is designed to support and strengthen that commitment.

As part of the contract, and to support GP practices, we have recruited more than 3,220 healthcare professionals since 2018. That is underpinned by an investment of £170 million this year, and our policy prospectus commits us to sustaining that investment through the primary care improvement fund and investing more in practices that service disadvantaged areas. We remain committed to increasing the number of GPs working in Scotland by at least 800 by 2027.

Photo of Claire Baker Claire Baker Labour

The cabinet secretary will recognise that, although he has promised 800 more GPs, Audit Scotland has warned that progress is not on track. In my region, NHS Tayside has recommended that Invergowrie’s practice should close later this month, with more than 1,800 patients being allocated to other practices. In Fife, 40 per cent of GP surgeries have closed their doors to new patients, which is a higher figure than anywhere else in Scotland. Among the current workforce, it is estimated that more than a third are unlikely to remain in general practice for the next five years, which would mean around 1,500 GPs lost.

What action is the Scottish Government taking to improve the retention of GPs, which will be crucial if we are to reach the required number?

Photo of Michael Matheson Michael Matheson Scottish National Party

We are taking forward a range of work to support the retention of GPs in general practice. That includes the funding initiatives that we have in place to encourage GPs to work in rural areas. Alongside that, in this year’s recruitment programme for GP training, we have more or less reached the quota that was set to support further GP provision.

I understand the concerns that the member is raising on behalf of her constituents, but I reassure her that investment in primary care, supporting the retention of general practitioners, recruiting more people into general practice and expanding the primary care workforce are all critical to ensuring that we have a sustainable primary care system. We have, for example, recruited more than 3,000 additional staff in primary care to help the wider workforce to support individuals with their healthcare needs in primary care settings.

Photo of Douglas Ross Douglas Ross Conservative

The cabinet secretary will be aware of the issues relating to the GP surgeries in Burghead and Hopeman, as I have written to him and to his predecessor about them. The very strong local action group, save our surgeries, is campaigning to retain those vital services, and I believe that there is cross-party support for that. Will the cabinet secretary agree to meet the campaigners, either in Moray or in Parliament, to listen to their concerns about the future of those two vital surgeries and to the local solutions that they are offering to keep them open?

Photo of Michael Matheson Michael Matheson Scottish National Party

I am aware of the issues relating to those surgeries. The principal route for those issues to be addressed is through the local integration joint board, health and social care partnership and health board, which will look at the design of services that are provided locally. The health board has a contract directly with the GP practices and will make decisions about the existing surgeries that are in place. It is important that that process is taken forward. I encourage the member and local campaigners to engage with the health board, the IJB and the health and social care partnership on those issues to ensure that there are sustainable services in the future.

Photo of Fiona Hyslop Fiona Hyslop Scottish National Party

Independent GP contractors in West Lothian have told me that having the ability to directly employ allied health professionals such as physiotherapists, occupational therapists and dieticians would make a real difference in allowing GPs to employ AHPs based on their practice’s needs, rather than there being centralised allocations. That would give GPs the authority to line manage the AHPs in their employ, and it would support flexibility, continuity and integrity of care for patients. Currently, our local health and social care partnership requires centralised recruitment and employment. Will the cabinet secretary consider that policy in order to support GPs to improve services for their patients?

Photo of Michael Matheson Michael Matheson Scottish National Party

I recognise the value of the wider skills group in supporting primary care. In particular, AHPs such as those who deal with musculoskeletal conditions, physios, OTs and dieticians can be used in a range of areas. We are trying to ensure that there is a steady increase in the number of AHPs being provided to GP practices across the country.

I recognise the concern that the member has raised. I have recently discussed the issue with GP practices in my constituency. I am not unsympathetic to looking at how we could improve the existing model in a way that would give GPs greater control over such matters. Equally, I want to ensure that the multidisciplinary teams in primary care expand and develop on a consistent basis, so that as many GP practices as possible can benefit. Some GP practices might want to do that directly; others might want that to be done centrally for them. However, I am certainly open to looking at how we can further improve the system.