Primary care services in some of Scotland’s island communities are in crisis.
That’s the warning from Highlands and Islands MSP Jamie Halcro Johnston who, raising his concerns with Health Secretary Neil Gray in Parliament on Thursday, said the Scottish Government’s failure to deliver support to help reduce GP’s administrative burdens has seen appointment waiting times increase dramatically.
In 2018, the Scottish Government introduced a new GP contract to be fully implemented in 2021 and this promised to include additional pharmacist, nurse, physiotherapist and mental health support to relieve pressures on primary care.
However, Mr Halcro Johnston, who is Shadow Islands Minister, as well as being convener of Holyrood's Cross-Party Group on Islands, said ministers had failed to keep their promise to GPs and this had led to increased workload for frontline doctors, with waiting times for many island residents to see a GP increasing considerably.
The Scottish Conservative MSP said GPs had told him that, where previously they had been able to offer same day appointment, many patients were now having to wait weeks to see their GP. Mr Jamie Halcro Johnston said: “Primary care services in island communities have been in crisis for years, but SNP ministers have shamefully failed to act.
“It is seven years since the SNP promised their new GP contract would reduce the pressure on frontline doctors, but in typical SNP style that promise has been broken and patients are suffering devastating consequences as a result.
“My island constituents can be left waiting weeks or even months to get an appointment with their doctor, but the SNP remain completely detached from the reality facing them.
“Neil Gray must do the right thing and finally ensure this contract is properly implemented and guarantees patients will get quick access to a GP.
“It is unacceptable that, yet again, islanders are being impacted because SNP ministers in Edinburgh are making promises they won’t deliver on”.
Jamie’s full exchange with Neil Gray is below:
1. Jamie Halcro Johnston (Highlands and Islands) (Con)
To ask the Scottish Government how it will reduce any administrative burdens on general practitioners across the Highlands and Islands to allow them to spend more time seeing patients. (S6O-04362)
The Cabinet Secretary for Health and Social Care (Neil Gray)
To support general practice, we have significantly expanded the primary care multidisciplinary team workforce, with more than 4,900 whole-time-equivalent staff working in services, including physiotherapy, pharmacy and phlebotomy, as at March 2024. Those teams help free up time for practice teams and GPs.
The Scottish Government funds an effective interface project with the Royal College of General Practitioners Scotland, the national centre for sustainable delivery and health boards to improve the interface between GPs and specialists. That ensures that referrals to secondary care require minimal administrative work, allowing GPs to maximise time spent treating patients.
In 2018, the Scottish Government introduced the new GP contract with a promise to fully implement it in 2021. It told doctors that it would support general practice by funding pharmacists, nurses, physiotherapists and mental health nurses in order to relieve the huge pressure on primary care.
In true Scottish National Party style, though, the Government has failed to keep its promise, and front-line doctors are suffering as a result. Island GPs have told me that patients used to be able to ask for an appointment and were often seen that day, without argument. Now, patients can wait four weeks for an appointment, despite some doctors working 12-hour days with no break.
GPs in my island communities are clear that primary care is at crisis point under this SNP Government, so will the cabinet secretary finally commit to implementing the 2018 GP contract, as promised?
We are working to implement the contract, and we are making progress on that. In that respect, I would reference two points, the first of which is the number of whole-time-equivalent multidisciplinary team staff working across the NHS Highland area. In Argyll and Bute, the multidisciplinary team workforce in the health and social care partnership numbered, at March 2024, 84.5 people, an increase of more than 17 from the previous year. In Highland, there was an increase of more than 19 from the previous year.
Secondly, the number of GPs working in rural health boards increased from 1,013 in 2018 to 1,030 in 2024. That is the equivalent of 10 GPs per 10,000 patients in rural health boards, compared with 8.4 across the rest of Scotland.
I recognise that there are particular challenges. Jamie Halcro Johnston and I hail from the same islands; I recognise the challenge in rural and island communities, and we are continuing to invest to ensure that there is support for GPs to respond to it.
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