GPS in crisis

Tom Peterkin conveys accurately the plight of general practice in Scotland in his recent article “GP crisis risks the fabric of Scottish society” (The Scotsman, 9 November).

The Royal College of General Practitioners has revealed that 52 practices in Scotland changed to 2C status in 2016 “Record number of Scottish GP practices return contracts” (The Scotsman, 26 September). A 2C practice is one which has returned its contract to the health board, feeling unable to meet its obligations. These practices look after 160,000 people in Scotland.

The reason this is happening in GP practices around Scotland is this: a stable practice has five doctors who have been partners for years. One doctor leaves and despite the best efforts of the practice cannot be replaced: “GP recruitment in Scotland close to impossible” (The Scotsman, 10 November). The remaining four knuckle down and absorb the extra workload. But then two of the older GPS reach retirement – 35 per cent of GPS intend to retire within the next five years. The remaining two GPS are unable to provide a safe service for their patients and with no chance of replacing the departing doctors they reluctantly hand back responsibility for patient care to the health board.

The practice will now be run by the health board with locums, if any can be found. The wait for an appointment lengthens; continuity of care is lost; a long-term relationship with your own GP becomes a thing of the past; referrals and admissions to hospital are likely to rise because patients are seen by doctors who do not know them, and the hospital service is swamped.

The RCGP estimates that Scotland will have a shortfall of 856 GPS by 2021. No practice in Scotland is safe from becoming a 2C practice – what we are seeing at the moment is the tip of the iceberg.

The GP crisis in Scotland should never have been allowed to become so serious.

The BMA are negotiating a new GP contract with the Scottish Government and the details are expected later this month. Its importance cannot be overstated: the health service will not function without GPS, it is as simple as that.

(DR) BRUCE HALLIDAY Dalbeattie Road, Dumfries