New NHS plan? No, the doctor still won’t see you...

SO, Nicola Sturgeon has unveiled her plan to get the NHS back up on its feet after Covid. The headline figure (and the SNP love a headline figure) was £1 billion of extra investment, but as always it’s the small print that really matters.

The money is spread over five years and, despite the huge waiting times created by so many cancelled procedures, much of the recovery is being pushed down the line, with most promised new National Treatment Centres not due to open until 2023 at the earliest.

Also missing was any significant uplift in funding to accident and emergency departments, which are facing their worst waiting times for six years, nothing new to tackle drug and alcohol deaths across Scotland, which are both at record highs, and no long Covid clinics to help those feeling the long-term effects of the virus.

This last point is significant because it means the suspected thousands of people who suffer from long Covid will likely engage heavily with their GPs as they try to recover. And it’s primary care where most people have the greatest amount of medical contact.

Yes, more than 100,000 Scots are currently waiting for one of eight key diagnostic tests, and yes, the first year of restrictions saw nearly 200,000 fewer operations, increasing the backlog further, but if we are to get the country healthy again, it’s the family doctors’ surgeries that deserve much greater attention than they are currently getting.

Because the plan for GPs contained within this week’s blueprint has nothing to do with recovering from Covid.

The pledge to have 800 more primary care doctors by 2027 is already four years old, first launched in 2017, before Covid19 was even considered, never mind discovered.

Indeed, Audit Scotland examined the SNP’s plans to increase GP numbers two years ago, and warned that they would struggle to get there because the plan didn’t account for basic considerations such as the number of GPs going part-time, or the increase in retiral rates with much of the workforce already over 50.

To reheat a four-year-old pledge and pretend that it is a Covid response is pretty shameful, but it’s even worse if, as the national auditor suggests, the Government will find it ‘difficult’ even to meet the original aim, despite a decade to do so.

But that’s not the only problem with the hand that patients are being dealt. The big NHS Covid bounceback plan that Nicola Sturgeon and Health Minister Humza Yousaf championed this week contained no return date for face-to-face GP consultations, only saying it was a ‘key action’ over the next five years.

That’s not good enough. People across Scotland have been incredibly patient and supportive of all the rule changes they’ve been subject to. They’ve done their bit by using pharmacies or calling phone lines rather than reporting to their local surgeries over the past 18 months for smaller issues. Folk have been acutely aware and sympathetic to the message that we shouldn’t ‘overwhelm our NHS’ but there’s a reason that GP consultations happened in person before the pandemic, and a real impact from continued absence.

NOT everyone is able to describe their symptoms as effectively as an examination can reveal them. Not everyone has the technical ability to take part in a video conference. Not everyone will present to their GP if they think they’ll be asked to phone or video, preferring instead to wait until they can get a ‘proper’ appointment. And this has consequences.

Cancer referrals were down by more than a fifth during the first lockdown, with hundreds of people fewer being sent for a scan or test, or starting treatment than the year before. Public Health Scotland said the sharp decline was due to a mix of diagnostic tests being delayed, procedures being cancelled so hospitals could deal with Covid patients instead and patients just not going to their GP in the first place.

GPs are often referred to as the gatekeepers of the NHS. Yes, there’s a ton of work to do to get operations back up to speed and waiting lists brought down, but we need to give some focus to family doctors’ surgeries too, as that’s the way into the system for so many patients.

The sector deserves more than a four-year-old recruitment plan that’s already in trouble.