National Association for Patient Participation

SCOTLAND Experts tell MSPs that general practice needs support

30 March 2017

The future of healthcare in Scotland is in the hands of our politicians. On 21 March, MSPs met to gather evidence about what our healthcare system should look like to ensure people remain as healthy as possible for as long as possible.

The future of healthcare in Scotland is in the hands of our politicians. On 21 March, MSPs met to gather evidence about what our healthcare system should look like to ensure people remain as healthy as possible for as long as possible.

General practice is always key in a conversation of this kind. GPs work with their patients to look after the ‘whole’ person and work to deliver care in the community helps prevent unnecessary admissions to hospital. It was great to hear Alison Johnstone MSP (Green) highlighting the work of Dr Helene Irvine, Consultant in Public Health at NHS Greater Glasgow and Clyde:

Employing more district nurses and GPs is necessary to enable them to react to genuine need in the community so as to minimise unnecessary reliance on secondary and tertiary care in the future. That is not preventative medicine as we think of it in public health terms. That is just intelligent, cost-effective health service planning.”

Dr Irvine has also advised that efforts should be focused on seeing the same GP each time you visit the practice rather than on individual projects for specific problems.

These comments strongly support the principles outlined in RCGP Scotland’s ‘Core Values’ statement, which emphasises the crucial role of GPs in providing continuity of care and coordinating the care journey for patients.

Dr Eleanor Hothersall, Consultant in Public Health medicine in NHS Tayside, told the Committee: “My perception of general practice… is that the difficulties are part of one of the biggest public health problems that we are about to endure, which is our inability to deliver the services that we want to deliver through primary care because of a lack of workforce and other facilities.

We say that we want something, but then we cannot have it on the ground because we do not have the people or the facilities available, because of systematic disinvestment over a very long time at every level and the increasing unattractiveness of the job.”

She continued: “I am really sorry to say this—don’t shoot me—but we have a recruitment crisis in general practice at every level because it is not a great job to have a lot of the time.
What we want—the whole philosophy underpinning moving care further into the community—puts much more pressure on primary care at a time when we have less and less ability to deliver the services there in the first place.”

Alison Johnstone MSP also referred to the link between general practice and health inequality, saying that Dr Irvine’s work “supports the view that, in areas of deprivation, we do not support general practice well enough to tackle unmet need and health inequalities.”

Government statistics released this week show the shocking extent to which health inequalities impact on people’s everyday lives. Dr Irvine and others’ research has shown that those most in need of healthcare have least access to it. GPs can help address the gap in health outcomes between the most and least deprived in our society.

However, we need the resources to allow us to deliver for our patients and ensure that postcodes do not determine health outcomes.

We can only hope that, for the sake of our patients, the Scottish Government listens to the advice of experts and takes action to ensure that general practice has enough resources to provide the quality of care our patients deserve.

To read the full text of the Scottish Parliament’s Health and Sport Committee’s  evidence session, click here.

You can also sign up to hear more about the Put Patients First campaign here.

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