Scot Gov have betrayed GPs and their patients. They have utterly failed to deliver the 2018 GP contract with rural practices by far the worst hit. There is now a postcode lottery of services available, with rural practices seeing barely any of the additional physiotherapists, mental health nurses, clinical pharmacists and urgent care staff that are common place in urban practies. Funding to General Practice has been slashed, with the archaic NRAC formula meaning that rural practices were losing out from the very begining - even before what was promised was withdrawn. Small health boards have lacked the staff, skills and expertise to mastermind implementation of essentially impossible Primary Care Improvement Plans and calls for help and support from SG have been ignored. All of this means that rural, and especially island GPs are expected to deliver general practice, physio services, mental health support, complex pharmacy reviews and more with less money and minimal staff. Top that with General Practice being the fall back point of contact for every patient facing a delay in hospital clinic appointments, operation dates and specialist reviews whilst already delivering more appointments every week than they did prior to the pandemic. Then consider the impossible position of facing all that whilst GP numbers are falling - cant be recruited or retained and SG cant even match funding to GP staff with what is awarded to hospital staff doing the same jobs. Its shameful.
The biggest issue facing rural general practice esp Caithness is the way that NHSH treat the staff that they already have. Why are rural GP practices not being included in the Caithness redesign, we have rural GP's /communities omitted from this progression instead focusing on the town GP's (with invested interest in the promotion of this scheme, no disclosure of any conflict of interest). NHSH champion the wrong people and leave rural communities with no security. Shameful, a fancy new buildings will never attract staff when NHSH cannot delivery equality to the whole population and workforce as they are forever known as bullies that have not learned nor changed the way they operate.
I agree with Prof Wilson. Island GP's proposal has the right analysis but fully implementing the 2018 contract is not the right answer as it was never fit for purpose or rural proofed. RGPAS (the Rural GP association of Scotland) strongly opposed the 2018 contract and gave detailed reasons why as well as alternatives. We were outvoted by the urban GPs who got a pay rise while we didn't and our predictions are sadly being proved right with the difficulties in recruitment and retention. The issues need a more comprehensive rural focussed solution that the 2018 contract cannot deliver - it was a one size fits all contract designed for the central belt majority and tweaking it will never be enough to address the underlying problems
The committee need to understand that the 2018 GP contract does not work in remote rural Scotland. We are not Glasgow or Edinburgh! We need a DIFFERENT way of working - the proper GP care way of working not 9-5
The underlying principles of the 2018 contract are wrong. Patients deserve continuity of care, easy access to qualified GPs and a fair allocation of primary care funding. The contract has had negative effects on all of these. We need a new rural contract.
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