DAVID STEWART: Views of our hardworking and dedicated GPs must not be ignored
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Student life finally came to an end last week, as after 24 months of toil and struggle, my dissertation on the Highlands and Islands Medical Service (HIMS) of 1913 was lodged.
As a final flourish, the wonderful staff at the Highland Archive Centre in Inverness found a picture of Fiona Ferguson, the first rural district nurse to use a motorbike in the Highlands in 1926, which now proudly adorns the cover of my dissertation.
We should all be proud of our medical heritage in the Highlands and Islands. HIMS was one of the first state-subsidised (though not free) health services in Europe and led to spin-off medical provision in both Canada and America.
One area where HIMS was very successful was ensuring the supply and retention of GPs in the rural north by bringing in a minimum wage for doctors. The model of the independent medical practitioners working alongside well-trained, graduate nurses revolutionised healthcare in the Highlands and Islands, and certainly contributed to the creation of the NHS in 1948.
However, the survey by the British Medical Association (BMA) of GPs this week makes for worrying reading. The survey revealed that almost a quarter of GPs may quit in the next year or two; two-fifths of doctors cannot meet demands from patients; and 60 per cent of those surveyed feared for the future of their practice if they lost a GP.
The BMA rightly wants urgent action from the Scottish Government. The alternative, they argue, is the continued loss of GPs, which will lead to patients finding it even more difficult to get appointments.
The shortage of doctors in Scotland is at a real crisis point. The BMA say that Scotland is short of 312 full-time-equivalent GPs. Bearing in mind that each GP can provide care for between 1300-1500 patients, this means nearly 500,000 patients are being squeezed onto existing lists.
The position is no better for our key junior doctors within the hospital setting, such as at Raigmore. In another survey, the BMA reported that over 40 per cent of junior doctors have researched leaving the NHS in the last 12 months.
Other countries, such as Australia, are working on capitalising on the dissatisfaction of our medics. A recent advert in the British Medical Journal (the in-house magazine for doctors) was taken out by Blugibbon Medical Recruitment in Australia. It said: “Got that Dr Adam Kay feeling – come to Australia!” Dr Kay, a doctor-turned-comedian, said: “If you don’t address doctors’ very reasonable pay concerns, alongside their conditions and wellbeing, guess where they’re going?”
The Scottish Government’s strategy to address this crisis is a two-pronged attack: to increase medical graduates by 100 per cent and to increase doctor recruitment, both domestically and internationally. However, it takes around 10 years to train a GP and doctors are leaving now because of exhaustion and fatigue.
We need to set this into context. The creation of the NHS in 1948, free at the point of use, was a high-water mark for politics in this country. Patients in other countries, such as America, look with envy at our system of free healthcare. In the USA, over a third of personal bankruptcies are caused by healthcare expenses.
Therefore, the views of our hardworking and dedicated GPs must not be ignored by the Scottish Government. Recruitment and retention of GPs and junior doctors, alongside our frontline nursing, paramedic, mental health and all the other support staff, must go to the top of the political agenda as a matter of urgency. Life or death, even.
