GP contract a disaster for rural practices, says Hillswick doctor
A Hillswick GP has hit out at a new Scottish GP contract – branding it bad news for the Highlands and Islands and claiming the plans are “a disaster”.
The GP contract is to come into play in April after being agreed at a national level with the Scottish government.
It has promised an extra £250 million to be invested in GP practices as part of the agreement.
But Dr Susan Bowie is not impressed with the contract. Speaking at the Integration Joint Board on Thursday she said she has had sleepless nights about it and had feared it would mean a 60 per cent drop in funding and the closure of her practice.
Dr Bowie said: “Only one practice is going to get any gain from the contract financially and that’s Lerwick and the rest [in Shetland] are going to be losers.”
She issued a lengthy handout to board members giving her views and those of the Rural GP Association of Scotland.
Eight out of 10 practices in Shetland are run by the health board, with Hillswick and Levenwick independent.
GPs were asked to vote on phase one of the contract in November.
Dr Bowie said the British Medical Association (BMA) had negotiated a new contract on behalf of all Scottish GPs with the Scottish government, but she told Thursday’s board meeting there was little consultation and felt it was a “done deal by the BMA”.
She said that along with 90 per cent of rural GPs, she voted against phase one of the contract.
This was on grounds of reduced funding for rural practices, the possibility of making smaller practices unviable and fragmentation of practice teams and services.
In her report Dr Bowie highlighted the continuing struggle to recruit GPs and said the number of Scottish GPs had remained static for a decade. She also flagged up looming retirements, including her own, in the next four to five years.
“The contract fails to recognise the unique kind of GP workload in rural areas, eg small populations but with big loads of chronic illness,” said Dr Bowie.
She said Hillswick had the highest rate of type two diabetes in the country and also noted other pressing health needs, including the practice dealing with the same amount of asthma and inflammatory bowel disease as practices three times the size.
Workload assessment, she said, had purely been based on patient numbers. The GP fired criticism at Deloitte, which had carried out the assessment of practices’ workload.
She said the Hillswick practice was assessed without Deloitte setting foot in it.
After phase one is brought in, a second phase of the contract is to be introduced, with GPs having a vote again in about three to five year’s time.
Dr Bowie said she has since been told her practice will be safe as it is under a special contract negotiated locally with the health board.
But she told the meeting there were fears the contract could be imposed on GP practices “whether we like it or not”.