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.

Hillswick GP Susan Bowie lobbied Integration Joint Board members over the GP contract which she calls a “disaster”.

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”.


Add Your Comment
  • David Spence

    • February 22nd, 2018 16:23

    As the impending gloom of Brexit comes closer and closer, I fear that GP and medical services within Shetland and other rural area’s will be massively hit hard as the NHS is forced to outsource services to the private sector on the basis monies to the NHS are cut more and more.

    How Shetland will cope with a private sector based health care system will really bring it to fore how much worse the private sector will be, and the cost of such a service being transferred to those who can afford it or insurance companies dictating what service and medication you can receive.

    Even if the NHS is protected in Scotland, it will not take much for Westminster to force the SNP to outsource the NHS, GP services to the private sector just by slashing the monies Scotland receives from Westminster regardless to what the Barnett Formula may say.

    It will also mean that every person will be forced to take out an Insurance Policy to cover any future medical requirements they may need, and it will be the insurance companies which will dictate what medical treatment and medicine you get, and not your doctor.

  • S V Jolly

    • February 23rd, 2018 20:10

    David, did you miss the bit then about two surgeries being independent but just happen to get NHS contracts? Do you not deem that to be a form of privatisation?

    Have you ever met a skint doctor?

    Have you ever found that a preferred drug is no longer available but you get a generic one instead or produced by a different manufacturer despite the fact you know you get less side effects from one?

    Now whilst I agree that Deloittes should have set foot inside the building and the pressures faced by rural practices, having read a load of the Scot. Gov. blurb regarding healthcare, there’s bound to be difficulties. That’s not the fault of BREXIT, it’s the fault of the current SNP-lead Government. BREXIT will permit us to source staff from outside of the EU, it won’t stop EU member state citizens from applying for jobs here. Other countries get on fine with work permits. What, however, we should have done, is made it easier and more financially viable for those wanting to work in the health sector be able to get training and support long before any crisis arose.

    The NHS is slowly imploding on itself, isn’t currently fit-for-purpose, and hasn’t been for probably the last two decades.

    • David Spence

      • February 23rd, 2018 23:19

      Well Suzy, I mentioned Brex*hit, because this will be the catalyst for the Tories to get the green light to privatise completely the NHS, and where they will benefit as share-holders or on top management of the US companies taking over. It is as simple as that.

      As for the performance of the NHS, yes, it is almost bursting at the seems due to the Tories for the past 8 years cutting the monies the NHS should get, thus the NHS very much struggling to perform to an adequate level. Yes, there is serious shortage of doctors and nurses, mainly because students do not want to go into this profession with a 40, 50 or 60 (no thanks to the Tories increasing tuition fee’s to £9,000 a year) thousand pound debt before they even start a full time job.

      In the league of tables, the UK NHS lies 30 out of 40 of developed countries, before hand, it was much higher, within the first 10, but since austerity cuts by the Tories this has plummeted. btw the UK is ahead of the USA, so why we would try to emulate the USA beggars belief…one step forward, two steps back.

      • Ali Inkster

        • February 24th, 2018 13:51

        it was sturgeon that cut nursing places and medical degrees at scots universities nothing to do with english tories or brexit David.

      • Christopher Johnston

        • February 24th, 2018 19:05

        The UK already emulates the USA by offering private health insurance, which sells well. If NHS were as goid as you state, then why do so many buy it? They buy it because they know the NHS and want better.
        I watched one grandfather die at Broadgreen Hospital, Liverpool in the early 1970s and the other die in a small public hospital in the USA ten years later. The treatment at Broadgreen was minimal.
        The daughter of a friend has contracted what she and her family believes is a form of lupus at age 30. NHS refuses to spend the money to fully diagnose her problem because then they would be obligated to spend the money to treat her. On the other side of the Pond, my wife at age 73 is being treated for rheumatoid arthritis, vasculitis, neuropathy, cardiac arrhytmnia, and a lung problem; we have paid out of our pockets a minimal share with our health insurance and government coverage paying the bulk.

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