Meeting of the Parliament 15 December 2015
I am pleased to be opening this afternoon’s debate. I want to take the opportunity to describe my longer-term vision for primary care, building on Sir Lewis Ritchie’s recent report, and the many innovative new ways of working that have been springing up across the country. I want to explain our delivery plan, setting out how we are going to make the vision a reality, and how all parts of the system will need to work together to make it happen.
First of all, though, I want to take the opportunity to thank all those who work in our health and care systems, particularly at this time of year with the pressures that winter brings. I know that our staff work particularly hard over this period. Although we are talking about primary care today, I take the opportunity to thank our hard-working health professionals in our accident and emergency departments, which have today delivered on the four-hour target. That is a huge achievement that I am sure will be welcomed by members on all sides of the chamber.
Within our primary care sector, we have a huge number of people who work very hard. I absolutely understand some of the challenges involved, which we will hear more about this afternoon. However, it is important that we are clear on the way forward to ensure that our primary care services are robust and sustainable and are able to change and develop to meet the changing demands that will be required as we go forward.
Sir Lewis Ritchie’s “Main Report of the National Review of Primary Care Out of Hours Services” was published on 30 November, and I warmly welcomed its findings. We have, of course, announced an initial investment of £1 million to begin to test his new models of care, which I will come back to later. Through our programme for government commitments, we identified 10 examples of test sites for change in primary care, and work is progressing across all of those; for example, the Lothian headroom initiative is focusing on improving outcomes for people in economically disadvantaged areas of Edinburgh. In addition, I am going to test two community health hub sites—in Fife and Forth Valley—where we will focus on the interface between primary and secondary care.
We will also achieve change in primary care through trusting our general practitioners and delivering on our commitments. When I spoke at the Royal College of General Practitioners conference on 1 October, I promised GPs that I would remove the outdated quality and outcomes framework—the QOF—from their contract. This morning, I was delighted to announce that, working closely with the British Medical Association in Scotland, we have delivered on that promise and that the QOF will cease to exist from April next year. That will help to free up more time for GPs to focus on essential patient care.
We have moved to implement some developments very quickly, but obviously more must be done. We need to go further and faster because Scotland is changing and the people who need healthcare are changing. We are living longer, which is a good thing, but all too often a longer lifespan brings with it more complex health needs and reduced quality of life. Meanwhile, people quite rightly expect to access quickly the right care by the right professional when they need it.
I hear our primary care practitioners when they say that they sometimes feel that they have too much to do and not enough time to do it. Statistics published today show that although the number of GPs working in Scotland has increased by 9 per cent since 2005, the number of patients over 65 has increased by 18 per cent over the same period. Our out-of-hours primary care services are relied on by hundreds of thousands of patients across Scotland each year.