Meeting of the Parliament 15 September 2021 (Hybrid)
Yesterday, we debated the extent of the crisis that is being experienced by the NHS, with services struggling to meet demand and waiting lists at a record high. Today, we are talking about GPs.
Much of the attention so far has focused on acute care in our hospitals and with emergency services, but the truth is that, if we are to resolve some of those problems, we need to mobilise and resource primary care. We all value our GPs. In fact, we value the entire primary care team—practice nurses, health visitors, dentists, pharmacists, and optometrists. They all do an important job in preventing and dealing with ill health, but they are often the first and most enduring contact in a patient’s journey.
It is unfortunate that the messaging from the Government has so far been confused, suggesting that somehow GP surgeries have been closed. In fact, GPs and their teams have been working really hard—[Interruption.] The minister might have got to the right message today, but in her previous appearances on media, she has suggested that surgeries have been closed.
GP teams have been working really hard. They are the ones at the vaccination centres, helping colleagues in hospitals with Covid patients, all while dealing with their own patients. Primary care has adapted and evolved, and yes, there might be more telephone or virtual consultations, but if someone needs to be seen, they should be given a face-to-face consultation.
I recognise that parents want the reassurance of a face-to-face consultation with their GP. Clinically, it is important, as some conditions need to be seen to be diagnosed, so virtual consultations should not be the default. However, GPs are operating to Scottish Government guidance, which wants a model of telephone consultations first. That has not changed, so it is ultimately up to the Government, and transferring blame to GPs is neither right nor appropriate.
Although I recognise the frustration that is felt by people over their access to a range of services, that is never a reason to be abusive to staff, who are doing their very best to help us to keep safe.
We all need to acknowledge the failure of the Government to support staff in primary care. That is not just a pandemic problem; it has been building for the past 14 years of the SNP’s mismanagement of the health service. The NHS recovery plan fails to address the pressure on staff, and the lack of a coherent workforce plan to build capacity to match demand is more than disappointing; it is a dereliction of duty.
During the previous parliamentary session, a promise was made to recruit an additional 800 GPs, but there is an urgent need for them now, not in 2027. Many are retiring early because they feel burnt out. What progress has been made on that? Multidisciplinary teams in GP practices were also promised, but progress on that has been, at best, extremely patchy. There are simply not enough physiotherapists or pharmacists in general practice. That is another pre-pandemic promise that has not been fulfilled. Mental health workers are also unlikely to be in place until 2026, which is five years from now.
Pharmacists have a contribution to make to NHS recovery, but the Government appears to be resistant to the opportunity, and I hope that that is not the case. If the Government extended the pharmacy first service, pharmacists could be the first port of call for many people. They could help with diagnostic testing to reduce antibiotic use, and deal with blood pressure, type 2 diabetes, and cholesterol testing. That would help to alleviate some of the load on GPs. Equally they could play a key part in helping with the management of those who have long-term conditions—[Interruption.] I genuinely do not have the time; I am in my final minute.
Pharmacists could provide pharmaceutical care and create the capacity for GPs to focus on acute presentation and reduce hospital admissions. More of that needs to be happening, so that we use appropriately the entire primary care team.
I will make equally brief mention of dentists. Patients are told that dentists are open for business, but Government guidance means that they are able to offer appointments to only a small number of patients. Again, there is mixed messaging from the Government, which leads to frustration for dentists and their patients alike. [Interruption.] The ministers may be laughing, but this is the truth. [Interruption.]