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Chamber

Meeting of the Parliament 23 November 2022

23 Nov 2022 · S6 · Meeting of the Parliament
Item of business
Primary Care

For most people across Scotland, the first point of call when it comes to their health is their general practitioner. GPs are very much at the front line of our national health service. Without functioning GP services, our health system would collapse.

In some areas of Scotland, however, GPs are closing their doors and handing back their contracts, and thousands of patients are being left without a GP. In other areas, lists are closed to new patients, and practices are simply unable to cope with the volume of patients that they have and to fill vacancies as GPs retire. I have letters from GPs in Lothian and Aberdeenshire and from a medical practice in Falkirk that is struggling to survive.

The Scottish Government must act to address the looming crisis in primary care, or more patients will struggle to get the help that they need. I will illustrate that point with some of the facts. GPs are seeing 500,000 people a week, which is a lot more than they were seeing before the pandemic. Most of them are working additional hours to try to meet the demand, and many can provide emergency appointments only due to short staffing as a result of vacancies or illness.

In a recent British Medical Association survey, 81 per cent of GP practices said that demand exceeded capacity, 34 per cent reported GP vacancies, and practices estimated that they are about 1,000 GPs short at present. The Royal College of General Practitioners says that there will be a need for even more GPs by 2027. Despite that, there is a lack of clarity about GP numbers. The Government bases its numbers on head count, but the truth is that many GPs work part time, and the flagship target of 800 GPs is well short of what is actually required. I ask the cabinet secretary to outline the urgent action that he intends to take to improve practice staffing and to say whether he will be transparent about GP numbers.

The SNP makes claims about the increase in multidisciplinary teams, but they are contradicted by GPs. Despite the recruitment activity, the Royal College of Nursing reports that 12 per cent of district nurse posts are unfilled. When we consider the numbers of allied health professionals, we see that there are 346 physiotherapy vacancies.

Faced with those challenges, it is extraordinary that the SNP has cut the health and social care budget by £400 million. Some £65 million has been cut from the primary care development fund alone, and £5 million has been cut from the GP sustainability fund. Our tone deaf health minister, Humza Yousaf, announced that at the same time as he is telling people to stay away from accident and emergency departments and to go to their GP instead.

That is just about the most wrong-headed decision that I have seen: cutting resources for GPs when they most need them, during a winter crisis. It represents breathtaking incompetence on the part of this SNP health minister. GPs are on their knees, and if the Scottish Government fails to address their serious concerns, more people will end up in already overwhelmed acute services when they could have been dealt with locally in primary care.

I urge the cabinet secretary to reverse the cuts and listen to the British Medical Association and the Royal College of General Practitioners. They are telling him that there is a crisis, so I say to him, “For goodness’ sake, please act.” Perhaps he could use for that purpose the £20 million that has been earmarked for a referendum. It never fails to astonish me that, when the nation is focused on a crisis such as the one that our NHS faces this winter, the SNP is focused on the constitution.

At the start of the week, there were extraordinary revelations that senior NHS executives were discussing the privatisation of our NHS. The discussion was green lit by Caroline Lamb, the most senior civil servant in charge of health for the SNP Government. Either the cabinet secretary knew about that and is complicit or he did not know about it, in which case he really cannot be trusted to be in charge. Either way, we can usually judge how close to the mark we are by the volume of abuse and aggression from SNP members and supporters, not just on social media but in the chamber.

This is a damaging story for the SNP, because it tells us that the NHS in not safe in SNP hands. Inside or outside the United Kingdom, the SNP—

In the same item of business

The Deputy Presiding Officer (Liam McArthur) LD
The next item of business is a debate on motion S6M-06899, in the name of Jackie Baillie, on protecting primary care. I invite members who wish to participat...
Jackie Baillie (Dumbarton) (Lab) Lab
For most people across Scotland, the first point of call when it comes to their health is their general practitioner. GPs are very much at the front line of ...
Gillian Martin (Aberdeenshire East) (SNP) SNP
Will the member take an intervention?
Jackie Baillie Lab
I will not. The member should listen to this. Inside or outside the UK, the SNP would contemplate a two-tier NHS where those who can afford to pay would get...
Gillian Martin SNP
Will the member take an intervention?
Jackie Baillie Lab
The minutes of the discussion are also interesting as they confirm something that we already know—that the cabinet secretary does not listen. He does not lis...
Audrey Nicoll (Aberdeen South and North Kincardine) (SNP) SNP
Will the member take an intervention?
Jackie Baillie Lab
As for the £1 billion black hole in the NHS budget, we should look no further than Nicola Sturgeon. When she was the health minister, she failed to pass on f...
The Cabinet Secretary for Health and Social Care (Humza Yousaf) SNP
Does it not show insecurity in her own argument that Jackie Baillie was not able to take a single intervention? This is meant to be a debate, but Jackie Bail...
Daniel Johnson (Edinburgh Southern) (Lab) Lab
Will the cabinet secretary give way?
Humza Yousaf SNP
At 14 seconds into my speech, I am happy to give way to Daniel Johnson.
Daniel Johnson Lab
If the cabinet secretary is so keen on interventions, will he answer this question? Did he know about the meeting and agree to it or did it happen without hi...
Humza Yousaf SNP
It was a meeting of five people with one chief executive present. Believe it or not, with the more than 160,000 healthcare workers that we have, I do not kno...
The Deputy Presiding Officer LD
Mr Johnson.
Humza Yousaf SNP
When I have met chief executives and the chairs of health boards, not one of them has ever floated the idea of charging patients. If they did that, I would, ...
Mercedes Villalba (North East Scotland) (Lab) Lab
I have previously raised with the cabinet secretary my constituents’ concerns about the declining quality of patient care at some general practices in Aberde...
Humza Yousaf SNP
I will give that update. Mercedes Villalba is absolutely right. She has raised the issue with me on several occasions. It is, of course, an issue for the loc...
The Deputy Presiding Officer LD
There is a little time in hand, so I can give members a bit of time back for taking interventions. I would far prefer that to people shouting from a sedentar...
Sandesh Gulhane (Glasgow) (Con) Con
Jackie Baillie’s debate today is timely, because this week we learned about damning minutes of meetings of senior management of Scotland’s health boards, whi...
Humza Yousaf SNP
It is better than England.
Sandesh Gulhane Con
—and the worst delayed discharge record, with an average of 1,832 beds occupied each day due to delayed discharge. I heard the cabinet secretary say “better ...
Gillian Martin (Aberdeenshire East) (SNP) SNP
Sandesh Gulhane said that “we live in Scotland.” Yes, we live in Scotland, but the Tories are presiding over the English NHS. Is it not right that we critici...
The Deputy Presiding Officer LD
Through the chair, please, Ms Martin.
Sandesh Gulhane Con
The first thing to say is that you should be representing your constituents—
The Deputy Presiding Officer LD
Through the chair, Dr Gulhane.
Sandesh Gulhane Con
The member should be representing her constituents here. The second thing to say is that we cannot trust SNP statistics, as we have found when it comes to e...
Humza Yousaf SNP
Will Sandesh Gulhane take an intervention?
Sandesh Gulhane Con
Yes, if I can get the time back.
Humza Yousaf SNP
I wonder whether Sandesh Gulhane will recognise and apologise for his party’s economic mismanagement, which has meant that my health budget is worth £650 mil...
The Deputy Presiding Officer LD
I can give you up to five minutes, Dr Gulhane.