Born in 1946 and brought up in Cupar, Fife, I was educated at the local school - Scottish Parliament
Wednesday 25 February 2004
(Afternoon)
[THE PRESIDING OFFICER opened the meeting at 14:30]
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General Medical Services Contracts
The Deputy Presiding Officer (Murray Tosh): The final item of business is a members' business debate on motion S2M-728, in the name of Alasdair Morgan, on general medical services contracts. The debate will be concluded without any question being put.
Motion debated,
That the Parliament is concerned that the provisions made for contracting-out out-of-hours care from GPs to local NHS boards may be insufficiently funded to meet the unique challenges encountered in rural practices; believes that rural practices thus unable to opt out will have serious difficulty in recruiting new doctors, and considers that the Scottish Executive should re-examine the level of funding allocated to NHS boards providing these services in rural areas.
17:10
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17:49
Stewart Stevenson (Banff and Buchan) (SNP): I would like to speak about some local issues in my constituency, starting with GP vacancies. We have two GP vacancies in Banff; two in Fraserburgh; one and a half in central Buchan; and, on the fringes of my constituency in a practice that is used by many of my constituents, two vacancies in Turriff. That is a huge number of GP vacancies, and most of them have existed for more than two years. That shows the problem against which we have to consider the out-of-hours provision. I suspect that things can only get worse. Some GPs in my constituency are telling me most vigorously that they fear that we will slip into the situation that we have with dental provision. I accept that the health board has a duty to provide GPs to those who cannot find them for themselves and that no such duty exists in dentistry. However, given the number of GP vacancies in the area that I mentioned, there is a real problem.
For Grampian NHS Board, which supports 10 per cent of Scotland's population, but receives only 9 per cent of health service funding, the provision of out-of-hours cover is a particular problem, given the rurality of the area. It is likely that costs for providing the service in Grampian will rise faster than they will in urban areas. There is no sign that the money that is provided will solve that problem.
My father was a GP. He used to have Dr Wilson come down from St Fillans to Cupar every year to be his locum. It is not without relevance that Dr Wilson was the grandson of David Livingstone—today we are looking for some new missionaries to fill the gaps in rural areas. The key point is that my father had to pay 17 per cent of his income to Dr Wilson each year to cover a gap of 7 per cent of his time. Out-of-hours cover is expensive relative to everything else.
We are coming up to the deadline. We do not know how the out-of-hours service will be provided and serviced. When I met representatives of NHS Grampian a few weeks ago, I found that the plans were pretty damn fluid.
GPs are concerned that the change in the contract will lead to their referring more injuries to accident and emergency units because they will not be paid to deal with them. That puts GPs in a difficult position.
GPs in my constituency want categorical assurance that there will be money for personnel to provide out-of-hours care. They want to know how we are going to address the problem in our rural areas. It is clear that transport will be a big issue. My father used to drive a Mini Cooper S and he occasionally took patients directly to hospital in Edinburgh, there being no other way. There are none of those cars around and my father has been dead many years. We need to hear from the minister.
17:52
