GPC Scotland chair warns of ‘end of the independent GP contractor model’

Scotland must be prepared to change direction and properly support the independent contractor model or it will be lost, GPC Scotland chair Dr Andrew Buist said in his opening speech to the Scottish LMC conference last week.

Dr Buist said he was ‘convinced’ that ‘some in government seek to undermine [general practice] to the point of destruction’.

He highlighted figures published by BMA Scotland last month which found that more than a third of Scottish practices had at least one GP vacancy, compared to just over a quarter the prior year, as well as the BMA’s wellbeing survey, which found only 18% of GPs would recommend a career in general practice.

‘Only the astonishing tenacity of practices in England to try to resist and survive keeps them going. But with a government set on breaking the model, their future must be uncertain,’ he said.

‘I don’t believe our [Scottish government] wants that to happen here, however the problem is that if our warnings go on being ignored, that is where we will end up too.

‘If we continue down this route, I believe we will see the end of the independent GP contractor model. The choice is stark, Scotland must be prepared to change direction now and properly support the independent contractor model or we will lose it forever.

Referring to the wellness survey, he said: ‘If this statistic doesn’t tell you that the service is in a terminal decline – what will? My huge fear is that as a nation we are sleepwalking into the death of general practice as we have known it.’

He blamed the problem on ‘excessive workload’ and said it was ‘no longer acceptable or safe’ to provide unlimited patient contacts.

‘We are witnessing the slow death of general practice in Scotland; it is being strangled by a severe lack of funding for an adequate workforce and drowned in a sea of workload. We no longer need service transformation; we now need a revolution in healthcare,’ said Dr Buist.

In October, Pulse reported on warnings that a £5m cut to a previously agreed sustainability fund for Scottish GP practices will negatively affect patient care.

And ahead of winter last year, the Scottish Government and BMA agreed a £30m pot of funding, which was to be paid in two £15m instalments in December 2021 and April 2022. However, due to rising inflation, the Scottish Government cut the pre-agreed fund last month.

In England, LMC leaders voted in favour of the BMA balloting GP members on industrial or collective action if no ‘meaningful’ contract changes are agreed in 2023/24 or 2024 onwards, Pulse reported yesterday.