The BMA has warned that 30 GP practices in Scotland are at risk of collapse after the Government decided to pause funding for a premises loan scheme.
A survey of GP practices in Scotland, carried out by the BMA, found that 30 practices described their position as ‘precarious’ following the pausing of the GP Sustainability Loan Scheme due to oversubscription.
Under the scheme, introduced as part the 2018 contract, GPs who own their own premises can apply for long-term interest fee loans worth up to 20% of the practice’s value, which is only repayable when the building is sold or converted to non-medical use.
Of the 30 practices at risk, six said having to hand back their contract was ‘likely’, meaning health boards would have to take on responsibility for provision of GP services.
And 47 out of the 55 practices that responded said that if they did receive the loan it would considerably improve their stability.
GPs told the BMA that it is ‘hard to see how we can survive’ and that they felt ‘deeply disappointed and let down’ by Scottish Government’s decision to pause funding.
They also expressed concerns that, without the funding, increasing building and staffing costs ‘may lead to staff redundancies’ and negatively affect recruitment and retention.
A GP who responded to the survey said: ‘Without the sustainability loan, we fear we will not be able to attract new partners and that the existing partners may leave.’
The Scottish Government told Pulse that it ‘intends’ to resume the scheme but that this depends on budget and ‘will likely not be until midway through the financial year’.
BMA Scotland GP Committee deputy chair Dr Andrew Cowie said the survey revealed the ‘huge impact’ even a short delay may have on practices that are already under pressure with ‘inadequate workforce’ and resources.
He called on the Scottish Government to restart the loan application process ‘immediately before it is too late’.
He said: ‘The scheme provided vital support to ease the financial risks of owning GP premises and increased the stability of practices, improving recruitment and retention of GPs.
‘Indeed, the Scottish Government said in 2019 it would contribute to its commitment to increase the number of GPs in Scotland by at least 800 over the next decade.
‘But the decision by ministers to now pause sustainability loan applications will destabilise surgeries and put at risk quality and continuity of care in many places. In some case it may even see practices close.
‘Owning a practice can make it difficult to replace retiring partners and the inability to recruit a new partner makes collapse and contract termination much more likely.’
A Scottish Government spokesperson said: ‘We greatly value the contribution general practice makes to the nation’s health and want to ensure GP practices have the support they need.
‘This is why we intend to resume Tranche 1 of the Sustainability Loan Scheme in 2024-25 once we have completed the disbursement of funds for those loans already completed and confirmed a budget. This will likely not be until midway through the financial year.
‘Our preference remains to continue the loan scheme into Tranche 2 and beyond – however, this will depend on whether the UK Government resumes the allocation of Financial Transaction Capital to the Scottish Government.’
In 2019, the Scottish Government increased investment in the sustainability loan scheme, from £30m to £50m.
But three years later, the Government announced a £5m cut to the loan fund, with GP leaders warning that this will negatively affect patient care.
At the end of last year, GP leaders voted in favour of a motion calling on the BMA’s Scottish GP Committee to explore an alternative to the 2018 GMS contract that is ‘appropriately’ funded and ‘more reflective of the needs of general practice and patients’ in Scotland.
