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GMS is ‘barrier’ to good patient care, says Scottish health minister



The Scottish health minister has said the GMS contract is a ‘barrier’ to the delivery of good patient care and blocks the development of a ‘shared agenda’ between primary and secondary care.

In response to a call from Pulse to address the workload crisis in general practice, the health minister’s office said the Scottish government was already working on boosting funding and better supporting the profession.

Pulse editor Nigel Praities sent the letter to Ms Robison before the general election, asking her to consider the demands in Pulse’s alternative election manifesto.

The manifesto was voted on by GPs and called for a boost to GP funding, the prevention of workload dump from secondary care and a halt to the ‘denigration of the profession’.

On behalf of Ms Robison, the letter from Lynda Nicholson in the primary medical services directorate, said all of these points were being worked on, including ‘new investment of £9.8m into the GP contract in Scotland for 2015/16’ and an additional ‘£2.2m to fund the population growth that took place in 2014/15’.

The letter added that the Scottish Government ‘greatly values GPs’ which is why it agreed to renegotiate the GP contract in 2017.

The letter said: ‘Thank you for your letter to the cabinet secretary… regarding your online project capturing the views of GPs across the UK on what should be considered by political parties… [W]hile the issues you have identified are UK-wide, we are already working to address a number of these in Scotland.’

It adds: ‘Going forward we need to understand what services patients should be expecting from their GP practice, and what services can be provided from the wider primary health team… It would be our expectation that this will extend to how primary care and secondary care work together on a shared agenda.

‘[H]ow we use the GP contract to support the delivery of services to patients that meet their healthcare needs will address many of the issues your review has raised. We plan to move away from the current GMS contract arrangements which seem at times to create barriers to this delivery.’

The comments come after the Scottish GPC developed radical plans to move closer towards a salaried model of general practice, although retaining their contractor status.

Speaking from the Pulse Live conference in Edinburgh last month, Ms Robison said making the profession more attractive would be a top priority for the Scottish Government.

Pulse’s alternative manifesto was voted on by more than 400 GPs, with the most popular demand calling on politicians to ‘promise to stop disparaging general practice and work with the profession to make it more attractive for new GPs’, supported by almost nine in 10 GPs.

Readers further called for a removal of restrictions on in-hospital referrals to stop patients being bounced back to GPs and enough funding to be able offer patients 15-minute consultations.

The Green Party became the first to support the manifesto in full, whilst health secretary Jeremy Hunt has not responded.