This site is intended for health professionals only

Scottish LMCs declare current GP model ‘broken’

Scottish LMCs declare current GP model ‘broken’

Scottish LMCs have declared the current GP model ‘broken’ and instructed its representatives to negotiate for full funding restoration.

LMCs in Scotland met for their annual conference in Clydebank today.

They 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.

However, the conference rejected a part of this motion asking the SGPC to enter negotiations with the Scottish Government to overhaul the current contract and move to a fully salaried GP service.

The conference also voted in favour of urging the SGPC ‘to develop a range of potential options for collective/industrial action’ and present these to members, in the event the Scottish Government fails to engage to address underfunding in general practice.

In his speech opening the conference this morning, BMA’s Scottish GP Committee chair Dr Andrew Buist said: ‘When we agreed the 2018 contract it was meant to see complete service transfers from practices to health boards, backed by substantial investment and an increased workforce pipeline to deliver it and free up GP time for where it is needed most.

‘But little was done by those responsible to boost the workforce supply; the funding has not been sufficient; and the willingness of Boards and Scottish Government to take full responsibility for these services has vanished.

‘And so instead of support to relieve the workload burden on general practice, as was meant to happen, the mismatch between what is asked of general practice and what it is resourced to do is only growing.

He added: ‘We need action now because we are running out of time. It seems to me the only chance that the Scottish Government now has to achieve the outcomes intended from the 2018 contract and to arrest the crisis in general practice is substantial direct investment into core general practice.’

Scottish health secretary Michael Matheson addressed the conference and, answering a question from the audience, he said he is ‘very open’ to exploring other options when talking about the GP funding model.

He said: ”I’m not saying that we have to stick with what we’ve got at the present moment – if there’s a better way in which we can do it, I’m open to exploring that and having discussions about that and then testing it to see whether it delivers a better outcome from the existing model.

‘Be reassured that I’m not weighted to one model and one model only, I just want to make sure that the outcomes are achieved as a result of doing so.’

Answering a different question from the audience, Mr Matheson also said he has ‘no agenda whatsoever’ to change the independent contractor model.

He said: ‘If the view is that it continues to provide a quality of healthcare that the public expects, I would see no need to change it from its present form.

‘There is no political agenda of looking at changing the independent contractor model, I’m not looking to do that, I want to support you in delivering that.’

In his speech he said: ‘We are working on where we want to get to in the next 10 years – I’ve asked my officials to work to develop our vision for health and social care and for plans and actions that will then follow from that.

‘It’s clear to me though that primary care is going to be front and centre in that health system. It will also require us to make difficult decisions on how we move finance in order to achieve that.’

He added that it is ‘difficult to drive this type of scale of change’ within a system given the ‘financial circumstances we are operating’.

Mr Matheson added: ‘I’m not going to stand here this afternoon though and say to you that all of the challenges will be simply magicked away by measures that I can take – that simply won’t happen.

‘It is however important to be very clear with you that where we are doing our utmost to try and support you in the important work that you are undertaking, it is also important that we ensure that the work that is being taken forward within the system is helping to support you effectively and importantly patients.’  

Earlier this week, the Scottish Government announced ‘record levels of investment’ into medical training to create 153 new speciality posts, including 35 to train new GPs. 

Last month, the RCGP complained that general practice has been ‘neglected’ in the Scottish Government’s plan for healthcare over winter.

Previously, the Scottish Government announced it will increase core GP funding by £60.4m in order for practices to award a 6% uplift to staff – but the BMA warned this was not sufficient. 

The motions in full:

Glasgow: That this conference condemns the chronic underfunding of general practice in Scotland both in absolute terms and as a percentage of total NHS spending in Scotland and:
i. recognises that this has resulted in significant funding degradation for GP practices CARRIED UNANIMOUSLY
ii. demands that the Scottish Government engages meaningfully with SGPC to address this underfunding and agree a plan towards funding restoration for GPs CARRIED UNANIMOUSLY
iii. in the event the Scottish Government fails to engage, urges SGPC to develop a range of potential options for collective/industrial action and present these to members CARRIED

Agenda Committee to be proposed by Lothian: That this conference recognises the failure of the 2018 GP contract and:
i. believes that, partly consequent to the Scottish Government reneging on its commitment to deliver in full the new GP contract, that the current model of general practice is broken: CARRIED
ii. calls on SGPC to explore an alternative to the 2018 GMS contract that is fit-for-purpose, appropriately funded and more reflective of the needs of general practice and patients in Scotland CARRIED
iii. believes the independent contractor model is no longer fit for purpose LOST
iv. calls for SGPC to enter into negotiation to move to a fully salaried GP service, with equivalent terms and conditions to our consultant colleagues. LOST