Scotland has spoken and it has determined that it wishes to remain part of the UK. However this does not mean that we will maintain a constitutional status quo. The Better Together Campaign, represented by the UK leaders of the Labour, Conservative and Liberal Democrat parties, has promised more powers to Scotland – so what does that mean in reality? Each party must now set out its proposals for key health issues such as raising taxes for fund public health services, and maintaining the Barnett forumla in its current guise, before they begin the campaign for the 2015 UK general election.
But now we have the referendum result, it is time for our politicians to get on with the job of dealing with the challenges facing general practice and the wider NHS in Scotland: our population is growing and it is getting older; more people are living with chronic illnesses and often have complex care needs; and there is rising demand for our services.
However, at the same time, the NHS budget is falling and we are in the midst of a recruitment crisis. Hard-pressed services in primary care are running on the goodwill of doctors and staff.
It is time to have an honest public debate about the future of our NHS and how we can continue to deliver high-quality care within financial constraints. Our politicians must refocus on the long-term sustainability of our NHS.
In the last few weeks of the referendum campaign, health dominated the debate and it is clear that both politicians and the public greatly value the NHS and agree with its founding principles: publicly funded, publicly delivered and available to all. With health being devolved, we can continue to focus on co-operation across the health service in Scotland, rather than the approach being taken in England of competition and commercialisation.
GPs across the country are telling us of the rising pressure on their workload, with many GP practices reporting that they are struggling to fill vacancies. The profession is not sustainable while this continues.
The recent agreement on the GP contract in Scotland is a small part of what needs to be done to start to overcome these challenges. We have agreed a period of stability for general practice with the Scottish Government, which will allow us to focus on addressing the issues that are causing this crisis in general practice: recruitment, retention and workload.
But it’s also time for the Government to accept that there is an urgent need to address the issues that are threatening the quality of care that we can provide to our patients.
Dr Alan McDevitt is the chair of the BMA’s Scottish GPC and a GP in Clydebank.