Mark McDonald, MSP for Aberdeen Donside addresses the Scottish Parliament regarding the promotion of sustainable general practitioner recruitment. Watch the video below and click "read more" to view the full text.
Having spoken a little bit about primary care in my speech during the programme for government debate and during a health debate that we held prior to the summer recess, I thank Jim Hume for bringing the issue back to the chamber. I was interested by the comments on workload. I have spoken in the past about how we can better align primary care services in order to reduce GP workload by triaging people to other services if they can more appropriately deal with their conditions—Malcolm Chisholm alluded to that. Some GP practices in my constituency do that; they speak to people when they request an appointment and redirect them to, for example, the pharmacy, if that is the more appropriate place for them to be seen. Some GP services do not do that yet, which might be a contributing factor to some of the workload issues. A percentage of the workload might be able to be redirected and dealt with in a different environment. How we use other primary care professionals needs to be examined. I am confident that that will happen through the work that the Scottish Government is undertaking to redesign how primary care is delivered. Good-practice examples exist: for example, the minister will be familiar with the Middlefield healthy hoose in Aberdeen, which is an example of good practice and good use of nurse-practitioner services based on which other areas could remodel their services, depending on their circumstances. The point on pensions that my colleague Rod Campbell raised in his intervention is relevant. The conversations that I have had with GPs—in particular, GPs who are in their mid to late 50s—suggest that, as a result of the changes that the UK Government introduced, they now face making the decision whether to continue to work in general practice and to take the pension hit that will follow as a result, or to retire early in order to benefit from their pensions. One does not want those GPs to have to make that decision, but there is a financial element to the decisions on retirement that they now face. We also have to consider the fact that the make-up of the GP workforce has changed over time. It used to be a predominantly male full-time workforce, but it is now a predominantly female part-time workforce. There are a number of reasons for that, which I probably do not have time to go into in detail. I acknowledge that you are shaking your head, Presiding Officer. Do not worry; I was not going to go into the issue in detail. We need to consider how GP services are structured in relation to that change in the workforce and we also need to think about how we attract graduates into the profession. That point has been made by members in various parts of the chamber. In discussions that I have had with medical students and their representatives, I have learned that the issue of partnership has been a decisive factor for many. I agree with the point that Dr Murray made about the issue also being about the fact that specialisms might be more attractive, but it might also be to do with the view that there might be a requirement to take on the role of partner, which is something that graduates might not want to do. That is why it is worth considering a confederated model, in which a smaller cohort of partners could operate a number of premises and employ GPs in them. I know that that is being considered by NHS Grampian. There are a number of things that can be done; the programme for government contains some encouraging signs with regard to the reforms that are taking place. I am sure that they will help us to address some of the issues that we face in our general practices at the moment.