Mark McDonald, MSP for Aberdeen Donside today addressed the Scottish Parliament with a speech at the Scottish Government Debate on Health. See what Mark had to say below and watch the speech in full:
I recognise the pressures that the NHS faces—indeed, I think that we all do. My colleague Kevin Stewart referred to the meeting that we held with NHS Grampian, which the cabinet secretary attended, to discuss issues that face the primary care sector in particular in the Grampian area. In my constituency recently, Brimmond medical group announced its decision to withdraw from the provision of general medical services as of 1 October due to upcoming GP retirements and a difficulty in recruiting to the practice. A letter advising to that effect was sent out to the practice’s 8,300 patients, of whom I am one. Discussions with NHS Grampian have established that the patients will continue to have a GP service in the area. I am aware that discussions about that are on-going and that a process is being followed.
What that case highlights, and what I will continue to highlight to the health board, is that at the point at which a practice faces pressures or closure and is deciding that the GPs will withdraw from providing general medical services, there is a need for on-going communication and collaboration with the practice as well as consideration of future provision, because there are obviously issues to do with the retention of existing staff and the Transfer of Undertakings (Protection of Employment) Regulations arrangements that could be put in place. There needs to be on-going dialogue.
The case also highlights to me that there is an opportunity to look more closely at what we are doing in primary care and how we access it. I think that NHS Grampian has said that it wants to look at a more confederated model. Instead of individual practices operating in small areas, which can obviously put pressure on GPs to take on partnership roles, the possibility of a practice having a number of premises across communities that deliver services can be looked at. Only a small number of the overall cohort of GPs would therefore be relied on to take on those positions.
An issue that has been highlighted has been the difficulty in attracting—[Interruption.]
One of the difficulties being faced is attracting new graduates into general practice, and one of the reasons for that is the view that graduates hold that they would be required to take on some of the responsibilities of partnerships, which many of them perhaps do not want to take on alongside the role itself. On top of that, there is the fact that a larger number of general practitioners are now part time and female. In the previous model, there was a larger number of male GPs who worked full time. That needs to change the way in which general practice is delivered.
When we talk about pressures on accident and emergency services, we talk about people who present to them who ought to be presenting at their GP surgery. We need to drill down a bit further and look at whether people who present at GP surgeries might be better dealt with by another health professional—for example, a nurse practitioner. I have highlighted before in the chamber the good example of the Middlefield healthy hoose in my constituency. The Minister for Sport, Health Improvement and Mental Health, Jamie Hepburn, is coming to my constituency to visit that facility next month, and I look forward to joining him on that visit.
Pharmacists and allied health professionals also have a role to play, and we need to ensure that an appropriate triage process is in place. In many cases when individuals phone their GP surgery, they are given an appointment with the GP without any examination of the issue that they wish to discuss. It is only at the point at which they present to the GP in the consulting room that the GP might think that they should really have gone to the pharmacist instead. We need to get better at dealing with that.
The other issue that faces GP practices—certainly in my constituency but also, I suspect, elsewhere—is the pressure of development as well as the pressure of demography. There are a large amount of planning applications in my constituency, which will add to the pressure on existing GP practices that are at full capacity or getting very close to it. Some practices—for example, Danestone—are operating in very constrained physical premises that have little or no room for expansion. We need to look again at how we utilise planning and the funding streams to develop and expand practices, and whether that needs to be done through a collaborative approach.
On the issue of the care sector, my colleague Bob Doris made some very important points about career pathways. The Bucksburn care home in my constituency was closed and the building abandoned by its owners, Pepperwood Care. I asked the NHS and Aberdeen City Council whether they would consider establishing a step-down facility at Bucksburn, similar to the Clashieknowe one, that could help to deal with delayed discharge. I was advised that the cost of bringing the Bucksburn site up to a suitable standard was too high and that it was not seen as a suitable facility. However, I know that talks are going on between the Scottish Government, NHS Grampian and Aberdeen City Council about possible future uses of the Bucksburn facility that would help to drive improvements in the care sector. I look forward to hearing more about that in the near future.
We have to consider whether there is a way in which we can develop a model or approach in the care sector that can chip away at the difficulties that have been caused by the genie being let out of the bottle and the privatisation element coming into care home provision. We need to consider whether there are ways and means by which we can address the challenges that that has presented.