MORE than a third of rural GPs in Scotland say their practices are facing major funding cuts under the proposed new GP contract.
They warn that the new "workload allocation formula" designed to calculate how much cash each surgery in Scotland receives will drive a massive shift in funding from rural to urban areas at a time when remote and rural practices are struggling with an unprecedented crisis in recruitment and retention.
Read more: New GP contract promises to reduce workload
It is intended to boost incomes for urban practice with high elderly and deprived caseloads, but an expert in primary care trashed the formula - drawn up by London-based Deloitte - as "flawed" and "simplistic".
It comes ahead of a conference in Clydebank tomorrow where GPs will be given the opportunity to debate the proposals for the first time. The new contract, which goes out to consultation on December 7, represents the biggest shake-up for general practice since health was devolved.
Dr David Hogg, chair of the Rural GP Association of Scotland: "Recruiting GPs to rural practices is extremely challenging and the concerns of our younger members about the proposed contract indicate that this will become very much worse.”
Read more: Island with no GP costing NHS £50,000 a month
An ongoing poll of RGPAS members found that more than a third anticipate losses to their practice of 40 to 69 per cent under the new model. In the north of Scotland alone, 90 per cent expect to see their allocated funding reduced by up to two-thirds.
Professor Philip Wilson, professor of primary care and rural health at Aberdeen University and a GP in
Inverness, said Deloitte-devised formula was based on outdated information from a small group of practices unrepresentative of the Scottish population, and an assumption that the "health need" of a community is proportionate to the number of appointments available.
He added: "They made some very simplistic assumptions about rurality and found it did not affect their ‘workload’ model and took no account of the fact that under-doctored areas would appear to have low workload because relatively few appointments are available.
"If a student of mine had produced a piece of work like this, I would have expressed grave concern about the quality. The fact that both Scottish Government and the BMA negotiators appear to have fallen for this flawed economic model is utterly bewildering.”
Deloitte declined to comment.
Read more: Third of trainee GP places unfilled for 2017 intake
However, the chair of BMA Scotland’s GP Committee Dr Alan McDevitt said: “It is completely untrue to suggest that any practice in Scotland will see a reduction in funding and extremely disappointing that this misinformation is being circulated.
“The proposed GP contract ensures that every GP practice will have increased or protected funding and if phase two is agreed, the higher expenses of rural practices will be directly reimbursed. There is no time limit on the protection of practice funding and it will be uprated along with wider practice funding."
He added that the contract would also expand golden hellos in rural areas and put in place financial assistance for relocation costs to aid rural GP recruitment.
Chair of BMA Scotland’s GP Committee Dr Alan McDevitt said: “It is completely untrue to suggest that any practice in Scotland will see a reduction in funding and extremely disappointing that
The new contract promises GP partners minimum earnings of £80,430, with the NHS also providing interest-free loans for premises with a view for no GP to own their premises by 2043. The financial risk associated with the upkeep of surgeries has been blamed as one of the factors deterring new recruits into the profession.
In addition, it scraps any expectation that GPs should provide out-of-hours care. Currently, practices have to opt out if they do not offer patient care when surgeries are shut and hand over six per cent of their budget to health boards so they can organise cover instead.
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