HEALTH Secretary Jeane Freeman has admitted that the Scottish Government “could have done more” to avoid the problems that led rural and remote GPs feeling sidelined by the profession’s new contract.
Ms Freeman told the annual conference of Scotland’s GP leaders that they had her “unequivocal commitment” that she would not reduce funds set aside to top up rural practice incomes, but vowed that the next phase of the new GP contract would do more to close the earnings gap between urban and rural practices.
READ MORE: GPs travelling from England to plug gaps in rural Highland and island practices
Ms Freeman said: “I accept that we could have done more earlier to recognise the problems in Phase 1 of the contract in terms of rural and remote general practice.
“Sir Lewis Ritchie has led the Remote and Rural General Practice Working Group and I accept his recommendations in full, including those in relation to the Minimum Practice Income Guarantee. You have my unequivocal commitment to maintain that guarantee. “
The introduction of the new Scottish GP contract was overwhelmingly rejected by GPs based in rural and island practices, but their votes were outweighed by the majority of GPs who are based in the Central Belt or cities.
The controversy rested on the contract’s Scottish Workload Allocation Formula (SWAF) which determined how much taxpayer funding each practice was owed.
The way the sums were calculated resulted in practices in more affluent urban areas with high elderly populations getting the highest uplifts in funding. In comparison, many rural practices with lower patient lists and practices in more deprived areas - where residents are less likely to visit a GP - got little or no extra money.
In some cases the formula indicated that their funding should be reduced, but in these cases the Scottish Government allocated special payments to ensure they did not end up worse of that before.
READ MORE: Rural GPs in Scotland vote to reject new contract
However, GPs in rural practices argued that the potential to earn substantially more in urban practices would exacerbate existing staff shortages in rural Scotland, and that the formula failed to account for the extra services rural GPs provide in areas where there is no nearby hospital.
Ms Freeman said Phase 2 of the contract would address discrepancies in GP pay. Practices have been asked to return data to the Scottish Government and BMA for the first time detailing their income, expenses and workforce, including practice running costs and how much GPs take out as salary.
Dr Andrew Buist, chair of BMA Scotland’s GP committee, said the information would be used to address variations in GP earnings and bring them into line with salaries of hospital consultants, without undermining GPs’ independent contractor status.
He said: “The earnings of all GPs in Scotland should be comparable to that of hospital consultants for core clinical work.
“And like consultants, GPs should also be able to earn additionally from enhanced services, private work and other sources of income.”
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