GP problems can be fixed by addressing list sizes and adjusting working hours
DR Andrew Buist, Chair of
BMA Scotland’s GP Committee, is right (“We’ll never fix the NHS until we fix our broken GP surgeries”, The Herald, May 1). But the medical profession needs to be more explicit about what is needed.
The critical issue is list size. I would suggest that one full-time equivalent (FTE) GP look after a flock of no more than 1,000 souls. In other words, a practice with a list of 10,000 patients needs 10 doctors. Each doctor would be unlikely to conduct more than 100 consultations per week, even in a busy week. This would allow practices, in Dr Buist’s phrase, to “put the genie back in the bottle” and take back responsibility for 24/7 patient care. An FTE GP would work three “normal” days (say, 8am-6 pm), one day providing “out-ofhours” cover (say, 6 pm-8 am), followed by a non-clinical day for administration, research, special interests, education, or simply to catch up with sleep. This is sustainable.
In addition, such a practice would have a short-stay unit attached, for patients whose primary need might be shortterm nursing care. It might even be possible to attach a care home to the practice. This might form the basis of a true National Care Service.
But what do I know? I’m retired. It’s up to my ex-colleagues to tell the politicians what is needed. There is nothing more demoralising than the sense of impotence, of not being in control, and nothing more empowering than the sense that you are taking charge of your own destiny.
Dr Hamish Maclaren,
Stirling.
DR Andrew Buist articulates a fact that is obvious to the vast majority of GP patients in Scotland. There is a chronic shortage of GPS.
The SNP Government’s target of recruiting an additional 800 GPS (from 2017) by 2027 is not on track to be met, a point recently reinforced by Audit Scotland. This will not be resolved until the numbers of medical students accepted from Scottish schools is increased.
Currently only about 55% of medical students in Scotland have passed through the Scottish education system and consequently pay no university tuition fees. The remaining 45% from the rest of the UK and abroad pay the fees that are essential to subsidise Scottish medical students.
The universities have been forced by the free tuition policies of the SNP Government to fill their medical school places with fee-paying students from abroad.
It is essential that this issue is addressed by the next Scottish government. The current Holyrood administration has had 17 years to improve the
NHS and the expectation that a new nationalist First Minister dredged from the shallow puddle of SNP talent will resolve any of its problems is wildly optimistic. James Quinn, Lanark.
A plague on both their houses
I AGREE with many aspects of Georgina Coburn’s letter (May 1) on the “industrialisation of the countryside”, though I’m not sure that it’s as simple as just blaming the multinationals.
The UK Government has a vested interest in using Scotland to supply England with power, not that we would ever be paid an appropriate amount of money for it in order for it to continue saying that we are subsidised. Look at the short-termism of oil policy as an example of UK thinking.
The Scottish Government has a vested interest in keeping the central belt nice and warm at the expense of others. Witness the ferries debacle, the woodburning stove debacle and much more. I’m confident they haven’t extracted enough money from the multinationals in their bid to appear green.
Wind farms are beginning to appear in more and more of the scenic spots in Aberdeenshire and surroundings. As with Beauly, though not as badly, we’re going to be adversely affected by the present policies. And as for green jobs replacing oil jobs, dream on.
A plague on both the UK and Scottish Governments for a complete lack of joined-up strategy, for not controlling the multinationals and for looking after their main voters at the expense of the countryside. Angus Maceachran, Aberdeen.
The whole truth on Dundas
ERIC Melvin (Letters, April 29) summarises pertinently Britain’s political situation in the 1790s on abolishing the slave trade.
Born and bred in Edinburgh and a resident for half my life, I find it surprising and regrettable that many of our capital’s “great and good”, despite such publicity in your columns, seem by their silence to be unconcerned at their council’s biased, misleading and insulting portrayal of Henry Dundas, Viscount Melville, given on its plaque in St Andrew Square.
Moreover, surely we could expect even Edinburgh University (maybe to make some amends for its absurd renaming of the David Hume Tower?), along with bodies such as, inter alia, the Royal Society of Edinburgh, Scottish History Society, Saltire Society and the Christian churches, to argue publicly that the council has a duty in such a vital matter to reflect “the whole truth” in fair and balanced wording, for the edification of both citizens and visitors, particularly the younger generations who are already subjected to too many one-sided versions of our past.
A bald fact may be true in itself but can mislead and distort, as in this case, hence our judicial obligation not only for the truth but for the whole truth. John Birkett, St Andrews.
Golden connections
WHILST I am pleasantly impressed to see the article in Tuesday’s Herald about a former colleague, Alison Houston, retiring after 50 years’ service in Gpo/bt/openreach in
Scotland (“Longest-serving Scots telecoms engineer reflects on 50 years of connecting people”, The Herald, April 30), I think The Herald and several other media outlets have got the wrong end of stick in their reporting about her being the only one who has completed 50 years’ service. I joined GPO in July 1973 and retired from Openreach last September completing just over 50 years and I suspect others have done their 50 years.
Well done. Alison, and enjoy your celebratory meal at BT Tower. It is a great day out. Douglas Jardine, Bishopbriggs.
Home truths on League 2
I NOTE a very informative article by Craig Fowler (“Game the loser as Scottish football finds itself in another fine mess”, Herald Sport, April 2) on the alleged reluctance of Buckie Thistle, the Highland League champions, to go for promotion to SFL2. One factor is surely geography; just imagine Wick having to travel to Stranraer.
Part-time players often can’t get time off for fixtures involving an overnight, and of course it costs the clubs. Is it not time to regionalise League 2, to at least alleviate this problem ?
George Morton, Rosyth.