Dr Andrew Buist, a GP at Ardblair Surgery and deputy chairman of the British Medical Association’s Scottish GP committee, has said there is no going back to Dr Finlay-style general practice.
He spoke ahead of a debate at Holyrood today on out-of-hours services in rural areas.
His organisation is calling for improvements for better co-ordination of out-of-hours services for patients.
Changes to the service have proved particularly contentious in rural Perthshire where Kinloch Rannoch area residents have campaigned for years for a return of a resident GP providing round-the-clock cover.
“There is a perception amongst politicians and the public that the problems with out-of-hours care stem from the introduction of the GP contract in 2004,” said Dr Buist. “This is not the case. In many areas, such as Greater Glasgow, the service that operated prior to 2004 is the same service that continues to operate, albeit the service is now directly managed by the NHS board.
“The BMA recognises that there is a need to improve some elements of out-of-hours care. This is a priority for GPs as well as politicians. Involving GPs and other service providers in the planning and co-ordination of services can deliver real improvements for patients. None of this requires a renegotiation of the GP contract.”
The new contract, which allowed GPs to transfer responsibility for providing out-of-hours care to the local NHS board, was designed to combat a crisis in general practice and ensure the sustainability of out-of-hours care for patients. Before the new contract, morale was at a record low.
“Doctors were working excessively long hours, and rural communities in particular were at risk of losing daytime GP service at the expense of out-of-hours availability,” said Dr Buist. “There is no going back to the old Dr Finlay model of general practice.
“In today’s modern service, much more complex care is provided to patients in hours and there needs to be a comprehensive out-of-hours service that does not rely on over-tired GPs bearing the brunt of the work.
“NHS 24 has improved over the last few years, but more needs to be done to educate patients as to who to contact out of hours. More should be done to promote NHS 24 to the public as the first point of contact for non-emergency calls out of hours.”
The BMA wants the Scottish Government to commission research on the beliefs which underpin decisions to contact out-of-hours services.