GP chief warns of revolving door of health ministers

Improvements to GP services have been stymied by the rapid turnover of health secretaries in the Scottish cabinet, a leading doctor has warned.
Andrew Buist, who is leaving his post as chairman of the Scottish GP committee of the British Medical Association, noted that four different politicians had held the health brief in the past four years.
Jeane Freeman served as Scottish health secretary between 2018 before standing down in May 2021. Since then Humza Yousaf, Michael Matheson and now Neil Gray have held the portfolio. Matheson left the brief after running-up an £11,000 roaming data charge bill on his parliamentary iPad. He initially claimed it had been used for constituency work before admitting his children had been watching football.
Buist, who has chaired the Scottish GP committee for six years, said: “We need a sustainable future in healthcare and more of the same approach will not cut it. Now, one of the things that’s held me back over the last six years is the turnover in health ministers. I really liked Jeane Freeman … she was straight to the point. We worked very closely during the pandemic and then we had Humza, Michael and now Neil.
“Health is a tough brief in the parliament and it takes time to get to grips with it. And if you don’t come from a health background, then you come in thinking it’s all about A&E and waiting times and hospitals and actually it’s not.”
Among Buist’s frustrations is the failure to transfer a greater percentage of the health budget to community services such as GP surgeries and slow progress in expanding the GP workforce to meet snowballing workload. The number of patients for every full-time family doctor in Scotland has risen by 200 since 2013.
Buist said: “That results in less access per patient. Our capacity has dropped and the number of patients wanting to see us has increased both in numbers and in age and in the complexity of long-term conditions.”
He added that although more GPs were being trained in Scotland many were choosing not to stay in the profession or the country. The Scottish government has previously pledged to increase the number of GPs by 800 by 2027, but Buist said progress towards this target had flatlined.
He noted Matheson’s conduct regarding his expenses was “unacceptable” but that the MSP was good because “he came from a clinical background in the community so he kind of got it”. Matheson worked as an occupational therapist before he was elected to Holyrood in 1999.
Buist explained: “You know, I was saying to him, we’ve got to transform what we do and we’ve got to shift a far greater share of NHS resources into community and general practice in particular. We’re now 6 per cent or something of the budget. Some other countries like Norway are putting in 14 per cent and it reflects on what people are getting.”
Gray, who took over as health secretary in February, is “still getting to grips with his brief,” according to Buist.
Now in his sixties, Buist has retired as a GP in Blairgowrie, Perthshire, but is spending time working as a locum in the Scottish islands.
He said he worried that the shortage of family doctors in Scotland means patients with potentially serious problems, such as sudden weight loss, could easily be put off seeking treatment because they cannot secure a swift appointment at their surgery with a familiar medic.
Buist also expressed concern about waiting times to see hospital specialists running into years, meaning GPs were faced with riskier decisions, such as patients asking for medication they had been advised to use by private providers both in the UK and overseas.
A Scottish government spokesman said: “The health secretary is committed to reforming and supporting Scotland’s health and social care system, and will continue to work with BMA Scotland to achieve that aim.
“We increased funding to general medical services to over £1.2 billion last year to ensure more people get the right care in the right place at the right time.
“Scotland has a higher number of GPs per head than the rest of the UK, and a record 1,200-plus trainee GPs coming through the training system. We are fully committed to increasing the number of GPs in Scotland.”