'Perfect storm' for GP practices in Moray
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Crippling energy bills, difficulties recruiting staff and growing hospital waiting lists are combining to create a "perfect storm" for GP practices in Moray.
Allied to that, an ageing population with more complex medical conditions, plus a fall in the number of practices are adding to the "significant and prolonged" pressure on doctors.
Those are the views of a pair of local GPs who, at a meeting of the Moray Integration Joint Board (MIJB), outlined what they see as the problems.
Dr Robert Lockhart, from the Maryhill Group Practice in Elgin, said: "Primary care feels more unstable than I’ve ever experienced before.
"We’ve felt locally in Moray, and locally in Elgin, what happens when practices close.
"It has a wide ripple effect on the health and social care system and its difficult to absorb that.
"The threat of primary care becoming unstable, and potentially running into serious problems, could have huge and far reaching impact for health and social care."
Since 2007 the number of GP practices across the NHS Grampian region has dropped from 84 to 69 – an 18% reduction.
However in Moray that fall is an even steeper 25%, from 16 practices to 12.
Two years ago Maryhill took on patients from Elgin Community Surgery when the GP contract was in danger of being handed back to the health board.
Also, the Elgin practice has run the surgery in Rothes since 2014 when the Speyside town’s doctor retired.
Dr Lockhart added he was frustrated with the 2018 GP contract, which he feels is neither suited for rural communities, nor backed by most of his colleagues.
Problems recruiting in Moray have resulted in funds for expanding the workforce being withdrawn.
Meanwhile, local practices can't access a reduced energy tariff available in other parts of the country.
Forres GP Dr Malcolm Simmons said: "Not only are we short of the staff that we need to provide health care to our communities, but the Scottish Government has withdrawn the funding and taken it back.
"Not having the staff doesn’t make the work go away. The demand is still there.
"Like households across the country, practices have been facing huge increases in utility bills. It cripples what we’re trying to do.
"When you can’t help staff, when you can’t provide services to patients, when you don’t have the money to pay staff fairly ... you’ve got a perfect storm unfortunately."
NHS Grampian has reduced GP funding from 7.8% of its operating costs in the financial year 2019-20 to 7% in 2021-22.
However, spending on other services has increased by 18%.
Dr Simmons warned members not to ignore the problems facing GPs in Moray.
He said: "If a practice collapses, hands back its contract and moves to a fully-employed model, what you're talking about is a model that is much more expensive and less efficient.
"There will be problems with continuity of care and probably more problems accessing the care you need.
"The scope of this is huge, and we’ll not be able to solve these problems quickly or easily.
"But I think general practice has a responsibility to look at its own identity, how it can get that message across and how it can help people access its services more effectively.
"There needs to be a wider awareness that if general practice fails, the problems will reach everyone."
Following efforts by local GPs, the board will lobby the Scottish Government to address issues disproportionately impacting practices in Moray.
Moray councillor Tracy Colyer (Keith and Cullen, Conservative) is also vice chairwoman of the MIJB.
She said: "I think all GPs and their staff do incredible work, but our primary care is under tremendous pressure.
"The feeling is that they are not able to offer the treatment and care they would like and their patients need.
"And of course nothing can be done without more money from the Scottish Government."
