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Chamber and committees

Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 4 May 2021
  6. Current session: 13 May 2021 to 5 November 2025
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Displaying 1251 contributions

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Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 19 December 2023

Dr Sandesh Gulhane

I have a couple of very quick questions. MDTs include not only our physios and pharmacists but people who work in schools, for example. I recently worked in NHS Fife, and children in schools there cannot be given basic medication such as Calpol unless a GP has prescribed it. Dr Kennedy, how is that helping our primary care services?

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 19 December 2023

Dr Sandesh Gulhane

The Fife local medical committee said that that was the case and that it had been struggling for a year to get schools to change their minds.

My second question also relates to NHS Fife. Those of us who work in primary care want to try to keep people out of hospital—I love to be able to do that as much as possible. In NHS Fife, people who work in primary care are not able to order pretty routine tests, such as a brain natriuretic peptide test for heart failure. Why are there such differences across the piece? There are some basic things that we can do, and I do not understand why it can be said that it is not acceptable for someone who is trained to order an examination that will keep someone out of hospital.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 12 December 2023

Dr Sandesh Gulhane

[Inaudible.]

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 12 December 2023

Dr Sandesh Gulhane

Thank you, convener. I declare my interest as a practising NHS GP.

There is a lot of clarity in what has been said, particularly by Nicola Gordon, who spoke about the remit of the national centre. Does the panel feel that the national centre’s remit, as it is set out right now, will significantly address the key issues facing workforce recruitment and retention in rural areas?

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 12 December 2023

Dr Sandesh Gulhane

It is quite clear from what the panel has said that we should be finding out from the minister exactly what the centre’s remit is and then we can certainly ask you and further panellists whether that is appropriate.

I heard Michael Dickson say that it should be “a badge of honour” to work in remote and rural areas. While I commend everyone who chooses to work in the NHS, and especially those going out to rural areas, that is surely not enough. Do we not need to incentivise people to go out and work in remote and rural areas and try to grab people from other areas to come into Scotland, or even those in the central belt to relocate, so that we increase the number of people coming in rather than try to move people who are already in the area? My question is about incentivisation.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 5 December 2023

Dr Sandesh Gulhane

We are hearing a lot about wider infrastructure issues, and we have heard a lot about incentives. My question relates to the work of Dr Gordon Baird in Galloway. Do you feel that having a rural and remote advocacy service would be helpful in ensuring equality as well as in holding boards and other areas to account, so that things are in place to allow people to go and work in rural and remote areas?

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 5 December 2023

Dr Sandesh Gulhane

Good morning to the panel. I start with a declaration of interest as a practising national health service general practitioner.

Among the many things that we talk about when it comes to rural healthcare, a big one is the 2018 GP contract, the point of which was to ensure a lot of allied health professionals in primary care. The idea was to take the pressure off GPs. Allied health professionals probably do a better job in many of the specific things that they choose to do. Musculoskeletal work is much better in physio, for example. However, and I have a quote,

“The new Scottish GP contract has been a complete failure based on unachievable promises. At a national level it appeared a sound plan”

but

“In rural areas there were never going to be enough pharmacists, physios, mental health workers and nursing staff to make this work”.

I turn to Sharon Wiener-Ogilvie first. Is that true? If so, what should we do?

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 5 December 2023

Dr Sandesh Gulhane

I certainly think that my colleagues will pick up on that, so we will not delve into it just yet. You talked about inequity, which I want to come to.

I think that physio is slightly more unique, because you have gone from centralised to local services. I think that a lot of the worry is the opposite way, about local things becoming centralised.

That brings us to the question of inequality. One respondent said that AHPs should be

“equally shared in all practices”.

They used Caithness as an example:

“some ... first contact services are mostly in the NHS managed practices so not equally shared with other or rural practices so patients”

are

“unable to have equal access for care.”

Is there inequality? Clearly, for physios, that does not seem quite to be the case, but are there inequalities when it comes to other allied health professionals, especially looking at vaccinations?

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 5 December 2023

Dr Sandesh Gulhane

Sorry—my colleagues will come in on the theme of travel, housing and other things. Will you focus a bit more on the contract and the difficulty in getting the numbers that you need?

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 5 December 2023

Dr Sandesh Gulhane

Thank you. I do not know whether anyone else wants to come in before I ask my next question.