Chamber and committees

There are 43 GP practices run directly by health boards, making up a small percentage of the 987 practices across Scotland.

Arrangements under section 2(C) of The National Health Service (Scotland) Act 1978 which allows GP practices to be directly run by the NHS board, is a legitimate way in which boards can establish GP services which are more tailored to local needs. Health boards are responsible for the provision of primary medical services for their areas and they have a range of options at their disposal in ensuring appropriate service provision, of which direct provision of services, 2C, is one such option and is commonly used.

2C arrangements are not indicative of the number or proportion of practices in difficulty, and it’s important to note that this number has changed very little over the past decade. It is a legitimate way in which boards can tailor services to meet local needs, for example to address the needs of homeless patients, who otherwise may have difficulty accessing health care.

Although there is no agreed definition of difficulty, there is an increasing awareness of practices facing sustainability challenges across Scotland. The Scottish Government is aware that there are 11 practices currently receiving support from their respective boards. However the situation is a dynamic one and the number may increase or decrease.

Information on the reasons for changes in status is the responsibility of health boards, however Information Services Division of National Services Scotland produces practice reports that are updated quarterly. These can be accessed at the following website:

http://www.isdscotland.org/Health-Topics/General-Practice/Workforce-and-Practice-Populations/Practices-and-Their-Populations/

Circumstances will arise where a practice experiences capacity issues and is unable to routinely accept new patients onto its list. We expect health boards to work with practices as constructively and as flexibly as is appropriate to help manage the situation.

NHS Scotland boards are required to have the correct staff in place to meet the needs of the service locally and ensure high quality patient care. The Scottish Government works closely with all boards to support their staff recruitment efforts.

The answer is publically available on page 13, exhibit 2 of the NHS in Scotland 2015 Audit Scotland report.

Audit Scotland’s report mirrors the Scottish Government's own assessment on the need for our NHS to evolve to meet the changing needs of Scotland’s people.

The 2020 Vision for Health and Social Care sets out the challenges facing the NHS, which include demographic and economic pressures. Over the next 10 years the proportion of over 75s in Scotland’s population – who are the highest users of NHS services – will increase by over 25%. By 2033 the number of people over 75s is likely to have increased by almost 60%. There will be a continuing shift in the pattern of disease towards long-term conditions, particularly with growing numbers of older people with multiple conditions and complex needs such as dementia.

Despite the cut to the Scottish Government's budget since November 2010, the report recognises that health resource spending has increased in real terms and highlights substantial progress including a record high workforce and continued advances in diagnosis, treatment and care. A national conversation is currently underway to seek a broad spectrum of views on how people can be supported to live healthier lives and on the future shape of health and social care services in Scotland.

This government has a clear vision for the future of our NHS and will take the right action to ensure we continue to have an NHS that Scotland can be as proud of in the future as we are today. This action includes an increase in the number of training places for GPs to contribute to a more sustainable future GP workforce, and investment of £200 million in the creation of a new network of elective treatment centres.

The information requested is not collected centrally.

This is a matter for individual health boards, and the information is not held centrally by the Scottish Government.

I have asked Caroline Lamb, Chief Executive of NHS Education for Scotland to respond directly in writing to the member with a detailed answer to these questions.

There has been a successful appointment to the West Region NHS Education for Scotland Health Inequalities Fellowship. The clinical component of this Fellowship takes place in the homeless practice, which is represented in the Deep End Group of practices, within Greater Glasgow and Clyde Health Board.

This appointment also involves undertaking a research project looking at the impact on GP trainees of having been trained in a Deep End practice.

Overall, health in Scotland is improving, and people are living longer, healthier lives. Reducing the health gap between people in Scotland’s most deprived and affluent communities is one of our greatest challenges. The government recognises that this problem cannot be solved with health solutions alone and that it is caused by entrenched problems of poverty, educational under-attainment and worklessness.

The Scottish Government is pursuing policies and practices to reduce health inequalities in line with the evidence presented by Health Scotland. Actions we have taken include:

The £100 million Attainment Scotland Fund, a four year initiative which aims to drive forward improvements in educational outcomes in Scotland’s most disadvantaged communities;

Investing £329 million in expanding childcare;

Over the lifetime of this Parliament, investment in affordable housing will exceed £1.7 billion;

A council tax freeze and a council tax reduction to protect over 525,000 vulnerable households in Scotland from increased Council Tax liabilities; and

Continued action on tobacco with the ban smoking outside hospitals and alcohol with minimum unit pricing.

However our actions to tackle health inequalities and support Scotland's most vulnerable are at immediate risk from the UK Government’s welfare reform programme.