Doctors say they cannot afford to recruit new GPs

Doctors are warning that many practices in Scotland cannot afford to hire new GPs, despite government promises to make it easier to see a family doctor.

Trainee GPs have also told BBC Scotland News that they are struggling to find either permanent or temporary jobs.

The Royal College of GPs and the British Medical Association say some practices are freezing recruitment and scaling back on the use of temporary staff cover in the face of severe financial challenges.

The Scottish government says it is taking steps to provide additional resources to general practice.

We have spoken to many Scottish GPs who say they are struggling financially.

Three quarters of surgeries in Scotland are run by GP partners, who absorb the costs of staffing and running a business and are then paid by NHS for the services they provide to patients.

Dr Annie Lomas is a partner at Linden Medical Practice in West Lothian and medical director of the Local Medical Committee for Lothian.

She says the financial situation is “the worst it has ever been” and warns that some practices may have to close because they cannot balance the books.

Her practice, which has eight doctors, is “trying to not go bust”, she says, because of increased running charges.

She says it now faces additional costs of between £35,000 and £50,000 each year due to a range of factors, including a hike in national insurance, the impact of NHS pay deals and rising charges from the health board.

The practice has been forced to reduce capacity, through steps like cutting back on the use of locums, and cannot afford to take on any additional GPs.

“If I can’t afford to employ staff then ultimately the person who is going to lose out is the patient,” she adds.

Dr Lomas says there are more doctors training to be GPs than there were five years ago, but that practices cannot afford to employ them.

Dr Samantha McCarthy is in her final year of GP training at Penicuik Medical Centre.

It is the largest teaching and training practice in Scotland but has introduced pause on recruiting new doctors.

Dr McCarthy, 38, initially specialised in obstetrics and gynaecology before choosing a career in general practice.

She says she and her fellow trainees are facing a “wall of unemployment”, with fierce competition for any vacancy that comes up.

“When I started three years ago the job market was hugely different. Practices were crying out for salaried GPs and locums, there were plenty of vacancies.”

She says things are so bad now, she is having to consider leaving medicine altogether, or moving her husband and young children to Australia, where there are more opportunities.

“I’m really concerned. It’s really sad that we are at this point and I’m really worried for the patients who can’t get appointments,” she added.

Tricia Dickson has been a patient at Penicuik Medical Centre for more than 30 years.

She doesn’t blame the staff, but says she can find herself 80th or 90th in the queue when she calls at 08:30 to make an appointment.

“They don’t have enough doctors and it’s just not fair because we are not getting the service we deserve,” she said.

“They are building new houses in Penicuik so where do these people go to see a doctor?”

Earlier this year, First Minister John Swinney outlined his top three priorities for the NHS – which included investing more in community health care to make it easier to see a GP.

The government also set a target in 2017 to recruit 800 new GPs by 2027.

However, the most recent workforce data showed a small decline in the number of full-time general practitioners, from 3,478 in 2023 to 3,453 in 2024.

Doctors say the workload for GPs has expanded as doctors meet the demands of a growing older population with more complex health needs; and manage patients who are on long waiting lists for treatment.

Professional body the Royal College of GPs says the fall in doctor numbers at a time of increased workload means they cannot ensure they deliver safe and timely care to their patients.

Dr Chris Provan, the chair of RCGPs in Scotland, said: “Nationally, many GP practices are experiencing dire financial headwinds owing to historic underinvestment, the impact of inflations, and the impending national insurance contributions.”

The organisation is calling for GPs to be included in the NHS exemption from national insurance charges, and for a clear workforce plan.

Dr Iain Morrison is chair of the BMA’s Scottish general practitioners committee.

He said: “We now find ourselves in the perverse situation where Scotland is paying to train new GPs but with jobs more scarce and employment hard to find, increasingly many GPs are looking for alternative work or emigrating to work in other countries.”

The proportion of the Scottish health budget allocated to general practice has fallen from 11% in 2004 to 6.5% last year.

The BMA union says investing 15% in general practice would allow practices to employ more GPs and ensure one family doctor for 1,000 patients.

A Scottish government spokesperson said GPs played a vital role in the health service.

“We have increased investment in general practice by £73.2m this financial year and are determined to increase the number of GPs in Scotland by 800, by 2027, with an additional 307 GPs added since 2017,” said the spokesperson.

“Our renewed plan for the NHS will ensure that a greater proportion of new funding goes to primary and community care. GPs will have the resources they need to play a greater role in our health system.

“This increased investment will result in GP services that are easier for people to access to ensure that health issues are picked up quickly and dealt with earlier.”