A LOCAL doctor who heads up Shetland’s only remaining independent medical practice says it is now more than a year that a vacancy for an associate GP has remained unfilled.
It comes as the chair of the Scottish arm of the British Medical Association (BMA) has fired a warning over a shortfall of staff in areas like the Highlands and Islands.
Dr Iain Kennedy told the Guardian that with a large number of vacancies the “rural-urban divide is getting greater, and that of course is widening health inequalities”.
Local GP Dr Susan Bowie said the situation has become “pretty desperate”.
She has been on the lookout for an associate doctor since October 2022 to work at the Hillswick practice for 26 weeks a year, with a starting salary of £60,000.
Attempts to draft locum cover in the meantime have not been without their difficulties; Bowie said she was quoted at £1,080 a day for one doctor.
However she said it looks like she has now managed to find a reliable locum in the meantime.
Dr Bowie said the lack of decent cover for rural doctors is a “problem everywhere”.
Last year it was announced that the Levenwick practice had gone under NHS management, having previously been independent.
“It’s one reason why so many practices in Shetland and nationally are giving their contracts back to the board – the costs and availability of locums,” Dr Bowie said.
A recent meeting of the NHS Shetland board heard that by month seven the organisation had already spent £3.6 million on locum and agency staff in the 2023/24 financial year.
This is part-funded by vacancies and other allocations, but it is the key reason why health expenditure in Shetland usually goes over budget.
At the moment NHS Shetland only has one GP vacancy listed on its website, at Lerwick Health Centre, although there are a number of nurse jobs up for grabs in addition to other roles.
On a wider level Dr Bowie said some GPs from England had been worried about committing to Scotland due to concern over future pension and taxation, so they may only offer to come as locums.
“That’s at least part of it, but it’s never been as bad,” she said, adding that in terms of Hillswick vacancy she is not sure about the exact reasons behind the lack of recruitment success – whether what is on offer, or that the successful candidate would have to do on call, is part of it.
Speaking to the Guardian, BMA Scotland’s Kennedy suggested the NHS had to “positively discriminate” in favour of rural doctors and rural hospital consultants.
He also advocated the idea of a new medical school in the Highlands.
A spokesperson for the Scottish Government said: “We are clear that patients who need to see a GP should always be seen, regardless of their location.
“That is why we have launched a new National Centre for Remote and Rural Health and Care, supported by funding of £3 million from 2023-26.
“The centre seeks to improve the capability of remote, rural and island primary care and enhance the delivery of community-based services.
“By working with NHS boards virtually and locally, the centre strives to improve rural workforce and retention and develop new and innovative services to deliver better results for patients.
“The Scottish Government also incentivises GPs into taking up rural positions by offering a £10,000 ‘golden hello’ scheme for those who join and stay for two years.
“Additionally, we recently committed to investing £1m into bursaries for GP trainees who agree to remain in remote and rural areas for the duration of their training – 50 x £20,000 bursaries will be funded in 2024/25, with priority being given to the most remote and rural posts.”
NHS Shetland has been contacted for comment.
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