GPs lambast Health Board for £800k loss

​A statement issued by the Western Isles Local Medical Committee, which represents GPs, claimed that reimbursements to the Scottish Government were “the highest of any Health Board in Scotland” despite the Western Isles board being one the smallest.

The dispute arises from money allocated by the Scottish Government to employ pharmacists and other professionals to support GP surgeries which are under exceptional pressure, partly due to an ageing population.

Having found themselves unable to make these appointments, the Western Isles NHS Board handed the money back to the Scottish Government rather than allocating it for “transitional arrangements” to support GPs.

It has emerged that the same issue arose last year, after the Western Isles board handed back more than half a million pounds. This led to the Local Medical Committee communicating a vote of no confidence to both the Health Board and also the Integrated Joint Board.

One GP told the Gazette: “In November 2023 the Western Isles Local Medical Committee wrote to the chairs of the Integrated Joint Board and NHS Western Isles expressing no confidence in their management.

“This letter covered issues of healthcare provision and concerns over management of funding lost to Primary Care in the Western Isles and was signed by the principals of seven GP Practices which covered over 90 per cent of the Western Isles patient population.

“The reply from the Chair of the Health Board was astounding that they were “… not an operational board” and “this was not a matter for the Board to become directly involved in”.

However, it has now been confirmed that the same thing happened again in the financial year 2023-24 with almost a quarter of a million pounds returned to the Scottish Government.

In their statement, which has been posted by several island practices on their web-sites, the GPs provide a general resumé of the challenges they face and claim that “large parts” of a contract promised by then Health Secretary, Shona Robison MSP, in 2018 have not been implemented.

The statement continues: “Even worse, when Health Boards have been unable to spend the money to employ additional pharmacists and other professionals to support General Practice, the money had to be returned to Scottish Government rather than being spent supporting your local practice.

“Other Health Board areas have used this funding to reimburse GP practices for transitional arrangements rather than it being lost. NHS Western Isles has chosen not to do this. In 2022/23 this amount in the NHS Western Isles was £565,000 and in 2023/24, £236,000.”

The statement continues: “There have been many further challenges both locally and nationally since then. Many people are unaware that the funding for practices comes through a national formula and doesn’t reflect how many times patients are seen. Practices are paid the same whether you are seen once or many times in a year.

“In 2017, the Scottish Government recognised that this did not work and promised to move towards a new funding model. This still hasn’t happened, and the funding uplifts have been well below inflation.

“On average patients used to contact their practice three or four times a year. This has now increased to six or seven. There are many reasons for this and include an older population, more people with illness (often multiple illness) and many more treatment options”.

However, an NHS Western Isles spokesperson firmly denied the assertions by the GPs.

“It is extremely important to clarify that any money that is unspent by Boards across Scotland is reallocated back into primary care, to ensure essential services and developments are prioritised and to ensure best value for the public purse,” they said.

“NHS Western Isles is not different from other Boards in terms of funding flow between Boards and Scottish Government departments and the resource allocation for new parts of the contract, and the statement is inaccurate in this respect.”

They said that “many of the other observations and perspectives in the article are not representative of the views of NHS Western Isles,” with waiting times “considerably shorter than many other areas”, consultant medical posts unchanged in over ten years and a “significant investment” in IT Server upgrades in GP Practices “in preparation for the change to a new case handling system planned for 2025”.