Scheme to boost rural GPs branded a miserable failure after securing just two new hires across north

A flagship scheme to boost the number of rural GPs in Scotland has been branded a miserable failure, with just two graduates taking up posts across the north and north-east – and four times as many leaving for England.

The Scottish Graduate Entry Medicine (ScotGEM) pathway was launched in 2018 as an alternative four-year route through medical school – and into rural working in particular.

The first cohort of 52 students graduated the generalist course in 2022, with 42 of the group eligible to go on into GP training.

But government figures show just 10 chose to take that route.

Of those, only two went to work in the Highlands region, with no graduates at all going to Grampian, the Western Isles, Orkney or Shetland.

NHS Scotland data shows 42% of GP surgeries have vacancies across Scotland – but in the Western Isles that number is 67%.

Meanwhile, 64% of surgeries in Grampian, 57% in Orkney and 56% in Shetland have vacancies.

The number of students who left Scotland to take up roles in England was four times higher than the number of new GPs in the north, at eight, while the destination of a further seven is listed as “unknown”.

The remaining 17 took up training or clinical fellow posts with NHS Scotland.

Scottish Conservative MSP Tim Eagle said the ScotGEM scheme has failed rural communities who desperately need fresh blood to staff GP surgeries.

He said: “It was lauded by the SNP as the solution to plummeting GP numbers outside the Central Belt.

“But it has taken six years to get two extra GPs into the Highland region, which desperately need fresh blood due to people leaving the profession.

“By any metric it has failed miserably.

“Every week, a rural practice hands back its GP contract to a health board which then has to deal with that extra pressure. Sometimes they just close altogether.

“Rural healthcare is on a knife edge and it needed those graduates taking up GP posts, not soon but now.”

GP numbers a worry

Figures released earlier this month showed Scotland has lost 222 full-time GPs over the past decade.

Doctors warn the dwindling numbers are having a “huge detrimental impact on patients who are facing a struggle to see their GP”.

That is despite a pledge by the SNP to recruit 800 new GPs by 2027 – a target it is not on track to reach despite health chiefs warning even that is too low.

A trend of doctors quitting rural practice has left many remote areas dependent on locum GPs, who are paid £900 a day.

Dr Chris Provan, chair of the Royal College of General Practitioners in Scotland, said every effort must be made to boost the number of GPs in rural areas.

Following pressure from the college, the health secretary recently launched a recruitment and retention plan to evaluate the impact of ScotGEM on the levels of qualified GPs.

Provan said: “GPs in remote and rural areas are highly valuable due to their unique ability to deliver generalist care and understand local needs.

“However, we know that recruiting and retaining GPs in remote or rural areas is difficult for many practices.”

Is it too early to tell?

Earlier this year, Dr Iain Morrison, chair of BMA Scotland’s GP Committee, called for rural GPs to get higher pay and special status to cope with a critical shortfall of medics.

He also suggested a new medical training school should be built in the Highlands.

Despite a disappointing uptake, Morrison warned it is too early to write off ScotGEM as a failure.

He said: “Given the stages of their career that the first cohort of ScotGEM students are at, and the limited control they will have over where they ultimately practice, it is far too early to judge the success or otherwise of the scheme in terms of tackling shortages of doctors.

“It’s important to fully evaluate ScotGEM at the appropriate point, as part of creative and concerted efforts to encourage more people into medicine and into general practice.

“As we have consistently said, no matter what route medical graduates take, the government must take stock on why the career is appearing so unattractive to newly-qualified doctors and work with us to make it the incredibly rewarding choice it can be.”

The Scottish Government said: “Scotland has more general practitioners per head than the rest of the UK.

“However we recognise the challenges we face in recruiting new GPs to rural areas and are taking action to counter these in a number of ways.

“This includes incentivised £10,000 ‘golden hellos’, a £1 million investment in bursaries for GP trainees who remain in remote and rural areas for their training and the ScotGEM medical degree programme.

“The first cohort of ScotGEM students completed their foundation training in August 2024 and it is too early to conduct a full evaluation of the programme at this stage.”