Only a 'sea change’ in doctor recruitment will address NHS crisis

A stock image of a hospital. Image: Shutterstock

First Minister John Swinney has been told only a “sea change” in doctor recruitment will turn around the crisis in Scottish healthcare.

We revealed last month how a scheme to boost the number of GPs working in rural areas had 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.

In a letter to the first minister, seen by The Sunday Post, Scottish Conservative health spokesman Sandesh Gulhane – who is a registered GP – highlights the scale of the issue.

He writes: “Fears of a brain drain have not only proved accurate, they are not going away. This means that Scottish taxpayers are effectively paying to send GPs elsewhere.

“This is unsatisfactory in terms of scrutiny, but it also has a terrible impact on debilitated and struggling GP surgeries.

“They are dealing with long-standing problems — the inflexible GP contract, reducing numbers due to retirement and frankly, people leaving because they no longer want to be doctors.”

Official figures showed 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.

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Swinney was accused of presiding over a broken NHS during first minister’s questions last week following a damning report from the Royal College of Nurses into hospitals across the UK.

It noted cases where 20 to 30 patients had been left in corridors under the care of one nurse and one healthcare assistant.

It said people has suffered cardiac arrests in corridors or cubicles which are blocked by patients on trolleys, delaying life-saving CPR.

The report also includes details of patients dying on trolleys and chairs in waiting rooms or being left for hours in soiled clothing.

Doctors warn the dwindling number of rural doctors is having a “huge detrimental impact on patients who are facing a struggle to see their GP”.

They say this puts further pressure on hospitals and the rest of the health service when they need to see seriously unwell patients who could have been treated earlier.

In his letter to Swinney, Gulhane, added: “Scot Gem has failed.

“The SNP’s other measures, such as Rediscovering the Joy of General Practice, have been ineffective.

“You have spoken about how important it is to train and retain GPs. But there has been no delivery.

“It is now time for a sea change in how this government approaches healthcare in Scotland.”

The Scottish Government said: “Scotland has more General Practitioners per head than the rest of the UK. However we recognise the challenges faced 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 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 therefore too early to conduct a full evaluation of the programme at this stage.”