Patients Turned Away As Crisis Looms

At least 11 GP surgeries in Scotland have shut their doors to new patients, despite record levels of pay and investment. But GPs’ leaders blame the closures on lack of resources and say the family doctor service north of the Border is heading towards a crisis.

The list closures mean inconvenience and delay for patients because they will have to travel further to find medical help. The revelation is politically explosive because of the new contracts recently signed with GPs that gave them substantial pay rises and removed much night-time and weekend work.

The surgeries affected are in Edinburgh, Glasgow and Dunfermline. In Edinburgh alone seven surgeries are refusing to register new patients.

But Dr Dean Marshall, chairman of the British Medical Association’s Scottish GP Committee, said the move was unprecedented in his 13-year career and that it marked a worrying new turn in the row over NHS funding.

He said: “This is the first sign of the problems with the new contract. GPs will decide to close their lists for a variety of reasons, such as not having enough room in their premises for the extra staff they would need in order to take on more patients. There may also be recruitment issues. But the other likely cause is the financial aspect of it.”

He added: “The bottom line is that practices need to consider if taking on new patients is going to adversely affect how efficient they are.”

Two surgeries in Glasgow, the Guthrie Practice in Dumbarton Road, and the Kelvin Medical Practice in Napiershall Street, are officially closed, which means they are not taking on any new patients, and seven in Edinburgh and two in Fife say they are “open but full”.

If GPs tell health boards their list is closed they enter a formal 12-month agreement and are not allocated any new patients but are not allowed to provide any extra services, such as minor injury or surgery clinics, which means they cannot receive extra funding.

When surgeries say they are “open but full” they can refuse to take on any patients who make personal inquiries but will take on new babies born to existing patients and family members of existing patients who fall ill while visiting. The situation is reviewed every three months and they are still allowed to provide extra services for which they would receive extra funding.

Duncan Miller, general manager for primary care contracts at NHS Lothian said: “All GP practices in Lothian operate open lists. There are practices whose lists are currently full. However, I would like to clarify these practices are still accepting patients on a limited basis, but are nearing capacity level.”

There are serious concerns about the impact of closed lists on patient health. The situation can lead to a vicious circle because once one practice closes its list, others in the area often have to do the same.

Some of the most vulnerable patients can be the worst affected. Health problems may be ignored and trips to the doctor postponed, and critics predict the problem will worsen.

Dr Anthony Halperin, chair of the Patients’ Association, said: “I am very surprised that lists are being closed. Doctors have been given substantially more money with the new contract.”