GP Recruitment and Retention

Debate between Jamie Stone and Ross Thomson

Wednesday 28th March 2018 Westminster Hall

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is a pleasure to speak under your chairmanship, Mrs Moon. I compliment the hon. Member for Houghton and Sunderland South (Bridget Phillipson) on a real tour de force around the issues before us today. Like the hon. Member for Strangford (Jim Shannon), I will dwell on an aspect of the issue that affects a constituency that is part of a devolved Administration. I hope that what I am about to say will be helpful at the UK level and possibly at the Scottish Government level.

I come from the basic premise that no matter where someone lives they have an equality of right to decent health services. I represent the second biggest constituency in the UK, and there is a particular challenge in the north of Scotland in terms of access to GPs and other medical services. In that context, within the past few days a big issue has developed—it has been fairly well reported in one of Scotland’s main newspapers. In the Caithness part of my constituency, in the top right- hand corner of Scotland, GP provision and access to other health professionals is not what it should be, notwithstanding the best efforts of the professionals that we do have. In no way do I want anything I say to denigrate their efforts because they work exceedingly hard, but the issue is a big concern for my constituents, and they raise it with me repeatedly.

Out of fairness to the Scottish National party represented here, the matter is devolved, but I hope that what I suggest will be helpful. A group called the Caithness Health Action Team has been formed and it outlines the problem on its Facebook page probably more succinctly and better than I can during the brief time available to me. I give credit to the fact that the group is campaigning in a constructive way to try to help matters.

NHS Highland has recently admitted that the recruitment and retention of GPs and similar professionals in other branches of medicine is proving a real challenge in that remote area. It really prompts the question of whether we say there is nothing we can do about it. Do we have to walk away and accept that some parts of the UK or Scotland will not have equality of provision, or do we say we will roll up our sleeves and tackle it? In my book, the answer is the latter.

Before I return to recruitment specifically, one of the most irritating things, or perhaps encouraging things, is that when we recruit a health professional in somewhere like my part of the world—although I daresay it is also true of Plymouth—after a while they begin to love it. There is every chance they might settle and their children be educated locally, and that is good for the community. That is a prize worth remembering.

I want to mention two specific points. Several Members have already mentioned a kind of bursary, a cash incentive to encourage someone to do GP training. We all know how expensive medicine is, how student debt can be built up and the length of time it takes to qualify. This is just a suggestion and it might not be possible within UK recruitment law—I am prepared to be corrected—but I am keenly aware that the armed forces can offer a bursary to go to college or university to be trained, but part of the deal is that when the person graduates the armed forces can send them to where they are needed most. I have a daughter who is serving in the armed forces and she knew right from the start that that was part of the deal. Whether that can be done within UK law, I do not know, but it might be worth looking at. A given health authority could help someone through their five years of GP training, but then have the right to say that for the next two or three years they will be placed in Plymouth, Wick or wherever in the UK. I think a cross-border UK-wide solution is best in that respect.

My second point is an old one. I remember that when I was a kid the nurse got a house. There were doctors’ houses, and that made a difference in recruiting people. As far as I am aware, the nurses’ houses have all gone and no longer exist, but it was part of the local authority’s responsibility to allocate such housing.

The answer in the Scottish context is for NHS Highland and probably the Scottish Government to take a co-ordinated and targeted approach to a specific problem in a specific part of the highlands. I think the willingness is probably there, to give credit where it is due. As and when a solution is found as to how we get people into the area, that experience could be useful to UK Government Ministers as well. There is everything to be learnt from each other. Should the Minister or the UK Government find a way to deal with these problems before the Scottish Government do—

[Ross Thomson]

As a constituency MP, the hon. Gentleman has no doubt had the same correspondence that I have had from Scottish students who have been denied access to Scottish medical school. I do not know whether he shares my concern that the current cap by the Scottish Government on Scottish domiciled student places means that only 51% of current medical places at university are filled by Scots.

[Jamie Stone]

That is a relevant point, and I share that experience. I do not want to go into the specifics, but within the past two days I have encountered the case of a sixth-year pupil at a school in my constituency who, because of the curriculum limitations in the sixth year, will be unable to pursue the tertiary education in the medical field that she would like to. It is a worry, but I shall take that up with the director of education.

The matter we are debating is a big issue in my constituency. It is particularly acute because of the distances involved, and it is at the forefront of my constituents’ concerns. I accept that it is devolved, but I feel duty-bound to air the matter in this place.