Dr Peter Terry, of the BMA, and Nicola Sturgeon, the health secretary, may both be correct (your reports, 5 July) when one calls for many more hospital consultants to improve quality and outcomes of care and the other responds that consultant "numbers meet demands identified by NHS boards".
These comments sit alongside recent suggestions that money be diverted from general practices in more affluent areas to those in areas of deprivation to improve health prospects and reduce inequalities. Diversion of money in primary care mainly happe
ns through annual UK negotiation of GPs' terms and conditions of service.
Additional funding by the Scottish Government or health boards can, if well targeted, improve quality and access in primary or secondary care. The Scottish "18-week referral to treatment" programme announced in March is an example of that aspiration.
Ms Sturgeon's response suggests that there will not be extra money for Dr Terry's 1,000 consultants. But what of the demand to level the primary care playing field? The difference here is that GPs and practice nurses cannot turn off the tap. Patients decide that they want to be seen. The door is open – though to an extent supply controls demand. My self-limiting illness may go in the time I wait for an suitable appointment.
If as GPs we are encouraging patients to live well and take charge of their health or chronic illness, encouraging that, endorsing actions and supporting when things go wrong are essential components. That means remaining fully available to the worried well in healthier areas as well as making special efforts with improved staffing in areas where illness and disease are more prevalent – and that requires additional resource, not diversion of money.
(DR) PHILIP GASKELL
Allan Park
Stirling The full article contains 294 words and appears in The Scotsman newspaper.
