SCOTLAND is facing a chronic shortage of GPs and will have to recruit foreign doctors and attract more men into the profession to plug the shortfall, according to a report presented to the Scottish executive.

The number of family doctors is due to fall by a fifth over the next decade, threatening to leave entire communities without adequate general practice cover. Remote and rural areas, which are already struggling to attract doctors and dentists, would be the hardest hit.

A combination of trends, including an ageing population, rising numbers of female part-time GPs, increasing workloads and the imminent retirement of a large number of doctors, is creating a ticking time-bomb, according to the report.

It warns ministers that urgent action is required to avert a crisis, including hiring more doctors from overseas, retraining nurses to carry out advanced duties currently performed by GPs and giving women doctors with families more support to work longer hours.

The report, prepared by Dr Brian McKinstry, a senior research fellow at the University of Edinburgh and a practising GP, warns that a recruitment drive is also essential to produce more male doctors.

Only 12% of male medical students in Scotland intend to become GPs. Given that half of NHS doctors are GPs, McKinstry said it is imperative that more men are encouraged to follow a career in general practice.

“I’d like to see the Scottish executive act in the next few months,” he said. “At the very latest, it needs to act in the next year or two, otherwise it risks a severe shortage of GPs. That will have serious repercussions for the quality of care delivered to patients across Scotland.”

The report warns that, while recruiting doctors from overseas would provide a short-term solution, it could be problematic because they would be unfamiliar with the NHS and many may have problems communicating with patients and staff.

Another solution would be to enhance the role of nurses. However, there is currently a shortage of nursing staff and there is no guarantee that there would be the numbers to bear the brunt of a GP crisis.

“Research shows that patient satisfaction is high when the role of the nurse is increased,” said McKinstry.

“But research also shows that nurses take about twice as long as doctors in dealing with cases.”

While the number of GPs has increased in recent years, this is largely the result of a rising number of female GPs. McKinstry’s research shows that women doctors in primary practice work fewer hours than their male counterparts. Enabling them to work longer hours would have a significant impact on the availability of GPs.

While the report was only made public this week, it has been in the hands of ministers for 12 months.

David Love, joint chairman of the Scottish General Practitioners Committee, said he was “baffled” at the failure of ministers to act before now.

“We’ve seen this coming for a long time. We’ve urged the executive to increase the number of GP training places for years. This report confirms our repeated demands were correct,” he said.

“Yet the executive continues to set a limit on the number of GP training places that is inadequate. Ministers are procrastinating. They hope that other health professionals can bear the workload. But that’s quite a gamble. If that doesn’t work, you can’t generate more GPs in an instant. You just can’t turn the tap on that quickly.”

Dr Nanette Milne, health spokeswoman for the Scottish Conservatives, said: “We are concerned with the findings of this report. The huge burden of paperwork and red tape under the Labour and Liberal Democrat coalition has taken many GPs to the brink of resignation.

“A balance needs to be struck between recruiting more young doctors into general practice, retaining a greater number of older GPs and allowing them more professional and personal freedom.

“The recent GP contract was implemented to curb the crisis in morale and recruitment that currently exists, with an additional aim of attracting more young doctors into General Practice as a whole.”

In 2004 Scottish universities announced plans to allow less academic students to study medicine in an attempt to address an acute shortage of doctors.

A spokesman for the executive said: “We are committed to training sufficient numbers of new GPs to help meet demand in NHS Scotland.

“We have in place a new, robust planning process agreed with key bodies such as the BMA which will match supply and demand over the long term. To this end, we have already supported an increase in the annual number of GP registrar places from 250 to 280.

This will be maintained for 2006/07.

“Between September 2004 and September 2005, the number of whole-time equivalent GPs in Scotland increased by 82 (2.1%) to 4,073 — an increase that is significantly higher than the year-on-year increases seen in recent years.”

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