IN the recent post-Budget debate, news coverage has mainly focused on the threat to small businesses from the huge increase in employer National Insurance contributions and to family farms by the punitive inheritance tax changes.
However, much less attention has been paid to how health and care services are similarly threatened by the counter-productive policies of Chancellor Rachel Reeves and her short-sighted government, especially when there are many fairer and simpler ways to raise more tax.
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This matter was certainly raised in the Commons last week by the Edinburgh LibDem MP Christine Jardine, who has been inundated with letters from Edinburgh GPs, but other than that I have seen very little news coverage of this, something I find very disappointing indeed.
Without doubt GP practices, especially partnerships, have been struggling to cope for many years but many partnership practices are now struggling to survive full stop. Others have already lost the battle, not only due to a shortage of GPs but due to a crisis in the funding situation for primary care across Scotland, something now severely exacerbated by the heavy NI increases.
Most partner GPs have been struggling over recent years with grant funding that has not kept pace with rising demands on the service. Unfortunately the current grant funding method is deeply flawed and doesn’t take account of individual practice staffing costs, or expenses such as utilities and maintenance.
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Indeed, things are now so bad that many partners have been forced to take a real-term pay cut in recent years to address this funding gap in order to support their staff, practice and patients. One GP I spoke to told me he had not had an increase since 2020 and has had in fact to take a pay cut in the last two years.
Surely it is simply unviable to expect GPs to continue to bail out the NHS/health board from their own personal income when in recent years they have been encouraged to expand their range of services, but with inadequate grant funding and very limited alternative sources of increasing their practice income.
Thus the situation was already chronic, but for GPs to be now told that they have to fund a severe increase in employer’s NI contributions really could be the fatal blow for many practices. This is very likely to result in either a reduction in doctors’ sessions (patient appointments) or possible closure. As a direct consequence, many practices are now facing the appalling dilemma of either making their salaried GPs redundant or reducing their own partner sessions. This will inevitably lead to a drastic deterioration in primary care and make it even harder for many patients to see a doctor, an utterly outrageous situation for all concerned.
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Clearly politicians of all parties must now waken up to this crisis as it has been brewing for some time. Doctors have been warning about it for a while, but unfortunately have so far been largely ignored as far as I am aware.
However, Rachel Reeves’s absurd NI increase, ironically intended to raise more money for the NHS, is simply the final straw which will inevitably lead to more practices closing and more GPs handing their contract back to the NHS.
Surely one simple measure to alleviate the situation would be to exempt partnership practices and other sectors of the health and care services from this ludicrous NI increase, especially when they are already struggling to cope. Primary care is in many ways the heart of the health service, but it is a heart that may well soon require emergency resuscitation unless this very harmful and counterproductive tax increase is removed.
John Hodgart
Ardrossan
I REALISE that at the moment the assisted dying bill will only be for the English legal system, but I feel that one very important factor needs to be discussed, and that is giving MPs a free vote which allows them to vote according to their “conscience” or personal preferences. This is surely not the outcome we should expect from our votes. An MP is elected to represent their constituents, and not to vote with their own personal views or prejudices. How many MPs have consulted their constituents, or at least attempted to gauge their opinions? I suggest that figure may well be zero. To be clear, I am not blaming my MP or MSP for this, it is a fault of our system.
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I have my own views on this subject, based on my own life experiences, having had to watch not just several friends suffering and dying from cancer, and MND, but also my wife who had terminal cancer. These experiences have resulted in my admittedly strong views. However, my views will not be consulted in any final vote on this subject, and I am concerned that the religious views of some MPs will play a strong part in their decision, contrary to my own secular stance.
Ricki McAllister (Letters, Nov 24) outlines the system of referendums in Switzerland, which is a much better and fairer system of dealing with such matters. MPs are expected to vote along party lines, and we all as voters, generally accept this stance. Free votes on the basis of “conscience” should have no place in our system of parliamentary democracy. In matters such as this, the people should have the right to a vote.
John Johnstone
Pitlochry
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