What are SCPN members telling us about cancer prevention? We asked Dr Susan Bowie to give us her thoughts on cancer prevention and management in primary care and where the challenges lie. Her story from rural Shetland echoes throughout the country and reminds us of the need to support essential primary care services.
I’ve been a GP now for 30 years. Most of my working life has been spent providing care to our practice in Hillswick in the far North of Shetland. As well as being a rural GP, I’m a patient, mother, wife, carer and I’ve also got cancer. Primary care is mostly what I do, though I also work in the hospital as a GP with a special interest in paediatrics.
Our practice may be small but it’s like a microcosm of the NHS. But never at any time in my working life have I been more worried about the NHS and the future of small rural practices. Patients are suffering as easy access to GP services (in or out of hours) diminishes due to losses of GPs due to retirement, not enough being trained, loss of GPs abroad, amalgamation of practices, GP burnout, change of contracts and lack of investment in primary care. Inevitably this means that patient care is affected including how quickly they can get diagnosed if they have worrying symptoms. If patients can’t see their GPs they end up clogging casualty departments, which means long waits for the seriously ill. And casualty is not a great place to diagnose cancer, with poorer outcomes, but that’s happening more and more [read more].
General practice in Scotland, especially rural general practice is under real threat. We need our Health Boards and Scottish Government to truly support primary care and to invest in their small GP surgeries which often provide extra value, such as dispensing of medicines, emergency and palliative care and covering their own out of hours. It is clear that when doctors leave or retire, positive investment is needed to see a future rather than threatening to close surgeries, amalgamate them, remove dispensing or substitute medical care by nurses.
So the last straw for me was when yet another GP left Shetland and one of our senior managers declared there was no future for single handed general practice, which of course has been the backbone of Rural GP care for 100 years. A few of us said enough is enough, and so Save Our Surgeries on Twitter and Facebook was started. We also have a 38 degrees campaign, and seem to have raised the profile in the press, at Health Board level, and at MSP level, that there is a significant problem. So far there has not been much in the way of solution other than a promise of more nurses in general practice though worryingly not much sign of more GPs who are the ones trained to diagnose and think about cancer.
Support is needed – lobby your MSPs, like and share our Facebook page, and talk to your Health Boards and remind them who they serve…their patients.