Fears for East Lothian GP practices’ future after huge hike in charges

Following the announcement of the Scottish Government’s Budget, NHS Lothian has warned that it must review service provision and funding models to plug a £120 million gap in its finances.

As a result, local GP surgeries are facing significant increases in facilities management charges, which include cleaning, utilities, and essential services relating to the building’s physical structure.

In Tranent, local GPs are warning that they face a fee increase of 600 per cent, while in North Berwick a 900 per cent increase is expected, and in Gullane doctors are warning that the rise in fees risks the future of the practice.

The increases only apply to GP practices which lease property from NHS Lothian or choose to contract hard or soft facilities management services.

Dr Gabriele Salucci, partner at North Berwick Group Practice, said: “We are concerned. We are facing a 900 per cent increase in charges.

“That’s going to mean we either need pay cuts or are going to face losing appointments.

“This is a Lothians-wide issue, it won’t just impact us, but with the news about the Edington and The Abbey care home (see story on facing page), we are facing a double whammy with this.

“The NHS has been hit hard and obviously have to make cuts.

“They say the increases will be phased over two years, but it’s 50 per cent of the full increase in the first year, 75 per cent in year two and 100 per cent there after.

“We are in the process of an appeal, but we are not optimistic and will have to make difficult decisions which will affect the service we deliver.”

'No other option'

The issue was raised in the Scottish Parliament by South Scotland MSP Craig Hoy, who said that Dr Jo Smail, a GP at Tranent Medical Practice, had used a letter to NHS Lothian, copied to local elected representatives, to warn that “in order to cover this new cost imposed on us, the practice would potentially have to lose about 3,200 GP appointments per year”.

Dr Smail and fellow GPs at the surgery used the letter to warn “we would no longer be able to provide primary care services for our patients and would have no other option but to hand back our contract”.

Mr Hoy later said: “The SNP Government must act urgently to avert the catastrophic cash crisis it has created across NHS Lothian.

“I will continue to speak up for local GP services, which are now at severe risk as consequence of the financial pressures imposed on NHS Lothian by the Scottish Government.

“It would be totally wrong for patient care in areas such as Tranent and Gullane to suffer as a result of the Government’s misplaced priorities. We should be raising the funding to primary care, not undermining it with increased costs which will only lead to greater pressure on already over-stretched GPs.”

Jenny Long, director of primary care at NHS Lothian, confirmed that facilities management charges were reviewed following a freeze in the costs. She said this freeze was “no longer sustainable”.

She said: “We reviewed the facilities management charges for GP practices who contract services from NHS Lothian to ensure they cover significant rises in inflation, energy, staffing and other supply costs.

“There will be a phased adjustment to practice charges over the next three years to help manage the cost increases to bridge this gap.

“Our aim is to provide services at a fair cost to all practices specific to their needs and use, but we must move towards ensuring all practices meet the full costs for services received.

“We encourage practices to discuss any issues with our land and property team, but systems are also in place for those who feel particularly at risk to raise concerns.”

'Eye-popping'

Kenny MacAskill, East Lothian MP, said such a significant increase in fees was “eye-popping”.

He said: “It’s an eye-popping amount. That level of increase can’t be soaked up or passed on. It will impact service delivery and the board need to think again.”

A Scottish Government spokesperson said: “We invested over £1.2 billion in general medical services in 2023-24 and are fully committed to increasing the number of GPs in Scotland to ensure more people get the right care in the right place at the right time.

“Last year’s uplift of £60.4 million for GP practices included a six per cent uplift for non-staff expenses.

“The Scottish Government expects NHS boards to have a fair and equitable system in place for all GP practices in health centres in relation to facilities management services.”