Scotland’s GPs are raising the alarm over a mounting crisis in general practice, with doctors warning that a £290 million funding gap threatens to destabilise the entire National Health Service. The British Medical Association (BMA) Scotland claims years of underfunding have left practices struggling to hire staff and meet soaring patient demand — and warns that unless urgent action is taken, a formal dispute with the Scottish Government could be on the horizon.
Doctors Sound the Alarm Over Eroded Budgets
According to new figures published by BMA Scotland, general practice funding per patient has steadily declined in real terms since 2008. Adjusted for inflation, the trade union says GPs’ share of the health service budget has shrunk year after year, with no meaningful correction despite escalating demand and operational costs.
Dr Iain Morrison, chair of the BMA Scotland GP committee, painted a bleak picture:
“Practices simply do not have the resources required to employ all the staff they need — and in particular GPs — at a time when demand is going up at a rapid rate. We know access is a real issue, and we share the frustration patients are feeling.”
Morrison added that the £290m shortfall is not an abstract number but a critical deficit that’s having tangible consequences for patients and practices alike.
“General practice is at risk of failing. We provide 90% of patient contact — without general practice, the NHS simply cannot survive.”
Recruitment Freeze, Job Scarcity and Growing Demand
The pressure is already being felt across Scotland. Some GP surgeries are reportedly freezing recruitment or cutting back on temporary staff. In parallel, trainee GPs have told BBC Scotland they are struggling to find permanent or even short-term positions in an increasingly cash-strapped sector.
Meanwhile, patients across the country face longer waits for appointments. The Royal College of GPs and the BMA say many surgeries simply do not have the capacity to deliver care at the speed or scale needed.
The Numbers Behind the Crisis
| Year | GP Budget Share vs Inflation (Est.) | Impact |
|---|---|---|
| 2008 | Baseline | Stable funding |
| 2015 | ↓ 6-10% adjusted for inflation | Early signs of staffing constraints |
| 2024 | ↓ 15-20% real terms funding erosion | Widespread recruitment freezes, rising demand |
Source: BMA Scotland analysis
Government Response: “We’re Investing More”
Scottish Health Secretary Neil Gray has acknowledged the financial pressure on practices, stating the government is providing an additional £73.2 million for general practice this year. He pointed to rising national insurance costs and inflation — both largely outside of Holyrood’s control — as key factors eating into the financial viability of GP services.
“General practice is the front door of the NHS and absolutely critical to its operation,” Gray told BBC Scotland’s Lunchtime Live. “We are determined to continue supporting them.”
Gray also signalled that new NHS funding would prioritise community care services, including support staff such as mental health workers, nurses and physiotherapists in local hubs.
A Growing Rift Over How to Spend the Money
At the heart of the dispute is a question of control. The BMA wants new funding routed directly to GP practices so they can hire more doctors and manage services in a way that reflects local needs. But the Scottish Government may prefer to invest in broader community care initiatives, spreading resources across a wider range of health professionals.
This difference in approach is deepening tensions. While the BMA has not formally initiated a dispute process or consulted members on potential strike action, the union’s language has become increasingly stark.
“The current direction of travel is leading us towards formal dispute,” warned Dr Morrison.
The Structure of General Practice
GPs in Scotland are largely self-employed, operating practices that function as businesses. Each receives a fee from the NHS based on the number of registered patients. But rising patient complexity — with more people living longer and presenting with chronic conditions — means that practices need to offer longer and more frequent appointments.
This requires more GPs, more support staff, and more time — all of which are becoming increasingly unaffordable.
Political Stakes for the SNP
This funding crisis comes at a critical time for First Minister John Swinney, who earlier this year promised to tackle NHS waiting lists and improve access to GP appointments. Swinney’s administration pledged 150,000 additional procedures and appointments in 2025, but it’s unclear how these will be delivered amid warnings of a recruitment freeze and growing GP burnout.
With the Scottish Government under financial pressure and already navigating crisis points in cancer care, dentistry, and emergency services, the prospect of a dispute with GPs adds yet another flashpoint to the country’s healthcare challenges.
