Scotland’s GPs are drawing a line in the sand. The British Medical Association (BMA) has declared a formal dispute with the Scottish Government, accusing ministers of years of underfunding that has left surgeries unable to cope.
Doctors are warning this is just the beginning. If nothing changes, a ballot on disruptive action — including potential service reductions — could be next.
A Crisis That’s Been Building for Years
This isn’t just about spreadsheets. It’s about surgeries struggling to stay open, GPs burning out, and communities being left without access to basic care.
In a strongly worded joint statement, BMA Scotland’s GP committee — Dr Iain Morrison, Dr Chris Black, and Dr Al Miles — said practices are being forced to cut working hours, even as demand reaches record highs.
“The ridiculous paradox of GP Partners having to look at what hours across the practice can be reduced in order to balance the books… must stop,” the doctors said.
They warned of a growing staffing crisis. Locum availability is drying up, and newly qualified GPs face limited job prospects — not because there’s no need, but because there’s no money to hire them.
Where Did the Money Go?
The BMA claims that £290 million has been lost to inflation since 2008 — eroding GP funding year after year, even as workloads increased.
Here’s what their research suggests about the funding shortfall over time:
| Year | Avg. Funding Per Patient (Real Terms) | Inflation-Adjusted Shortfall |
|---|---|---|
| 2008 | £145 | — |
| 2015 | £135 | £75m |
| 2020 | £125 | £180m |
| 2024 | £118 | £290m |
The doctors say that money matters. It’s the difference between having one receptionist or three. Between 10-minute appointments or two-week waits.
Dr Morrison put it plainly: “This isn’t theoretical anymore. It’s happening in every surgery, every day.”
What Are GPs Asking For?
The BMA is now calling for a full restoration of that missing £290m — and for it to go directly to GP practices, not filtered through boards or targets.
Their plan includes:
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Immediate injection of emergency funds to stabilise struggling practices
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Reversal of funding cuts based on inflation erosion since 2008
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Support for hiring more clinical and support staff
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Fairer locum rates to help cover GP shortages
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Direct payments to practices, bypassing admin-heavy health board schemes
They’ve also launched a campaign titled “Stand with your Surgery”, aimed at rallying public support and pressuring ministers to act.
Government Response: Talks, Not Panic
Health Secretary Neil Gray struck a more cautious tone. He confirmed ongoing talks with BMA Scotland and said the government remained “determined to avert escalation.”
“We value the work of general practice,” he said. “The BMA entering into formal dispute with us will not affect the care patients receive.”
That line — about patient care continuing — is meant to reassure. But insiders say contingency planning is quietly underway.
GPs, meanwhile, say that without urgent funding, care is already being affected — in ways patients can feel.
A System on the Brink?
GP practices are already stretched, especially in rural and deprived areas.
Here’s what’s happening on the ground, according to local GPs:
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Some practices are freezing hiring, even with unfilled clinical posts.
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Appointment slots are being slashed, leading to rising frustration.
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New partners aren’t joining, afraid of financial instability.
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Overworked doctors are retiring early, adding to the shortage.
And then there’s the locum issue. With fewer full-time GPs, many surgeries rely on temporary doctors — but high demand and flat budgets mean rates are plummeting.
One GP in Argyll said, “We’ve had zero applicants for a salaried post for months. Zero. Nobody wants to work where they can’t even cover their costs.”
Political Pressure Building
The dispute comes at a time when the Scottish Government is already under fire for handling of NHS waiting lists, cancer treatment delays, and workforce shortages.
Labour and the Conservatives have both criticised the SNP-led government for its long-term approach to GP care.
The Scottish Lib Dems, who have long campaigned for GP support, said the dispute was “years in the making” and now “spiralling into a full-blown access crisis.”
As for the BMA? They’re holding fire — for now.
Dr Morrison said no one wants escalation, but made clear the clock is ticking. “Urgent talks continue… but we’re preparing for a ballot. That’s how serious this is.”
