By Steve Bargeton, political editor

SCOTLAND’S FAMILY doctors are being asked to consider going on strike as a shortage of GPs reaches “crisis” level.

A report published today states that one in five GPs plans to retire within five years and too few doctors are being trained to replace them.

The Royal College of GPs estimates that by 2012 Scotland will be short of at least 750 GPs.

However Health Secretary Nicola Sturgeon last night said the number of GPs and the number of family doctors under training was “healthy.”

The warning comes as GPs gather in Clydebank for the annual conference of Local Medical Committees.

One motion, from the conference agenda committee, says, “Industrial action needs to be seriously contemplated in view of the relentless and continuous erosion of the GP contract.”

The report on the GP workforce in Scotland by the BMA found that half the country’s GPs report low morale, fewer are completing training and rural and deprived communities will be hit hardest as they struggle to recruit GPs.

Dr Dean Marshall, chairman of the BMA’s Scottish GP Committee, said, “General practice is the cornerstone of the NHS and it is essential that Scottish Government recognises the importance of planning a GP workforce for the future.

“There is increasing demand from doctors of both sexes for family-friendly policies, including part-time working.

“It is vital to support these policies not least to retain highly-skilled professionals in the service, but with significant numbers of GPs now working part-time, this represents a significant fall in the availability of GPs that must be addressed urgently.”

The report bluntly warns that the NHS in Scotland will face a severe shortage of family doctors in the next five years unless action is taken now.

It says women make up 46% of GPs. This proportion is set to increase and that 53% of female GPs retire at age 50.

Figures from the NHS statistics and information service show that 849 female family doctors are presently in the 40-49 age group.

“If recent trends continue, this will mean at least 420 of these GPs will retire over the next decade,” the report states.

“The proportion of GPs aged 35 or less fell from 24% to 12% between 1990 and 2002.”

An increasing number of GPs are also choosing to work part-time. The BMA’s GP opinion survey of 2007 showed 30.9% of GPs now describe themselves as part-time.

“This means that although there are 4231 GPs practising in Scotland, this equates to only 3782.3 full-time equivalents,” states the report.

“It is likely that this trend will continue, with the number of GPs electing to work part-time increasing over the coming years.

“The number of new GPs entering training has not increased to keep up with this trend.”

The report states that the GP “crisis” is exacerbated by the fact that fewer medical students are choosing general practice upon qualifying.

In 1989 general practice was the most popular choice for medical graduates. During the 1990s its popularity declined steadily.

The BMA estimates that the number of training places needs to be increased to at least 350 to compensate for the numbers that do not complete the training.

This is because of a combination of the changes in the demography of the medical workforce, the capping of GP registrar training numbers and the shift in service delivery from hospitals into primary care.

In its report the BMA recommends a “step-down” scheme for GPs approaching retirement which would allow them to continue to contribute through working reduced hours and taking part in appraisal schemes.

There is a call for an increase in GP Speciality Registrar places and moves to encourage training opportunities in rural practices.

Ms Sturgeon said the government is confident vacancies will be filled.

“The Scottish Government values the dedication of our GPs and they are offered a very attractive working package,” she said.

“We have robust GP workforce plans in place to retain and recruit doctors.

“Trainee numbers are reviewed every year and take into account a range of issues, including retirement, that affect GP numbers.

“Last year, the number of trainee GPs increased by 50 to 887 and we will train the same number this year.

“This figure, and the total number of GPs, is very healthy and we are confident we will be able to fill future vacancies.”

NHS Fife’s medical director Dr Frances Elliot said, “NHS Fife acknowledges the findings in the report and we would be happy to discuss with our Local Medical Committee issues that we can resolve locally in Fife, including opportunities for flexible working.

“With regard to increasing the numbers of GPs training places, this is a discussion that needs to take place at national level.

“NHS Fife is committed to working with the LMC to consider how to support proposals to increase these training places.”

Today’s gathering will debate a range of pay issues—and several motions “deplore” tactics used by central government over changes to the GP contract.

Motions complain of “successive pay cuts” and “collapsing pay levels” for GPs.

As part of a wider NHS pay deal, Nicola Sturgeon announced earlier this month that payments to GP practices which provide core services will rise by “2.7%, resulting in a 2.2% increase in earnings.”

However the BMA said 2.7% was removed from another income stream— resulting in a zero net pay rise.

Other initiatives will also be attacked including proposals to extend GP opening hours, and the SNP’s plans to abolish prescription charges.