Viewpoint - Healthcare planning leadership in Scottish communities is crucial

In his latest editorial, RCGP Scotland chairman Dr John Gilles discusses the South African healthcare system, the legacy of the Dewar Report and the Legionnaire's disease outbreak in Edinburgh.

Dr John Gilles: 'Prompt and calm response of GPs to the outbreak of Legionnaire’s disease in Edinburgh.'
Dr John Gilles: 'Prompt and calm response of GPs to the outbreak of Legionnaire’s disease in Edinburgh.'

I had a busy but fruitful time in Cape Town last month at the South African Academy of Family Physicians' annual conference. South Africa is gradually introducing a national health insurance scheme and re-engineering primary care to address this major challenge, I was asked to speak on lessons from the RCGP, and suggested that a strong focus on generalism, regular evaluations of family medicine assessments, building quality improvement into any innovative scheme and developing leadership skills to help family physicians meet the challenges of the future were all important.

We hope to build on this link over the next year, as I think we have much to learn from one another. Professor Bob Mash form Stellenbosch is coming to our International Development day on 2 October to give a keynote address, and Professor Khaya Mfenyana from Walter Sisulu University and a former president of WONCA Africa is giving a keynote at our main conference.

Dewar Report

Nearly 15 years ago I wrote an article, published in The Herald highlighting the ‘unsung heroes’ of remote and rural healthcare in the early 20th century. The unsung heroes I referenced included Sir John Dewar, who chaired an examination into the state of healthcare provision in the highlands and islands of Scotland.

The subsequent report, published in 1912, led to the formation of the Highlands and Islands Medical Service (HIMS), which was the first model of state-funded healthcare in the world and provided a blueprint for the NHS.

This year marks 100 years since the publication of the Dewar Report and I was delighted to see the importance of the report was recognised at a recent debate in the Scottish parliament sponsored by Dave Thomson MSP and to which Nicola Sturgeon, deputy first minister for Scotland and cabinet secretary for health and wellbeing also contributed.

The debate marked an extremely significant moment for the legacy of the Dewar Report and for our own social history and I am delighted that what was said is now recorded permanently on historical archive for Scotland. The debate also demonstrated an understanding from our politicians that their leadership in healthcare planning within communities in Scotland remains crucial.

Huge improvements have been made in remote and rural healthcare but challenges remain, and these were a key focus of a conference to celebrate the centenary of the Dewar Report in Inverness last month at which I was pleased to be a contributor along with RCGP president Dr Iona Heath.

It was a truly enjoyable and fascinating day attracting a wide range of delegates including GPs, historians and other interested individuals. The conference and a host of other activities have been organised by an enthusiastic working group comprising grassroots GPs from the north Scotland area as well as academics and other interested individuals.

Legionnaire's disease

Finally, I think that mention should be made of the prompt and calm response of GPs and a range of NHS personnel to the outbreak of Legionnaire’s disease in Edinburgh: a difficult and stressful situation has been adeptly handled.

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