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Scots have been told to "think twice" before seeking help from GPs and warned they may never regain the right to in-person appointments with family doctors.
As the crisis in the NHS deepened, doctors' leaders said on Monday that the profession was opposed to plans to restart default face-to-face GP consultations, suggesting receptionists would be given more influence in deciding which patients were seen in surgeries.
Under a formal plan for NHS Scotland's recovery from the Covid crisis, published last month, restoring "face-to-face GP consultations as quickly and safely as possible" was described as a "key aim".
However, Iain Kennedy, a GP and medical director of the Highland Local Medical Committee, said on Monday there was "no way" that all patients who wanted an in-person appointment would be able to get one.
Meanwhile, Andrew Buist, a Blairgowrie-based family doctor who is chairman of BMA Scotland's General Practitioners Committee, backed Humza Yousaf, the health secretary, who last week urged the public to "think twice" before calling an ambulance. He claimed this was the correct message to send to the public given the strain the NHS was under.
Dr Buist said the position also applied to family doctors, despite other public health experts urging people not to hesitate to seek help if they have health concerns.
Last March, most GPs moved to video and telephone consultations by default, only agreeing to in-person consultations if they were necessary for medical reasons.
While the vast majority of Covid restrictions have been lifted, many surgeries have maintained the system put in place during the pandemic.
Dr Kennedy, an Inverness GP, said the BMA "did not support" the view that routine in-person consultations would return to normal, arguing that remote appointments were more convenient for many patients.
However, some concerns have been raised that patients may be more reluctant to discuss personal medical details with non-medical staff – which would be needed to get a face-to-face appointment – or that symptoms could be missed if a patient was not seen in person.
"There is no way that we will be going back routinely to all patients who want an appointment [face-to-face] to get an appointment,” Dr Kennedy, who said the NHS was facing a "perfect storm", told a BBC Scotland phone-in. "That is just not feasible with the current resources in the NHS."
Last week, the SNP government asked the British Army to provide support to Scotland's NHS, with soldiers expected to run Covid testing centres and drive ambulances.
Dr Buist said the health system was "overheating" and called on the SNP ministers to "explain to the public what is going on". "Humza Yousaf said think twice, and I support that, that is the right thing to say," he added. "Momentarily, think twice. That's the way we'll need to be for the next six months if we're not to fall over."
Dr Sandesh Gulhane, a Glasgow GP who is also health spokesman for the Scottish Tories, claimed Mr Yousaf had "kicked off an unhelpful debate", adding: "Even though frontline services are under intense pressure, I would never tell a patient in an emergency situation to think twice.
"The SNP should be working to bring the level of service up, not lower it down until fewer people are using Scotland's NHS."
The Scottish government was approached for comment.