14/06/2016 Scotland 2016

Why are so few doctors choosing to work in general practice?

Doctors press the Government for more money ringfenced

As MSPs pay their respects to the Orlando

victims, calls for gay equality to be actively promoted

And students give us their take on how a Brexit vote could affect

The number of GP practices in Scotland with a vacancy

for a doctor has doubled in just two years.

Now one in five practices has an unfilled post.

Yet one in five training places for GPs also went

So why aren't more Scottish medical students choosing to work

I'm joined now by the Chair of the BMA's Scottish GP Committee,

Dr Alan McDevitt, and Dominic Waugh, who's a fourth-year medical student

Welcome to both of you. Doctor McDevitt, the Health Secretary says

Scotland has the highest number of GPs per patient in the UK so how big

a problem do you think this is, the number of vacancies? After 27 years

in general practice this is the first time we have had the risk of

practices closing because we are unable to recruit. It is as serious

as that, it is the first time that has happened in my lifestyle. We

don't have as many threats of closure as in England but that

doesn't mean it is not serious. There is an ?85 million dry Marie

care fund, ?2 million being spent on these staff shortages. -- primary

care. Is it just a question of funding? No, I think it is a range

of issues. People are being put off for a variety of ways from joining

us so we have a big job to change that to attract the brightest young

doctors into general practice. Dominic Waugh, you are studying and

you don't want to do general practice, why not? When I have been

on placements and other specialties I have enjoyed what I have done.

There is a bit of a misconception in medical school that general practice

is the soft option but as soon as you spend some time in general

practice and see the work that GPs do alongside allied health

professionals you discover it is false and it is quite a rewarding

career. What doesn't appeal to you from what you have experienced so

far? It is not a matter of things not appealing, it is just that you

find other things more interesting. Everybody has their own interests.

The students I have met who are interested in general practice very

much want to do it and the question is how we can encourage other

students to have a similar viewpoint. Honestly, though, how

would you say general practices seen among medical students? Too early.

It is seen as the soft option. -- poorly. It will be an uphill battle

to convince colleges -- for colleges to convince students otherwise. What

do you think we can do to attract medical students like Dominic? A lot

of this is about the status within the medical profession and one of

the problems is that general practice is not well represented

among the teaching. There is inherently a lack of role models

within general practice within academia. And it is pretty stressful

and hard work presumably. It is, and that is the message that is putting

people off, the intensity of the job, we are almost hoisted by our

own success. The work load involved in supporting people with a range of

problems does mean that the intensity is high and the day is

longer but I think we are ahead of the game in Scotland in discussing

with the government how to change the future to make it an attraction

Willett attractive option for medical students. -- unattractive

option. For many years we have talked about primary care, which is

important as a concept, and it is also nurses and health visitors and

social care staff and that is important in achieving the right

care for patients. In amongst that general practice is an important

element that is often forgotten and there comes a time you have to say

you have to know the investment will go to the right place. So often

money goes to primary care and Little reaches the GP's surgery. Do

you think it is all about money, Dominic Moore or do you think there

can be changes in the way it is taught? -- Dominic, or do you.

Depending upon which medical school you are at it is structured

differently but you spend far less time on primary care so you have

less time to fall in love with it and that is maybe an issue, the fact

that the difference in practice is not reflected in the teaching.

Dominic Waugh and Doctor Alan McDevitt, thank you very much for

coming in. Now, as more details continue

to emerge of Sunday's massacre in an Orlando nightclub,

one surgeon says he "would not be The attack, in which 49 people

were killed and 53 were wounded, is the worst mass shooting

in recent US history. Across the world, tributes continued

to be paid to the 49 people killed on Sunday morning. It was a sombre

mood at the Scottish Parliament today as MSPs held a minute's

silence in honour of the victims. The number of reported hate crimes

relating to sexual orientation in Scotland is up 20% on the year

before. First Minister Nicola Sturgeon said more needed to be

done. Scotland is making progress in becoming a fairer and more equal

society but we will only achieve that if we face up to the areas

where there is work to be done and I give and commitment to Parliament

that this government will do that. It was a session marked by in

motion. For some, it was personal. We have stayed here too often in

recent years as such extreme hate has shocked us all but we know our

country has not been immune from attack spawn of twisted ideology.

This attack comes during the holy month of Ramadan when millions of

Muslims across the world are making personal sacrifices to recognise

those less fortunate. Like the First Minister said, they are saying

loudly and peacefully, not in our name. Many of us joined together in

glass yesterday. I have only ever felt joy seeing the rainbow flag

from the city Chambers and I can't express how it felt to see it at

half-mast. For the Scottish Greens, -- the Scottish Greens' Patrick

Harvie, it was a chance to suggest LGBT issues could be taught across

Scottish schools. How long will it take for Scottish schools to promote

the dignity of all of their people including LGBT people. I am not

going to stand here and off the top of my head give timescales that I

will give a commitment that I as First Minister, this government,

will continue to work with campaigns like that. Details are still

emerging about Sunday's terror attack but what lessons might be

learned when it comes to tolerance and acceptance in our own

communities? Joining me now to talk about this

is Colin Macfarlane from the LGBT You heard Patrick Harvie asking when

all schools will actively promote equality for LGBT pupils. Do you

think more needs to be done in Scottish schools? Yes and I

completely agree with what Patrick was saying. We have come a long way

in the last few years in Scotland but in schools there is still a

tremendous amount of work to do. 99% of young people still here

homophobic language in classrooms, only 16% of teachers have had

training to talk about LGBT I issues. It is now 16 years since

section 28 was abolished but still far too many young people go to

school terrified because they are being bullied for who they are so I

welcome the First Minister's commitment to work with

organisations to campaign on this but we need action and not

commitment so I would like to see further commitments about when we

are going to see every school and teacher in Scotland being able to

talk about these issues with competence. She stopped short in the

chamber of committing to any timescale in any of this. What

exactly do you think she should be doing? We need more visible

leadership and more statements like that from the First Minister, her

words were bold and they spoke I think for the whole of Scotland that

it shouldn't take a massacre of 49 LGBT people for this kind of

statement. We need more from our government around why this is such a

crucial issue. If we are tackling hate and hate crime, education is

absolutely the crux to do that. Young people need to feel safe and

secure, people in school need to learn about the fact that LGBT I

people exist and need respect and teachers need to feel empowered and

confident about teaching these issues, that is not happening in

every school in Scotland and it needs to. Everybody is horrified by

what happened in Orlando but it is a difficult line to tread, talking

about actively promoting this in Scottish schools, because not all

parents agree with you. It is not about promoting and I object to that

language because that takes us back to section 28, it is about talking

about the fact that LGBT I people exist and should be treated with

dignity. You know that that makes some parents uncomfortable whether

it is faith issues or general homophobia. Every young people

person should feel safe and it is the job of education authorities and

teachers to do that but too many young people say they don't have the

confidence to talk about these issues, 75% of primary school

teachers say they feel they can't talk about these issues in the

classroom. We will never tackle issues like hate crime and prejudice

and less we can talk about this and all teachers can feel confident so

we are asking the Scottish Government to talk about a long-term

strategy so all teachers can feel empowered to talk about this in the

classroom. How do you feel personally after everything that has

happened in Orlando? What is it like today in Scotland to be a gay man in

the wake of all of that? Personally, and that question has thrown me a

bit, I feel more vulnerable now than I have done for a very, very long

time and my heart actually really breaks, excuse me, for young people

in Scotland, for many of those young people who may have been building up

the confidence to come out and to feel confident about who they are,

for those who may have just done it and are feeling liberated and happy

and free, to have seen those horrific scenes on our television,

the fear and the isolation and the real terror that some of them might

feel really makes me sad and what I would say to them is when you wake

up tomorrow tall and full of pride, for every one person who wants to do

us harmed there are many who don't and hate never wins.

The future of university education has become a key issue

The Remain side says it's vital to stay in, to ensure important

international funding is maintained, while Leave campaigners

argue a Brexit would make the current system fairer.

Our students future is at risk if we leave the Ukraine was some British

students be treated fairly if we stay? Some of the key questions

being asked about university education. This man got his

undergraduate degree back home in Spain but was attracted to Glasgow

to do his Ph.D. By the facilities and funding. He thinks the UK needs

to stay in the EU to insure it can continue to work with other

countries. I think it will affect the collaboration because we don't

know what will happen if the UK leaves the EU. It will bring a lot

of uncertainty. And uncertainty is never good for building anything. He

is not the only student who take the same view. Staying in the EU is a

huge benefit for all students because it gives you the chance to

experience a different way of life and that can help you grow as a

person. It gives you a enormous benefits for your CV. Companies are

becoming more international these days and the more international

experience you have got, the better. But not everyone in higher education

feels that way. Scottish students studying in Scotland do not pay

tuition fees. Neither do other EU students. Students from other parts

of the UK coming to Scotland do pay. And one leave campaign are hoping to

get into college is concerned about the future. Two friends of mine, one

studying marine biology and one studying law, at Glasgow University

might have had slightly worse qualifications but they were born

here and they believe and the Scottish people believe that they

should get the places first. That makes sense to me. By living in

Scotland having the basic locations you should be able to get on that

course. But European student should be treated the same as Scottish

students. I don't think that's fair. And another student working with the

Leave campaign says when it comes to the EU there is too much take and

not enough gay. We spend ?1.5 billion every year. -- not enough

give. It is only a fraction of what we send. If we left, we would have

control of all that money and we could invest in the health service,

education. Senior Leave campaigners say a Brexit could level the playing

field by saying the EU students they are welcome here but charging them

the same as those from the US. When we do that, we have a batch of money

that we haven't had before that we can use to grow our own University

Centre to encourage working-class kids to come to university. We have

a bigger problem with that than anywhere else in the UK. And to

safeguard free tuition for Scottish students. John Edward from the

Remain campaign say that universities don't see students as a

cash cow and in this referendum, this issue is irrelevant. That issue

is to do with United kingdom government, not the EU. We have

reciprocal arrangements between EU students and Scottish tunes who get

the same conditions whether they are home and abroad. How English

students are dealt with appears to be problem for the UK Government.

Like so many questions, an argument or two sites. We will see which way

it goes after the 23rd of June. Scotland has met its annual climate

change target for the first time The Scottish Government wants

to reduce greenhouse gas emissions by at least 42% by 2020,

and 80% by 2050. The latest figures suggest in 2014

a 45.8% decrease had A short time before we came on air

I spoke to the Climate Change I'm sure you are delighted with

these new figures. Which of your government's policies has

contributed most to this drop in emissions? They are great figures

and I know there have been -- they have been a while in coming. You are

seeing the Cumulus of impact over years. If you look at different

seconds -- you see the cumulative impact. Various policies have made

an impact, residential policies have made a big contribution to this and

energy as well. That has been -- we have been a great proponent of

renewable energy. Across all the sectors it has been uneven, there is

a lot of work to be done. But some say this is due to mild winter, loss

of heavy industry, changing share of European credits, not really about

government Wallasey? Is a bit like what did the Romans ever do for us,

isn't it? These are the things we live with the year-on-year. People

are now referencing a milder winter, but remember these are 2014

statistics. So the winter you would be talking about is the winter of

2013. People should remember that. But remember we had two very bad

winters in a row. If you would not cut slack. The year-on-year targets

can be quite difficult but we also have that smoothing out interim

target which we have blown right through, six years early. So both

the set of stats are good news. Now you are setting out a new and more

testing climate change target for 2020. Is that an admission that

policy has not been bold enough so far? I don't think so. What we are

doing now is recognising... And there are slight changes every year,

they get work through every year as we get better and measuring. What we

are recognising with this result of this year is that when it comes to

2020, we want to stretch the target. We have made a commitment from

moving that to 40% to over 50% but we need to have a bit of a

conversation with the Committee on Climate Change to be absolutely sure

that when we do set the target, it is the right one. Can you say, hand

on heart in your new role as climate change secretary, that cutting air

passenger duty and increasing air traffic will be good for the

environment? There are a number of things which curiously enough, will

not have an enormous impact on the stats. It's not going to make a

better? But APD does not have an enormous impact, what it would in

impact on a source emissions. They don't have that much impact on these

longer-term targets. When you are recording against targets,

interestingly, they don't really make that much difference. What we

want to do is actually get a far better measurement of actual

emissions from Scotland. Very briefly, will you be pushing for a

rethink on APD? I think I will be part of the conversation. There is a

Cabinet subcommittee on the. All those around the table will have to

think carefully about it but we have to look at the balance right across

the whole of government and consider what is in the best interest of

Scotland. Roseanna Cunningham, thanks for coming in.

Joining me now to discuss that and some of today's other main

stories is the Daily Record's feature writer Anna Burnside

and Rob Edwards, environment editor of the Sunday Herald and co-founder

of investigative website The Ferret.

Welcome to both of you. Let's stick with that good news story. Scotland

exceeding its target to reduce greenhouse gas emissions. You heard

Roseanna Cunningham there not singling out one bold government

policy to bring this all about, as the government done enough? I think

most people who care about the subject would say they haven't. She

was more or less admitting that they hadn't done enough. To give credit,

they have increase renewables which has made a difference. They have

saved... Reduced in the energy that comes from waste, -- produced some

of the emissions that come from waste but some of the changes have

been marginal. Reductions in emissions from housing will

transport or industry have been very small. If you percent or less. She

talked about how it is warm weather, and she said it is partly warm

weather and partly a change in the accounting system. It seems to me

extraordinary that you have a system where you are relying on this

complex piece of emissions trading that nobody really understands and

also, if you close long gannet all have air passenger duty, it doesn't

make any difference. That needs to change as well. If we are going to

make radical targets, we need radical sacrifices, are we ready for

that? A tough one. I personally think that some of this reduction

may have come from austerity and individuals turning down their

eating, using their car less, replacing their car with a smaller,

more efficient car. Not for ostensibly green reasons, just to

save money. I think that has prompted a behavioural change that

many worthy speeches has not. Whether we are ready for more of

that, I'm not sure. It is certainly true that austerity or recession,

helps save energy. The biggest bulk of the energy saved since the

baseline of 1990 has been saved in the first ten years, up till 2009.

And that is all to do with the closure of Ravenscraig, the kind of

industry and nothing to do with government policy to cut climate

pollution. What about when we look at government policy like cutting

air passenger duty. Roseanna Cunningham was refusing to be drawn

on whether she will press for a reversal, but do you think that is

inevitable? I think it is doublethink to celebrate meeting

these figures while on the other hand carrying on with this policy.

If they are now saying we need to do more, we have got harder target

coming in, we need to face up and do harder things, that is a really,

this place to start. But it is she said, a balancing act. We have to

think about the economy and the same time? And they are very strongly

committed to cutting air passenger duty, it was in their manifesto and

they defended it. But notice that Roseanna Cunningham didn't defend

it! But that is but one of many contradictions that they face.

Climate change and cutting climate emissions challenges a lot of

fundamental economic assumptions that the SNP and other governments

have relied on for decades. Sticking with energy, industry and government

figures have been attending the annual Oil Gas UK conference,

talking about the downturn in the industry. It was announced yesterday

that some oil and gas workers could retrain as teachers and be

guaranteed a job for four years. I think that is a great idea. It is

fantastic to have people from different backgrounds in the

classroom. There is a nationwide shortage of teachers in the Stem

subjects and surely the oil and gas industry must cover just about all

those bases. I don't really see any downsides of this policy. And I

would also hope that as well as going into secondary teaching,

teaching Stem subjects, that some of the people from the industry would

go into primary and even nursery education because I'm guessing here

that most people who work in the oil and gas industry are men and there a

shortage of men these areas. Going back to the weather gas

industry, will be difficult to support people in that industry

while doing something about climate change. As Allah said, it is an

example of doublethink, or cognitive dissonance. -- as Anna has said. We

have had people saying we have to lead the world by leading the world

-- by cutting climate emissions and we also have to lead the world by

the supporting oil and gas. You cannot do both. This idea of

training oil and gas workers to be teachers is the kind of thing we

need, but we don't just need one initiative, we need a whole is

tragedy where you can diversify and move out of oil so that the pain

that we are going to suffer as the industry winds down as I think it

will, can be lessened. And briefly before we go this evening and we

come back to the Orlando story when we had Colin McFarlane talking about

how gay equality needs to be talked about in Scotland's classrooms, do

you think it is difficult for teachers to talk about LGBT issues,

giving the views of some parents and some faith groups? It is difficult

and teachers need to be very clear that this is part of their

responsibility and their duty of care to their pupils to make their

schools safe and secure. It needs to be included in the teacher training

curriculum so there was no doubt and no quibbles and nobody can say but I

don't want it for this reason that reason. I think it has to have a

ring fenced based in the curriculum. All children need to learn about

this and to be educated in an environment where they are free from

bullying and prejudice and any other nonsense that might affect their

education. Because there are absolutely clear figures that show

that homophobic bullying and general language of and all the elements of

it really affected these children's education and that is not

acceptable. Would you like to see the First Minister leading from the

front, very briefly? The Scottish Government clearly needs to do more.

It is ironic that they are not doing it as much in education as the

Westminster government, which is strange. We will have to leave it

there, Rob and Allah. Thanks for coming in. -- Rob and Anna Burnside.

I'm back again tomorrow night, usual time.

the most important issues of the EU Referendum,

and it'll be in front of a live audience of thousands,