Groups including the British Medical Association (BMA) Scotland and the Royal College of General Practitioners (RCGP) Scotland are calling for primary health care infrastructure to be considered at the planning stages of all new housing developments with developers compelled to contribute towards costs.

They say that with planning and additional funds, local healthcare services could employ additional locums and other healthcare workers, as well as build new surgeries or expand existing ones.

Currently, when developers build new houses, they enter into agreements with the local authority that can oblige them to provide funding towards the expansion and development of related infrastructure like schools, roads and green spaces.

While existing agreements with local authorities oblige developers to provide funding towards the expansion and development of related infrastructure like schools, roads and green spaces, there is no legal requirement for them to spend on healthcare infrastructure.

According to an investigation by The Herald, in conjunction with independent investigative journalism co-operative The Ferret, this has left GP capacity across Scotland outstripped by increasing demand.

Last year, in Midlothian, a record number of new houses were built with a total of 822 completed in the year. As people moved into their new homes, local GP lists increased, but the council received no contribution towards healthcare facilities.

The analysis shows that in Midlothian – where 8,000 new residents have moved into developments since 2018 with a further 10,000 expected by 2028 – GP lists have been rising rapidly.

In December, Danderhall Medical Practice revealed it was closing because GPs said they could no longer work safely. Its list has increased by more than 40% over six years.

At the nearby Pathhead Medical Centre, where list sizes have increased by about 20% over a three-year period, Dr Sigi Joseph said workloads were manageable by working long days of up to 12 hours.

She agreed action should be taken to ensure the impact on GPs was considered by developers.

Dr Joseph said: “A lot of new people are moving into an area, and of course they need a GP but there is no expansion of the service to meet that need.

“Developers contribute to a new school, or a park if they are building over a certain number of houses, but they don’t contribute to GP services.”

She said GP surgeries found it difficult to recruit after the lists had already increased “because the job comes with so much pressure”, underlining the need for better planning.

Her comments were backed by the Royal College of GPs (RCGP) in Scotland.

Joint chair Dr Chris Williams said the organisation had been calling for action for more than a decade.

He added: “If this was done during the inception stage of planning, primary care services could be better deployed and more effectively integrated, to the benefit of patients and communities.”

Local authorities across the UK already have the power to demand funding for GP surgeries as a condition of building, but are under no obligation to use them in this way, or at all.

But a 2021 report on developer contributions in Scotland found that while the funding of healthcare infrastructure is permitted within the section 75 legislation, requests for such contributions were rare and not clearly understood.

The British Medical Association said the Scottish Government, councils, health boards and developers should work together to ensure the need for increased GPs infrastructure considered in the planning stages.

Dr Patricia Moultrie, deputy chair of the BMA’s Scottish GP committee, said: “It becomes simply unsustainable for primary care if planning for new housing developments does not take into consideration the health care resources available in the area.”

“We need immediate action… ensure that new practices are built and staffed in areas with high levels of residential construction in order to provide the public with the GP services they need and deserve.”

A Midlothian Council spokesman said: “Councils don’t have any responsibility for GP practices and Midlothian Council already charges developers higher than average percentages.

“We use that money to build supporting infrastructure like schools, roads and other community facilities.”

A Scottish Government spokesperson said that “infrastructure requirements” should be “clearly identified and evidenced by authorities early in the planning process”

The spokesperson added: “Councils can already seek healthcare contributions using existing mechanisms, such as section 75 planning obligations.

“It is for them to determine how much to seek from developers, taking account of the specific impacts of a proposed development and relevant planning policies, and to allocate that money according to local needs.”