'Warnings over the state of the NHS can no longer be ignored'

Warning lights about the state of Scotland’s NHS cannot be ignored any longer, doctors’ leaders have insisted.

A new survey found more than nine out of ten medics believe the health service needs more cash to continue providing existing levels of care.

The survey by the British Medical Association (BMA) Scotland found 61% of doctors think the service is funded “well below” the amount required.

Meanwhile, 92% believe the NHS will not be able to continue to provide the current range of services it does into the future without additional financial resources.

More than a third (36%) of doctors said staffing levels in their workplace had deteriorated in the last five years.

And half (50%) said they had experienced a situation where “the pursuit of targets has resulted in pressure to overturn clinical judgement”.

The initial findings of the survey were released as BMA Scotland chair Dr Lewis Morrison insisted the “undoubted problems” that existed in the NHS before the coronavirus pandemic must be fixed.

With a new, faster spreading strain of Covid-19 having arrived in the UK, he said that “the first part of the year will likely remain very difficult, for the country and our NHS”.

Dr Morrison warned: “Simply getting through will be hard enough.”
But with vaccinations against Covid-19 now being rolled out, and with Holyrood elections taking place in May, he said the NHS now had a “real opportunity for change that cannot be missed”.

Dr Morrison used his festive message to insist: “We can ignore the warning lights about the state of our health service no longer.”

He added: “As we roll out a complete Covid vaccination programme and life starts getting back to normal, there can be no going back to what was normal in the NHS. Because that normal was a normal of understaffing, under-resourcing and unrelenting pressure.

“Our national debate will focus on the Scottish Parliament elections in May and whatever the outcome, the message to all political parties must be that healthcare deserves better than more of the same.”

He said the results of the BMA Scotland survey, which was conducted in November, showed that “doctors are working in a system which simply isn’t funded sufficiently to even keep doing what it does at the moment”.

He added: “Staffing levels are either getting worse or simply not keeping up with demand and the system is often based on blunt targets can be used to side-line clinical judgement.”

He demanded a “clear and unambiguous plan to fix recruitment and retention issues” – claiming so far all the ministers had done was “publish a plan to have a plan”.

Dr Morrison also insisted action was needed to tackle the “target-driven culture many of us work in” in the NHS, saying this can lead to “bullying and a blame culture which does little to improve patient care”.

He stressed: “The backlog of healthcare delayed by the pandemic, and all the new healthcare needs that will arise as a matter of course, cannot be dealt with if we do not fix these issues.”

The BMA Scotland chair said he genuinely believed “that the will is there to change course”, adding that after the “toughest of years” the Covid-19 crisis had shown that “working together works”.

Dr Morrison said: “That is why I am convinced we can seize the opportunity to change during this next year.

“We have a responsibility to rebuild the NHS to make it a far, far better place for staff to work – and the evidence is clear that that will deliver better care for the people of Scotland.”

Scottish Labour leader Richard Leonard urged the Government to “listen to this significant intervention from BMA Scotland”.

He said: “More than a decade of under-funding and under-resourcing from the SNP left Scotland’s National Health Service unprepared to tackle Covid-19, and ministers will have to account for this in the forthcoming public inquiry.

“But as this survey makes clear, NHS Scotland needs more funding now even to maintain its current services.

“SNP promises of ‘jam tomorrow’ ahead of the Scottish Parliament elections won’t cut it – this NHS funding crisis has happened on the SNP’s watch, and we need the change of course that BMA Scotland and other professional associations and trade unions are calling for.”

Liberal Democrat health spokesman Alex Cole-Hamilton said: “This is a stark warning.

“The Scottish NHS was missing its waiting targets before the pandemic.

“It will take huge effort and dedication from staff to turn this around and catch up. Scottish ministers need to commit to find the money needed to make this happen.”

A Scottish Government spokesman said health and social care spending in 2020-21 would exceed £15bn for the first time amid “record workforce and funding levels”.

The spokesman said: “The Health Secretary meets with the BMA on a very regular basis, understands the issues they raise and addresses these directly where that is possible.”

Citing the priority framework announced by Jeane Freeman in November, he added: “As we continue to respond to Covid-19, this necessary guidance will ensure patients have a clear and realistic expectation of when they will receive treatment that is clinically appropriate to their individual circumstances.

“This is especially important as we approach winter and the additional pressures this places on health services, together with the continuing critical need for the NHS to respond to Covid-19.”

On the issue of targets, the spokesman said: “Towards the end of 2019 and pre-pandemic, the Health Secretary had initiated a discussion with key stakeholders including the Royal Academies on the question of targets. This was necessarily paused as our NHS responded to Covid-19, but the intention remains to continue this work as soon as we sensibly can.”