Now is the time for politicians to be courageous enough to put party politics aside and have an open, honest discussion with the people of Scotland about the future of Scotland’s NHS, BMA Scotland chair Dr Lewis Morrison said today.
In his written speech to the BMA’s first virtual Annual Representatives Meeting – which was due to have been held in Edinburgh in June but was cancelled due to COVID-19 – Dr Morrison stressed the importance of taking a long-term view of the NHS, with a clear focus on patient outcomes with time and space to allow changes to bed in and develop properly.
Ahead of next year’s election and as the country looks to recover from COVID-19 and keep the recent rises in cases under control, Dr Morrison said the NHS must no longer be a political football and that “it is not good enough to keep squabbling over NHS figures like they were the latest opinion poll results.”
Dr Morrison called for an end to the toxic target-driven blame culture in the NHS and for politicians to come together and have a mature conversation with the people of Scotland about what we ask of our NHS.
Alongside the speech, BMA Scotland has also published a paper outlining 4 principles for measuring our NHS – which sets out the basis from which it will be possible to move away from the current narrow focus on judging performance simply on the basis of waiting lists.
Dr Morrison said: “We cannot return to the target culture which so dominated our lives before COVID-19. Now is the time to finally be honest that the NHS cannot deliver all we ask of it with current funding and staff. That will need bravery from opposition politicians to come to the table with realistic proposals, and we need the Scottish Government to listen to other ideas and be honest about the true scale of the challenges our NHS faces – spread across workforce, buildings, beds and medicines.
“Politicians need to speak to their constituents, including those who are patients and health care workers, to the professions and trade unions – and most importantly they must listen to what is said about what is working, and what isn’t.
“Healthcare is not a political football and it is not good enough to keep squabbling over NHS figures like they were the latest opinion poll results. Of course, political scrutiny of the NHS will always be a reality, but that needs to sit side by side with a more constructive approach, an understanding that appropriate clinical priority is best defined by the teams that deliver healthcare, and a better consensus around long-term goals and aims. That is why I want to ask all of our political parties today to put party politics and point scoring to one side, and unite to make our NHS a less politically driven institution.
“This is the time for a new sense of partnership between Scotland’s people, politicians and the healthcare professions. We need a national conversation about what we want and expect from our healthcare services, what is possible with current resources and whether we are, as a society, willing or able to increase those resources.
“Patients, and staff welfare, must be put at the heart of any proposals – not number crunching and unrealistic expectations of what can be delivered with the resources we have. This is our chance to make a change for the future of the NHS – let’s not waste it.
“That is why I will use this opportunity of this speech to ask all our political parties to share in this vision, to put party politics and point scoring to one side and unite to depoliticise the debate on our NHS.”
On targets, Dr Morrison said:
“Today we have set out an approach to underpin how we assess how the NHS delivers on what we believe it needs to. This unapologetically references the evidence-based views and reports of our new president Sir Harry Burns on this issue.
“We must start by asking some fundamental questions: what do we want our NHS to deliver? How will we know our NHS is performing well? And how will we know how it performs not just on how much it does, but how well it does it, as well as looking after those who deliver that care?
“That questioning approach must lead us away from a tired focus and narrative on numbers seen and how long it takes to be seen. We need a much clearer idea of what we need to measure. This should also see a shift away from the current language and culture of targets which simply demands that they are met and takes little or no account of local circumstances and external factors.
“From this foundation we have also suggested four key principles that we believe should be used to judge any new proposals for healthcare from political parties. These principles emphasise an evidence-based but realistic approach signalling an end to blame and shame NHS culture.
“To our politicians, I say that they must reflect on this approach when considering what the NHS should aim for in the run up to next year’s election and beyond.”
The four principles BMA Scotland have set out for proposals for measuring our NHS are:
• Is a proposal realistic?
• Is it evidence-based and outcome focussed?
• Have health and care staff been involved in designing the aim?
• Does it take into account impact and relationship with other parts of health and social care?
Notes to editors
The BMA is a trade union and professional association representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.