The number one “quick fix” priority for Scotland’s NHS as we move into 2023 must be the retention of our invaluable healthcare professionals, the chair of BMA Scotland said today (Wed, Dec 28th).
Dr Iain Kennedy said any plan for further recruitment, investment in the systems and aspirations of improvement will “fall flat on its face” unless there is a laser like focus on keeping the experienced staff our NHS already has.
Dr Kennedy, who was speaking as he delivered his annual festive message for doctors, added that the need for an open discussion on the NHS is now greater than ever.
His renewed call for a national conversation on the future of the health service comes as BMA Scotland shares more than 100 testimonies from doctors about what working in the NHS is like at the moment and their concerns for what the future holds. Comments included:
- “There have been a number of critical incidents in the last six months involving unsafe staffing levels. The acuity of the workload has increased. Patients are generally getting sicker and more complex, but we have less resources or time to care for them. It’s hard to keep them safe. I wouldn’t want to be an inpatient at the moment, and hope everyone in my family remains well for the foreseeable.”
- “It feels unsafe – because it is. It’s not safe for patients, and it’s not safe for staff either. I have gone from being a passionate committed GP to being a shadow of my former working self. I want to leave the profession and I am devastated by this.”
- “Things are very bad. Chemotherapy can only be delivered four weeks after seeing a consultant because of a chemotherapy nurse shortage. Radiotherapy preparation scans can only be done two weeks after seeing a consultant because of lack of radiotherapy staff/physicists – and it’s another two or more weeks before radiotherapy can actually be delivered.”
Dr Kennedy said:
“The NHS is haemorrhaging crucial staff – staff who we urgently need now more than ever before – and the government must step up to stop it. They can talk as much as they want about recruitment of staff, of investment in the system or of plans for improvement, but every single one will fall flat on its face unless there is a laser like focus on keeping the staff we have. That is why the retention of healthcare professionals – keeping them in the service – needs to be the number one priority in terms of the quick fixes to help us just make it through this winter with the NHS in Scotland somehow intact.
“I desperately want to be optimistic and forward looking, to set out some hope for the future – for the medical profession that I am so proud to be a part of, and the Scottish health service that I am equally proud to work in.
“But it’s not easy to find that indication of a brighter future – especially after reading the, frankly, harrowing comments from some of my NHS colleagues about what they are experiencing day in, day out. No one working in the health service would give me any credibility if I gave an upbeat description of the way our NHS will, or can, get better and how the working conditions of those caring for the people of Scotland will miraculously improve.
“All the statistics tell us that it’s a desperate state of affairs. Things are as bad, or worse, than they have ever been. Winter is a meaningless term now – this entire year has been winter. But looking beyond the statistics, looking at the people behind the statistics, the picture being painted is even more grim and concerning. The experiences my colleagues have shared speak louder than anything I could say, and anything any official stats could imply.
“We face crises across workload, workforce, working conditions, pay and pensions – all of these are hitting efforts to retain doctors, which we are already short of across both primary and secondary care. Hospitals have too many vacancies – indeed the current vacancy rate for consultants alone is 14.32% – and GP practices are falling over, with the Scottish Government not even close to being on target to deliver their promised 800 additional GPs by 2027.
“In the face of everything else pay and pensions are – incredibly – fairly quick fix issues. The government can make a decision to improve pay for NHS workers. And the UK Government can finally once and for all sort out the pension taxation issues that penalise senior doctors across primary and secondary care and force them to cut hours or face massive and unexpected bills. These two things will make a difference in staff retention – junior doctors will feel more valued and be more likely to stay in the NHS instead of looking to move abroad where they will be paid more and have a better work life balance. Senior doctors will be less likely to reduce their hours and more likely to work waiting list initiatives if they know they won’t receive a huge tax bill for doing so. We are beyond crisis point now – urgent action is needed to save our NHS and that simply must focus on investing in the workforce.
“Looking beyond that, of course we need to finally get a proper long-term workforce plan in place. But even more fundamentally we need, as a whole society, to grasp the nettle, face up to hard truths that have been brushed under the carpet for too long, and have a proper grown up, depoliticised national conversation about the future of the NHS in Scotland.
“Sticking our heads in the sand – or using the NHS as a political football to exchange snappy soundbites – will not cut it anymore. It’s clear we need to reflect on what we ask of our NHS and the levels of funding we, as a country, are prepared to provide to meet those asks, and to ensure the health service stays true to its founding principles and remains free at the point of delivery. The current approach of pushing insufficient resources harder and harder, then blaming staff when standards fall has failed and is failing patients every single day. I know doctors across Scotland are suffering moral injury as a result.
“Let’s stop putting healthcare workers in the impossible and insidious position of having to constantly be apologising and being the bearer of bad news. We need politicians on all sides to be brave and act – by bringing us together and finally actually properly talking about a plan for a future NHS we can all confidently get behind. And a better NHS will be better not just for Scotland’s doctors, but for the many people who rely on it for care.”
Notes to editors
The BMA in Scotland asked for personal experiences of doctors from early December and had more than 200 individual responses outlining the many pressures being faced.