Scotland’s NHS is in the grip of a worsening workforce crisis as exhausted doctors consider either cutting working hours or leaving the Scottish health service altogether, BMA Scotland Chair Lewis Morrison warned today.

The warning comes in Dr Morrison’s speech to the BMA’s Annual Representative meeting – being held virtually this year.

Dr Morrison said the pandemic, years of covering for absent colleagues, rising verbal abuse and a feeling of not being valued financially or professionally has left the profession feeling “worn out”.

He also pointed to data from a BMA survey of 1,429 doctors following this year’s below RPI inflation pay award which shows:

• Nearly two thirds were not satisfied that the Scottish Government valued their contribution to the NHS. Half of those were extremely dissatisfied.
• More than 30% said the pay award had either confirmed or prompted a decision to reduce their clinical commitments. More than a quarter said it had prompted or confirmed their decision to consider moving away from Scotland and working in its NHS altogether.

Dr Morrison will further warn that unless addressed, the problems with the workforce threaten not only NHS recovery but also the sustainability of healthcare in Scotland.

Doctors from across the BMA met with Cabinet Secretary for Health Humza Yousaf this week to discuss the immediate pressures being faced and Dr Morrison has welcomed the Scottish Government’s commitment to working with the profession on key issues.

However, Dr Morrison warned an urgent short-, medium- and long-term workforce plan is required to address each and every issue currently undermining recruitment, retention and recovery.

In his speech – to be published online – Dr Morrison will say:

“We now have huge evidence of how tired so many colleagues are from delivering Covid care and everything else that patients need, with the addition of all the pent-up demand for healthcare that is currently being released. Indeed, there is so much evidence that there’s simply no need to debate it.

“It is a statement of fact that the physical and mental health of many doctors has suffered during this pandemic. Fact it may be, but we cannot accept this as inevitable. No-one – in any profession, let alone a caring one – should suffer in this way or at this scale – simply through doing their job.

“Why has this happened? It’s partly because NHS Scotland came into this pandemic with so many senior doctor vacancies. Last year our research showed up to 15% of consultant posts were unfilled, and by the Government’s own admission we are shy of at least 800 whole time GPs. There is no other way of describing this other than as a workforce crisis – and a crisis that is deepening.

“Add to that a promise of NHS Scotland being run at 110% capacity and the rising incidence of verbal abuse and worse against NHS staff, and you have a picture of a medical profession worn out from the pandemic and years of covering for absent colleagues, who don’t feel valued financially or professionally and are facing years of being pressured to work even harder.

“It’s no wonder doctors at all stages of their career are considering their options whether it be to improve their training, working conditions or work-life balance. That includes looking elsewhere in the UK or abroad, reducing working hours or retiring earlier than planned. That’s a cocktail of problems that threatens the sustainability of healthcare in Scotland, let alone recovery from the pandemic.

“There are no quick and easy fixes to the myriad of problems we face, but our government has to start now and with genuine short, medium and long-term workforce plans which address each and every issue undermining recruitment, retention and recovery. And a plan that restores and values continued medical education and training for doctors instead of solely focusing on clinical work and catching up. Even that phrase conjures up visions of a race we can’t win.

“Recovery also has to include paying doctors to match what Scottish government say about valuing us. Years of pay erosion and current punitive and unfair pension tax issues must be righted.

“We must aim for a genuine sustainable work life balance for doctors and stop driving healthcare harder and harder in the pursuit of unrealistic political targets. We need honest messaging, which manages public expectations of the NHS – crucially including primary care - and makes clear abuse of healthcare staff will not be tolerated.

“And whilst we clearly need more doctors, those who train them must have the time to do that. An exhausted overworked medical profession covering for absent colleagues does not make for either good training or a good example of what people can look forward to.

“We have hammered these issues home again and again with the politicians and organisations associated with healthcare. No government could hope to sort everything out overnight, but the pandemic can no longer be a reason or excuse for not making a start. Indeed, we had a constructive meeting with Humza Yousaf this week where we able to highlight key issues and gain a welcome commitment to work on them together for the benefit of the workforce, the NHS and the patients it serves.”

Notes to editors

The BMA survey data quoted is based on questions asked of 1,429 doctors conducted during the last two weeks of August this year. The full results of the survey will be published shortly.