The BMA’s most senior doctor told those gathered for the Association’s annual conference that the ‘goodwill’ of doctors – which has kept the NHS from total collapse – has all but run out.
Dr Chaand Nagpaul, who this year steps down as BMA Chair of Council after his 5-year term, told hundreds of the UK’s doctors that, in the absence of a properly staffed and funded health service, it has been primarily their goodwill that has kept the NHS on its’ feet – not just during the pandemic, but for many years before that.
In his speech he said that doctors have worked over and above throughout the pandemic to keep patients safe during the most gruelling period of their professional lives. He said that this goodwill has been exploited by the Government and that “despite the government failing in their duty to care for us, we have unstintingly fulfilled our duty of care for our patients with integrity and professionalism.” Dr Nagpaul made clear this goodwill is rapidly diminishing as exhausted and demoralised doctors say enough is enough.
Dr Nagpaul warned ministers that “Doctors are utterly exhausted. Their well-being rock bottom with 40%1 suffering from depression, anxiety or burnout. And with one hundred thousand NHS vacancies unfilled, we’re at serious risk of haemorrhaging further doctors as half say they are now more likely to take early retirement and 7 in 10 are more likely to work fewer hours due to burnout.”
“You cannot run an NHS by exploiting a well of goodwill which has totally run dry. Doctors will, and are, walking away.”
The toll the pandemic has taken on the workforce formed a significant part of the speech and Dr Nagpaul said that there must be a guarantee that doctors will never again be forced to risk their lives because of failed pandemic planning and poor infection control measures.
He called on the government to guarantee there will not be a repeat of ‘the shameful squandering of billions on a disgraced private test and trace service,' which managed to contact trace only about 60% of non-complex cases against the target of 80% which was needed for an effective test and trace system. This led to a failure to curb transmission of the virus which in turn lead to the deaths of so many people and so many more being desperately ill in hospital.
Drawing upon the BMA’s own published ‘Lessons Learnt’ review, he called for ‘guarantees the government will address the glaring truth that the NHS cannot run with one third fewer doctors than countries like Germany, which resulted in White Elephant Nightingale hospitals standing empty because we didn’t have the staff to fill them. Guarantees to reverse our drastic deficit in hospital beds - half that of comparative European nations - forcing last minute cancellations of operations each time there’s a surge in demand.’
His speech also touched on so-called ‘Partygate,’ talking about how the BMA challenged, head on, statements from MPs who suggested healthcare staff were also partying after hours, saying, ‘it’s an absolute insult to the dedication of doctors that as we topped up intravenous fluids for sick patients, government ministers and the Prime Minister merrily topped up their glasses in defiance of the rules they themselves set.’
Dr Nagpaul also said the NHS needs a radical culture change to improve patient safety as doctors are afraid of speaking out about safety concerns due to fear of recrimination.
He said this fear is creating a “Vicious cycle whereby a lack of openness prevents learning and continues to perpetuate avoidable harm to patients… these are the hallmarks that led to the tragedy in Mid Staffs” and that “10 years on it’s shameful that nothing has changed, with the same headlines of healthcare staff terrified to speak out in Shrewsbury echoing through the Ockenden report.”
He told the country’s doctors that, "we need a culture where blame is replaced by learning and improvement and you’re thanked for raising a concern, rather than be pilloried for being a whistle-blower."
Commenting on the founding principle of the NHS, that everyone should be treated equally, Dr Nagpaul concluded it is “painful to see that this is not applied to our own NHS workforce, where inequality and discrimination runs rife.” Following the BMA’s landmark report on racism in medicine, he concluded “that racism is not only wrecking doctors’ lives, but it’s damaging patient care and threatening services with ethnic minority doctors leaving, falling sick and unable to function normally.”
He concluded by saying after his term ends “I’ll be rolling up my sleeves to do more frontline work in my practice adding to much needed GP workforce capacity. I hand over the baton to my successor and a new council to continue to fight for a health service where each of us is given the time, tools, facilities, support, and compassion to be the doctors we were trained to be and do the good we all want to do for our patients.”
Notes to editors
1. BMA COVID-19 tracker survey 2020 October wave https://www.bma.org.uk/media/3451/bma-covid-19-survey-results-for-hospital-doctors-oct-2020.pdf
BMA Covid Review 2 'The impact of the pandemic on the medical profession' https://www.bma.org.uk/media/5645/bma-covid-review-2nd-report-19-may-2022.pdf
The full speech can be found here.
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