BMA Scotland council chair Lewis Morrison said it was time for a new sense of partnership between people, politicians and health care professionals – and called for a mature conversation about what is asked of the NHS.
In a speech prepared for the BMA’s first virtual annual representative meeting Dr Morrison also called for a move away from a ‘tired’ targets narrative towards one where the health service focused on patient outcomes. This call is expanded in a BMA Scotland paper outlining four principles for measuring the NHS in a more holistic and inclusive way.
‘We cannot return to the target culture which so dominated our lives before COVID-19,’ Dr Morrison said. ‘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.’
He said politicians should speak to their constituents, including those who are patients and health care workers, to the professions and trade unions – and that 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.’
The four principles set out by BMA Scotland for measuring the NHS demand asking the following questions: is a proposal realistic; is it evidence-based and outcomes-focused, have health and care staff been involved in designing the aim; and does it take into account impact and relationship with other parts of health and social 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,’ Dr Morrison said. ‘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.’
Dr Morrison said that patients and staff welfare must be put at the heart of any proposals, rather than number crunching and unrealistic expectations of what can be delivered with available resources.
‘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 [to the Scottish Parliament] and beyond.
‘This is our chance to make a change for the future of the NHS – let’s not waste it.’