The leader of Scotland’s doctors has said it is time to stop ignoring the ‘warning lights’ about the state of the NHS and to seize the opportunity to make change.
BMA Scotland chair Lewis Morrison said that there could be no going back to the old ‘normal’ – and that healthcare deserved better than ‘more of the same’.

Reflecting on the last year in a blog, Dr Morrison said he had never been more proud of what the profession and colleagues across healthcare had achieved. He also expressed condolences for those who had lost loved ones, and those who continued to be dealing with the ongoing effects of COVID-19.

‘I believe 2020 has underlined how much we need and have to value the NHS in Scotland, and what I mean by that is those who work in it. They are the health service,’ he said.

Although it was tempting to look back and consider what could have been differently, now was not the time, he added. ‘I want instead to look forward to next year and the pressing need to fix the undoubted problems we had in healthcare before the pandemic, but which the pandemic has exposed very clearly.’

It will be hard enough just to get through the next few months, Dr Morrison said, but we must also have an eye to the future. ‘Next year there is a real opportunity for change that cannot be missed. As we roll out a complete COVID vaccination programme and life starts getting back to normal, there can be no going back to what was normal in the NHS. Because that normal was a normal of understaffing, under-resourcing and unrelenting pressure. Our national debate will focus on the Scottish Parliament elections in May and whatever their outcome the message to all political parties must be that healthcare deserves better than more of the same.’

This call is backed by results of a BMA survey of 900 doctors which will be used to form the BMA Scotland Manifesto ahead of the election, he said.

‘The clear early results from the survey tell us doctors are working in a system which simply isn’t funded sufficiently to even keep doing what it does at the moment. Staffing levels are either getting worse or simply not keeping up with demand and the system is often based on blunt targets that can be used to sideline clinical judgment. As we have heard before, that system can create damaging cultures and behaviours.’

Dr Morrison said that the pandemic had taught us that we must be honest about the NHS and that all politicians should be open about the challenges, and that it would not be possible to address the backlog of healthcare created by the pandemic – let alone new healthcare needs – unless the underlying issues were fixed.

‘So when we hope 2021 starts to get us back to some form of normality, let’s not pretend any more that the NHS can go on achieving everything we ask of it with current finding and staffing.

‘It has been the toughest of years for many of us, and we have some difficult times still to face, but if we are to take anything from 2020 and the pandemic then it’s surely that working together works. That’s why I’m convinced we can seize the opportunity to change during this next year.’

BMA Scotland survey

Results of the BMA Scotland survey suggest:

• 92 per cent of doctors don’t think the NHS can continue to provide the current range of services it does into the future without additional financial resources. 61 per cent think the NHS is funded well below what is required.
• More than a third (36 per cent) of doctors feel medical staffing levels where they work have deteriorated over the last 5 years. A further 20 per cent said while there had been increases in staffing, this wasn’t keeping up with demand. Only seven per cent said staffing had improved.
• Half of doctors have experienced a situation where in their view the pursuit of targets has resulted in pressure to overturn clinical judgement.