The BMA has warned that additional cash promised to the Scottish health service will not be enough to deal with current and future pressures.
Finance secretary Derek Mackay announced an increase of almost £730m for health and care services in his draft 2019-20 budget, increasing direct investment in mental health by £27m, and increasing investment into health and social care partnerships to more than £9bn.
But the draft budget was published shortly after Audit Scotland warned that health boards were struggling financially, with several requiring a Scottish Government bail-out, or relying heavily on one-off savings.
The Audit Scotland annual review of the NHS also found that performance against targets dipped, with more patients waiting for longer for treatment.
BMA Scotland chair Lewis Morrison said that resources needed to deliver care in Scotland were simply not keeping up with demand for care. ‘While there is welcome extra funding for health in today’s budget, it is unlikely to make any significant difference to this growing gap, and the negative impact it is already having on our health services,’ he said.
‘We know that gap between demand and resources exists – both from our own members, who believe that finances are prioritised above care and indeed from the Scottish Government’s own financial framework, which highlights the scale of the expected gap which will need to be bridged in coming years. There simply is no clear plan in place to deal with this growing gap, and despite increased funding, substantial efficiency savings are still likely to be demanded of NHS boards.’
Dr Morrison called for a clear, realistic and detailed plan to reduce the funding gap. ‘Simply repeating the mantra that funding has increased and is now at record levels simply isn’t good enough while demand for NHS services continues to grow at a faster pace,’ he added.
‘A real-terms pay cut for senior doctors’
Mr Mackay said that it was a budget for ‘stimulus and stability’ that delivers for today and invests in tomorrow ‘with fairness, equality and inclusiveness at its heart’.
He said: ‘This budget delivers the public services, social contract and economic investment people expect while mitigating, where we can, the impacts of the UK Government’s policies of austerity and Brexit that are causing so much harm.’
A spokesperson for the Royal College of Physicians of Edinburgh welcomed the increase, but added that the NHS was under pressure and that resources must be targeted and effective. ‘We must ensure that we continue to recruit and retain a world-class workforce to deliver the best possible patient care. The workforce must continue to be highly skilled, and Scotland’s clinicians must be valued.’
The finance secretary also announced a public sector pay policy with an above-inflation increase for workers earning up to £36,500.
Dr Morrison said that, if applied to doctors, this would amount to a real-terms pay cut for senior doctors.
‘We warned of exactly this at a similar point last year, and sure enough the eventual pay award for doctors, and consultants in particular, was simply unacceptable. Damaging pay restraint and indeed real-terms cuts do nothing to attract or retain doctors delivering frontline care in Scotland. It is no surprise that this leads to difficulty in filling vacancies, which in turn leaves services vulnerable and doctors in post stretched to the absolute limit.
‘Moving forward, it is vital that more is done to reverse years of real-term declines in pay and make sure working as a doctor in Scotland is as attractive a career choice as possible.’
Read more news from Scotland: Doctors say finance and targets are given more priority than patient care
Read more from Jennifer Trueland and follow on Twitter.