Consultant Scotland

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BMA lays out its vision for secondary care

Hospital signage on wall SMH2016 
St Marys/Hammersmith Hospitals 21-12-16

The leader of Scotland’s consultants has called for urgent action to put the nation’s hospitals on a sustainable future.

BMA Scottish consultants committee chair Simon Barker warned that morale was at ‘rock bottom’, particularly among senior doctors, and said the system could not be expected to go on as it was without substantial change.

Mr Barker was speaking as BMA Scotland published its vision for secondary care services, a detailed set of proposals intended to be a positive contribution and to provoke debate.

Secondary Care Matters: Shaping the future of safe, sustainable hospital-based healthcare in Scotland, has three main themes, calling for a collaborative, sustainably funded structure, a supportive culture and a valued workforce.

Put together following feedback from – and consultation with – members and groups from across the medical profession, it lays bare the problems in the system and points to solutions.

These include a more mature approach to targets, an honest debate about funding, involving doctors in decision-making, and ending the culture that sees doctors fear that they will be unfairly blamed for issues resulting from system-wide failings.


Bad planning

Mr Barker, a consultant paediatric surgeon in Aberdeen, said: ‘I have frankly lost count of the number of times the Scottish Government has been warned that the NHS, as it is currently run, is simply unsustainable. 

'The care provided in our hospitals suffers from a chronic lack of coherent planning, substantial underfunding that forces impossible prioritisation decisions on front-line clinicians, and undeliverable targets which seem to be driven by arbitrary lengths of time, rather than quality of care.’

Mr Barker said things had become progressively worse for those delivering care, who were being asked to work in services with neither enough staff nor money.

‘For the future of our hospitals and the people who depend on them, this simply has to change,’ he added.

‘If it doesn’t, we can no longer expect hospitals to provide the kind of comprehensive care we have always relied on them for. It’s a choice that Scotland has to make because doing nothing is making a choice. The inertia of recent years is a choice: a choice for reduced services, a choice for demotivated and fewer staff, a choice for less.’


Time to deliver

Mr Barker said there was an opportunity to do things differently.

‘I hope the document we published today, which is focused on solutions, will be a positive contribution to the debate about the future of care in hospitals. The people of Scotland need to decide what they want from our health service and then we can get on with delivering it – but services cost money. Magical thinking that we can have everything and not pay for it has to stop.’

Specific proposals in the document include increasing spending on health to 10 per cent of GDP in line with comparator countries, a fair system of pay and rewards for consultants that improves recruitment and retention, and trusting consultant-led teams to lead and innovate for their patients.

‘I remain convinced that this improved, sustainable service across our hospitals is what the people of Scotland, and the politicians who represent them, want,’ Mr Barker added.

‘At the BMA we are committed to working with politicians of all parties to deliver a better future. We all owe it to our patients – both today and in the future – to strive to get this right.’

Read Secondary Care Matters: Shaping the future of safe, sustainable hospital-based healthcare in Scotland

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