Scotland

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New survey of doctors reveals stark reality of a profession pushed to the brink

Two thirds of doctors who responded to a BMA survey in Scotland think inadequate resources are significantly affecting the quality and safety of care provided by the NHS.
 
The initial findings of the survey of nearly 1,000 Scottish doctors were revealed by Chair of BMA Scotland Peter Bennie, delivering his final speech to the BMA’s Annual Representative Meeting in Brighton, before he steps down this Autumn.

Results of the survey show a profession “stretched to the edge”, Dr Bennie told the conference, with nearly 9 out of 10 doctors who responded saying that staffing is inadequate for providing quality care.
 
And, in a warning about the future sustainability of the NHS, the survey also shows that almost nine out of ten doctors who responded agree that without a significant funding increase, the NHS in Scotland will not be able to offer comprehensive care within a decade.
 
Dr Bennie used his speech to welcome the enduring commitment to an NHS in Scotland that is not exposed to competition and privatisation, and to highlight strong progress in areas such as the new GP contract for Scotland.
 
He warned that while the BMA survey shows that doctors in Scotland are slightly less negative in their views of the state of the NHS than those in other parts of the UK, Scotland’s NHS is experiencing many of the same issues and must aim higher than the “very low bar” of simply being better than England. 
 
Dr Bennie said:
 
“The survey results in Scotland demonstrate the stark reality of a profession pushed to the brink. While doctors are delivering high quality care wherever and however they possibly can, we are stretched to the limit of what we are capable of.
 
“Perhaps we have not quite reached the dire working conditions and morale seen in England, but we are clinging by our fingertips from sliding down a similar path.
 
“Over the last four years as Chair of BMA, it is with dismay that I have seen more and more expected of doctors, with demand and pressures increasing substantially year on year. At the same time, pay has been hit in real terms. Vacancies have increased and become harder to fill. It is just not sustainable, for our NHS or for our profession.
 
“We know from the survey that two thirds of Scottish doctors who responded think resources are inadequate and this is significantly affecting the quality and safety of care, while 71 per cent feel that overall NHS services have worsened in the last year. Nine out of ten Scottish doctors say staffing is simply not adequate to provide quality patient care. 

 “This is simply not good enough, either for patients or doctors. We all want to provide the very best care we can, but we are being prevented from doing so by an under resourced and under staffed system. It illustrates the urgent need for action at all levels of Government.”
 
On the action required, Dr Bennie said:
 
“First, there must be a clear plan to close the gap between resources and demand that we see impacting on the service on a daily basis. The survey reveals that almost nine out of ten doctors in Scotland agree that without a significant funding increase, the NHS will not be able to offer comprehensive care within a decade.
 
“The plans for additional investment in England’s NHS announced in recent days, and the expectation of further resources for Scotland, may give us an opportunity to stop that gap growing further. While the precise figure for the money coming to Scotland may not be known for some time, we can be sure that this alone will be insufficient to move NHS Scotland to a fully sustainable footing for the longer term. Investment on a greater scale is still going to be required in the years ahead, along with concerted action to tackle the issues with recruitment and retention. 

“Pay and conditions must be improved to reflect the challenges and responsibilities of the job, reversing the years of real terms pay restrictions that have done nothing to attract doctors to live and work in Scotland. 

“And we must end the obsession with a narrow range of targets that tell us little about outcomes for patients, and lead to a culture of blame and political pressure. There will always be a need for data on our NHS – but the political and media narrative is often driven by waiting times that say very little about standards of care or what is best for the patient.

“To conclude, I know that we all hope to secure a future in which our successors - and some of us - will be gathered in a place like this, thirty years from now, reflecting with pride on the continued achievements of our four NHS, as they mark their centenary.
 
“If that is to be the case, then the Scottish Government need to listen and respond to the call for action in the areas I have set out today. Only by doing so will they ensure we have an NHS in Scotland that we can celebrate for many birthdays to come.”

BACKGROUND:

The speech refers to high level findings of a survey of 999 doctors in Scotland conducted between 3rd May and 5th June 2018. The BMA will be using the survey to help develop policy and proposals to support doctors in the future and deliver a more sustainable NHS in Scotland. More details here: 

https://www.bma.org.uk/collective-voice/policy-and-research/nhs-structure-and-delivery/future-vision-for-the-nhs

The survey results referred to were:

1. “Two thirds of doctors who responded to a BMA survey in Scotland think inadequate resources are significantly affecting the quality and safety of care provided by the NHS.”
Doctors were asked: Which of the following statements best reflect your views about NHS resources in your nation:
Adequate for patient services: 3%
Inadequate and slightly affect the quality and safety of patient services: 31%
Inadequate and significantly affect the quality and safety of patient services: 66%

2. Results of the survey show a profession “stretched to the very edge”, Dr Bennie is expected to tell the conference, with nearly 9 out of 10 doctors who responded saying that staffing is inadequate for providing quality care.
Doctors were asked: Do you agree or disagree with the following statements?
Staffing levels are adequate to deliver quality patient care: Agree: 6%: Disagree: 89%: Neither: 5%

3. In a warning about the future sustainability of the NHS, the survey also shows that almost nine out of ten doctors who responded agree that without a significant budget increase, the NHS in Scotland will no longer be able to offer comprehensive care within a decade.
Doctors were asked: To what extent do you agree with the following? Without a significant budget increase the NHS will no longer be able to offer comprehensive care within a decade. Agree: 88% Disagree: 3%. Neither: 9%

4. 71 per cent feel that overall NHS services have worsened in the last year.
Doctors were asked whether they felt over NHS services in Scotland had improved, worsened, or stayed the same in the last year.
Worsened: 71 per cent
Stayed the same: 22%, 
Improved: 1%

For further information please contact:

BMA Scotland, 14 Queen Street, Edinburgh, EH2 1LL
Telephone: 0131 247 3050 | 0131 247 3052 | 0131 247 3018 
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07768 005 850 
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