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Doctors in Scotland believe that finances and targets are prioritised above quality of patient care

A substantial majority of doctors in Scotland feel that patient care is being given lower priority in Scotland’s NHS than both finances and national targets, a major BMA survey has found.

In all 72 per cent of the doctors surveyed (999 in total) believe targets are prioritised over quality of care, while 68 per cent feel the same about finances.

The full results of the survey, conducted over the summer and published for the first time today (Wed, 28th), reflect the “deep concerns our members repeatedly express” according to BMA Scotland chair Lewis Morrison.

Further key results show:

• 91 per cent of doctors are working over their allotted hours;
• Nearly four in 10 (38 per cent) say bullying and harassment is an issue in their workplace, and a quarter of doctors would not feel confident in reporting such behaviour;
• The overwhelming majority of doctors (93 per cent) are often or sometimes fearful of making a medical error, and nearly half (48 per cent) say that fear is getting worse.

The report also highlights concerns over excessive workload pressures making it difficult to retain staff and a belief that staffing levels have deteriorated in the last year. 

Dr Morrison said:

“Our survey provides clear and worrying evidence that doctors in Scotland believe both national targets and finances are prioritised above the quality of patient care.

“This would indicate that the way our NHS is currently run is skewing priorities and not always putting the patient first. That simply cannot be right – everything our health services does should be about delivering the best care possible, and not simply meeting financial or waiting times targets, which often tell us little about the actual quality of care.

“Indeed, the evidence from this survey simply reinforces the deep concerns that our members repeatedly express. It is clear from the results that there are simply not enough doctors to deliver the quality care we all strive to provide. Doctors are fearful of making mistakes and then being blamed for them – despite being overworked and in a system under too much pressure.

“It is also clear from this survey that bullying, and harassment of doctors continues to be far too prevalent. This type of behaviour is completely unacceptable, and we need urgent steps to promote a more positive workplace across the NHS in Scotland – something the BMA is committed to working towards.”

On using the results of the survey to prompt tangible actions, Dr Morrison said:

“This survey must be more than just a means to highlight the problems doctors are experiencing. It has to be the start of a process that begins to reverse the deterioration in working conditions for doctors and other healthcare workers, in Scotland. I truly believe that if they are used constructively, the results will be a useful tool not just for us, but for policy makers, employers and managers at all levels.

“These are the challenges – making doctors truly feel valued again, ensuring Scotland better attracts and retains doctors, delivering real improvements in doctors working lives, putting services on a long term sustainable footing and closing the gap between resources and demand. Only by tackling these challenges can we hope to keep pace with the increasing needs for healthcare of the people of Scotland. 

“We must also adopt a much more nuanced and mature attitude towards targets and indicators. They are often used in isolation, or overly simplistically to making sweeping judgements on the how the whole of our NHS is performing. This can lead to both political and media pressure around waiting times targets that simply don’t provide anywhere near the full picture, or any information at all on the outcomes of patients being treated. It can also create a negative workplace culture, where meeting targets becomes the overriding focus and the source of undue and unjustifiable pressure, as has been reported by doctors and other healthcare workers across Scotland.

“We need to trust and value doctors judgement more, so they can focus on the care they deliver to patients. These are considerable tasks, and there is much to be done. But listening to those who have devoted their careers and their lives to healthcare is a vital first step. The results of this survey provide that opportunity and I very much hope those with the power to bring about change will listen, take notice and act.”


The results of the survey can be viewed here.



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