NHS Scotland crisis: Entire system has reached a tipping point and could collapse – Simon Barker

As the end of an era with the current Scottish Government administration approaches and we await a new First Minister, it’s clear from today’s Audit Scotland report on the state of our NHS that the health service should be at the very top of the new FM’s agenda.

It paints a bleak picture, one the BMA and others have been warning of for some time. The financial sustainability of the NHS in Scotland is “concerning”; it has been since pre-Covid and things do not look to be getting any better with a predicted funding gap of £221.8 million across our health boards by the end of the year. Demand is outstripping capacity and the NHS simply cannot deliver what it is asked to under its current limitations, while ensuring it stays true to the fundamental value of remaining free at the point of delivery.

The report highlights the tension between the NHS Recovery Plan’s service delivery targets and the finances available to boards to meet them. We have said time and time again, without the funding and adequate staffing levels, we simply cannot meet the expectations and demands of the Scottish Government’s plan, let alone what we simply ask of the NHS day in, day out. The Scottish Government’s apparent refusal to truly reflect how challenging it has been for NHS boards to recover is frustrating and demoralising for staff who continue to do everything they can for their patients with extremely limited resources.

The same frustrations are held by our patients who are not always being given clear information from the Scottish Government about how long they may need to wait for planned care, leaving staff bearing the brunt of trying to manage expectations. This target-driven culture must end and there must be more transparency on the delivery of services and waiting times.

Additionally, I back Audit Scotland’s repeated call for the Scottish Government and NHS boards to improve the availability, quality, and use of data to ensure workforce planning, which is currently abysmal, is based on accurate projections of need. The actual consultant vacancies in Scotland appear to be much higher than the official government figures claim.

In fact, our most recent Freedom of Information request revealed there are 937 whole-time equivalent consultant vacancies, 14.32 per cent of the entire senior doctor workforce. The Scottish Government claimed the vacancy rate was 6.2 per cent based on figures that exclude certain vacancies.

With all of this in mind, we reinforce our call for a national conversation on the NHS. Indeed today’s report echoes our view that the Scottish Government should “urgently implement a programme of engagement with the public to enable an open discussion about the challenges facing the health sector in Scotland and help inform future priorities and how the delivery of services will change. It should make clear to the public what can realistically be achieved and involve them in the difficult choices that may have to be made.”

This must be met with a sense of urgency, the NHS in Scotland has reached its tipping point. The entire system is in crisis, from primary care to secondary care to social care. It is a teetering house of cards; if one falls, so will the rest.

Simon Barker, deputy chair of the British Medical Association’s Scottish Council