SCOTLAND is becoming an increasingly “uncompetitive and unattractive” place for doctors to work, medical leaders have warned as they called for increased pay for the profession.
The British Medical Association (BMA), in evidence to the body which makes recommendations on doctors’ pay, said medics deserved “an award in excess of inflation this year”.
The union highlighted numerous examples of the increased pressures on the profession and long working hours which warranted better pay to reflect the job being done.
In Scotland, the BMA flagged up problems recruiting both consultants and GPs and worsening work conditions which it said were impacting on services.
It said within the UK and globally, Scotland was becoming a less attractive place to work.
This year, the Scottish Government honoured a “modest” 1 per cent pay rise for doctors recommended by the Doctors’ and Dentists’ Pay Review Body (DDRB), while in England it was limited to those staff not already due a rise because of progression through their pay band.
In its evidence to the body, the BMA put forward its case for doctors across the UK to receive a pay rise again next year, despite indications from Westminster that pay restraints would remain in place in England.
“This year, the BMA believes doctors merit an award in excess of inflation,” it said. “We are not however including a figure we are seeking by way of a pay increase.”
The BMA said that since its last evidence, it had seen the start of a decline in the performance of the NHS across the UK “reflecting an exhausted staff, working at capacity, to deliver ever more with ever less”.
It flagged up growing warnings that budget pressures meant doctors were working longer hours and more intensely, without any recognition or compensatory reward.
Focusing on Scotland, the evidence pointed to increasing unfilled consultant posts, with vacancies rising from 4.7 per cent in June 2013 to 6.9 in June 2014.
The report also highlighted moves by NHS employers in Scotland to restrict the time consultants are given for non-clinical activities, such as training, research and appraisals.
“This restriction is strongly demotivating, with Scotland developing a reputation for unattractive consultant jobs,” it said. Along with a freeze on consultant distinction awards the evidence said this made Scotland “even more uncompetitive and unattractive, not only in the UK market for consultants and clinical academics, but also internationally”.
The current payscale for consultants in Scotland ranges from £76,000 to £102,000, while GPs can earn about £88,000 a year.
Anecdotal evidence suggests UK-trained doctors heading overseas are tempted by higher salaries. A UK GP working in Australia can earn £143,000-£165,000 a year.The report also highlighted individual doctor stories to illustrate the pressures on the profession.
One Scottish consultant surgeon said he had cut back on his NHS commitments due to not feeling valued, instead taking on more medico-legal work which was more rewarding and less time-consuming.
“Waiting lists have increased in his hospital, but ‘goodwill fatigue’ from lack of recognition has made many consultants in his hospital unwilling to take on extra work,” the evidence said.
Longer days forcing GPs to take work home
It also highlighted continued pressure on GPs, flagging up one Scottish GP whose practice had struggled to recruit a new partner.
Longer days meant doctors had to take work home with them, even after working 7am to 7pm, it said.
The GP was forced to give up voluntary work and in the end, due to concerns about her own health and recovery from illness, she decided to become a locum doctor to “regain control of her work-life balance”.
Dr Peter Bennie, chairman of the BMA in Scotland, said: “Hospital doctors and GPs in the NHS in Scotland are under huge pressure and increasingly are having to cover gaps where vacancies cannot be filled.
“This is an unsustainable situation for our colleagues. Scotland is struggling to attract and retain doctors and the Scottish Government needs to take urgent action to address this.”
Jean Turner, from the Scotland Patients Association, said while people would point to the high salaries already received by doctors, many worked long hours in their roles.
“If there are not enough consultants to cover the work then they are working extraordinarily long hours,” she said.
A Scottish Government spokesman said: “We offer a competitive package in Scotland based on terms and conditions which are used across the whole of the UK.
“In Scotland, basic salaries are generally higher than those in England as the Scottish Government has fully applied the NHS pay review bodies recommendations this year. This means that consultant pay in Scotland can be up to £1,000 higher in Scotland than in England.
“Furthermore, within our existing pay policy, NHS Employers have certain flexibilities they can consider when facing particular challenges in specific employment areas. Unlike the NHS in England, we also offer the added security of a no compulsory redundancy policy.”