The future of the NHS in Scotland deserves a national debate as austerity cuts continue to bite and demand for services continues to grow. So it is refreshing to hear the head of the British Medical Association in Scotland, Dr Peter Bennie, call for an “honest” approach to the situation from political leaders today.
But it is a bleak picture of the health service which emerges in the senior medic’s assessment of the current situation on the ground. Hard-pressed doctors and nurses are increasingly “burnt out” as the strain on resources take their toll. The fact that NHS funding is continuing to rise is of no comfort when it is being outstripped by the requirements of an ageing population and public expectations of what the service should be delivering.
Perhaps this why the concerns raised by Dr Bennie about the chronic problems in recruiting and retaining staff in many areas of the country is an issue which must be focussed on. The widespread vacancies among the medical workforce show that these positions have been budgeted for, so this problem doesn’t appear to be one of just funding. If staff are feeling undervalued or that the service doesn’t offer a future for them, or perhaps more worryingly that the workload pressure is simply too much bear, then ministers must address this as a matter of priority.
The BMA has called for “action ... needed now to make Scotland a more attractive place to work”. That is a big demand, but it forces us to consider why good jobs cannot be filled.
The issue will become even more acute in the coming years as the shift towards merging health and social care becomes a reality, given the turnover of staff and low wage culture in Scotland’s care sector. If this is to be at the centre of delivery of services in the years ahead, then Scottish ministers must get on top of the situation regarding staffing. So it is something of a concern that health Secretary Shona Robison makes no mention of the issue in a response to Dr Bennie’s concerns.
It remains to be seen whether Scotland is capable of the “honest” debate being sought by Dr Bennie. The NHS has always been a political football and the opposition parties are quick to criticise the SNP over perceived cuts. And in fairness, it’s exactly what the SNP did in opposition, winning power in 2007 on a promise to reverse planned “centralisation” of A&E services by the Labour/Liberal Democrat administration. A decade on and the biting impact of austerity has left the SNP pursuing a similar course.
Given the repeated warnings we have had about the state of the NHS from leading orgainsations, the agenda must surely move on from party political knockabout to the realistic reforms that will secure the future of the service.
But first, the problem of how to fill existing vacancies must be addressed, and resolved. The only way the NHS will have a fighting chance of delivering its objectives during this era of austerity is if it can utilise every resource allocated to it. Until existing roles are filled, the NHS will be remain in a position where it has to run just to stand still.