Analysis: ‘Concentrating resources would help’

WE DO recognise that there is a staffing crisis in the midwifery profession and in many other parts of the NHS.

That’s why there’s a great necessity for the NHS to plan to ensure that there are enough staff and that includes ensuring there are enough GPs as well.

There’s a real need to look at how services are going to be organised and to then plan carefully by looking at how many students at medical schools and graduates will be needed to provide enough GPs and consultants.

This is something that’s vital, so that we can ensure that there is enough expertise within the NHS. Of course a big problem for the NHS is that we are talking about it being years before someone at medical school has a firm position in the service.

When we go on to the issue of new technology for the NHS, we have to look at how we reconfigure services and how we can ensure that each piece of equipment benefits as many people as possible in different parts of Scotland.

For example it may be that we have different regions specialising in different areas of expertise such as neurosurgery.To have the same piece of new technology at every hospital would be unsustainable, as the machines cost a huge amount of money, yet could sit idle for 16 hours of the day for example.

There may be a need for different areas of Scotland to share this specialist equipment and new technology to ensure that we get the best possible benefit for patients. It has to be about concentrating this equipment on a regional basis and that’s the direction that the NHS could go in. This needs to happen for reasons of efficiency and to ensure that we have an effective use of resources.

Scotland’s 14 health boards might also see changes, as it could reasonably be asked why each regional health board needs its own IT department.

There could be a strong case for having each health board specialising in one area such as IT or personnel for the whole of Scotland.

There has to be a balance between universality, localism and the efficient use of resources. We’ve moving towards real advances in the world of medicine and we could for example perhaps have a situation where stem cells are used for the eye.

At the moment we’re just scratching the surface of all this, but we will have to see a concentration of resources.

• Dr Brian Keighley is chairman of the BMA’s Scottish Council