'Lone wolf' doctors accused in damning health report

THE health service in Scotland is in the grip of a staffing crisis which will bring the system to its knees, a long-awaited government report on the future of the NHS will warn this week.

The report by one of Scotland’s most respected medical figures will blame the lack of team work among ‘lone wolf’ medics for exacerbating the problem, which has left almost 100,000 Scots waiting for treatment.

It will also say the shortage of front-line doctors and nurses is “unsustainable” and radical measures are needed to save the NHS.

Professor John Temple’s report, details of which have been obtained by Scotland on Sunday, will demand an urgent and radical overhaul of the way doctors are trained, recruited and work in Scotland.

It will recommend throwing open the doors of Scotland’s medical schools – traditionally the preserve of white, middle-class, privately-educated students – to a wider spectrum of society.

And Temple, the president of the Royal College of Surgeons of Edinburgh, will say existing doctors must change their hallowed work practices and attitudes.

Temple will call for them to hand over some of their traditional roles to nursing staff and other medical professionals so they can focus on providing the best specialist treatment for patients.

The study, which is the most fundamental review of the NHS workforce ever carried out in Scotland, will also call for urgent action to reverse the exodus of family doctors from rural areas and that of Scots medical graduates to England and abroad.

Temple was appointed by the government to carry out his investigation more than a year ago amid mounting concern at the widening shortfall in medical staff north of the Border.

Hospital doctors are lacking in many key specialities, such as cancer.

The Beatson oncology centre in Glasgow – the country’s busiest – is still seven consultants short, nearly a third of the number it needs. Meanwhile, there is also a shortage of around 1,200 nurses in Scotland.

The staffing shortfall will be exacerbated by new rules which limit doctors’ hours, increased assessment and audit, and the ageing population in Scotland, which will put extra pressure on NHS resources in the coming years. It takes around 15 years to train a hospital consultant.

A source close to the Executive told Scotland on Sunday: “Professor Temple makes it clear that we need an increasing number of doctors coming into the NHS and we need appropriate workforce planning.

“His report says that the approach we have at the moment is unsustainable if we hope to have the medical workforce that will deliver what we need in the future.

“We have to change. This is an opportunity that we either use or lose.”

One of the key recommendations of the report is to expand the intake of Scotland’s medical schools and measures to stem the brain-drain of young medical graduates leaving Scotland to work elsewhere.

“The report says that we need to be much more flexible and innovative about how we get people into medical schools,” the source said.

“It suggests expanding the number of mature students and encouraging greater diversity. The report concludes that the best way to increase the Scottish medical workforce is by shutting down the drain of medical talent out of the country.”

Scotland on Sunday understands there will also be criticism of doctors who work in isolation rather than as ‘team players’.

The source said: “There are some quite tough words for the medical profession, in particular for doctors who see themselves as lone wolves operating in isolation.”

They will be told to relinquish some of their duties to focus on providing the best specialist care for their patients.

In addition, the report highlights the growing exodus of GPs from rural Scotland. Around 10% of GPs in remote districts have resigned in the past eight months because of soaring stress levels and mounting paperwork.

It will call for improved career structures to be put in place to attract doctors to rural practices and for them to be given support to keep them in their jobs.

Last night, Professor David Levison, dean of Dundee University’s medical school, broadly welcomed the recommendations but criticised the government for not having taken action to increase the number of medical students sooner.

Levison said: “I’m keen on the idea of widening access. There is no doubt that Scotland needs more doctors.

“It has put Scotland medicine at a disadvantage not to have allowed the Scottish schools to increase their intake.

“The intake in England has gone up by about 2,000 places over the last few years but the Scottish government has not permitted us to bid for additional places.

“It has argued that the number of doctors per head of population is higher in Scotland than it is in the rest of the UK. This is true but it is still short of levels in most of Europe and certainly other parts of the world.”

Dundee University medical school has gone further than some of its counterparts in attracting mature students – currently one in six of its yearly intake – and people from less privileged backgrounds.

But, while Levison said he was in favour of greater diversity, he said he would be opposed to any changes in admission standards.

Yesterday, shadow health minister Nicola Sturgeon said: “What is being suggested in this report will take time and getting more people into medical schools is a long term solution to a current problem.

“In the short term we need to recruit more aggressively from abroad and provide better incentives for people to come to Scotland.

“There is already a staffing crisis in the health service in Scotland and I fear it will get worse before it gets better unless we take some quick steps to stem the tide.”

Margaret Davidson, of the Scotland Patients’ Association, said she supported the call for people entering the medical profession to come from all walks of life.

She added: “We need more doctors, more nurses and more medical staff across the board because the NHS in Scotland is going to have to treat more and more patients, particularly with an ageing population.

“The government has to get these new ideas up and running now, it should be done yesterday.”

Tracy McFall, chairwoman of the Royal College of Nursing in Scotland, whose members make up about 50% of the NHS workforce, warned: “The reason we have a crisis at the moment is that we have had poor workforce planning in Scotland all along.

“If we do not get our act together and get some proper planning in place there is no doubt that patient care will suffer.”