NHS must retain the staff it already has as well as recruiting more - Chris Smith

Junior doctors make up around half of Scotland’s medical workforce

Anyone who’s read a newspaper, listened to the news, or scrolled through social media will know that our NHS is buckling under increasing pressure and demand for services.

We hear tales of record NHS staffing levels – the highest they’ve ever been. But the real story is slightly different. Just because we’re told that the NHS has more staff than ever, it doesn’t mean it has enough staff – and that’s the crucial issue. We don’t have enough doctors. We don’t have enough nurses. The reality of the situation is that demand for services is so high that staff on the ground are struggling to even take the breaks we’re entitled to or leave on time at the end of the day. We need more staff across the board.

Earlier this week the Scottish government announced plans to expand medical training posts for junior doctors – an additional 152 training posts to be exact. While having more trained doctors working in Scotland’s NHS is a good thing and I welcome the investment behind it, there remain issues that need to be resolved.

Junior doctors make up around half of Scotland’s medical workforce – we’re the ones you’re most likely to see doing rounds on hospital wards or in A&E. We juggle training and exams with the practical aspects of being a doctor, often working 12-hour-plus shifts.

The scale of these increases relative to the challenges the workforce is up against meaning that these junior doctors are at risk of being used to simply plug gaps in barely safe rotas rather than being integrated meaningfully as part of a well thought out strategy, which is what we need to make a real difference to the chronic workforce shortage we’re facing.

Service pressures and a lack of time and resources mean that junior doctors are already missing out on training opportunities, and adding another 152 doctors into the mix won’t change that. The Scottish government must make sure that adequate resources are provided not only for the doctors in these new posts but also the doctors we already have. Junior doctors cannot be trained without senior doctors – with 15 per cent of consultant posts in Scotland unfilled, proper training will be very hard to deliver.

Further investment must be part of a comprehensive, long-term workforce plan that moves beyond year-on-year fluctuations and improves support for existing staff; without increasing retention these new measures will provide a temporary solution at best. A crucial investment that will make a huge difference to doctor retention is into our pay; doctors are leaving Scotland at an alarming rate for better salaries and working environments overseas. To remedy this the 23.5 per cent real terms pay cut we’ve endured since 2008 must be reversed.

This coming winter will only deepen the year-round crisis – doctors need support now, so we are not forced to leave Scotland’s NHS prematurely because of exhaustion, stress or being undervalued. These new recruits will not stem the tide of junior doctors leaving the profession if urgent changes are not made to ensure we feel valued as a workforce.

So, while the investment to train more doctors is welcome, it needs to be part of a much bigger plan which includes urgently improving pay and workplace morale – before it’s too late.”

Dr Chris Smith, chair of the BMA’s Scottish Junior Doctor Committee.