Scotland's NHS crisis: Why I've stopped apologising and patients are less angry about totally unacceptable conditions – Dr Lailah Peel

It’s now undeniably spring. Days are getting longer, brighter and warmer, and you can nearly smell the potential threat of ‘taps aff’ weather and all the joy that summer brings.

But it’s hard to feel optimistic when at work we’re still firmly in the midst of what feels like a dark and dreary eternal winter. I work in A&E, where we’re short-staffed, overcrowded and generally operating unsafely more often than not right now. It’s been this way for nearly two years, with A&E statistics breaking records for all the wrong reasons as it gets worse and worse, month after month.

To put this in context, national targets are for 95 per cent of patients to be seen, assessed, treated and transferred or discharged out of A&E within four hours. Across Scotland, we are currently struggling to achieve that even within 12 hours.

Our NHS is failing daily. It’s breaking more with each week that passes. Not just in A&E but far beyond. Ambulances queue outside our A&Es as we essentially run a modified one in, one out system. Not because we’re overwhelmed at the front door but at the back door instead. Our A&Es are too often at a standstill simply because we’ve got “nae beds” – our hospitals are bursting at the seams, because discharges are being delayed mostly due to failings within the capacity of our social care services.

I no longer apologise to patients for the systemic failings that are so often causing them harm. Not because I don’t care. But because I care too much. It simply is too painful, apologising so many times in a day to patients and relatives, and absorbing some of the guilt for this chaos.

Whether that be to the frail elderly patient who waited in pain for more than 12 hours for an ambulance to arrive, before then waiting more than three hours outside A&E in that same ambulance before I could finally diagnose their fracture from the fall nearly 24 hours prior – or the patient apologising to me for “jumping the queue” because we’d rightly prioritised assessing them with their heart attack over the countless other people in our waiting room. Or the numerous others in similar situations, or worse, waiting hours on end in brightly lit, noisy departments on uncomfortable trolleys awaiting the rarest of commodities these days – a bed on a ward.

What I will do, however, is correct people whenever I hear total untruths in an attempt to attribute blame for the mess that is our health service right now or explain how it’s got as bad as it is. Like that this crisis is caused by Covid or that the pandemic is over – both incredibly untrue. Or the many discourteous comments I hear suggesting our GPs are to blame, despite the fact that they too are struggling with their constantly increasing workload whilst continuing to achieve more with less and less.

Thankfully the anger from patients and relatives that I see is less these days – because this is just the ‘new normal’. Long waits in A&E are just expected. But make no mistake, it’s not safe, and it’s most definitely not how it should be, and sadly it’s still getting worse.

Dr Lailah Peel is deputy chair of BMA Scotland