NHS can’t rely on staff goodwill says BMA leader

SCOTLAND must find a way of making its health service sustainable instead of relying on the goodwill of its staff, the chairman of the body representing doctors in Scotland has said.

The drive to meet targets diverts NHS resources, an Audit Scotland report found. Picture: Stephen Mansfield

Dr Peter Bennie has used his first Christmas message as chairman of the British Medical Association (BMA) in Scotland to call for change in 2015.

He highlighted a number of recent reports which have been critical of the NHS, including an investigation into above-average mortality rates in NHS Lanarkshire, and an inquiry into a deadly Clostridium difficile outbreak at the Vale of Leven Hospital in West Dunbartonshire.

He said: “Before we look forward, we first need to look back to learn from mistakes and missed opportunities.

“In October of this year, an Audit Scotland report raised questions around the impact of the target culture in the NHS, flagging up points of concern shared by the profession.

“It found that the drive to achieve targets at all costs diverted resources and undermined the professionalism of doctors.

“The Health Improvement Scotland (HIS) report into NHS Lanarkshire and the inquiry into the Vale of Leven both illustrate that systems can become unstable when resources are stretched too thinly.

“In Aberdeen, it is reassuring that the HIS review of the Royal Infirmary showed that patient outcomes had not suffered in spite of the cultural and organisational problems at the hospital.

“There has been a huge reliance on the goodwill of staff across Scotland to keep things going but this is not a sustainable solution.”

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He added: “The focus must be on delivering high-quality care to the people of Scotland and to make sure our NHS is sustainable for future generations.

“BMA Scotland is keen to develop greater consensus across the profession about how to do this, and to ensure that the new Cabinet Secretary [Shona Robison] is supported to make it her priority too.”

He said progress towards implementing the findings of the Kerr Report – a blueprint for the future of the NHS published in 2005 by Professor David Kerr – should be reviewed.

Dr Bennie also expressed disappointment that legislation to introduce minimum unit pricing for alcohol continues to be challenged in the courts, and highlighted concerns over the implications for the NHS of the Transatlantic Trade and Investment Protocols (TTIP) negotiations.

“The possible increased risk of privatisation of NHS services is now well recognised, but the opportunity for public health policies to be undermined by investor protection arrangements within TTIP is not,” he said.

A Scottish Government spokeswoman said: “The Scottish government agrees that the way we deliver health and social care in Scotland needs to change and our vision for the NHS is to see more people treated at home or in a community setting.

“Landmark legislation to bring the delivery of health and social care together was passed this year and will be fully implemented across the country by April 2016.

“The full integration of these services is designed to get patients home or to a homely setting as quickly as possible and ease pressure across the system.

“The Health Secretary has identified reducing delayed discharge as one of her key priorities for the year ahead and we have invested an additional £10 million in ensuring people are not waiting unnecessarily in hospital when they are fit to be discharged.

“This is as part of the Scottish government’s £28m investment this year in preparing for winter. As part of our focus to treat more people at home and in the community, we have also committed to investing £40m in GP and primary-care services to support new ways of working that can help meet the changing demographics of our population.”

The spokeswoman added: “We have made clear to both the UK government and the European Commission that, like the BMA, we have concerns about the possible impact of TTIP on the NHS and have pressed to ensure that the NHS is explicitly exempt from TTIP.

“The Scottish Government and the public must see the full legal text of any agreement before we can be fully assured that the NHS will continue to be safe in public hands.

“The BMA has been a key partner in our drive to bring real improvements to Scotland’s NHS and we look forward to continuing our work with them.”

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