NHS in Scotland will struggle to see out another year without 'urgent' reform, warns BMA

Dr Iain Kennedy, chairman of BMA Scotland, sounded the alarm

The NHS in Scotland will struggle to see out another year without "transformative and urgent" reform, the doctors' trade union has warned.

Dr Iain Kennedy, chairman of the British Medical Association (BMA) Scotland, said healthcare staff are struggling to cope in a system "in constant crisis".

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He said: “We are only at the start of the winter period and yet we are already seeing examples of an NHS that is desperately struggling with the demands and expectations being placed on it.”

Concerns have been raised over the state of the NHSConcerns have been raised over the state of the NHS
Concerns have been raised over the state of the NHS | Jeff Moore/PA Wire

Dr Kennedy said current evidence suggests there will be a large increase in people who do not believe the NHS can provide them with adequate care, forcing them to go private.

It came as BMA Scotland published results from its annual winter pressures survey, in which some 980 doctors took part.

A total of 99 per cent of respondents said they were either extremely concerned (76 per cent) or concerned (23 per cent) about the impact of increased pressures on the NHS throughout winter.

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Meanwhile, 70 per cent said the NHS is in “crisis mode” all year round, and 29 per cent said they believe it is in crisis mode often, but not always.

The survey found 84 per cent do not believe the NHS has enough staff to cope with the increase in demand this winter, and 12 per cent said they were unsure.

Elsewhere, 86 per cent said they had no confidence that the Scottish Government would give the NHS sustainable funding, and 13 per cent said they were unsure.

The survey included an option for doctors to record their experiences of where they work. More than 575 shared their concerns, with a major focus on the impact on patients.

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One testimony read: “It has become the norm to be operating at 115-120 per cent capacity and have between 10 and 20 admissions sleeping in the ED overnight in corridors. The system is broken and needs to be addressed as an emergency.”

Another said: “We feel like we are sinking. We are working hard to get patients fit for theatre, but the lack of elective beds means we continue to cancel patients. We can never get on top of elective surgery demand with the model we currently have.”

One GP wrote: “Been crisis mode here for months. Critical incident in November. Feels like nobody in management – acute sector or community is listening or actually admitting the seriousness of the situation at all levels.

“This has and continues to have an impact on lives let alone safety and staff morale.”

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Other testimonials cited similar issues of lack of staffing, bed shortages and employees being stretched thin.

Dr Kennedy warned the time for words had passed, and there now needed to be “action in the form of reform” over the coming year.

He said: “Our survey adds the stark, but very real experiences of doctors on the frontline, who are now facing, on a daily basis, moral distress and injury being unable to provide the care for our patients that we want and know they deserve.

“What was apparent in our survey was the frustration doctors feel at not being able to do the best we can for the people we care for, with patient’s needs featuring in 70 per cent of written responses.

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“Doctors are finding themselves working in a system that is neither prepared nor staffed adequately. They are struggling to cope in an NHS that is in constant crisis, which is both mentally and physically exhausting.

“While there are continuous pressures on the NHS we are only too aware that at this time of year there is always an additional winter surge, higher demand due to seasonal illness and bad weather, which just emphasises the inability of the health service to cope with what we ask of it.   

“We know the NHS is valued and that, politically, all agree with the founding principle of ‘free at the point of need’. What needs to be put in place are measures that protect our health service for the long-term, giving the system stability and patients peace of mind. 

“The measures need to be transformative; the NHS needs to be reformed, we cannot continue to simply plug gaps with short term funding, there needs to be a whole system approach, looking at primary, secondary and social care, how they are appropriately funded and how they interact.”

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He added: “Doctors have heard a lot of warm words recently from the First Minister and his team about the NHS being at the heart of their recent budget, but words must be matched with a clear vision, a timetable for reform and action.  

“The NHS as we know it will struggle to see out another year, as its founding principles, which we all value so highly will be at risk with more and more people forced to go private or simply left to suffer as they cannot access the care they need, when they need it.

“It is not too late to turn this around and protect our NHS but now is the time to finally act and set out a clear plan to get to grips with the many complex issues we face.” 

SNP health secretary Neil Gray agreed with the BMA’s stance on reform and said the Scottish Government is listening to patient and clinical opinions to steer how it delivers services.

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He added: “The measures we set out in the draft Budget, including record £21 billion investment for health and social care, would mean quicker treatments, more GP appointments, and world-class facilities for people across Scotland.

“But we will only be able to deliver these transformational investments and drive further improvements for patients if our Budget is agreed. I urge Parliament to unite behind it.”

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