A doctors’ trade union has warned that without “transformative” and urgent reforms, the NHS will struggle to see out another New Year.
Dr Iain Kennedy, chairman of the British Medical Association (BMA) Scotland, said in his annual New Year message on Tuesday that current evidence suggests there will be a large increase in people who don’t believe the NHS can provide them with adequate care, forcing them to go private.
BMA Scotland published results from its annual winter pressures survey, in which some 980 doctors took part.
Some 99% of respondents said they are either extremely concerned (76%) or concerned (23%) about the impact of increased pressures on the NHS throughout winter.
70% said the NHS is in “crisis mode” all year round, and 29% said they believe it is in crisis mode often, but not always.
84% do not believe the NHS has enough staff to cope with the increase in demand this winter, and 12% said they are unsure.
86% said they had no confidence that the Scottish Government would give the NHS sustainable funding, and 13% said they were unsure.
Of those who responded to the survey, 98% had no (86%), or were not sure if they had (13%), confidence in the Scottish Government to put the NHS on a sustainable footing
The survey included the option for doctors to record experiences of where they work – with more than 575 sharing their concerns, with a major focus on the impact on patients.
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 testimony reads: “It has become the norm to be operating at 115-120% 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 says: “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.”
Other testimonials cited similar issues of lack of staffing, bed shortages and employees being stretched thin.
Dr Kennedy warned the “time for words has passed” and that in 2025, there must be “action in the form of reform”.
He added: “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.”
We know that the pressures we are seeing on the acute services are linked to lack of resource in general practice and social care, so to help guide the overall reform we need an urgent, comprehensive workforce plan
He added: “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.”
“We know that the pressures we are seeing on the acute services are linked to lack of resources in general practice and social care, so to help guide the overall reform we need an urgent, comprehensive workforce plan.”
Citing the doctors’ doubts on Scottish Government funding, he said: “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.”
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.
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.”
