Holyrood

OUR NHS NEEDS REALISM AND HONESTY NOW AND IN THE FUTURE

- BMA Scotland By Dr Lewis Morrison, bmascotlan­d.home.blog

▏ This is a watershed moment for NHS Scotland, when we have a unique opportunit­y, while we start health service recovery, to genuinely look to the future and ask what Scotland needs from its health services. This last year makes plain how precious a commodity the NHS is and that despite its longevity even under unbelievab­le pressure it has been able to rapidly deliver innovative and brave ways of delivering healthcare. We cannot expect things to continue the way they are or even were preCOVID-19 – some changes are here to stay, and others will be required.

The unrelentin­g pressures the NHS has endured for so long with under-resourcing and understaƒng, a perennial ’must sort out’, now needs to provoke a proper national conversati­on about the NHS’S future. The pandemic has in many ways exacerbate­d and made so very public what NHS sta… have known for years, it highlights their determinat­ion, dedication and resilience - which is nothing short of incredible, and they are the reason the NHS been able to continue to provide the unrivalled level of care that it does. However, that makes it even clearer now that how we did it before is simply not sustainabl­e.

BMA Scotland believes now is the time for a definitive national conversati­on about our NHS. To make Scottish healthcare sustainabl­e for the future we need to ask the diƒcult questions about what it should provide and how that should be funded but also listen to and act on the answers. This conversati­on needs to be cross-party, include all NHS stakeholde­rs, and critically must put patients and the public at its heart. We need to be realistic about the challenges, honest about needs and wants, and consider how much, as a nation, we are prepared to invest in health and care.

Success for the NHS, has for too long, been based on the ability to meet arbitrary and politicall­y motivated targets. COVID-19 has shown that a focus on patient outcomes, clinical leadership and assuring sta… wellbeing leads to success and positive results, and not the ticking of boxes. The more flexible, cooperativ­e and multidisci­plinary ways of working, introduced during the pandemic, should be built upon; the provisions put in place to help sta… to cope and deal with pandemic pressures are not luxuries or special measures, they should have always been there. The wellbeing and health not only of patients but also of sta… must be front and centre. The needs of both of these groups must be the foundation of all we do as recovery, remobilisa­tion and potentiall­y reconfigur­ation are progressed together. The NHS is its sta… and as well as putting their welfare at the heart of plans we must be honest that, as it stands, there is currently no proper NHS workforce strategy: we need one that is forward-looking and acknowledg­es the high sta… vacancy rates across healthcare.

In the final days of this election campaign what the NHS needs from all politician­s is realism about what healthcare can deliver. Some of the promises being made by political parties risk raising public expectatio­ns to unrealisti­c levels, of the capacity of the NHS now and in the future, without the required detail of how to make those promises a reality. Any promises on future delivery of services must be balanced with current capacity and developed in associatio­n with NHS and all its stakeholde­rs.

We owe it to the people of Scotland to make sure our health service is the best it can be but just as importantl­y we owe it to the many thousands who work in it.

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