The Herald

NHS needs a clear plan for the future


HE warnings about the state of the NHS have become louder and more persistent in recent months and are impossible to ignore. Earlier this year, Audit Scotland said the health service in Scotland was not keeping pace with demand and the Scottish Government had not provided a clear strategy. Now Dr Peter Bennie, chairman of the British Medical Associatio­n in Scotland, has made similar criticisms.

Speaking in his Christmas address, Dr Bennie said the speed with which demand was outstrippi­ng resources in the NHS was rapidly increasing and that an honest debate was required about whether Scotland was willing to invest the resources needed to deliver the present range of services. Healsosaid­theScottis­h Government’s emphasis on the record number of doctors and nurses employed by the NHS missed the point that long-term medical vacancies were on the rise.

It is not necessary to look far to find evidence for Dr Bennie’s diagnosis. New figures have revealed that more than 600 patients a day are having to travel from their own area to receive treatment from other health boards or non-NHS providers, equal to10 per cent of patients last year.

The figures on NHS recruitmen­t are also well known. Earlier this year, the Scottish Government announced a 27 per cent increase in the number of medical graduates looking for their first hospital job in Scotland but it is still far from enough to fill the jobs that need done in the NHS. Indeed, more than 200 trainee posts for hospital specialist­s and GPs were left vacant last summer. The bottom line is that we have not trained or employed the staff we need.

As Dr Bennie says, the Scottish Government has not formulated a clear and public strategy to deal with the staffing problem but, writing in The Herald today, Health Secretary Shona Robison is correct to point out that the pressure on staffing will be increased by a crisis that is not of the Scottish Government’s making: Brexit. According to Ms Robison, non-UK EU citizens account for around five per cent of the total NHS workforce in Scotland; the proportion is even higher among doctors licensed to practise in Scotland at just under seven per cent.

Brexit cannot be allowed to distract the Scottish Government from its responsibi­lities on the NHS but Ms Robison is right to be concerned that it could make the recruitmen­t problem in the NHS even worse. If Britain no longer benefits from a single market that allows freedom of movement, the effect on the health service could be devastatin­g and the UK Government must guarantee that staff from other EU countries will be welcome here after Brexit.

As for the Scottish Government, it must listen to Dr Bennie and its other critics and engage in a much more honest discussion about where the NHS is and where it needs to be. Scotland’s NHS does not have the funding it needs, or the staff. There is a danger that the UK Government will allow Brexit to make the crisis worse. But the Scottish Government must also be honest about where the funding gaps in our NHS are and whether it is willing to invest the money needed to fill them.

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