Official figures ‘mask true scale of doctor shortages’
Consultant vacancies could pose patient risk
CONSULTANT vacancies in NHS Scotland are more than twice as high as official statistics suggest, as doctors’ leaders called on the Scottish Government to face up to the “true scale of the problem”.
Data released under freedom of information reveals that a total of 1,076 consultant posts have no permanent doctor in place, compared to the 439 vacancies counted by official workforce statistics.
This includes roles being temporarily filled by a locum as well as posts which have not yet been advertised or where recruitment efforts have been abandoned.
These are routinely excluded from the official vacancy tally.
It comes weeks after new safe staffing legislation took effect in Scotland which places a legal obligation on health boards and social care providers to ensure that there are enough trained staff in post to deliver safe care.
Dr Alan Robertson, chair of the Scottish consultants’ committee at BMA Scotland – which obtained the FOI responses – said the law is unworkable without “honest” data.
He said: “You need to know what the gaps are before you can work out your workforce plan to fill the gaps.
“If you’re the person on the ground, without a colleague next to you, it really doesn’t matter what the reason is.”
He added: “The failure to acknowledge the true scale of the problem reflects our wider concerns about the culture of fear, blame and lack of openness that often dominates debate about our NHS which can prevent proper, open discussion on solutions.”
The FOI data suggests that the whole-time equivalent vacancy rate for consultants is actually 15.2%, meaning that one in six posts is either unfilled or has a medical locum in place.
This is up from 14.3% when the BMA last requested the data in December 2022, and compares to the 6.9% vacancy rate thrown up by official statistics.
Research published yesterday in the BMJ warned that a reliance on locums was “potentially harmful to
patient safety”, because they tended to be working in unfamiliar departments with less support from colleagues or a lack of access to vital computer systems.
Dr Robertson, a consultant cardiologist based in Tayside, said it was also “false economy”, given the high cost of locums compared to permanent staff.
Annual spending on agency medics by NHS Scotland has soared from £67 million to nearly £120m over the past decade.
Meanwhile, consultants’ salaries
have fallen by 25% in real terms compared to 2008 due to successive sub-inflation pay increases.
The Scottish Government is under pressure to match the pay offer recently accepted by consultants in England. This includes a £3,000 uplift for those who have been consultants for between four and seven years, as well as reductions in the time it takes for consultants to reach the top of their pay scale.
Dr Robertson said the current situation – combined with
Scotland’s higher income tax rates – means that senior clinicians are now worse off in Scotland than England.
He said this, combined with opportunities overseas, is contributing to the rise in vacancies.
He said: “Potentially, it’s an issue of people moving elsewhere.
“I know a couple of A&E consultants who have gone to Dubai. A lot of A&E consultants have gone to Australia because it’s better working conditions. There’s also the issue of whether we are retaining trainees.
“I’ve also had a couple of emails over the past few months from consultants in England who were thinking of moving to Scotland who are not any more.
“The increase in tax, for some people, was the final straw.
“Previously, we were in a situation in Scotland where people – before tax – were actually paid slightly better than in England, whereas now we’re in the situation where it’s worse, so we need the Scottish Government to actually come up with a plan.”