Associate Feature: The NHS cannot be restored without its staff

If a further year of COVID has taught me anything, it’s that pandemic predictions are generally unwise. Such uncertainty about the future would make it tempting to simply look backwards – but there will be plenty of chances to do that.

Now is the time to look forward at what needs to be done in the year ahead to make a career in Scottish medicine genuinely attractive, and without the risk of the job damaging the mental and physical wellbeing of doctors. Without the staff, we have no NHS: it really is that simple.
We have huge evidence of how tired so many colleagues are from delivering COVID care and everything else that patients need, with the addition of all the pent-up demand for healthcare that is currently being released. Indeed, there is so much evidence that there’s simply no need to debate it – because it is a statement of fact that the physical and mental health of NHS staff has suffered during this pandemic.

Staff got through these past 18 months on adrenaline and determination, but now general practice and hospital departments are running on fumes and are at risk of breaking. That this has been going on for years risks the word crisis seeming overused, but it makes it no less true. Scotland’s NHS is in a workforce crisis, and one that is deepening.

The Scottish Government recently published its NHS recovery plan – but it really is only a start at best, and many key issues and solutions are missing from it. There is no real mention of the need to retain the doctors we currently have, but instead promises of recruitment from overseas, which we know from experience cannot tackle staffing issues on the current scale. It has always been the case that Scotland has welcomed doctors from across the globe, but such an increased emphasis on actively asking doctors to come here in a peri or post pandemic world seems optimistic at best.

There is no quick fix to the myriad of problems NHS Scotland is facing, but our government has to start now, and with genuine short, medium and long-term workforce plans which address each and every issue undermining recruitment, retention and recovery. And a plan that restores medical education and training instead of solely focusing on clinical work and catching up – even that phrase conjures up visions of a race we can’t win.

I would urge the Scottish Government – and all politicians in Holyrood – to aim for a genuine sustainable work life balance for doctors and stop driving healthcare harder and harder in the pursuit of unrealistic political targets. Time and again I have called for honest messaging, which manages public expectations of the NHS and makes clear abuse of healthcare staff will not be tolerated.

And whilst we clearly need more doctors, those who train them must have the time to do that: an exhausted overworked medical profession covering for absent colleagues does not make for either good training or a good example of what people can look forward to.

The way to start moving our NHS forward is to listen to and believe us, and publicly acknowledge we have too few doctors, that the demand for healthcare must be managed properly, and promises of doing even more are not realistic. A medical profession that wants to help lead us out of this pandemic does not mean elitism or doctor knows best, but that we have the skills to be key contributors to that recovery.

I believe that ultimately fixing all the problems our NHS workforce faces means everyone wins: a better doctored NHS that doesn’t result in those doctors burning out, becoming unwell, or leaving can only be better for patients as well. And for government – if they really do have a vision for a future of Scottish healthcare that is genuinely world class – they will achieve that if they listen and act and work with us. It cannot be done without us.

This article is sponsored by BMA Scotland.