BMA response to Auditor General's report on NHS in Scotland

Main Category: Public Health
Article Date: 06 Aug 2004 - 0:00 PDT

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Commenting on the Auditor General's Overview of the performance of the NHS in Scotland, Dr Bill O'Neill, Scottish Secretary of the BMA (British Medical Association) said:

"This report provides a valuable insight into the NHS in Scotland. It is shameful in this day and age that deprivation and inequalities ensure that we remain 'the sick man of Europe', despite increased spending on health and investment in the NHS workforce.

"Public health issues and preventative measures are highlighted as the best means of improving ill health. We would welcome detailed plans of long term investment in measures to protect and improve the public health such as legislating for smoke-free public places, improving access to healthy food and reducing consumption of alcohol, particularly among young Scots.

"However, the most important part of this report is the section that deals with investment in the NHS workforce. The report questions the value for money of new contractual agreements for doctors, nurses and other health care professionals. NHS reforms cannot be achieved without investment in the workforce.

"It is no longer acceptable that doctors be expected to work extra hours for the NHS for free. Consultants had been working an average of 53 hours each week, without receiving any additional reward for this commitment. A new consultant contract was long overdue. This new contract offers value for money for the NHS and for patients. A more structured work plan for consultants means that time spent on direct patient care can be measured and service redesign can be planned more effectively. It goes without saying that improved terms and conditions of service will improve morale, which will be reflected in better recruitment and retention of doctors and better care for patients.

"Hospital managers have known for more than 10 years that failure to comply with the terms of the New Deal for junior doctors would incur additional financial pressures. Despite this, some continue to fail to achieve its requirements and it is right that they should be penalised financially for non-compliance.

"The General Practice workforce is ageing and there are not enough doctors taking the place of those who retire. The new GP contract offers a solution to the workforce problem by enabling doctors to pass responsibility for out of hours care to the health board. The increased cost to boards reflects just how much GPs have provided for so little reward in the past. It also enables them to better manage their workload and focus on the prevention of ill health. For the first time, practices will be rewarded for the quality of care they give patients under the quality and outcomes framework. The provision of enhanced services will ensure that more services are provided in the community and closer to people's homes.

"These contracts have only been in place since April, therefore it is impossible to measure the improvements that they have brought at this early stage. However, as the changes bed down, it is likely that patients will begin to see the real benefits of the new contracts.

"But there remains much to be done. There is an urgent need for better workforce planning for doctors and other health professionals. We agree with the report that it is not simply a case of recruiting more doctors. Any plans must go hand in hand with a review of how we deliver services, particularly in the most remote and rural communities in Scotland.

"The BMA shares the concerns of the Auditor General and hopes to be able to work with NHS employers and the Scottish Executive Health Department to overcome the particular workforce challenges highlighted in this report."

Ends

For more information please contact:

Scottish Press Office
Tel: 0131 247 3050/3052 Mobile: 07979 510421
Fax: 0131 247 3051
Email: press.scotland@bma.org.uk

BMA Scottish Office
14 Queen Street
Edinburgh
EH2 1LL

Tel: (0131) 247 3000
Fax: (0131) 247 3001

email: info.edinburgh@bma.org.uk

Web: http://www.bma.org.uk/scotland

After 6.00 pm and weekends:
07979 510421