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by Lewis Morrison, BMA Scotland
30 April 2021
Associate feature: Our NHS needs honesty and realism - now and in the future

Associate feature: Our NHS needs honesty and realism - now and in the future

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 pre-COVID-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 understaffing, 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 staff 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 difficult 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 staff 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 staff 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 staff 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 staff 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 staff 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.

Dr Lewis Morrison is chair of BMA Scotland. This article was sponsored by BMA Scotland.

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