BMA Scotland has warned that “urgent discussion” on the future of the NHS must not be limited to election cycles, as it welcomed a commitment from ministers to engage on health and social care reforms.

The doctors’ representative organisation says a national conversation on the future of health and care services in Scotland must deliver “real, tangible change” for staff and patients.

Yesterday, the government announced that it will conduct a programme of national engagement with the public, the health and care workforce and the third sector to inform NHS service reforms.

Responding to the news, Dr Iain Kennedy, chair of BMA Scottish Council, says that the NHS, staff and patients “cannot wait another year for a list of solutions”.

He adds that BMA Scotland has long been calling for an “honest, open and transparent national conversation” to tackle the challenges facing the health service and deliver reforms that will make it sustainable.

This comes as both waiting lists and long-term vacancies within the NHS reach record levels.

The BMA’s Scottish Consultant Committee Chair says this underscores a “continued workforce crisis” across NHS Scotland which is having a “real and terrible” impact on patients.

Agency spending on locums in 2023/24 was the highest figure in a decade at £129.6m in 2023/24 – an increase of 8.3% compared to £119.6m the previous year.

BMA Scotland says this reflects a “sticking plaster approach” in place of long-term solutions to the workforce crisis.

Dr Kennedy says the national engagement on reforms should not be a long-drawn-out process “disrupted by electoral cycles” or delayed by debates around money from Westminster, and instead must deliver “real tangible change and reform”:

“The NHS is in a crisis which has been building for years with the result that there is no longer any difference between winter and summer pressures - indeed pressure has become the defining feature of the health service with a huge mismatch between supply and demand.

“We welcome the debate and tone of building consensus set out by the Cabinet Secretary, and he is right to bring a focus onto a preventative agenda that will be vital in making our NHS sustainable.

“But we need urgent clarity on what a series of engagements means, and that it doesn't become a scaling back of the commitment made to a genuine, honest and open national conversation.”

Awaiting plans for change

In February 2023, national watchdog Audit Scotland called for transparency around progress on NHS recovery and the challenges facing services.

A year on – then newly appointed – Cabinet Secretary for Health and Social Care Neil Gray first promised reforms for NHS Scotland, saying he would set out his vision in the coming weeks.

Responding to Audit Scotland’s call for transformation in the face of increasing demand, Mr Gray recommitted to share a vision for NHS reform in the coming weeks – a statement repeated this April by a government spokesperson after a snapshot of NHS recovery revealed many services yet to fully reopen.

Now, BMA Scotland’s Dr Kennedy says MSPs from all parties must positively engage with plans for reform:

“We are at a crunch point with the future of the NHS and it must not be treated as a political football, with reforms constrained to election cycles.

“A national conversation must result in real tangible change and reform and not just end up as a tick box exercise, or the basis for another policy document that gathers dust on a shelf.

“Of course we won’t agree on everything, and healthy debate is to be welcomed.

“But I cannot say clearly enough that we need to all work together to find the urgent solutions required – and place to one side any divisive politics that may blow us off course.

“At this point, while the NHS in Scotland is struggling desperately to be financially sustainable – it equally urgently requires a vision for the future and an immediate plan for action on how this will be achieved.”

Dr Kennedy says this must be the start of discussions around expectations, capacity and sustainability.

He adds that BMA Scotland is “disappointed” in the lack of clarity in the government’s plans and what “feels like further delays” for those facing the daily stresses and strains of working in health and social care.

While both the Cabinet Secretary and First Minister have promised to stand against attempts to privatise the NHS, Dr Kennedy says a two-tier system of healthcare is rapidly developing:

“After a period of engagement and careful consideration about what we want and expect from our health and social care services, then consensus is needed about how we take forward those reforms.

“What must then follow is a period of stability.

“Patients are facing unacceptably long waiting times and a two-tier system of healthcare is rapidly developing where only those who can afford it are able to access timely treatment. This is unacceptable and threatens the founding principles of our NHS.

“Indeed, the starting point for any discussion must be that our health service should remain free at the point of need, but we need to examine how this can be achieved for both now and the future.”

Read more: New tech to cut NHS theatre waiting lists; Making cervical cancer a ‘rare disease'; Carers rights not yet a reality; Rapid cancer diagnostic network improves outcomes; Uncovering the hidden role of carers in Scotland; Charity: Long COVID needs long-term funding plan

Sign up to our bulletin for key health & social care updates straight to your inbox and you can follow healthandcare.scot on Google News.