Protecting Scotland’s NHS in the coming years will need “transformative and urgent” reforms says the British Medical Association (BMA), as its latest survey reveals doctors feel like they are sinking.

BMA Scotland chair Dr Iain Kennedy has warned that the founding principles of the NHS are at risk and – without reforms – it will struggle to see out another year.

The results of BMA Scotland’s annual winter pressures report revealed that 76% of almost 1,000 doctors surveyed are extremely concerned about the increased pressures on the NHS this winter.

Dr Kennedy said the findings highlight the “stark but very real experiences” of doctors on the frontline who are struggling to deliver the care patients deserve, adding:

“We are only at the start of the winter period and yet we are already seeing examples of an NHS that is desperately struggling with the demands and expectations being placed on it.

“There has been warning after warning, and to be frank the time for words has now passed. In the coming year there needs to be action in the form of reform.”

One doctor surveyed said staff and patient wellbeing is suffering as a result:

“It has become the norm to be operating at 115-120% capacity and have between 10 and 20 admissions sleeping in the emergency department overnight in corridors.

“The system is broken and needs to be addressed as an emergency.

“It is therefore no surprise that in such a reduced capacity, bed and staffing model, that the NHS lurches from crisis to crisis falling further and further behind a basic acceptable standard of care.

“We feel like we are sinking.” 

BMA Scotland has warned that all the evidence suggests more people will experience an NHS unable to provide the care they need when they need it over the next 12 months, which will likely force some to go private.

This comes after the doctors’ organisation warned earlier in 2024 that Scotland is ‘sleepwalking' into private healthcare.

Of the doctors surveyed this month, 84% said they think the NHS is not staffed adequately to cope with the increasing demand this winter.

Around 86% of doctors surveyed had no confidence in the government to put the NHS on sustainable footing.

Now, BMA Scotland’s Dr Kennedy said that the government must move beyond “warm words” to deliver transformative change and lay out a clear timeline for reform:

“We know the NHS is valued and that, politically, all agree with the founding principle of ‘free at the point of need’. What needs to be put in place are measures that protect our health service for the long-term, giving the system stability and patients peace of mind.  

“The measures need to be transformative; the NHS needs to be reformed, we cannot continue to simply plug gaps with short-term funding, there needs to be a whole-system approach, looking at primary, secondary and social care, how they are appropriately funded and how they interact.

“We know that the pressures we are seeing on the acute services are linked to lack of resource in general practice and social care, so to help guide the overall reform we need an urgent, comprehensive workforce plan.”

He warned that the “NHS as we know it will struggle to see out another year” with people being pushed into private care or “simply left to suffer”, but added:

“It is not too late to turn this around and protect our NHS but now is the time to finally act and set out a clear plan to get to grips with the many complex issues we face.”

Read more: Health and care workforce to be bolstered over winter; NHS Scotland: waiting lists and beyond; Partnership working for Scotland's population health; Pay and balance “crucial” to stop doctors leaving; Chief medic: Innovate to tackle health & planet crises; New collaboration to tackle health inequalities; Health and care in the Scottish budget; Watchdog: action needed now on NHS reform