'Real change' in Scots NHS urged by BMA chief

Real change is needed to tackle the challenges facing the NHS in Scotland, the body representing doctors has said.

Chairman of the BMA in Scotland, Dr Peter Bennie, said the health service must learn from past "mistakes and missed opportunities".

He said there had been huge reliance on the goodwill of staff, but that this was not a sustainable solution.

The Scottish government said it agreed that the way health and social care is delivered in Scotland must change.

In his first Christmas message since taking over as chairman of the BMA, Dr Bennie highlighted a number of recent reports which have been critical of the NHS.

These have included a probe into above-average mortality rates in NHS Lanarkshire, and an inquiry into a deadly Clostridium difficile outbreak at the Vale of Leven Hospital in West Dunbartonshire.

'Target culture'

He said: "Before we look forward, we first need to look back to learn from mistakes and missed opportunities.

"In October of this year, an Audit Scotland report raised questions around the impact of the target culture in the NHS; flagging up points of concern shared by the profession.

"It found that the drive to achieve targets at all costs diverted resources and undermined the professionalism of doctors.

"The Health Improvement Scotland (HIS) report into NHS Lanarkshire and the inquiry into the Vale of Leven both illustrate that systems can become unstable when resources are stretched too thinly."

The BMA chairman also mentioned the HIS review at Aberdeen Royal Infirmary and said it was "reassuring" that showed that patient care had not suffered in spite of the "cultural and organisational problems" at the hospital.

He added: "There has been a huge reliance on the goodwill of staff across Scotland to keep things going but this is not a sustainable solution.

"The focus must be on delivering high quality care to the people of Scotland and to make sure our NHS is sustainable for future generations."

Dr Bennie also expressed disappointment that legislation to introduce minimum unit pricing for alcohol continued to be challenged in the courts, and highlighted concerns over the implications for the NHS of the Transatlantic Trade and Investment Protocols (TTIP) negotiations.

"The possible increased risk of privatisation of NHS services is now well recognised, but the opportunity for public health policies to be undermined by investor protection arrangements within TTIP is not," he said.

'Ease pressure'

The Scottish government said legislation to bring the delivery of health and social care together was passed earlier this year and will be fully implemented across the country by April 2016.

A spokeswoman added: "The full integration of these services is designed to get patients home or to a homely setting as quickly as possible and ease pressure across the system.

"The health secretary has identified reducing delayed discharge as one of her key priorities for the year ahead and we have invested an additional £10m in ensuring people are not waiting unnecessarily in hospital, when they are fit to be discharged.

"This is as part of the Scottish government's £28m investment this year in preparing for winter.

"As part of our focus to treat more people at home and in the community, we have also committed to investing £40m in GP and primary care services to support new ways of working that can help meet the changing demographics of our population."

On the issue of TTIP and what effect it could have on the NHS in Scotland, the spokeswoman added: "We have made clear to both the UK government and the European Commission that, like the BMA, we have concerns about the possible impact of TTIP on the NHS and have pressed to ensure that the NHS is explicitly exempt from TTIP.

"The Scottish government and the public must see the full legal text of any agreement before we can be fully assured that the NHS will continue to be safe in public hands."