Dr Lewis Morrison’s speech at ARM 2019

It is my genuine privilege to address you for the first time as Chair of Scottish Council.

I must give huge thanks to all of the staff of BMA Scotland, my deputy chairs Sue and Nikki, committee office bearers and countless other committee members for their support and hard work. It’s the cohesive efforts of elected members and staff that lead to achievement.

We have focussed on a small number of key priorities, informed by what members have told us matters to them.

Our three main aims have been to:

  • Promote a much more positive workplace culture
  • Demand improvements to doctors’ contracts, pay and working lives;
  • And provoke a genuine debate about the future of healthcare in Scotland.

We have had clear successes.

From next month junior doctors in Scotland will be entitled to a minimum of 46 hours rest after working nightshifts, and we’ve reached agreement on time off for life events. We’re currently pursuing minimum notice periods for fixed leave and securing enhanced shared parental leave for all NHS-employed doctors.

We’ve worked to ensure a fully implemented Scottish SAS Charter, and discussions on how to improve the attractiveness of the grade.

A Safe Staffing Bill is now law in Scotland. BMA input has made it more relevant to doctors. The proof of the pudding will be in whether it genuinely deals with understaffing and rota gaps.

The new GP contract implementation progresses, but is patchy in places, where there is a need to pick up the pace. A minimum income guarantee is now in place for GPs, who will benefit from a loan scheme for premises costs.

These are of course just the highlights of our work.

But bullying and harassment in NHS Scotland is the issue that has dominated this year. The issues aren’t new but are only now coming fully to light.

Our survey showed that nearly 4 in 10 doctors had seen bullying in their workplace, swiftly followed by four brave doctors in NHS Highland going public on the issues there.

Cases in many other health boards emphasise the problem is everywhere.

We welcomed the NHS Highland review, led by John Sturrock QC, whose report makes for stark reading.

We applauded the apologies that followed from our Cabinet Secretary Jeane Freeman. The short life working group set up to address the problems is a positive move.

But that group must ask why the NHS in Scotland has become such fertile ground for wholly inappropriate behaviours, and then it must address the reasons head on.

It’s time to move beyond fact finding and apologies. The opportunity for change and rebuilding trust must not be squandered. Healthcare workers in Scotland must be able to go to work unafraid.

We will set out our own positive proposals but Scottish Government and health boards must take action.

We are regularly told staffing is at “record levels”, which infuriates colleagues working in hospitals and general practices with under-recorded vacancy levels. We are still waiting for government’s much delayed workforce plan.

And Audit Scotland says the NHS in Scotland is currently financially unsustainable.

The funding gap dictates ambitious and potentially unachievable additional savings from regionalised working and health and social care integration, whilst treatment targets which focus on numbers are still prioritised, not need or quality. We continue to question these approaches.

We need positive solutions not just critique. We need an honest conversation about what can be delivered with the resources and staff we realistically will have, and plans which meet needs, not political objectives.

It’s no surprise to see the link Sturrock made between targets, stretched resources, and unacceptable behaviours. Overzealous measurement of what the NHS does, risks fuelling a blame driven and bullying culture. This has to end.

Finally, at the heart of all these issues is whether doctors are valued and feel valued. Our members too often tell us they aren’t. Our cabinet secretary heard that loud and clear directly from doctors at a recent event we held.

The message is plain. Value us, through actions, not just words. If we can work in a system where we are genuinely listened to, in well-staffed supportive services, and be properly paid without threat of financial penalty, then Scotland will be a place where doctors want to train and crucially stay.

Dr Lewis Morrison, Chair of BMA Scotland, speaking at ARM 2019 in Belfast on 26/06/2019

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