Scotland seems to be tentatively emerging from the immediate challenges of the Covid pandemic.
Life is starting to feel a bit more normal. But for healthcare and the public the danger from Covid is still out there – we just don’t know if or when cases may rise again.
There’s no room for complacency – but doctors, healthcare staff and the public alike do I think understand that in Scotland. The health service isn’t back to anywhere near full capacity and another wave of Covid may more severely test our resources and what little reserves – physical and mental – that we have left.
I haven’t updated you on BMA Scotland activity as frequently recently – after all we have for months been bombarded by information and at this stage where things seem more routine (that routine being far from normal mind you) it’s right to be more selective. But that belies the huge range of issues we’re dealing with on your behalf, particularly on remobilising non Covid healthcare and on that and other issues it’s a good time to update you.
As the NHS does begin to resume paused services, we are also clear that this must be done with safety of staff as an absolute priority. That means ongoing assurance about PPE and careful procedures in place to do all we can to prevent spread of the virus.
I know this will be a particular concern for BAME doctors. At the BMA, the disproportionate impact of Covid on doctors from these backgrounds is something we have been monitoring extremely closely. We have thankfully had better fortune in Scotland but the deaths of BAME doctors in England is a stark and tragic reminder of the risks. And National Records of Scotland have now confirmed that looking at the general population, deaths amongst people in the South Asian ethnic group were almost twice as likely to involve COVID-19 as deaths in the White ethnic group, after accounting for age group, sex, area-level deprivation and urban rural classification.
This confirmation must lead to extra support and consideration for doctors and indeed all healthcare staff from BAME backgrounds whilst Covid remains present in Scotland. While prevalence of the virus is falling that risk emphasises the need to avoid complacency, and the need to acknowledge that colleagues and our patients at higher risk remain so.
That also applies to those in the highest risk groups in Scotland who have been shielding and any relaxation of that for doctors must properly address the ongoing health risks they face and returning to clinical work must be with appropriate safeguards in place.
We have been clear the Scottish Government must ensure employers provide full and effective risk assessment for all staff – and this applies in particular for those from a BAME background. We’ll be raising that again with the Scottish Government and the First Minister has confirmed the issue will be discussed at the Covid and Ethnicity expert group. If any member has any concerns about this – please do contact the BMA and we stand ready to support you.
Next, as the NHS does begin to remobilise, doctor wellbeing is top of my list. It was before Covid and it’s even more important now as many doctors are weary from their frontline Covid efforts.
Both myself and SGPC Chair Andrew Buist sit on the Government’s Mobilisation Recovery group. It has a large membership across health and social and voluntary care and how effective such a group can be remains to be seen. It’s our job to get the voice of doctors heard in this and all the other fora we now attend remotely.
The group has already met once and I used the opportunity to remind everyone that many doctors and their teams in primary care and hospitals have been pushed to the limit over recent months and there can be no expectation that we simply pick up where we left off. I’ll keep you updated as that work progresses.
To turn to something that in these worrying times might seem less pressing; car parking is nonetheless an issue that has real impact on NHS staff. The ability to get to and from work without worrying about the availability and safety of public transport has clearly helped those working in frontline Covid care. The potential resumption of charges in England is unfair and precipitant. Whilst most hospital parking is free in Scotland nevertheless to hear that in Scotland that those places with charges under PFI schemes will remain free until at least the end of September and possibly beyond is welcome. But beyond that there’s a real lesson that parking availability for those who really do need it is a key part of staff welfare.
As the clapping recedes, delivering concrete actions that benefit NHS staff is one real way to show they are valued. We will also continue pushing to make sure that other gains made during Covid – such as signs of an improved culture, proper break facilities and access to hot food are not lost.
The NHS turned 72nd recently and whilst it’s not usually a landmark birthday, it is the first we have ever experienced in a pandemic. On that basis we have been using that as an opportunity to look to the future – and urge politicians to think long term and less tribally about how we run and measure the success of our NHS.
Resetting and restoring our NHS post Covid is an opportunity to not go backwards, and instead work together with politicians of all colours and the public, to build healthcare services better focussed on staff and patient welfare, not numbers and targets. Some may think this is unrealistic, particularly with an election just around the corner, but I do believe there’s a chance to channel some of the recent collaborative and cooperative vibe into a different approach which doesn’t treat the NHS as a convenient political football.
Which leaves me lastly to thank you all again. The dedication and commitment you have shown as a profession has been amazing and humbling. I desperately hope that due to Covid you won’t have to step up and do it all again but come what may BMA Scotland is here for you, 24 hours a day if you need us.
Dr Lewis Morrison is Chair of BMA Scotland
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