In recent years in Scotland, the feeling of living through events of historical significance seems to have become an annual exercise.
From the independence referendum, to the whole, seemingly never-ending, Brexit saga, I suspect many of us were growing somewhat tired of such turbulent times. Each passing year has seemed desperate to outdo the events of the preceding year, but it’s fair to say 2020 and the COVID-19 pandemic has taken this to a whole new level.
There has been no doubt at all that we have experienced the kind of events that we have not seen for many generations.
First and foremost, this has been a tragedy that has taken far too many of our loved ones from us, far too soon. As consultants in Scotland’s health service we have seen this first-hand and appreciate well the pain the pandemic has caused for families up and down the country. Our first thoughts are, and always will be, with them.
But I also don’t underestimate the impact it has had on you; both professionally and personally.
We were already working in an overstretched, under resourced system, really struggling to do the best we can for patients. We then dropped a lot of our normal work to focus on Covid when it first hit.
Equally, we have now been trying to play our part in restarting services where possible, while cases have risen again in this second wave.
This is important as I know many of you have struggled as we stopped non-urgent care during the first wave. All we ever strive to do is the best we can for patients. When events outwith our control mean we are prevented from doing this, the distress this causes is extremely difficult, primarily for patients of course, but also for us as doctors.
All of this has added up to an incredibly trying year: whether you have been directly involved in Covid care or affected by the impact it has had on healthcare in general.
That hasn’t been helped by the failure of the Scottish Government to agree a national deal for fair renumeration for consultants taking on extra work due to Covid. That was hugely frustrating and has been compounded by lack of local progress on resolving this – with the excellent agreement the BMA achieved working with NHS Ayrshire and Arran a rare exception.
In the meantime, we’ve produced our own guidance on taking on extra work and pay.
Longer term, and looking ahead to 2021, my real fear is the impact this will have on our workforce and, from my point of view of course, our senior doctors.
I really do worry that the last year will have pushed many to the limits of what they can cope with. We already know that many were disillusioned with the job, felt a proper life-work balance wasn’t achievable and issues with pensions had forced their hand on taking early retirement. I think the experience of Covid will only have made that worse.
We can barely afford to lose any more senior doctors, with workloads increasing unremittingly and vacancy levels already too high (and indeed underestimated by official statistics – although that’s a story for another day).
It is why there must now be a clear, renewed and much improved focus on retaining senior doctors in the new year. There are many long-standing issues that must be resolved, from work-life balance, career development opportunities, flexible working, to the need to reverse years of pay decline and finally resolving pensions issues.
At the BMA consultants committee we are going to make pushing for improvements on this our key priority for 2021. We hope this will result in improved retention of our valued senior doctors across Scotland.
We are working on the evidence base for this at the moment, with the aim of producing briefing materials before the end of January to support our lobbying strategy on the worsening workforce crisis. Real world examples of the challenges we face speak powerfully, particularly where they impact local services, so please let us know of your personal experiences as we can then take this directly to government.
Of course, we hope that next year will see the Covid pandemic begin to recede, and we start to put it behind us as yet another thing that can be consigned to the history books. That will give us the chance we need to truly focus on making things better for senior doctors and the difference that will make for patients is beyond doubt.
On that note, all that remains is to thank you for everything you have done in 2020. Your efforts have been magnificent, and at the BMA we see and recognise them. I also know what it’s like to work through Christmas: just one of the many sacrifices you make for the job. Whether working or not, I hope you have a good Christmas, and all the very best for 2021.
Here are some useful links you may need for working during the Covid pandemic and beyond. They include information for consultants and SAS doctors on changes to working patterns, pay rates, annual leave and arrangements for staff who are sick or shielding, as well as agreements on doctors’ wellbeing and appraisals.