A year ago today, as the reality of wave one of the Covid pandemic was fast dawning on us, I was asked to appear on a live TV news show in the evening to answer questions about what might happen.
As my clinical day came to a close the news was breaking that a full national lockdown was now imminent. My interview came minutes after the lockdown was officially announced and any questions I might have expected were replaced by an avalanche of those asking what this all really meant and what would happen.
That now seems like such a very long time ago.
Whatever inkling we had of what was coming or how difficult it was going to be, the scale of that first wave of the pandemic was something none of us were prepared for, nor how we would have to respond, because we knew so little about Covid and what it was going to do to individuals and the country more widely.
But we changed the way we worked almost overnight because we had to, and doctors led that change with their clinical and managerial colleagues.
Healthcare staff drove rapid reconfiguration with a team ethic and a determination that blew away bureaucracy, targets, and hierarchies to achieve a common goal to keep patients and staff safe, and look after the many thousands who got ill with Covid.
We knew it already but that absolutely underlined that the NHS in Scotland IS its staff. They are a precious resource that cannot be taken for granted, and they need looking after too.
In hospitals the response in kind was better access to hot food out of hours, better rest facilities free parking in places that still charged for it. They may seem like smaller things to some, but they mattered, and they made a difference to NHS staff during the most stressful time of our careers.
A year on and after the longest hardest winter because of Covid the end of the worst might be in sight in Scotland because of vaccination and an even longer lockdown, but there’s some way to go yet. This last six months of wave two have been even harder in so many ways.
First and foremost, today is about remembering and mourning all those we’ve lost and recognising the impact on others whose lives have been changed by Covid. It is going to be hard day for all of us, I suspect – and we have endured far too many hard days already. But we also owe to ourselves and indeed everyone who has suffered during the last 12 months to look beyond the pandemic and recognise the consequences not just for individuals but for healthcare itself. And the people that are the NHS. I know how very tired so many colleagues are. And that many have been unwell themselves. And the worries for their families that have weighed heavily too.
The “little things” done to look after us that made wave 1 of the pandemic more bearable have not been maintained in many places. The fact that they should have been a routine part of staff welfare emphasises that that hasn’t been a priority for years.
As the calls for a return to normal get louder, we must remember that “normal” wasn’t great. Any rapid return to pre Covid conditions and workload would totally fail to acknowledge the physical and mental exhaustion many healthcare staff are suffering from, and the imperative to recover from that. To not now deal with the problems we started this pandemic with, which have not gone away, and with the spectre of many doctors considering retirement or reducing hours to protect their own health, would be to kick us when we are down.
BMA Scotland recently published a report highlighting just how pressured many doctors are from dealing with Covid and maintaining and restarting other NHS services. And that we came into this pandemic woefully short of doctors in general practice and in hospitals. But it’s also clear that there’s no real plan to fill all those vacancies or a realisation of why so many posts are empty.
So there must be genuine attention to wellbeing. A commitment to ensuring recovery, no barriers to taking leave and access to physical and mental health support services. There’s a critical need to restore the teaching and training and careers of the students and junior doctors which have been so affected by the pandemic. But beyond that we need more doctors, and, yes, I will say it, to achieve that our pay and conditions and the workload we have been expected to just shoulder for so long must all be addressed.
As the pandemic hopefully recedes, and with a Scottish parliamentary election approaching, there’s a risk of lots of talk and not enough action. But there is an opportunity to genuinely put right at least some of the wrongs in the NHS. If our next government can’t do that we risk squandering much of what we’ve achieved, in the most trying of times, over this last terrible but sometimes amazing and humbling year when we consider what the NHS has done.
So, whilst I will again profoundly thank doctors and healthcare staff for all they’ve done in this last year, it’s also a time to stop thanking us and make things better.
Dr Lewis Morrison, chair BMA Scotland
bmascotland.home.blog 