Only through Collective strength will we deliver what matters for doctors

It’s a huge and pretty humbling honour for me to be writing this blog in my new role as Chair of BMA Scotland’s Council.

There are some major challenges facing the medical profession in Scotland – and I am under no illusions about the scale of the task we are facing together.

And I want to emphasise that it’s absolutely crucial that we do face them together. Let me be very clear that I am an absolute believer in the importance of teamwork – both large and small scale. It’s only through staying united, backing each other and showing our collective strength as one profession that we will be able to deliver some of things that really matter for doctors and patients, and we know are urgently needed.

I’m eager to get going and today will be chairing my first Scottish Council. As I see it – and as many doctors have told me – I think we have five key priorities, indeed crises – that we need to work on rapidly across BMA Scotland and with key partners who must deliver the changes we need.

They are:

Pay – let’s make no bones about it, this year’s pay award (and it’s categorically not a pay rise) was in fact a substantial real terms pay cut. Following a long period of sustained pay erosion, it’s no wonder doctors feel devalued and unsupported at all stages of their career. My predecessor Lewis Morrison has blogged comprehensively on the position on pay and has set out next steps. One key element of our plan is an urgent early discussion with the Cabinet Secretary for Health to make clear the strength of feeling from Scotland’s doctors, and that the ball is firmly in the Scottish Government’s court to deliver better pay and address the years of pay erosion we have faced. Doctors need to know what the Scottish Government plans to do – and we need to know now. I’m in the process of setting up that meeting – and will update you on the results.

Pensions – too many senior doctors are still being forced to give up working for the NHS earlier than they are ready or cut their hours due to the ridiculously complicated and counter-intuitive pension tax rules that end up penalising them for extra work. The UK Government holds the main levers on this – but there is equally more the Scottish Government can do to mitigate the impact. Just have a look at my consultant colleague Alan Robertson’s latest blog if you want to find out more. The key message is that the BMA understands the importance of this – we are on it and have been for some time.

Working conditions – where to start with this? It covers a myriad of issues, both large and small and will mean different things for different parts of our profession at different stages of our careers. I think perhaps the best way to put it, is that the NHS simply has to be a better and more enjoyable place to work.  Doctors deserve a more supportive culture and steps taken to actually help us do our jobs – rather than throw things in our way which only serve to distract us from doing all we can for patients. That might be getting a locker at work, hot food out of hours, easy access to parking, a doctors’ mess, better rotas, better IT or feeling safe to speak out on issues like bullying. All of these things affect how we, as doctors, feel and all will help us to look after patients.

Workforce – it would seem about the only people who don’t realise there is a massive crisis in medical recruitment and retention are those in the Scottish Government. We’ve had years of ineffective workforce planning that leaves us now dangerously short of doctors in hospitals and general practice. NHS Scotland lacks meaningful workforce data in primary care, consistently undercounts consultant vacancies, and doesn’t even bother counting SAS vacancies. We’re long past time for action – and doctors across Scotland know that it’s patients who are already suffering.

Workload – it’s tied closely to the above – but I know many doctors are struggling to cope with spiralling workloads. As a working GP I hear and see it regularly from colleagues – and anyone working in healthcare knows the scale of the challenge in our hospitals, with backlogs building up and waiting times lengthening. Producing more doctors and keeping more of the ones we already have will help – but that’s a slow process. The risk of burnout is simply too high for doctors working long hours well above and beyond what can reasonably be expected of them and we need urgent Scottish Government action.

This isn’t an exhaustive list. All my BMA colleagues across junior doctors, GPs, SAS, consultants and students will be working tirelessly to deliver on the key issues for their members. But I hope it does give you some indication that I will be aiming to lead your trade union with an unrelenting focus on the issues that matter to members.

One of the ways I think you may know me prior to this job, was through my role as a lead whistleblower at NHS Highland, which exposed the dangerous culture of bullying that existed within the health board and was so well described by the Sturrock review. I believe my role in that process will give you some indication that I will not hesitate to speak up for doctors and will use my position as chair of BMA Scottish council to get our key issues centre-stage and acted on. We need others to work with us to deliver on the priorities I have set out – so early positive engagement across the political spectrum and with key stakeholders will be important. But make no mistake, when there are difficult messages to deliver, your trade union will never shy away from doing so. Knowing, with confidence, that I have thousands of you behind me when I do that will only add considerable power to my elbow.

I want to finish with a word for my predecessor, Dr Lewis Morrison, who has led the BMA through the last four years and through some seriously troubled waters – not least the Covid pandemic. I don’t suspect anyone would have predicted what lay ahead when Lewis took up office, but he has dealt with what was thrown at him admirably and leaves the job with the BMA strongly positioned to deal with the new set of challenges coming our way. He has mine – and am sure your – huge gratitude, and I personally wish him well for the future. For me, there is a huge job to be done to build on Lewis’ legacy – and the work starts now.

Dr Iain Kennedy is Chair of BMA Scotland Council

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