Chair’s update: Pushing hard on your priorities

It is only just over three weeks since I wrote my first blog as chair of BMA Scotland Council – but it’s fair to say the days have passed in a whirlwind and a great deal has happened in such a short space of time.

The team and I at BMA Scotland – including my newly elected deputy chairs Lailah Peel and Simon Barker – have been getting straight down to work to act on your priorities, which I set out from my first day in the job – namely, pay, pensions, working conditions, workforce and workload.

These aren’t things that are going to be solved overnight, or indeed three weeks – and its action from others like the Scottish and UK Government and health boards that will deliver what we need.

But on an almost daily basis we are out there and making the case on your behalf. Pay and pensions are top of the list, so that’s where I’ll start.

One of our key early actions was to seek an urgent meeting with the Cabinet Secretary for Health, Humza Yousaf and brief him on the results of our pay survey. I’m pleased to say that introductory meeting has happened and I’m grateful to him for making the time and for the positive and open way he approached the discussion.

Sadly, that doesn’t mean we have achieved a key breakthrough yet – but in encouraging news, he was able to accept the seriousness of the position in the workforce I presented. In terms of concrete actions, he has agreed to meet with Junior Doctors leaders in Scotland to consider what might be done about their pay. I appreciate that doesn’t immediately help other parts of the profession, but our survey tells us the strength of feeling on pay is greatest amongst juniors, and from the meeting it is clear that’s where the Scottish Government is most willing to listen. Of course, that’s far from the kind of urgent action we all know is needed, but to at least be open to the discussion is somewhere to start from. At the same time, as promised, each committee is considering its own position – and we’ll say more when that process is complete soon.

In terms of steps that may help more senior doctors, the Cabinet Secretary indicated he may well be able to make positive moves on pensions issues in Scotland very soon. We all know that acting within the Scottish Government’s powers cannot come soon enough if we are to stop haemorrhaging more and more senior doctors at a time when we really can least afford it – a point I made crystal clear in the meeting. We’ve been told to ‘watch this space’ before, but I do feel the commitment to deliver is genuinely there – in particular around a possible pension recycling scheme. Sadly, the full solution does remain within the UK Government’s powers, and the actions in the UK’s NHS plan last week patently do not go far enough to deliver the fundamental changes needed. We’ll keep pushing on that.

In terms of workload, which I know is a vital issue for GPs and hospital doctors, I have highlighted the impact this is having – pushing many of us to burnout and beyond – in the meeting with the Cabinet Secretary and the introductory meetings I have had with various politicians and media.

In that respect it has been particularly concerning to see parts of the Government’s reaction to the extremely challenging A&E stats of recent times, with boards being instructed to achieve certain new actions and targets in very tight timescales. Of course, no-one wants to see the kind of waits in A&E that are all too common at the moment. But simply asking those on the frontline to work harder is no kind of solution. As we all know, the workforce itself has no more capacity to give – it is overall system wide, solutions and investment – in particular increasing the workforce that is required. We are concerned that these new directives push doctors even further past what they can cope with. I would urge you on that basis to protect your own wellbeing, don’t work beyond the safe levels you are contracted to – and seek urgent advice from the BMA on any of this should you need it. These are incredibly tough times, and the risk of pushing staff too far is all too real. Have a read of this blog from my BMA colleague Patricia Moultrie for more on helping each other through.

The final two priorities are workforce and working conditions, which are intrinsically linked to all of the above. There is lots of work going on across committees on these issues, but I have been shining a light on the huge workforce crisis in all my media work. You may well have seen the front page of the Times – or the interview I did with the BBC – in both cases highlighting solving the workforce crisis as the only way we can ever get the NHS out of the desperate, gruelling struggle to care for people it currently finds itself in. Lailah Peel – with her particular expertise in A&E has been banging the same drum – and indeed was mentioned at FMQs by both main opposition parties this week. I know the power of the media, and I am determined we use it effectively to shine a light on the way our NHS is being run, and the improvements we desperately need.

So far, I have been genuinely humbled by the support and backing you have given me. I feel the weight of this responsibility throughout all the work myself and the team are doing – but equally it drives me on. There is much to do – and we will only achieve progress if we stand together as one profession and as one union, making sure we have each other’s backs. Never has that been more crucial. So spread the word – let’s stick together – and build our movement. Now is the time, to join us, or if you are already a member encourage others to join the BMA.

Dr Iain Kennedy is Chair of BMA Scotland Council

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