With just under two weeks until the UK General Election, I want to take the opportunity to highlight the key asks for the incoming UK Government in The BMA’s election manifesto 2024.
We have heard a lot about the health and care sector throughout the campaign so far, and we should remember that health is a devolved policy area in Scotland.
That being said, the results of this Westminster election will have implications in Scotland on health, particularly around funding.
For this blog, I want to flag and focus on those asks that will have an impact on you, our members, in Scotland.
Value
The BMA asks that the new UK Government ensures that doctors trying to reduce waiting lists will not face punitive financial penalties in the form of tax charges. There must be guarantees that the punitive impact of the Lifetime Allowance (LA) and the Annual Allowance (AA), which has forced thousands of doctors to retire early or reduce their working commitments to the NHS, will not return. And that the personal and AA tapers and childcare eligibility threshold to ensure that doctors are not penalised for taking on additional overtime are removed. This is of course both crucial for doctors, but also if we are to begin tackling unacceptably long waiting lists in Scotland.
Protect
Doctors, and only doctors, should be called “the medical profession”. We need to see a stop to the substitution of doctors with medical associate professions (MAPs). Halt the recruitment of ‘associates’ and give medical teams genuine ‘assistants’.
The use of MAPs, including Physician Associates, must not come at the expense of skilled and expert doctors. MAPs are not doctors and cannot take on the role of doctors. The patient safety risk this is causing must be addressed immediately.
MAPs must be regulated by the Health and Care Professions Council; so the legislation which regulates them by the General Medical Council (GMC) the doctors’ regulator, must be amended. There must be legislation to protect the titles ‘assistant’ and not ‘associate’ and halt the unsafe substitution of doctors by other professionals in medical care. And there must be a pause in any further recruitment of MAPs until the medical profession’s patient safety concerns are fully addressed.
Of course, the regulation and deployment of MAPs is devolved to Scotland but we are keen that there is consistency across all the nations in addressing these issues, and hope that a new incoming UK Government might lead the way.
We want to see the draconian anti-trade union laws revoked, including the Strikes Minimum Service Level Act, to protect unions’, and their members’, right to take legitimate industrial action.
Governments should seek partnership and agreement with trade unions and staff groups, not ever-increasing restrictions on their legitimate representative functions.
Fund
We want to ensure that all UK health services have the necessary funding they require to deliver high quality, patient-centred care that meets the needs of their local communities.
The health and care system is under significant financial pressure; overall investment must be increased to meet rising demand across all health and care services so that doctors can deliver the services they so desperately want to provide.
We ask that the new UK Government provide the additional staff and services the public deserve by increasing funding for primary, secondary, community and public health services across the UK, including respective Barnett formula increases, via a multiyear settlement at least in line with historical averages, alongside additional funding for pay restoration.
Safeguard
We want to see the country get well again by prioritising measures to boost prevention of ill-health. Prioritising prevention is not only the right thing for the public and its health outcomes, but also for the NHS and the Treasury. By increasing the public health grant in England to at least 2015/16 levels, with equivalent funding for each other UK nation, and allow for an increase numbers of public health specialists, to give local public health teams the means to provide vital preventative services. The incoming UK Government will need to tackle health inequalities across the UK by implementing robust public health and preventative measures to address harms caused by smoking, climate change, obesity, alcohol use, drugs and gambling. And guarantee resources to improve pandemic preparedness, resilience, and response, implementing the UK and Scottish COVID-19 inquiries’ recommendations.
It is important that the collective voice of the medical profession is heard. Across the UK, our National Health Services have never been under more pressure, as doctors we need to send a clear message that in order to make the NHS sustainable for the long term,, we need to value the staff we have.
I know it is a busy time for everyone, but it is vital that we hold all parliamentary candidates to account, so please ask your local candidates to commit and to act on the issues I’ve set out, hold them to account and please share this blog either by forwarding to colleagues, friends and family or via your social media accounts. But most importantly remember to vote!
Dr Iain Kennedy, Chair of BMA Scotland
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