Front-line NHS services already feeling the pressure of economic crisis in Scotland

(issued by BMA Scotland Sunday 27 Jun 2010)

Recruitment freezes and unfilled vacancies mask the true impact of economic pressures on the NHS according to a new UK-wide survey of doctors published by the BMA today (Sunday, 27 June 2010).

Launched on the eve of the BMA’s annual conference, where NHS finances are likely to dominate doctors’ debates, BMA research shows that, despite reassurances that there will be no compulsory redundancies in Scotland, NHS organisations are already taking actions which could have devastating and long-lasting consequences for the NHS.

The survey of Local Negotiating Committees (LNCs) [1] found:

    • Around one in four respondents (24%) said redundancies were planned in their NHS organisation.
    • Almost two thirds of respondents (62%) said that there was a freeze on recruitment. Seventy per cent of respondents reporting a freeze indicated that it covered medical posts and 80% that it applied to nursing posts.
    • Just over half (55%) of those with no explicit freeze indicated that there were unfilled vacancies.
    • Nearly three quarters of respondents (72%) indicated that clinical service or infrastructure developments were being postponed for financial reasons and two in five that access to treatments or therapies was being limited.
    • Just under half (45%) of responding LNCs were being consulted on cost and efficiency savings. The amount of savings being sought varied considerably around an average of just under 6%.

Commenting on the research, Dr Brian Keighley, chairman of the BMA in Scotland, said:

“NHS Boards in Scotland have been upfront in publishing planned cuts to the NHS workforce, however these figures may not tell the whole story. Hospital doctors across the UK report that some NHS employers are freezing recruitment whilst medical and nursing vacancies remain unfilled.

“The Cabinet Secretary, Nicola Sturgeon, has already made a commitment to work with us and the other NHS Trade Unions to scrutinise NHS Board plans and it is in this spirit of partnership that I will be writing asking her to clarify the situation in Scotland regarding the findings of this survey.

“We recognise that there is intense pressure to make savings in the health service and as the NHS budget begins to shrink, Boards will inevitably have to consider cuts to frontline services. However, making indiscriminate cuts is not only short-sighted but could cause irreparable damage to the NHS.

“Even changes to back-room functions or administrative processes have consequences for front-line staff, who in many cases, have to pick up the work themselves; this means less time for patients.”

Although the Scottish Government has made a commitment to protect NHS funding the growth in spending in real terms is likely to be minimal and efficiency savings still have to be made. NHS Boards are already under pressure to make their funding go even further, eliminating waste and improving productivity. The BMA accepts the need to be realistic but says that involving clinicians and local populations in decision making is key.

Dr Keighley said:

“There are areas in the NHS where there is a genuine need to examine ways of working and service delivery to ensure that they are delivered in the most cost-effective manner – without affecting the quality of patient care. But all too often we see indiscriminate cost cutting decisions made, seemingly taken for political and financial expediency rather than because of good clinical evidence.

“Doctors and other health professionals should be actively involved in the decision making processes. I am pleased at this government’s commitment to work with us to scrutinise NHS Boards’ workforce plans but I also urge the urge NHS managers to work with us and focus on identifying areas where they can truly eliminate waste and achieve genuine efficiency savings rather than be tempted to make arbitrary cuts and introduce poorly thought out policies.”

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