The Burnt-out NHS

Doctors in Scotland are suffering “stress and burnout” as growing NHS workloads take their toll, medical leaders today warned.  BMA Scotland chairman, Dr Keighley has warned that the fall in hospital bed numbers over a number of years has led to rising waiting lists and more pressure on Accident and Emergency.

Health boards and the Scottish Government are struggling to deal with the pressures of an ageing population, Westminster-led funding cuts and rising expectations from patients which include a shift towards a seven day working week in hospitals. New contracts are now being proposed for doctors, along with “radical” changes to training and greater weekend working. Dr Keighley insisted doctors are ready to look at new ways of working.

The crucial contact between doctors and patients has particularly suffered, according to Dr Keighley.

The “inexorable rise of managerialism” in the NHS has been a “major cause of dysfunction”, he added, and there is a need to return to clinical priorities. “I disagree with suggestions that managerial and process change holds the solution to sustaining high quality care and believe instead that it is only by working with doctors and other healthcare professionals that a solution will be found.

Docs Get Ready to Fight

The British Medical Association is poised to ballot its members on industrial action for the first time in 40 years. Under the Dept. of Health plans, doctors' pension contributions would increase immediately by up to 2.4%, with continued increases over the next two years. It also wants to raise the retirement age to 68 and end the final salary scheme for hospital doctors. Although the DoH proposals are intended to apply to NHS workers throughout the UK, Scotland has its own devolved NHS pension scheme which is overseen by the Scottish Public Pensions Authority. However, if the Scottish Government decided to break with the reforms it is likely Holyrood would have to pick up the tab for any shortfall.

Dr Dean Marshall, outgoing chairman of the BMA's Scottish General Practitioners Committee, said doctors north of the Border had been let down by Holyrood's inaction and the Scottish Government's "complicity" with Westminster on the issue.

Dr Marshall said: "Is it fair for NHS staff to be taxed for the Government's failures to properly regulate the banking sector? And while the Scottish Government argues it does not agree with these plans it appears to be going along with the UK Government and is therefore complicit in taxing public-sector workers for the failures of the private sector. Scottish ministers could seek to do something different and I urge them again to find that solution – not just invite us to new talks"

Dr Marshall said doctors were unhappy that pension reforms were being "foisted" on them just four years after they agreed substantial changes to their package.

He added: "We agreed to tiered contributions where higher earners contributed more than lower paid workers. We agreed to the increased retirement age of 65 and we agreed to a cap on employer contributions so that the taxpayer would not pay for any future shortfall in the scheme. These changes worked and the NHS Pension Scheme is in surplus to the Treasury to the tune of £2 billion, and this is projected to continue into the future."

Another union ready to fight

Doctors are threatening their first wave of industrial action in nearly 40 years, after they overwhelmingly rejected proposed changes to their pension plans. Under the final offer proposed by the UK government, some doctors will see their pension contributions rise from 8.5 per cent to 14.5 per cent of their salary. They will also have to work longer before they can retire. Existing methods of pension accrual will be replaced by a career average revalued earnings scheme for all doctors and there will be no automatic lump sum, currently enjoyed by some doctors upon retirement. According to the BMA, the proposed changes would see doctors working until 68, an age beyond which many feel “competent and safe”.

A UK-wide survey by the organisation of 130,000 doctors and medical students – including 6,638 in Scotland – found an overwhelming majority opposed to the pension reforms, with almost two-thirds prepared to take some form of industrial action. More than a third (36 per cent) of doctors aged 50 and over said they intended to retire if the changes went through. It is unlikely they will agree to an all-out strike. However, one option is for a form of work-to-rule, which could see the cancellation of some clinical procedures, particularly at weekends.

http://www.scotsman.com/news/health/gps_set_for_first_industrial_action_in_37_years_1_2064378