Politicians must rise above the current political instability and focus on what must be achieved in the health service if the NHS in Scotland is to flourish, warns chair of BMA Scotland Peter Bennie.
In his speech to the BMA’s annual representative meeting in Bournemouth, Dr Bennie will say:
"The health service is never out of the political spotlight. Over the past three years, the NHS has been front and centre in two referendums, the Scottish election, and two general elections. And we live with the on-going debate over the impact we can expect from leaving the European Union and the possibility of a second independence referendum in Scotland.
"Throughout this period of political instability, we at BMA Scotland have worked hard to deliver a consistent message to our politicians, urging them to focus on what must be achieved if healthcare is to flourish in Scotland."
Dr Bennie identifies a number of key areas where urgent action is needed now including the underfunding of the health service; a shortage of doctors to deliver adequate care to patients; a lack of resources to deliver a truly integrated health and social care service; and the lack of time for doctors to keep themselves up to date, to teach others, and to make joint decisions with patients.
The pressure the health service is under is make achieving these changes critical as doctors feel increasingly stressed and overburdened and patient care suffers as a result, explains Dr Bennie.
"Scottish Government repeatedly says that there are more doctors than ever before - but this is simply ignoring a major risk to the health service, and it is demoralising and frustrating for doctors to hear time and time again.
"We need a realistic approach to workforce planning in Scotland which is based on an honest and shared understanding of the current medical workforce numbers, and an evidence based view of what future healthcare demand will mean for the number of doctors required. We need a clear and agreed approach to delivering and retaining this future workforce.
"We need to be able to fill vacancies so that we can look after our patients properly and take care of our own health, reducing the risk of burnout.
"Government and employers need to work with us, to listen to the opportunities we have identified for improving the working lives of doctors, and to take urgent action now.
"Our Chief Medical Officer has produced a report called Realistic Medicine in Scotland. This embodies the way we have all been taught to practise, and that we all try to practise.
"It is about sitting with a patient, discussing all the options, and helping them to decide what is best for them. It is about patients having clear information about their own responsibilities for their health, about the full range of help available, and about how to use it.
"It will only work if doctors and patients have enough time together to make joint decisions. And it will only keep working if doctors have the time to keep themselves up to date, and to train others to provide that expertise in the future. If the government and employers in Scotland are truly committed to realistic medicine, they need to demonstrate this by properly valuing the contribution and leadership role of doctors beyond the direct patient care they provide."
As well as the significant pressures on the clinical workforce, Dr Bennie reiterated concerns about the financial difficulties facing the NHS in Scotland.
"Good health services cost money and health spending is a political choice. The UK spends a smaller proportion of its national wealth than the average levels spent by comparable leading European nations, and the BMA is calling for that to change, in all four nations.
"We want the Scottish public to be consulted on what they need from the health service, and they must be told honestly how much it will cost.
"Politicians must then decide if this is affordable, and if not, how they are going to bridge the gap - through additional funding, or by being honest with the public about what they are prepared to fund."
Dr Bennie was also clear that if we are to reduce the burden on our health service in Scotland, which is already dealing with the impact of an unrelenting rise in demand, it is vital that the government takes action to address the root causes of ill health. He warned:
"...doctors cannot fix the underlying social problems which so often have a detrimental impact on the physical and mental health of our patients. The Scottish parliament took clear action on smoking more than ten years ago, with very positive results for the health of our population. Minimum unit pricing for alcohol has been on the statute books in Scotland for five years, but the Scotch Whisky Association is fighting a disgraceful rear-guard action through the courts, and this life-saving intervention is still not in operation.
"Drugs and alcohol, obesity and poor nutrition, deprivation and health inequalities all blight the health of the people of Scotland. In the medical profession, we can, and we do, give advice based on best evidence, but it is a political decision, and a political responsibility, to take action.
"At BMA Scotland, we will continue to do all that we can to hold our politicians to account to ensure our health service in Scotland can respond to the pressures it faces now and in the future."