Meeting of the Parliament (Hybrid) 17 November 2021
The pandemic has been an extremely difficult time for all those who are learning and working in the NHS, and I, too, express my sincere thanks to them for their efforts.
We know that the NHS workforce was under pressure before Covid and that the pandemic has intensified that pressure, and it is vital that every avenue is explored in efforts to ensure that our NHS has the staffing levels that it needs. However, it is also important that any decisions are made with a view to the long-term impact.
In its statement about today’s debate, the BMA said about the Conservative motion:
“Simply taking steps such as these without a proper, strategic long-term plan for our whole workforce could potentially be counterproductive.”
Right now, we have staff shortages in the NHS, and the staff who are in post have experienced huge increases in their workload. That means that the number of clinicians who are available to engage in teaching and training is reduced. Any move to increase medical student places must take account of that, or we risk piling even more pressure on existing staff and creating bigger class sizes with fewer teachers, which, as the BMA has warned, could affect the learning experience.
In the wake of the pandemic, proper workforce planning will be essential if we are to secure the sustainability of the NHS, but that must be long-term strategic planning that anticipates how the decisions that we make now will affect the workforce in future generations. The BMA has also warned that, if the Conservatives are proposing that we lift the cap on Scottish students without increasing student numbers overall,
“there are issues around how that is done fairly and appropriately.”
Increasing student numbers is, of course, an important part of long-term workforce planning, but we must also look to the short term. We need to retain the staff who are in place now, but that will become increasingly difficult while the pressures on the NHS continue to increase. Staff are exhausted. They are worn down and burned out. Mental health support will play a key role in supporting the workforce, and I have heard positive feedback about the national wellbeing hub, although it is only part of the picture.
Fundamentally, we need to improve working conditions for staff and ensure that they feel valued and that their contribution is recognised. I have been dismayed by some of the questions that have been asked in Parliament about why GPs are “not seeing patients” or when GP practices can “reopen”. GP practices are open and GPs are seeing patients. General practices in Scotland deal with more than half a million appointments every week. There are, of course, on-going issues with waits for appointments, and I do not want to minimise the distress that that is causing to patients. People are waiting for far too long, which is unacceptable, but that is due to the immense pressure that is being placed on GP services and it is not because their doors are shut to the public. We do GPs a disservice by pretending otherwise, and that will certainly not help retention.
I turn to widening access. I welcome the Scottish Government’s commitment to doubling the number of widening access places to help to create a more diverse medical workforce. The NHS needs to reflect the diversity of Scotland, and there is evidence that a diverse workforce can improve the quality of care. Widening access is essential from a social justice perspective, but it also has numerous benefits for the NHS and patient care.
We know that students from the poorest 40 per cent of neighbourhoods are less likely to study medicine, or the other professional courses such as law, veterinary medicine and architecture. People who are care experienced, young carers and asylum seekers might also be less likely to study medicine. That means that we are missing out a significant pool of people who could go on to become excellent clinicians. That is to our and the health service’s detriment, and it needs to change.
17:23