The British Medical Association's Scottish council has voted to oppose SNP plans to reduce the number of health boards in Scotland, warning the move will not improve care for patients.
The reorganisation is part of Scottish Government plans to address a £5 billion blackhole in Holyrood's finances. BMA Scotland chair Dr Nora Murray-Cavanagh said the move was “the wrong set of reforms”, adding that they had “many concerns” about the proposed restructuring.
BMA urges rethink
The BMA's Scottish council is now “urging the Scottish Government to withdraw and rethink its whole approach,” she said, calling on ministers to adopt a “fresh focus on steps that will benefit patients more immediately and directly”.
Dr Murray-Cavanagh stated: “Our position is not one that argues NHS reform isn't necessary – no-one thinks we can simply go on as we are. As doctors, we know better than most the precarious state of services across Scotland.
“But this is the wrong set of reforms, and it will set Scotland on a path of a costly, time-consuming, resource-sapping reorganisation, with no serious engagement with those of us holding the service together and no clear evidence put forward on how it will benefit patients.”
Concerns over larger boards
She continued: “At the core of everything is the lack of any evidence on how these reforms will practically make care better.”
The BMA's Scottish chair said a “particular concern” was over the impact of moving to two health boards “covering vast swathes of the country”.
As well as saying this could “weaken local accountability and the ability to make decisions which reflect the needs of specific communities”, Dr Murray-Cavanagh said having health care organised “on a much larger scale may mean patients have to travel further for the care they need”.
She cautioned: “This could negatively impact patients in rural and remote areas, older people, those on lower incomes and those without access to private transport or wider support and runs the risk of widening already deep and pernicious health inequalities.”
Workforce and consultation concerns
She also claimed there was “nothing in these reforms” that would “improve the dire situation of the medical workforce in Scotland or, as a result, the care that we can provide to our patients”.
Speaking out, Dr Murray-Cavanagh said that instead the change “risks making things worse, by potentially stretching an already thin workforce over even greater areas and asking them to do more and more to keep services running”.
And she said a “lack of engagement or consultation” between the Government and doctors before the plans were announced “creates the serious concern that these reforms will simply be bulldozed through, without proper consideration and input, both from those working in the NHS and the public”.
Health Secretary Angela Constance met Dr Murray-Cavanagh this week, saying she “reiterated that our plans for NHS reform are focused on improving services for people across the country, regardless of where a person lives”.
Constance stated: “They will simplify how people get the care they need and remove the current geographic and bureaucratic barriers that exist between 14 health boards, which we know are currently causing unwanted variation and duplication.
“These changes will build on important work already ongoing since last November through sub-national planning in the East and West which has involved every NHS Board.
“The development of detailed proposals will be supported by a full business case and will include engagement with NHS Boards, staff representatives, trade unions, local government, integration authorities, social care partners and the public.”
