Staffing black hole at the heart of NHS …
By Lucy Ashton
BMA Scotland’s data suggests that the consultant vacancy rate may be more than double the official figures, it was revealed today.
Herald Scotland’s health correspondent Helen McArdle exposed the fact that over 45% of consultants surveyed are considering retiring in the next five years.
And that urgent action is required to address the worsening crisis in the consultant workforce.
Dumbarton MSP Jackie Baillie says there are an additional 600 consultancy vacancies in Scotland’s NHS,
Scottish Labour’s health spokesperson said: “This new information reveals a huge staffing black hole at the heart of Scotland’s NHS – with consultant vacancies more than double the number previously reported by the SNP Government.
“That these new figures exclude the number of consultant posts currently staffed by locums means that the true scale of this staffing crisis at the top of the NHS is yet to be revealed.
“While almost one in six Scots remain stuck on NHS waiting lists, it is simply shameful that the SNP is overseeing such a catastrophic level of staff shortages in these vital roles.
“It’s high time that the SNP government take their head out of the sand and tackle the crisis in our NHS before more patients are failed.”
Data released under freedom of information reveals that a total of 1,076 consultant posts have no permanent doctor in place, compared to the 439 vacancies counted by official workforce statistics.
This includes roles being temporarily filled by a locum as well as posts which have not yet been advertised or where recruitment efforts have been abandoned.
These are routinely excluded from the official vacancy tally.
It comes weeks after new safe staffing legislation took effect in Scotland which places a legal obligation on health boards and social care providers to ensure that there are enough trained staff in post to deliver safe care.
Dr Alan Robertson, chair of the Scottish consultants’ committee at BMA Scotland – which obtained the Freedom of Information responses – said the law is unworkable without “honest” data.
He said: “You need to know what the gaps are before you can work out your workforce plan to fill the gaps.
“If you’re the person on the ground, without a colleague next to you, it really doesn’t matter what the reason is.”
He added: “The failure to acknowledge the true scale of the problem reflects our wider concerns about the culture of fear, blame and lack of openness that often dominates debate about our NHS which can prevent proper, open discussion on solutions.”
The FOI data suggests that the whole-time equivalent vacancy rate for consultants is actually 15.2%, meaning that one in six posts is either unfilled or has a medical locum in place.
This is up from 14.3% when the BMA last requested the data in December 2022 and compares to the 6.9% vacancy rate thrown up by official statistics.
Research published on Wednesday in the BMJ warned that a reliance on locums was “potentially harmful to patient safety” because they tended to be working in unfamiliar departments with less support from colleagues or a lack of access to vital computer systems.
Dr Robertson, a consultant cardiologist based in Tayside, said it was also “false economy” given the high cost of locums compared to permanent staff.
Annual spending on agency medics by NHS Scotland has soared from £67 million to nearly £120m over the past decade.
Meanwhile, consultants’ salaries have fallen by 25% in real terms compared to 2008 due to successive sub-inflation pay increases.
The Scottish Government is under pressure to match the pay offer recently accepted by consultants in England.
This includes a £3000 uplift for those who have been consultants for between four and seven years, as well as reductions in the time it takes for consultants to reach the top of their pay scale.
Dr Robertson said the current situation – combined with Scotland’s higher income tax rates – means that senior clinicians are now worse off in Scotland than England.
He said this, combined with opportunities overseas, is contributing to the rise in vacancies.
He said: “Potentially, it’s an issue of people moving elsewhere. Ireland – there’s a much more attractive package there.
“I know a couple of A&E consultants who have gone to Dubai. A lot of A&E consultants have gone to Australia because – as well as the money – it’s better working conditions.
“There’s also the issue of whether we are retaining trainees as they come through.
“I’ve also had a couple of emails over the past few months from consultants in England who were thinking of moving to Scotland who are not anymore.
“The increase in tax, for some people it was the final straw.
“They’re big on the recovery of the NHS and waiting times – but if we don’t have the staff, I don’t see how that’s going to happen.”
Scotland’s six-tier income tax system levies 45% on workers earning £75,001 to £125,140, and 48% on those with salaries in excess of £125,140.
In England there are only three income tax bands – 40% on £50,271-£125,140, and 45% on earnings over £125,140.
Consultants in NHS Scotland, who qualified from 2004 onwards, have a starting salary of just under £97,000, rising to just under £129,000 following 20 years’ experience.
A spokesman for the Scottish Government said its workforce figures meet the official statistics code of practice.
He added: “NHS Boards are clear that all advertised vacancies within the NHS are reflected within official figures.
“Our workforce in NHS Scotland is our most important and highly valued asset.
“The Scottish Government has noted the new offer to Consultants from the Department for Health and Social Care, has been accepted by the BMA and HCSA trade unions in England.
“We are carefully considering the details of this, and the implications for Scotland’s health service.
“We must however have transparency on the funding arrangements supporting this pay offer and the extent of any consequentials we would expect to receive for Scotland.”
Top of page picture:
Consultants performing a procedure on a patient during the Covid 19 pandemic.