SNP ministers are providing “no political direction” in the healthcare crisis, leaving doctors to make crucial decisions about rationing treatment, a leading GP has said.
Iain Kennedy, chairman of the British Medical Association in Scotland, said the NHS’s “all-you-can-eat buffet” approach was no longer sustainable.
He accused SNP ministers of shirking decisions on prioritising care and forcing frontline NHS staff to do it for them. Humza Yousaf, the health secretary, has repeatedly refused to countenance any rollback of NHS care for less critical illnesses, despite a crisis in accident and emergency and acute wards where doctors struggle to deliver lifesaving procedures.
Writing in the Scottish Mail on Sunday, Kennedy said: “The NHS is dying because of crippling staff shortages, the A&E crisis and a broken health and social care system.”
He challenged the SNP’s free prescription policy, questioning why the NHS spent so much on paracetamol when it can be bought for a few pence in supermarkets.
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Kennedy said he had been inundated with correspondence from members of the public offering to pay more towards managing long-term conditions to free up the NHS to handle critical care.
The BMA said it was “fundamentally opposed to a two-tier service” but warned that the NHS “can no longer offer everything to everyone”.
Kennedy said: “Despite that, the Scottish government is still advising chief executives of Scottish NHS boards that everything is a priority.
“No political direction is being given on what they should prioritise and, of course, that means already scarce resources are spread too thinly.
“The public and politicians need to decide what they want to prioritise and they will need to make choices. Politicians need to have the courage to ask the public, now, what they want.”
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He said that rationing was “already happening”, with some appointments and treatments limited unless a condition is causing serious problems.
His own clinical practice has turned away patients seeking treatment for varicose veins unless they have developed significant complications.
Hospitals will no longer see many patients with benign skin lesions. Last week The Times reported that skin cancer deaths hit a record high in 2021, with fears that patients were not receiving treatment for suspicious moles until it was too late.
Kennedy said: “Doctors are not happy that patients struggle to see their GPs; we’re not happy that patients wait too long for outpatient appointments or at A&E; we’re not happy about the lack of social care across Scotland.
“Crippling staff shortages, the growing A&E crisis and a broken health and social care system are issues which now require urgent attention from us all.”
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According to the latest figures, almost 50,000 operations have been cancelled in the past eight years because of a lack of capacity or for non-clinical reasons.
Pamela Nash, chief executive of Scotland in Union, a pro-UK campaign group which uncovered the data, said: “The SNP has been in sole charge of the health service in Scotland for more than 15 years. It must take full and frank responsibility for this issue.”
Figures published last week showed that there were 50 deaths a week in Scotland because of the NHS crisis. The figure for the UK was about 500. Adrian Boyle, president of the Royal College of Emergency Medicine, blamed problems with emergency care, telling Times Radio: “We cannot continue like this. It is unsafe and it’s undignified.”
Boyle said ambulance response times were a marker of the stress the system was under. “Last January the average response time for a category two ambulance call, that’s a stroke [or] heart attack, was 20 minutes. Over December, it’s been over an hour and a half.”
Yousaf said: “We are closely monitoring the situation in emergency departments and are in daily contact with health boards to ensure all possible actions are being explored.”
