ONE of Scotland’s leading doctors said alternative models of healthcare funding are “worth having a debate” but remains a “big supporter” of the NHS.
Professor Rowan Parks, the newly appointed President of the Royal College of Surgeons Edinburgh (RCSE), said colleagues who had gone to work in the Middle East or the US.
Although Professor Parks said he would not rule out controversial suggestions such as asking wealthier patients to contribute to the cost of treatment, he stressed that this “would need a much broader discussion” and that he “would not take an opinion until I have heard from those who do.” have proposed or understand more about it”.
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Leaked minutes of a meeting of the chief executives of the health board sparked an outcry last week when it was revealed that they had promoted the idea of adopting a ‘two-tier’ system, where the wealthiest are asked to pay for NHS operations, as a way to reform the cash-strapped service.
First Minister Nicola Sturgeon said an SNP-led Scottish government would never resort to such an arrangement.
However, the dispute has raised interest in whether alternative financing models should be considered.
Professor Parks, a pancreatic surgeon, professor of surgical sciences and assistant director of medicine at NHS Eduction for Scotland (NES), which oversees medical training, said: “I still think our NHS in Scotland is second to none for all the people in need.
“Yes, you can go to the United States, Hong Kong, to the big hubs in China, and you’ll see state-of-the-art delivery, but that’s not delivered to your entire population.
“I think it’s always worth having a debate. One of the privileges I’ve had traveling the world is having those conversations, maybe not with politicians and senior managers, but with clinical and surgical colleagues.
“There should be an ongoing discussion about what other models might consider, I don’t shy away from that debate, but I have always come back to the view that the NHS provides care in a very good way.
“I have clinical colleagues who have gone to places like the Middle East or the United States to work for a while and then become disillusioned with how things are done.”
Professor Parks, who was acting director of the NES during the pandemic, added that he did not acknowledge suggestions in the leaked minutes of a “disconnect” between the government and its clinical advisers.
“That has not been my experience,” Professor Parks said. “My experience is that the clinical voice is heard.”
Professor Parks takes over the leadership of the RCSE at a time when the number of people on waiting lists for an elective procedure in Scotland has almost doubled, from around 77,000 before the pandemic to almost 140,000 at the end of June this year.
The next set of statistics, which establishes the position as of September 30, will be published today.
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Prof Parks said the creation of dedicated elective centres, separate from the main acute care hospitals, would “immediately help” to eliminate backlogs by ensuring operating room staff, beds and space were not “constantly withdrawn” to cope to emergency admissions.
In the short term, however, he said patients’ surgeries should be prioritized based on need rather than a drive to reduce waiting list numbers as quickly as possible by performing many simpler operations.
Professor Parks said: “Overcoming a large amount of low complexity, high volume work will be an aspect of [clearing the backlog]but there also has to be some prioritization of need.
“It is relatively easy to say that cancer patients should be given priority, but there are also patients who have non-malignant, non-cancerous diagnoses whose quality of life is significantly affected by disability and pain.
“I know from my orthopedic colleagues that it is a major problem.
“It’s all about the ‘clinical voice’: the clinical voice will be very important when it comes to prioritizing patients based on their needs, as opposed to what might just be a way to cut numbers.”
Professor Parks said his “main focus” would also be on training, recruitment and retention, with pay and conditions “repeatedly” raised as an issue by College members.
Doctors and dentists across the UK have been dealt a 4.5 per cent pay deal that the BMA has called a “brutal pay cut”.
However, no decision has yet been made on whether to vote consultants in Scotland for industrial action.
There is also anger over “punitive” pension taxes that are prompting some top doctors to reduce their hours or retire early.
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In July this year, a damning report from the Westminster Health Select Committee, chaired by now Chancellor Jeremy Hunt, called the situation a “national scandal” and called for “urgent action” by the government to reform NHS pensions. “to prevent hemorrhage in the elderly”. staff”.
However, Hunt’s fall statement did not address the issue.
Prof Parks said making elective surgical centers a reality would require a combination of “re-hiring and thinking a lot about retaining staff who would otherwise leave.”
He said doctors in their 50s and 60s could be persuaded to stay longer if they could reduce “arduous front-line and on-call commitments” but added there are also fears that many younger doctors will retire.
“Morale has been low after the pandemic,” Professor Parks said. “There is a perception that some of our trainees will leave and go abroad and therefore be lost in the workforce.
“That is not something new. I did some work five or six years ago looking at patterns across the UK and, yes, there is a proportion of young doctors who leave at the end of basic training.
“They usually go away for a year or two at the most, but because we can track them using their GMC number, we know that 85-90% of them, at least historically, have come back again.
“During the pandemic, all of that dried up. Now, after talking to my younger colleagues and seeing what they’re saying on social media, I suspect some of them will come out.
“It remains to be seen if they return.”
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However, Professor Parks stressed that the statistics also show an “opposite trend” of applications for doctor training positions in the NHS increasing year on year from a mix of UK and international candidates.
He said: “We are beginning to see the benefit of the additional numbers of medical students who entered five or six years ago.
“Those students are now beginning to graduate, so the number of ‘domestic’ applicants for training positions is increasing.
“What we have also seen, due to the change in immigration regulations, is an increase in international applicants.
“Enjoyingly, applications for 2023 training positions are increasing, and that has increased year-over-year in recent years, despite the pandemic.”
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