Dr Peter Terry, Chairman of Scottish Council
Speech to ARM 2005
29 June 2005
Before I report on the situation in Scotland I would like to pay a special tribute to my predecessor John Garner. John worked tirelessly on behalf of BMA Scotland and on behalf of all doctors in Scotland. He was Chairman of Scottish Council for a full five years and in that time witnessed devolution, a major office re-location exercise to Edinburgh’s Queen Street and the negotiation and implementation of several new contracts. I certainly found John’s calm, steady, and wise advice invaluable as I am sure colleagues in other crafts did. John, thank you.
For general practitioners and consultants, most activity in the last year has been related to the implementation of new contracts. Although we should not underestimate the work still being done, the truth is that implementation has been a success with more than 98% of consultants now on the new contract. Meanwhile, Scotland’s GPs have clearly demonstrated the quality of care they deliver to patients with a high national average achievement in the Quality and Outcomes Framework; and evidence is already emerging that it is easier to recruit GPs in remote and rural areas of Scotland – a direct result of the new contract.
For SAS doctors we must support them in their current UK contract negotiations but with a careful eye on the specific needs of those working in Scotland.
As for our junior doctor colleagues, the main issue is Modernising Medical Careers – a project that has been set a ridiculously tight timescale. In Scotland, we have been able to make some progress, largely because the relevant players know each other well and can at least sit round the same table.
During the past year we were sorry to lose Malcolm Chisholm as our health minister but welcome Andy Kerr and we will work with him constructively.
The health service in Scotland has its problems. We have experienced an improvement in funding and yet Scotland remains the sick man of Europe. Since devolution all Health Ministers have set an agenda that tries to address the particular needs of Scotland. Thus much of their policy relates to public health improvement, care for those with chronic disease, and care for the most vulnerable in society such as the elderly and those with incapacity – not hospital-based services and not just the immediately measurable. This agenda has been reinforced by the recent Kerr report. It is an agenda that has the support of society and the profession in Scotland.
However, this agenda is not designed to buy quick, high profile political wins.
It is inevitable that the results of vote-buying, quick win initiatives in other parts of the UK, albeit expensive and inefficient, will influence the Scottish health agenda. Waiting times are important, especially for those with urgent or painful conditions and we must make improvements in Scotland. However, investing in independent care providers will do little other than to drain the NHS of much needed resources and workforce.
Only recently the Scottish Health Minister announced funding that is specifically to be spent on independent sector providers and we are now seeing the creeping introduction of privately run diagnostic and treatment centres in an attempt to drive down waiting times.
And earlier this year we witnessed the pressure placed on Scottish ministers during the election campaign. But if we are to embrace devolution we should resist such pressures and develop Scottish solutions for the problems of our Scottish NHS.
I would urge ministers and the Scottish media not to lose sight of the need to improve the health service for all – not just those with surgically amenable conditions which can be counted and measured every three months.
Tomorrow our Scottish Parliament will host a landmark debate. A debate that has the potential to improve the health of Scots and establish what I hope is a precedent for the rest of the UK. MSPs will debate a bill which at its heart provides the framework for a comprehensive ban on smoking in enclosed public places. This legislation has had support from politicians from all parties, except the Conservatives, and I hope that it will pass and Scotland can become ‘smoke free’ by spring next year.
Scottish ministers should be congratulated for leading the way on this public health issue and for the way in which they have been guided by the evidence and by the views of the majority of the people in Scotland. And they should be applauded for the resolute way they resisted the lobbying from those whose sole intention is to profit from the misery and diseases of smokers. We say to Scottish politicians “very well done, do not lose your resolve – back this legislation tomorrow.”
Recently, Mac Armstrong, one of Scotand’s leading advocates of smoke-free legislation and a well known figure at the ARM, retired as CMO in Scotland. It seems as if CMOs in Scotland either come from the BMA as Mac did, or move to the BMA as David Carter did. All the same Mac trod that difficult tightrope between the profession and politicians with great skill and we wish him all the best in his retirement.
And finally. Our thanks go to all the BMA staff in Scotland. A more professional and hard working bunch I have yet to meet. A special thanks must go to Bill O’Neill, our Scottish Secretary. He has been with us now for 5 years and like John Garner, he has guided us through some of the most challenging and interesting times. Under his direction and always with good humour BMA Scotland runs efficiently and increasingly effectively. Bill, personally and on behalf of all doctors in Scotland, thank you for your help and considerable support.
Chairman I move.
