Vacancies

Reform of the health service is firmly on the agenda. With the general public disillusioned with long waiting lists and “postcode” prescribing denying patients in some parts of Scotland which is available elsewhere, confidence in the government’s ability to deliver for the NHS is shaky. So reform is welcome.

I met the Royal College of Nursing at Parliament this week. They have a monthly Parliamentary forum where MSPs can discuss with a wide section of nurses current issues.

This month it was car parking.

For Banff and Buchan, this is the one NHS problem yet to hit us. But for nurses, and others who work in our health service, the new PFI-funded Edinburgh Royal Infirmary presents a major problem.

It is well away from the city centre. And well off the main bus routes. In any event travel at night – except by car – is nigh impossible.

So with nurses being charged large sums of money to park at their work, there is a big issue for many of our precious and rare staff.

And patients are not exempt. Some are finding that their parking bill can be as much as £50 a month to visit their relatives in hospital. Is the money collected going to help the NHS provide better services? You bet not! Instead it goes straight into the profits of a private company.

But if nurses in Edinburgh – and across Scotland’s central belt – are suffering from huge parking charges, elsewhere in Scotland it has emerged that other – even bigger – transport issues have arisen.

Community Nurses spend their time on the road. We would expect that the NHS would pick up the tab wouldn’t we? Not necessarily so it turns out.

Many are having to provide their own car – as many others outwith the NHS have to – but are being far from fully compensated.

In my calculations – admittedly on the back of an old parliamentary document while at the nurses’ meeting – I found that 10,000 miles a year in their own car could mean that a nurse was up to £1,000 out of pocket. And that from their tax-paid income.

No wonder nurse recruitment is struggling. And with Parliamentary answers showing an aging nurse population expected to be retiring in droves over the next few years – big trouble looms.

But we are there already in many respects. Most major hospitals rely on agency, or “bank”, nurses. A major cost for the NHS and a dripping roast for many agencies.

The major reform exercising the Scottish government, the Executive, concerns GPs – the people with whom 9 out of ten of us make our first contact when we are ill. There is much in the proposed bill on the subject that all will welcome.

GPs will be assured time off overnight and at weekends. A welcome change. The payments to general practices will be better balanced with the work.

But there are warning signs.

GPs in training are at a lower figure than ten years ago. And in our area vacancies are creeping up alarmingly. Across Scotland vacancies are increasingly difficult to fill. A smaller proportion of medical graduates are choosing general practice as their career.

Indeed in Edinburgh we may see the future.

Nearly 300 doctors work as locums. They do not have permanent positions. Instead they choose when they work, whether they work. And hire themselves out on an ad hoc basis. Making much more in the process than their permanent colleagues.

We seem to be heading towards a GP service reliant, as nursing has become, on agency GPs.

Over a number of years we have seen the position of GPs decline to the point where their substantial training and the commitment we require of them is rewarded little better than a parliamentarian.

When we have rising vacancies in GP – and even more so in nursing – with declining numbers of applicants and can contrast that with the average 5 applicants (candidates) for every MP or MSP vacancy – it is time to ask whether the rewards of working in the NHS are sufficient.

But then not every political job attracts the high class, high number of applicants that can ensure that quality is achieved.

Just think about the vacancy caused by the ejection from office of Tory leader, Iain Duncan Smith.

Population Growth

For the second time in recent months the SNP has been experiencing growth. MSP Colleague Shona Robison gave birth to Morag in July. And Richard Lochhead, well known as Shadow Fisheries Minister, and his wonderful wife Fiona have just taken delivery of Angus Findlay Lochhead.

All the best from us all.