Act now to deliver a future for the medical workforce in Scotland, says BMA

The BMA today welcomed the publication of two Scottish Executive reports into the education and training of the medical workforce in Scotland acknowledging that they offered many solutions but, warned that they would only be successful if the recommendations are followed and effective action is taken now.

Dr Bill O'Neill, Secretary of the BMA in Scotland said:

"A wide ranging review of the medical workforce in Scotland is long overdue. These two reports offer insights into the current and future needs of doctors as well as providing strategic direction for medical education and training. I believe that they have great potential to tackle some of the long term problems facing the medical workforce in Scotland.

"Medicine has historically been the domain of the middle classes and it is essential that we encourage diversity among applicants to our medical schools. Around half of applicants to Scottish medical schools come from outwith Scotland, and 50% of those who graduate leave Scotland to work elsewhere. This is especially true for graduates from St Andrews who do their clinical attachments in Manchester and Keele. We welcome plans to increase student numbers, particularly with the requirement that these additional places focus on diversity and broadening access. Encouraging greater numbers of applicants who are Scottish domiciled to study medicine should also support the retention of medical graduates in Scotland

"We welcome proposals to co-ordinate activities between medical schools with the establishment of a Board of Medical Education. Creating more experts in specialist medical education will ensure that Scotland's medical schools maintain their worldwide reputation and continue to attract high quality students and staff. We also need to address the shortage of medical academic staff in Scotland and the additional threat that may follow the introduction of top up fees in England.

"Workforce planning cannot be considered in isolation, it must be considered in the context of service delivery. In order to gain public and political acceptance of local service reconfiguration, it is essential that they are engaged in the process at an early stage. Professor Temple's report recognises the requirement for service redesign and the importance of public involvement in the shaping of safe, local health services and this is to be welcomed. The report explicitly states that maintaining services as they are is not an option and we support that. We also agree with Sir John's conclusions that there should be a reduction in the number of health boards which would facilitate regional planning not only in service delivery but also for training purposes.

"Proposals to improve postgraduate training will offer more efficient and focussed career development for junior doctors. In order to ensure that NHS Scotland continues to produce high quality doctors, these proposals must be resourced.

"It is also vital that these changes build greater flexibility in training opportunities for those doctors who have left training grades and choose not to become GPs or consultants, but continue to work in the NHS."

Dr O'Neill concluded:

"Increasing the number of medical students will not provide doctors overnight. It will be 10 to 12 years before the expansion of student numbers has an impact on the number of trained doctors in Scotland. In the meantime, recruitment and retention of doctors and the reconfiguration of hospital services must remain a priority for the Scottish Executive Health Department.

"The reports offer many solutions to problems in undergraduate and postgraduate medical education and training. It is essential that the Scottish Executive act on these proposals now to deliver a future for the medical workforce and patients in Scotland."