The Scottish chair of the doctors’ organisation, the BMA, has warned that the “very existence of the NHS as we know it” is under threat – and the Scottish government must produce a detailed plan for inclusive engagement on reforms as a matter of urgency.

In his speech to the union’s annual representatives meeting in Belfast, Dr Iain Kennedy told delegates the NHS across Scotland a permanent crisis with winter pressures “365 days a year”.

He warned that Scotland is “sleepwalking” into sacrificing an NHS that is free at the point of use, with the growth of a two-tier health care now “beyond question”.

The intervention in the month that Scotland’s Cabinet Secretary for Health and Social Care Neil Gray outlined a national programme of engagement on NHS reform with the workforce, patients, and other key stakeholders.

Both Mr Gray and Scotland’s First Minister John Swinney have committed to keeping the NHS in public hands, stating the government will “stand against any and all attempts to privatise the NHS”.

However, Dr Kennedy told the conference this morning that, while the commitment is welcome, efforts so far have failed to deliver change – reinforcing his call for leaders during the election campaign to recognise that the NHS is not a ‘political football’.

In his speech today, he said, despite growing demand outpacing progress against a backdrop of increasing financial pressures, doctors continue to do all they can to try to meet patients’ needs:

“Scotland’s NHS is in a state of permanent crisis. Winter pressures are here 365 days a year.

“Since my last ARM [annual representatives meeting] speech at the end of April last year, over 58,000 patients have waited more than 12 hours in a Scottish A&E department – that’s 24 times greater than five years ago.

“This massive deterioration in performance is completely outwith the control of our doctors who work tirelessly in traumatic circumstances.

“And these figures are a warning light that the whole health and social care system is not coping with the demand.”

Dr Kennedy suggested that the Scottish government’s plans for engagement on NHS reform “lack clarity and urgency”, and that the government has so far failed to deliver on promises over pay and conditions this year. He added that the only path to a sustainable future for the NHS will be through properly valuing and supporting its workforce.

Dr Kennedy questioned how long the NHS can operate in its current form without reform:

“Long waits are forcing those who can afford it, to go private. A two-tier health service in Scotland is now beyond question. If you can stump up the cash, then you can get the care you need.

“But we all value an NHS free at the point of use. 

“Yet, Scotland is sleepwalking into sacrificing this principle, threatening the very existence of the national health service as we know it.”

Dr Kennedy said the national conversation on the future of the NHS in Scotland must be accompanied by a commitment to deliver change:

“While I welcome the Scottish government’s plan for direct engagement with the public and stakeholders this year, it lacks both clarity and urgency.

“So, today, I urge the Scottish government to come forward now with a detailed plan to guarantee an inclusive national conversation, along with a plan to implement what it tells us.”

“If we are to emerge from Scotland’s NHS perma-crisis, we must properly invest in doctors, and support doctors to look after patients.

“The path to a sustainable future for Scotland’s NHS must be based on properly valuing doctors.”

Read more: GPs in ‘moral distress’ over drug shortage crisis; NHS is not a ‘political football’, warns BMA; Snapshot of NHS recovery revealed;

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