Psychological well being campaigners have protested concerning the important use of non permanent locum psychiatrists in Scotland, alleging that it results in substandard and dangerous medical care.
Peter Todd, a campaigner based mostly in Caithness within the north of Scotland, mentioned the heavy reliance on locum psychiatrists by the NHS was an indication of a rising disaster in psychological well being providers throughout the nation.
Scotland’s NHS boards informed him they’d spent greater than £125m since 2019 paying for locums to fill in for the scores of consultants who’ve both retired, give up the NHS or not been recruited.
Todd mentioned that in his expertise, which echoes these of different sufferers in his space, the heavy reliance on locums led to poor continuity of care and badly maintained notes. A survivor of kid sexual abuse, he mentioned every new psychiatrist meant restating his lifetime experiences and medical points, a course of that had amplified his trauma.
“Whenever you see a everlasting psychiatrist, you solely have to clarify as soon as, however if you happen to’re seeing locum after locum after locum, you’re feeling such as you’re a tape recorder having to repeat your self and repeat your self,” he mentioned.
NHS Tayside, which has run up a sequence of serious deficits, has spent greater than £29.8m on locum psychiatrists since April 2019, NHS Grampian £22.3m, and NHS Fife £17m.
The true price of the disaster emerged earlier this month when NHS Western Isles confirmed that it had spent greater than £1.2m in 2022/23 on locums to fill two psychiatry posts at its common hospital in Stornoway, paying them by the hour.
For a inhabitants of 26,600 folks, it has needed to spend greater than £4.3m on freelancers to cowl these posts because the 2019/20 monetary yr.
In widespread with different rural well being boards, NHS Western Isles struggles to recruit docs on present pay scales and has been compelled to pay effectively above regular. Final month it supplied new GPs salaries of as much as £150,000 to work a 40-hour week, 40% greater than regular.
The Scottish Liberal Democrats mentioned NHS knowledge confirmed that in October final yr 117 locum psychiatrists have been working within the area, in contrast with 462 workers psychiatrists, and that as much as 46% of posts have been unfilled in some boards.
NHS Grampian mentioned the Covid pandemic was not a reason for the disaster. “Recruitment and retention was a difficulty pre-pandemic, and this persists,” it mentioned in a press release. “Some clinicians have opted for early retirement, partly resulting from a change of their pension guidelines, and there are fewer suitably skilled psychiatrists coming into the job market. This isn’t a difficulty distinctive to Grampian.”
Dr Jim Crabb, of the Royal School of Psychiatrists, mentioned much more wanted to be executed by the NHS and Scottish authorities to incentivise and worth psychiatry. Psychological well being had not had the ten% of well being spending it had been promised, and was being reduce by 5% a yr.
“Funding has all the time been unhealthy,” he mentioned. “Regardless of critical sicknesses reminiscent of schizophrenia, melancholy and anxiousness costing economically developed societies greater than circumstances reminiscent of bronchial asthma and arthritis, far much less is spent on psychological well being in comparison with bodily healthcare.”
NHS Tayside mentioned it confronted important recruitment challenges; it takes 13 to fifteen years to coach as a advisor psychiatrist. Information confirmed that 42% of advisor psychiatrists have been over 50 years outdated, and that many meant to retire early.
“This peak in retirements will far exceed the variety of new consultants,” it mentioned, including that it was working exhausting to recruit docs from the native space.
“Regardless of these efforts, trainee numbers are comparatively low, and this, coupled with the size of coaching, means restoration from the present place of excessive locum utilization in psychiatry will take a variety of years to attain,” it mentioned.
Willie Rennie, a Scottish Liberal Democrat MSP who campaigns on psychological well being funding, mentioned: “It’s all very effectively for ministers to pay lip service to psychological well being, however the proof is within the pudding in the case of finances time.
“Alongside coaching extra workers, there additionally must be a critical take a look at how we entice and safe workers to work in each kind of neighborhood so that everybody can entry psychological well being help irrespective of the place they stay.”
A Scottish authorities spokesperson mentioned recruitment had been bettering lately, however agreed that extra wanted to be executed “to safe greatest worth” for well being spending.
“We’re contemplating how we will higher help the recruitment and retention of psychiatrists, together with actively exploring doable options to deal with points reminiscent of using locums and the way we entice new or present psychiatrists to take up posts in Scotland,” they mentioned.