Warning of 'tough year' for NHS

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The leader of Scotland's doctors has warned of a tough year ahead for the NHS due to increasing demands on the service and falls in funding.

Dr Peter Terry, chairman of the British Medical Association Scotland, said rules on hours worked by junior doctors would also leave a gap in provision.

But the consultant said government strategies to tackle smoking and the misuse of alcohol should be supported.

His comments were made in a New Year's message to the profession.

Dr Terry, who works in Aberdeen, said that since devolution Scotland had faced up to its "appalling" record on public health. Progress was being made, but he said this was happening slowly.

The consultant said: "Tackling our poor public health record, however, is not the only challenge for government in 2009.

"Funding for health is falling and NHS managers have to make tough choices on what the NHS can afford to provide in an increasingly tight budget.

"This, matched with an increased demand for services, is going to make it a tough year for the NHS."

'Insidious creep'

Dr Terry said August would see the implementation of the European Working Time Directive to cover junior doctors' hours and reduce their time on duty to 48 hours per week.

He said: "This service gap must be filled and new training rotas for junior doctors must not compromise on their education and training.

"It is disappointing that we have known about this change for more than a decade, yet it looks like NHS boards are nowhere near prepared to deal with it."

He added that he had a personal goal to protect the profession from an "insidious creep" towards the creation of what he called a sub-consultant grade, and described Scottish consultants as among the best trained in the world.

Dr Terry welcomed proposed legislation that would put further controls on the sale of tobacco from cigarette vending machines to restrict access by under-18s.

He also supported government efforts to tackle the sale of cheap alcohol.