From the Daily Mail yesterday:
PLANS to recruit an army of cut-price doctors to plug gaps in Scotland’s crisis-hit NHS have sparked safety fears. There are already almost 150 medics with only two years of training working across the health service in Scotland. Now NHS chiefs are considering expanding the roles of ‘physician associates’ to plug gaping holes in the frontline workforce.
https://www.dailymail.co.uk/news/article-12633761/The-cut-price-doctor-Health-chiefs-raise-safety-fears-plans-recruit-doctor-associates-two-years-training-chronic-staff-shortages-NHS.html
You’ll not be surprised to hear there are more gaping holes in this story than there are in Scotland’s NHS staffing.
First,
Physician associates are clinical graduates trained in the medical model. They must pass an intensive 2 year university course at diploma or masters level to learn clinical knowledge and skills after completing a 3 year biomedical or healthcare related degree.
https://www.hee.nhs.uk/our-work/primary-care/physician-associates-primary-care
Second,
Physician associates are by far the most numerous of the MAPs. The Faculty of Physician Associates estimate that there are currently around 3000 qualified PAs working in the UK [England].
https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/workforce/medical-associate-professions-briefing#:~:text=Physician%20associates%20are%20by%20far,AAs%20working%20in%20the%20NHS
According to the Mail, there are ‘almost 150’ PAs in Scotland, so the level per capita in England of these ‘cut-price’ docs is more than twice as high.
Third, there are 5 209 GPs in Scotland.
The 150 represent, then, less than 3% of the total workforce.
Fourth, Dr Kennedy of the doctors’ union cannot be trusted. See This:
Talking-up Scotland 'Albatraz' 
The BMA ( Scotland ) should have ”serious concerns” about the politicisation of the NHS by Dr Kennedy .
And using the self-publicist Gulhane as a posterboy for Scottish GPs may be more than many GPs can stomach given his constant undermining of the Scottish NHS – usually with him appearing wearing an NHS lanyard , which ( I think ) is illegal .
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The story which the Scottish Secretary of the BMA has placed with his chums in the Daily Mail is an example of one professional group acting in a way to exclude other groups. Sometimes, this was called ‘dilution’. It is action to protect, as they see it, the professional standards and also to prevent what they feel might result in lower remuneration and lesser working conditions.
The medical professions are not unique in this. All professional groups do it, as do time served artisans. There are good reasons, based on bitter experience, for professional bodies and trade unions for doing this. However, professions and trade unions are not averse to objecting to and hindering others from getting employment in order to maintain their bargaining position, by deploying discriminatory restrictive practices.
For example, doctors have opposed ‘nurse practitioners’ where experienced and trained nurses run and treat patients who have common minor injuries. Teachers have opposed the deployment of classroom assistants claiming they will undertake ‘teaching’ tasks which they feel are the preserve of teachers.
During wartime, when many men were in the armed forces large numbers of women entered the workforce and undertook works which were formerly the preserve of men (a restrictive practice.) ‘Rosie the Riveter’ was an example of this.
My mother and the mothers of most of my schoolmates undertook skilled work during the war and, when the war ended, the political parties and trade unions insisted these women be dismissed and that men be given their jobs. One of the mechanisms used was the ‘marriage bar’, which decreed that married women were not permitted to do ‘men’s work’. The pretext was that their duty was to rear weans, like me, and be ‘housewives.’
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‘army of cut-price doctors to plug gaps in Scotland’s crisis-hit NHS have sparked safety fears’ states the Daily Mail.
This choice of alarmist and denigrating language does nothing for the professional standing of the BMA’s Dr Kennedy: is he providing these phrases to the Daily Mail or is he content with (and thus still complicit in) their use?
A search of the BMA’s website using the term ‘Physician Associate’ makes clear the BMA’s concerns with these healthcare professionals being employed ACROSS THE UK but made in a reasoned, professional (albeit arguably protectionist) way.
Why is Dr Kennedy on behalf of the BMA resorting to the use of the Daily Mail and only directed at Scotland – especially so given the comparative statistics in the main TuS blog post? Is there a particular, an oppositional political agenda in play – just from Dr Kennedy or from the BMA at large – when it comes to NHS matters in Scotland?
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