Delegates to the Scottish TUC conference in Aviemore have today backed the establishment of a Scottish government taskforce to address a growing shortage of senior hospital doctors.
The full text of the speech by HCSA delegate Dr Bernhard Heidemann is published below.
"Congress, Bernhard Heidemann, a first time speaker and also proud to be here as the first ever delegate to Scottish TUC on behalf of the Hospital Consultants & Specialists Association, HCSA.
"We are the professional association and trade union for all post-graduate hospital doctors and today we are seeking your support to tackle a crisis of major concern to our members.
"All of us know about staff shortages in the NHS.
"HCSA shares and supports the worries of all health professions in this regard, but the long-standing Hospital Consultant staffing crisis is particularly disturbing to our members.
"In 2010 we were concerned that Scotland faced a Consultant shortfall of 139, with half of those vacancies unfilled for more than six months.
"2017 saw this shortfall almost treble to 430 with nearly two-thirds having been vacant for more than six months.
"HCSA believes strongly in the value of a consultant-led health service, but while consultant numbers have increased, it is simply not by enough.
"Against a backdrop of rising patient demand we are seeing an ever-growing disconnect between staffing need and staffing reality.
"For patients this means longer waits for diagnosis and treatment and the ever increasing pressure on overstretched teams is a threat to the quality and safety of care.
"The failure to tackle this crisis also creates its own dynamic, driving ever more hospital doctors to consider their position as stress impacts on their well-being.
"Hospital doctors are bound professionally to care for those in need but do health boards and politicians feel a duty of care towards the medical workforce?
"For several years the public-sector pay cap has seen NHS staff earn less in real terms year on year.
"Scotland’s ability to attract Hospital Consultants has been hampered by the unilateral suspension by the Scottish government of national distinction awards.
"This has widened the pay gap between Scottish Consultants and those in neighbouring countries.
"Higher pension contributions, a reduced lifetime allowance and a tapered annual allowance cause consultants to retire earlier than originally planned and the NHS to lose its most experienced doctors.
"Not a native of this country, German by birth and European at heart, I have more than a passing interest in the outcome of Brexit.
"I am dismayed how little work appears to have been conducted to assess the impact of Brexit on the healthcare workforce in Scotland.
"I do appreciate that the Scottish Parliament Health and Sport Committee has been seeking to assess this impact.
"However, there appears to be no central recording or reporting of the origins of healthcare workers. A charitable description of the official position would be that we are working on guestimates based on guestimates.
"Scottish Parliament researchers tell us that, amongst doctors, EU citizens range between 3 and 5 per cent of the workforce.
"In other staff groups this percentage is almost certainly higher.
"Geographical variation is evidenced by a 2016 Scottish Parliament report stating that, of 13 consultants working at the Western Isles Hospital, one was Scottish, three were from outside the European Union and eight were from the EU.
"But this insight was the exception - for most of Scotland, the data simply is not there.
"So in truth, Congress, we have very little idea what the impact of Brexit will be on medical or healthcare staffing.
"This lack of information is matched by a lack of action which extends beyond this area and to the entire question of medical staffing in Scotland, now and in future.
"What HCSA is calling for, and why we are seeking the STUC’s support here today, is a dedicated taskforce, involving medical trade unions, to head off this deepening Consultant workforce crisis.
"Rather than continuing to be reactive, we need to assess future need and engage in workforce planning which will allow us to maintain a functioning NHS for our patients.
"As a medical student I felt inspired by the NHS and I am proud to be a consultant in the NHS. This year sees the 70th birthday of the NHS. Let us celebrate its achievements and work together on making it a service to celebrate for decades to come.
"Congress, I move."