The extent of the crisis engulfing Scotland’s NHS is being hidden from the public, doctors have warned, as they savaged SNP ministers for failing to set out a plan to save the health service.
Iain Kennedy, the chair of the British Medical Association in Scotland, said that he was now no longer able to advise his patients in what year they would receive specialist appointments and that problems in the NHS meant it was “failing” patients.
He also warned that England had become “considerably more attractive” for senior clinicians than Scotland due to the SNP’s high tax policies and that vacancy levels were likely far higher than official figures suggested.
His intervention, at an event hosted by the Reform Scotland think tank, comes in the wake of a damning Audit Scotland report which found there was no “overall vision” for an NHS which was no longer able to meet demand.
Figures published this week also showed that waiting times in A&E departments were continuing to rise, with almost 9,000 people waiting more than 12 hours to be seen in January.
Meanwhile, activity levels have not returned to pre-pandemic levels, with 55,000 fewer operations carried out over the course of a year, and more people being added to waiting lists than are being seen.
“We do have an absolute crisis and it’s not sustainable,” Dr Kennedy, an Inverness GP, said. “It seems unbelievable that there is no vision, no strategy, no plan for NHS Scotland.
“Even the small building I’m in here, a medical practice for 10,000 patients, has a written-down strategic plan. To think that NHS Scotland has no vision, no plan, seems quite incredible.”
‘True figures hidden’
The senior medic said that figures showing consultant vacancies had risen to 436, a rise of 6 per cent on last year, told only “half the story” due to some posts being hidden in official figures.
He said that the BMA had complained to the information commissioner after the country’s largest health board, NHS Greater Glasgow and Clyde, refused to disclose the true total.
He added that the scale of the problems were being “hidden from the public” with a “culture of cover-up and secrecy” in the health service coinciding with Nicola Sturgeon taking over as First Minister in 2014.
Dr Kennedy said a lack of basic information was being made available to patients about waiting times, and that he had paid for two family members to go private as he was unwilling to see them languish on NHS lists.
“Doctors are voting with their feet and what they are doing is well beyond strike action,” he said. “They are retiring early, they are reducing their hours, they are emigrating.
“Doctors in England earn more, they’ve just been given a pay offer this week. And if you add in the fact that doctors in Scotland are taxed more, it’s considerably more attractive now to be a consultant in England than it is in Scotland.
“Young doctors are making a choice and they just look at the hard facts, the pound signs, they’re going to choose a country that is outwith Scotland.”
Scottish doctors hit by tax hike
The NHS England deal will mean consultants who are a few years into their career will get an extra £3,000 – on top of a six per cent rise for all consultants.
But in Scotland the new tax rate means anyone who earns more than £75,000 will pay 45 per cent rate and those over £125,000 face paying 48 per cent.
Despite the turmoil in the Scottish NHS, it emerged on Wednesday that bosses at struggling NHS boards were being handed “superior” or “outstanding” performance appraisals which are linked to pay rises.
The Scottish Government was approached for comment.
Estate agent suspended after 'anti-Semitic' post that appeared to celebrate death of Lord Rothschild
An estate agent has been suspended after appearing to celebrate the death of Lord Rothschild and hoping all Zionists would die.
Lord Rothschild, the financier and member of the Rothschild banking family, died at the age of 87, his family announced earlier this week.
Following his death, Amanda Hardy from Barkers Estate Agents in Borehamwood, Herts, allegedly wrote a social media post which said: “The world is a better place with this Zionist dead. Just got to hope all the others follow.”
Speaking to Jewish News on Tuesday, she apologised for the offence caused and said she had been unaware of what the word “Zionist” meant. She denied her comments were anti-Semitic, saying: “I had a different impression of the word and totally misunderstood the meaning.
“I got the meaning completely wrong. I respect and care deeply about the Jewish community and have lots of close friends and clients who I have worked with over 20 years. I would never wish death on anyone. I’m a caring human and want peace for all of us on this beautiful planet we are blessed to live on.”
She added: “It’s nothing against the Jewish religion at all… It’s the same as the Muslims and the terrorists. There are always the good and the evil. Not everyone prays to the demons. That’s how our world is set out.”
The university said the course, which starts in September, will include two days a week of teaching to allow students to work on other days alongside their studies.
A spokesman for the Royal Agricultural University told The Telegraph that the new estate agency course was “in line with our standard delivery model”, which includes 36 hours per module, of which 12 are online learning.
She said: “The breakdown of contact hours are detailed on our module specifications, which are provided to the students ahead of enrolment. Alongside this route, prospective students are also encouraged to speak with programme leaders ahead of applying and attend events such as open days and webinars when this information is covered.”
Competition and Markets Authority guidance states that providers should tell students about the number and type of contact hours.
Paul Wiltshire, a parent campaigner, claimed that “an increasing number of universities are no longer even offering real in-person lectures and think that it is perfectly acceptable now to just serve as much as 100 per cent online lectures and still charge the same fees”.
He called on the Office for Students (OfS), the higher education regulator, to “force universities to openly declare whether their teaching is online”.
An OfS spokesman said: “We are unable to comment on individual cases. Students should receive clear detailed information about how their course will be delivered, and are supported to develop the skills they need.
“Universities and colleges should ensure that decisions about the balance between online and in-person learning are underpinned by solid reasoning that does not compromise students’ experience.”
This challenge has become more apparent in recent years after the Brexit vote and the pandemic, when investors withdrew their money over fears of a property crash.
By comparison, closed-ended funds such as real estate investment trusts (Reits) do not suffer from a liquidity mismatch, as they have a fixed pool of capital that is not affected by investors buying and selling.
In terms of funds to buy, Ms Admans recommended CT TR Property Trust which is mainly invested in listed property shares, with physical property accounting for a maximum of 15pc of the portfolio.
The geographic split is 25pc to 50pc UK, with the remainder in Europe. It is currently trading at a discount of 7pc to net asset value.
“The manager, Marcus Phayre-Mudge, has deep sector experience and has built up a strong track record of generating income using a differentiated approach to property investing,” Ms Admans added.
John Moore, of wealth manager RBC Brewin Dolphin, recommended PRS Reit which invests in new-build family homes for the private rental market.
“Even though it is one of the scale players in the sector, it only manages 5,000 units, which is a drop in the ocean of [the Government’s] 300,000 per year new homes target – so there is huge room for growth,” he said.
“Yet the share price has not reflected any of that – it trades at a substantial discount to net asset value and offers a yield of more than 4.5pc.”
In addition, Ms Admans tipped Finsbury Global Property and Schroder Global Cities Real Estate. Both are open-ended funds, however they invest in Reits and listed property companies, removing the liquidity risk.
Shares in property companies
There is a chronic shortage of housing in the UK, and it could be wise to invest in companies that are working to address this issue.
Vistry and Persimmon are among the housebuilders who stand to benefit from the pledge to build more housing. Mr Moore said: “There has been a lot of movement in Vistry’s share price since interest rates picked up – even by the sector’s standards.
“But it should be in line to benefit as greater efforts are made to reform the planning system and provide more affordable housing, while offering a yield of nearly 6pc in the meantime.”
A major hospital trust at the centre of a police investigation allowed significant numbers of unregistered consultants to operate on patients, it has been claimed.
At least 105 cases of medical negligence and allegations of a cover-up at Royal Sussex University Hospitals NHS Foundation Trust are currently being probed.
The Telegraph has learnt that, as part of the investigation, officers are considering allegations that numerous surgeons in the troubled general surgery department in Brighton held the title of consultant without having qualified for the specialist register.
It can also be revealed that a weekly clinical safety meeting was scrapped in favour of a monthly meeting shortly before the period that saw many of the mishaps currently under review.
In order to qualify for the register, aspiring senior doctors must undergo a lengthy training under different mentors and pass multiple specialist exams.
Under NHS rules, only those who are on the register may take up any fixed-term, honorary or substantive consultant post in the NHS, subject to a few exceptions.
However, foundation trusts are not bound by this rule, in recognition of their greater legal autonomy compared to traditional hospitals.
Sources have claimed that, at its worst point, the proportion of unregistered consultant surgeons at the Royal Sussex County Hospital exceeded 40 per cent, although the trust is understood to dispute this figure.
National shortage
There is currently a national shortage of consultants and concerns have begun to emerge from the medical establishment in recent years about a growing use of non-registered consultants to deal with rising patient demand.
A spokesman for the trust said: “Appointing experienced doctors not on the specialist register to consultant positions is common practice in the NHS, provided they can demonstrate the required training and expertise in their field.”
However, a source told The Telegraph: “The Royal Sussex County Hospital is a major trauma centre and supposed to be a teaching hospital.
“To claim it’s acceptable to have a high number of unregistered surgeons at a centre like this is entirely wrong and dangerous.”
A recently published review by the Royal College of Surgeons criticised “bullying” and a “culture of fear” at the trust.
Meanwhile, a damning Care Quality Commission report found a “wide disconnect in the relationship between staff and senior leaders”.
Governance drastically reduced
The Telegraph can disclose that in 2019 there was a major shake-up of clinical governance in general surgery which drastically reduced the frequency of morbidity and mortality meetings, where deaths and complications were discussed in order to learn lessons.
For several years up until that point, the reviews had taken place weekly on a Friday afternoon.
However, at a meeting of the department in the summer of 2019, new leadership scrapped the weekly meetings, with staff allegedly told their time could be put to better use.
The trust said the meetings became monthly, and that this was in line with Royal College of Surgeons guidelines.
The guidelines state that: “A frequency of one meeting each month is the most common arrangement.”
However, the guidelines add: “In large, busy units and for specialties in which complications are more prevalent it may be appropriate to meet more than once a month.”
Mr Peter Duffy, a consultant neurosurgeon who is now campaigning for better protection for whistleblowers in the NHS, said the decision to reduce the frequency of morbidity and mortality meetings “rings serious alarm bells”.
“If senior clinicians came to the conclusion that they needed weekly meetings and they were overruled, that raises serious alarm bells.
“At best it suggests a dysfunctional relationship there. Without these meetings, deaths can sometimes be brushed under the carpet.
“There are a range of clinical governance benefits.”
It is understood that at the 2019 meeting senior surgeons were also told that their offices would be moved away from the main department, a significant walk away.
Dr George Findlay, the trust chief executive, has promised improvements in the wake of the CQC report.
He previously served as deputy under Dame Mariane Griffiths, a close ally of former health secretary Jeremy Hunt, who retired in 2022.
At least two Employment Tribunals of former senior doctors at the trust are expected to go ahead in the coming weeks.
A spokesman said: “In 2019, a new Surgery leadership team changed case reviews to monthly which is in line with the Royal College of Surgeons guidance on frequency of M&M meetings.”
He added: “All surgeons employed by the Trust are licensed to practise by the General Medical Council.”
A member of the Barclay family has called in estate agents to sell off more than 100 properties on Sark, as part of efforts to raise cash under the threat of bankruptcy.
Alistair Barclay, 34, has enlisted Knight Frank as he races to pay down debts.
It comes as Mr Barclay, the youngest of Sir David Barclay’s sons, faces the threat of bankruptcy in Britain after he was hit with a petition from a leading private bank.
The family has said the court action is a personal matter unrelated to their business interests.
Sark, one of the Channel Islands where cars are prohibited, has been linked to the family since twin brothers Sir David and Sir Frederick acquired the nearby island of Brecqhou in 1993.
It is understood Alistair, co-founder of the online estate agent Yopa and a motor racing driver, inherited the parcel of properties when Sir David died in 2021.
Any sale of Sark properties would not include the family’s private castle on the neighbouring island of Brecqhou.
Sir David’s and Sir Frederick’s sides of the family fell out over debts and control of their businesses, which include The Telegraph and the online retailer Very.
The Barclay family regained ownership of The Telegraph in December after repaying £1.2bn in overdue debts to Lloyds Banking Group. They are barred by law from exercising any control, however.
The Barclay family’s activities on Sark have sparked controversy, as Sir David and Sir Frederick were embroiled in conflict with the island’s leaders. The brothers objected to Sark’s ancient constitution and particularly the powers it grants to the unelected Seigneur.