Mental health activists are protesting the heavy use of temporary psychiatrists in Scotland, claiming it leads to substandard and harmful care.
Peter Todd, an activist based in Caithness in northern Scotland, said the NHS's heavy reliance on community psychiatrists was a sign of a growing crisis in mental health services across the country. .
Scottish NHS boards told him that since 2019 they had spent more than £125 million on staffing costs to replace the large number of consultants who had retired, left the NHS or were not employed.
Mr Todd said that in his experience, as well as that of other patients in his area, over-reliance on locums had led to poor continuity of care and poor record-keeping. A survivor of child sexual abuse, each appointment with a psychiatrist means retelling his life experiences and medical problems, a process that exacerbates his trauma. He said that he had done so.
“When you see a full-time psychiatrist, you only have to explain things once, but when you see a psychiatrist one after the other, you feel like a tape recorder that has to repeat the same thing over and over again. “It will be,” he says.
NHS Tayside, which has suffered a series of significant deficits, has spent more than £29.8m on local psychiatrists since April 2019, £22.3m in NHS Grampian and more than £17m in NHS Fife.
The real cost of the crisis came earlier this month when NHS Western Isles admitted it had spent more than £1.2 million on locums, paid by the hour, in 2022/23 to fill two psychiatric posts at Stornoway's general hospital. Sometimes it became clear.
With a population of 26,600, it has had to spend more than £4.3 million on freelancers to cover these posts since the 2019/20 financial year.
Like other local health boards, NHS Western Isles is struggling to recruit doctors at current pay levels and is being forced to pay significantly more than normal. Last month, the company offered new GPs a salary of up to £150,000, 40% higher than usual, with a 40-hour week.
The Scottish Liberal Democrats say NHS data shows there were 462 psychiatrists on staff, compared to 117 working in the region as of October last year. board said up to 46% of posts were unfilled.
NHS's Mr Grampian said the coronavirus pandemic was not the cause of the crisis. “Recruitment and retention was an issue before the pandemic, and this issue continues today,” the company said in a statement. “Some clinicians are choosing to retire early, partly due to changes in pension rules, and fewer appropriately trained psychiatrists are entering the job market. It's not a unique problem.”
Dr Jim Crabb, from the Royal College of Psychiatrists, said the NHS and Scottish Government needed to do more to encourage and value psychiatry. Medical spending on mental health was less than the promised 10% and was being cut by 5% a year.
“Funding has always been bad,” he says. “Serious illnesses such as schizophrenia, depression, and anxiety cost economically developed societies more money than illnesses such as asthma or arthritis, yet more is spent on mental health.'' The expenditure is much less than physical medical care.”
NHS Tayside said it was facing significant recruitment challenges. Training as a consultant psychiatrist takes between 13 and 15 years. Data shows that 42% of consultant psychiatrists are over the age of 50 and many intend to retire early.
“At this peak, the number of retirements will far exceed the number of new consultants,” the company said, adding that it was working hard to recruit doctors from the local area.
“Despite these efforts, the number of trainees is relatively low and this, combined with the length of the training period, means that it will take several years to recover from the current situation of high locum use in psychiatry. ,” the report said.
Scottish Liberal Democrat MSP Willie Rennie, who is calling for mental health funding, said: “It's all well and good for ministers to pay lip service to mental health, but when it comes time to budget, the evidence is implicit.” he said.
“In addition to training more staff, we are also looking at how to attract and retain staff to work in all types of communities, so that everyone has access to mental health support no matter where they live. It needs to be seriously considered.”
A Scottish Government spokesperson said recruitment had improved recently, but agreed more work was needed “to ensure the best value” for health spending.
“We will actively consider possible solutions to address issues such as the use of locums and how to attract new and existing psychiatrists to take up posts in Scotland. “We are looking at ways we can better support the recruitment and retention of psychiatrists, including through