THE message from doctors is clear: the NHS, as it stands, is unsafe.

The warnings have been reiterated over and over during the past week alone.

Delivering his first Christmas message as BMA Scotland's new leader, Dr Iain Kennedy shared a number of worrying testimonies recently received from members.

One doctor described how patients are "getting sicker and more complex, but we have less resources or time to care for them", adding: "It’s hard to keep them safe. I wouldn’t want to be an inpatient at the moment, and hope everyone in my family remains well for the foreseeable."

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Unsafe staffing levels had been linked to a number of critical incidents during the past six months, according to the same medic, while another doctor told BMA Scotland that nurse shortages meant that patients were waiting four weeks to start chemotherapy after being referred by a consultant.

“All the statistics tell us that it’s a desperate state of affairs," said Dr Kennedy. "Things are as bad, or worse, than they have ever been. Winter is a meaningless term now – this entire year has been winter."

The latest warnings from the RCPE and SAM come hot on the heels of the dire statistics in A&E. The logjam in hospitals is literally, and needlessly, costing lives.

There are no quick solutions, but staff retention should be a priority because it is at least easier than recruitment. The ongoing pension tax issue looms large for senior doctors: why would they 'pay to work' when they can retire comfortably, and earlier, instead?

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Likewise we are increasingly haemorrhaging nurses to more flexible agency jobs where they will cost the NHS much more to hire.

In social care, staff are leaving for jobs in sectors such as retail and hospitality, where they can earn the same or more for much less stress.

This makes no sense.

If the NHS workforce continues to shrink relative to demand, the health service as we have known it will implode. Arguably, it is already happening.

Likewise, without adequate social care in the community, hospitals will remain permanently and dangerously full.

Stemming the exodus of staff in the NHS and in social care must be the short-term focus.

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There is no magic money tree, of course, but governments - particularly at a UK level - will have to make some serious decisions in 2023 about the future of the NHS as it turns 75 this year.

What should it continue to provide; how should it be funded; and is the existing model fit for purpose in the face of a population that is not only living longer, but spending a larger chunk of its lifetime in poor health? In the longer term, a healthier population may be the only way to ensure an affordable health service.