New rules are changing the length of time doctors work

The British Medical Association and the Royal Colleges claim patient care and services face drastic times ahead.

They said the only way to solve the problem is to increase staff recruitment, training and centralise specialist services.

But the Scottish Executive disagreed with the claims and said staff planning had to cover the whole healthcare team.

The physicians' warnings were made in reports to the Scottish Parliament's health committee on Tuesday.

In an outspoken report, Professor Graham Teasdale, of the Royal College of Physicians and Surgeons of Glasgow, said there had been a failure so far to follow the advice of the medical profession on staff numbers and training.

'Expected deficit'

He warned that potential disaster was near unless the NHS and the Scottish Executive meet the challenges of specialisation, the European Working Time Directive and the fact that half of medical graduates from Scottish Universities are women wanting career breaks.

Prof Teasdale said: "It's always difficult to predict the future, we have been warning that it's going to get more difficult.

"I think we're going to be in a position where the number of hospitals across Scotland cannot be staffed to keep them all doing the same thing they are doing at the moment."

We're going to be in a position where the number of hospitals across Scotland cannot be staffed to keep them all doing the same thing they are doing at the moment Professor Graham Teasdale

Competition for staff from the new Foundation Hospitals in England and the need for the concentration of specialised services in fewer hospitals are also having a knock-on effect, he said.

Dr Mairi Scott, of the Royal College of General Practitioners, predicted "a clear expected deficit of 500 GPs by 2012 in Scotland".

She warned that failing to train medical students in the essential role of general practice could prove "catastrophic" - particularly with the movement of the NHS towards more care in the community and the need to serve remote areas.

A report from British Medical Association (BMA) Scotland called for an increased number of training posts in hospitals and general practice to encourage graduates to stay in Scotland, and broadening access to medical schools through fast-track programmes.

But before doctor numbers can be boosted, service redesign of the health service must deliver for patients.

Workforce problems

The association also reiterated fears that Scottish medical academic staff could be attracted to medical schools in England because of increased salaries and better facilities through top-up fees.

The Royal College of Anaesthetists, the Chartered Society of Physiotherapy Scotland and the Society of Chiropodists and Podiatrists pointed out the pressures on such specialisms and called for improved training to meet demand.

Another report, from the NHS Consultants Association, admitted the pressures of the EWTD were leading to a policy of centralisation and hospital closure or overstaffing, claiming "in effect what we are doing is building a health service around the welfare of doctors rather round the need of patients".

Mr Kerr said planning was done on a service-wide basis

The executive insisted that it was facing up to the challenges ahead.

Health Minister Andy Kerr said 8.5% more resources were already being put into the health service every year.

Mr Kerr said: "I don't completely share the views that are being expressed and clearly within the health service we need to plan our workforce.

"That needs to be planned on the basis of the whole healthcare team, working at a local level and in our hospitals - that includes nurses and doctors and consultants."