GOVERNMENT targets and the pressure to save money are a toxic mix behind many dysfunctional hospitals, a leading Scottish medical organisation has warned.
The Royal College of Physicians and Surgeons of Glasgow (RCPSG), which has more than 10,000 members, has warned in a statement that there is a danger focusing on political targets and budgets is deflecting attention away from patient care.
The message was published on its website in response to The Herald's NHS Time for Action series.
The campaign is examining how well Scottish hospitals are coping with the ageing population and is calling for a review of capacity to ensure both hospital and community services can manage the growing number of frail, elderly people safely.
The RCPSG, led by president Dr Frank Dunn, said: "The NHS in both Scotland and England are faced with major challenges.
"Our ageing population and the reduced number of inpatient beds for unscheduled care without question add to these challenges. There are also workforce issues within the medical profession, especially within the key areas of emergency and acute medicine."
Shortages of senior trainees in these two specialties in Scotland, with just seven out of 25 emergency medicine posts filled through the national recruitment system, have been highlighted during The Herald's campaign.
The college said targets, such as those driving down waiting times for heart bypass surgery, have benefited patients.
However, it continued: "There is a danger a target driven philosophy is dominating the thinking of those running the NHS.
"This, coupled with the constant pressure for financial savings, is a toxic mix at the heart of many dysfunctional hospitals. The gravity of this situation is that it impacts adversely on the care of our patients with, in some cases, irrevocable consequences."
A culture where cost-cutting and target chasing took priority over good quality care has been identified at Stafford Hospital in England following the scandal over its poor standards and high death rates.
A review of 14 other English hospitals with higher than expected mortality figures, published last week, also highlighted a series of failings.
A number of initiatives, including better integration of the NHS and social care services in Scotland, are under way, with a view to looking after the elderly in particular more efficiently.
The RCPSG, along with other medical colleges, is involved in these projects. It warns, though, there are "no easy solutions".
Its statement praised the commitment of NHS staff, concluding: "It is paramount we give them the resources to deliver this care at all times and allow them the freedom to easily, and without fear, voice their concerns on issues that affect them and their patients."
A Scottish Government spokesman said targets were set to drive forward improvements.
He added: "The targets introduced by this Government have reduced waiting times to record low levels. This has seen more Scots diagnosed and treated quickly for cancer, greatly improving their chances of survival.
"We consult with stakeholders such as health boards and royal colleges on the targets, and reduced the number of overall targets to ensure they bring the most significant benefits for patients.
"We have ensured the NHS resource budget will rise by £293 million in 2013-14. This means boards will see an overall increase of 3.3% in funding in 2013-14."
He said the Government was also working towards substantial investment across the whole of health and care services.
He said: "This involves working with the Royal College of Physicians and Surgeons and other clinical experts as part of our National Unscheduled Care Programme to deliver a £50m unscheduled care action plan.
"Our plans to integrate health and social care services will make sure people receive the right kind of care, in the right place and at the right time."
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