A fall in health funding together with an increased demand for services will make 2009 a tough year for the NHS, said the leader of Scotland's doctors in his New Year message to the profession.
Dr Peter Terry (pictured), Aberdeen consultant and Chairman of the British Medical Association (BMA) in Scotland, set out a list of challenges for the NHS in 2009.
He claimed that "since devolution, Scotland has faced up to the reality of its appalling record on public health and recent figures show that we are beginning to make progress on tackling health inequalities in Scotland, albeit slow."
Dr Terry said that the implementation of new legislation proposed for 2009, on restricting the promotion of tobacco and alchohol, would continue this progress.
"Tackling our poor public health record, however, is not the only challenge for government in 2009," he warned.
"Funding for health is falling and NHS managers have to make tough choices on what the NHS can afford to provide in an increasingly tight budget. This, matched with an increased demand for services, is going to make it a tough year for the NHS."
Dr Terry said GPs want to work with Scotland's ministers to ensure that future policies can be delivered in the primary care setting, in light of the Scottish government's commitment to NHS general practice.
"Ensuring that general practice is fit for the future will require evidence-based policies that seek to address the fundamental problems that exist in what is the lynchpin of the NHS," he said.
"Our government should be proud of the work done by each and everyone working in the NHS in Scotland, as I am," he added. "We must work together in a spirit of partnership to ensure that, as we face the tough times ahead, we do all we can to ensure that patients continue to receive the care they need."