Health inequality should be Labour's priority

Neil Findlay, Shadow Cabinet Secretary for Health led a discussion at tonight's AGM of SHA Scotland.

Neil's focus was the appalling levels of health inequality in Scotland. This reflects other socio economic factors in disadvantaged communities. The problem has been analysed to death, in effect reinventing the Black Report several times over. We now need to take action.

This is not just about the NHS. It's about jobs, income, housing, education, and community networks. Neil drew a comparison with investment in community services in the developing world. We need better integration and local initiatives, not just hospitals. Others pointed to the need for health impact assessments of every policy decision by health boards and councils. We also have to look at how resources are targeted on those areas most in need.

He also highlighted the pressures on NHS Scotland that he had heard from a wide range of staff, patients and healthcare organisations. These include budget pressures, staffing levels, vacancy rates, bullying and harassment, A&E waits, private sector payments and many others. In hospitals, crisis management is the norm with the target culture distorting priorities and putting unbearable pressures on many staff. Neil has called for a review of NHS Scotland, recognising the contribution staff make to the NHS that is Labour's finest achievement.

Community services are also under pressure. Neil used the example of Deep End GPs who use support staff to help patients with wider issues, but need more time with patients. One practice had not had a health visitor allocated for a year, others had limited contact with social work. Other members at the meeting were highly sceptical that the latest version of care integration is going to work. On local democracy, health workers made an unfavourable contrast between the NHS and the outsourcing initiated by many councils.

Home care quality is been driven to the bottom as council budgets are slashed. This was illustrated by the example of a 17yr old who was given four days training then allocated 30 visits in her first day, including patients with complex conditions. She was paid £5.13 per hour and worked from 8am to 10.30pm. Neil argued for good national standards and where services are contracted out they should compete on quality not wage levels. We should be raising the status of care workers so there is continuity of care, slowing the growing turnover rates.

There are similar problems in private care and nursing homes, where there is one scandal after another. In Edinburgh, 100 patients are bed blocking because of the number of nursing homes under investigation or being closed. A number of members referred to the size of new homes, creating new institutional environments.

Neil has established two reviews on social care and inequalities to feed into the SLP policy process that has just started. There was a detailed look at the remit for the health inequalities review and SHA Scotland is well represented on the group. Members made a range of contributions that will be fed into that process.