Thursday, January 16, 2014

More bluster than solutions in health debate

NHS Scotland may not be a 'basket case', but it is under huge pressures that the Scottish Government would do well to recognise. Sadly, not much sign of that in yesterday's Scottish Parliament health debate.

Shadow health minister Neil Findlay opened the Labour debate, he said: "The reality is that the NHS in Scotland, the staff who work in it are under pressure like never before". He drew attention to  budget pressures with "fewer staff being asked to do more for less" as some of the problems facing the NHS, along with bed blocking, waiting times increasing and a "skeleton weekend service" in hospitals.

The Cabinet Secretary for Health's response was combative rather than constructive. He dismissed a Labour demand for a review as the "laziest, most vacuous motion" he had encountered in 15 years of the Scottish Parliament. This is of course a classic lazy and vacuous response and a bit rich from a Government that has used reviews extensively, particularly when the alternative is a difficult decision!

Neil ­Findlay cited unions and professional bodies who believed the NHS in Scotland was close to breaking point. He said, "The Cabinet Secretary has a choice - he can either ignore those informed voices or he acts now and instructs a wide-ranging review of the health and social care system. As these voices have grown louder the Cabinet Secretary's response appears to be to stick his fingers deeper into his ears. This simply is not good enough."

Staff concerns are reflected in the latest NHS Scotland workforce survey. Three of the five lowest scoring statements related to how involved in decisions staff felt they were. The statement ‘Staff are always consulted about changes at work’ received the lowest percentage positive response of all (26%).  The second lowest percentage positive response was ‘There are enough staff for me to do my job properly’, with only 31% of respondents answering positively.

While the NHS has got off relatively lightly in the huge Scottish public sector workforce cuts, 6,000 posts have still gone. This is at a time when the demands on the NHS are increasing. It is therefore not surprising that NHS workers don't believe there are enough staff to do their job properly.

The Health Secretary yesterday referred to 'Everyone Matters: 2020 Workforce Vision'. This is an important document and reflects the constructive way NHS Scotland is seeking to address workforce change. However, this is largely a process document, it doesn't set out how change will be delivered in the current financial environment. Helen Puttick, makes a similar point in her entertaining but caustic analysis in today's Herald. Seeking practical measures she asks, "Why, then, do we have a plan that does little more than describe planning structures?"

NHS finances are also under pressure as the recent Audit Scotland report highlighted. They said "In 2012/13, pressures on the NHS’ capacity became more apparent and the health service spent more on short-term measures to deal with them". That's polite auditor language for putting a sticking plaster over the cuts. And real term cuts they are, when inflation and other cost pressures, not least drugs, are added to the balance sheet. For example, recent statistics revealed that there were 149,866 emergency admissions among people over 75 in 2012/13, compared to 116,128 in 2003/4. That's 410 a day.

The NHS in Scotland does an amazing job, but we do need to recognise that all is not well and staff are working under growing pressure that will impact on patient care. Political bluster is not the solution.

Neil Findlay MSP will be expanding on these themes at the the AGM of SHA Scotland on 30 January 2014.

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