As things stand, the contribution of the SNP 56 will require only a short entry from future chroniclers of UK parliamentary democracy: they were enthusiastic about making speeches and posting them on social media. If the fabled 56 get any more intoxicated on their own conceit at Westminster some may soon require to be reminded why they were elected in the first place.
It seems, though, that the self-congratulatory froth into which the SNP at Westminster is in danger of disappearing is thickening. The priority now, according to Angus Robertson, the party’s Westminster leader, is to go on a charm offensive across England to show our fellow Brits that they are all nice and inclusive. Back home in the real world, though, the NHS is coming apart at the seams. Quite clearly, it is not fit for the 21st century.
Last week, it was revealed that a crisis in GP recruitment has led to more doctors’ surgeries being taken over by health boards. More than 40 practices are now under health board control. This means that efforts by the Scottish government to improve and expand primary care and relieve the pressure that currently threatens to submerge hospitals are being rendered irrelevant.
The response by the Scottish government was predictably trite when addressing concerns over health service provision: there’s no crisis and we’ll just lob £50m at the problem, “ensuring patients get the service they deserve”. Meanwhile, the CEO of NHS Lothian insists that more government cash is needed to tackle a £70m funding gap. Perhaps they could get Angus Robertson to organise some “outreach planning”.
One of the modern indicators of life in 21st-century Scotland is the “missed health target”. Hardly a week passes, it seems, without news of another failure to reach an arbitrary measure of competence and commitment to patients. The most serious of these is the target of treating 90% of patients within 18 weeks. At the end of last year, more than one in 10 patients had to wait longer, the second time the target had been missed. During the final quarter of last year, the NHS also failed to meet a legal obligation for treatment to start within 12 weeks of its being agreed by a specialist. The Scottish government also pledged that 95% of patients would be treated within four hours in accident and emergency. They’ve been missing that target every week for the last six years or so. Some of these targets, at first glance, might seem unrealistic and, admittedly, many of them are missed by very small margins. But when you discover that the Scottish government spends more than £11bn on health, one-third of its overall budget, there is no excuse for failing on so many levels.
The birth of the new £842m South Glasgow University Hospital, now renamed the Queen Elizabeth University Hospital, has been beset by so many difficulties that it probably now requires the attentions of its own midwife in an intensive-care ward. The hospital was the worst performing in Scotland for patient waiting times, with a mere 78.3% of patients being seen and treated within four hours.
After describing such figures as “a dip”, the health secretary, Shona Robison, said that “experts” would be sent to the hospital to improve management systems. Presumably, these weren’t the same “experts” who were sent to Paisley’s Royal Alexandra Hospital earlier this year in similar circumstances. They’ve never been heard of since and a search party has been dispatched.
In recent years in Scotland, the most lucrative game in town is “let’s all play at being CEO of a major health board”. Thus an assortment of unremarkable, usually male, executives with the right sort of management qualification and golf club membership tour the country picking up top jobs in Scotland’s dysfunctional health service. These are inevitably followed a short time later by six-figure pay-offs until such time as their pension pots are sufficiently full and the kids’ school fees have been paid off. In Scotland right now, one of our biggest health boards is being run by an individual whose record of failure in England and Wales is the stuff of legend.
Don’t let’s kid ourselves that any of this will be solved by privatisation. When you create a situation where preference is given to the most lucrative procedures, then you are applying market forces to measure the value of an individual’s health. This is immoral, though not as immoral as the way in which we permit consultants, trained and funded by the state, to top up their already considerable salaries by devoting 50% of their working week to private sector work.
It might be interesting to compare how many lucrative private hip procedures these consultants can rattle off in a day with the rate at which they do them on the NHS. And who scrutinises their weekly job plans and what constitutes their 30% “administration” time. That’s “administration” spelled “G-O-L-F”.
The Scottish government is right to focus on primary care, but Shona Robison must show leadership in ensuring that health boards promote and enable more patients to be cared for in their communities for as long as possible. Thousands of patients are being treated in hospitals when they require only primary care by nurses or physiotherapists. And the GP crisis could have been averted years ago if the government had shown a more enlightened approach to the reality of female doctors with families who want to work part time. Quite simply, this should have been planned for by recruiting more over the past five years.
The NHS in Scotland has changed little in more than 40 years and so there are questions about how fit it is for the 21st century. Why, for instance, do you have to queue on a phone for a GP appointment when most of us use Skype, smartphones and tablets? Not very long ago, women spent more than a week in hospital to have their babies. Now they spend little more than a day before they are back home being looked after by community midwives.
The SNP has had eight years to get the NHS right. Only when it finally does should it start thinking about independence once more.
