Meeting of the Parliament 02 November 2016
It is fair to say that the NHS is having to deal with the impact that Tory austerity has had on many of our most vulnerable citizens, and that this Parliament has had to spend money to mitigate the impact of many damaging cuts. It would have been nice to see some of those constructive proposals in Donald Cameron’s motion.
It is absolutely right to criticise the Government for doing too little to shift the balance of care. The Royal College of Nursing has called the pace of change painfully slow. However—although it does not feel comfortable for any of us to say this—we need to think carefully about our approach to service redesign. Audit Scotland says that NHS boards face significant
“political resistance to proposed changes to local services.”
I accept that there have been issues with public consultations on some of the service changes that health boards have proposed. Part of the problem, as Audit Scotland has pointed out, is that neither the Government nor individual health boards have done enough to open up meaningful public conversations about the long-term direction of service delivery. However, the Parliament has an incredibly important role to play in that regard. We must debate the issues broadly, openly and collaboratively, wherever possible.
The British Medical Association put a very blunt statement to us when it said:
“there needs to be a significant increase in the investment to close the funding gap. If there cannot be a commitment to more resources then a range of realistic future health service models using current planned resources must be set out.”
The truth is that we need both. We need sustainable investment in our health services and we need to think about future health service models that meet people’s complex needs.
Audit Scotland has asked the Government to model the cost of implementing the national clinical strategy. I want that modelling to consider the contribution that health services make to local communities and local economies, because such consideration has been lacking so far. We cannot have a fully informed debate about the impact of service changes without understanding the economic and social role that health services play in different parts of Scotland.
We need to ensure that there is equitable access to primary healthcare. I point out that yesterday’s report—