Meeting of the Parliament 10 June 2015
Absolutely, and that is exactly what the NRAC formula is intended to reflect—population growth, need and deprivation and urban and rural populations. The Government has signed up to the formula; it now simply needs to deliver it.
Fully funding the health service in Grampian matters. Whole-time equivalent nursing staff numbers went down by 465 between 2009 and 2013, and there are still nearly 400 unfilled nursing posts. That is not just about money, but extra funding would certainly help.
The strain of making ends meet also contributed to the crisis of leadership in NHS Grampian, which reached a head at the end of last year. A number of senior managers have left the board and a number of senior consultants may well follow.
The causes of the crisis were thoroughly investigated by two inquiries in 2014. Health Improvement Scotland looked in general at how secondary health services were delivered, while the Royal College of Surgeons was brought in to examine the professional conduct and standards of consultants in general surgery at Aberdeen royal infirmary. It is for NHS Grampian to implement the findings of the HIS report, and I understand that senior HIS staff believe that good progress in that regard continues to be made. Incidentally, I am pleased that, after a period of uncertainty, the leadership of the local NHS is now settled in the very competent hands of Professor Steve Logan, as chairman of the board; Malcolm Wright, as chief executive; and Dr Nick Fluck, as medical director. Mr Wright’s appointment on a permanent basis was confirmed only a few days ago, and will, I think, be welcomed by staff across the service.
The findings of the report of the Royal College of Surgeons, on the other hand, remain largely shrouded in secrecy. Only the recommendations have seen the light of day; even the conclusions on which they are based have yet to be published. That is a pity, because the people of Aberdeen and Grampian deserve to know what the investigators found. Unlike the HIS report, the findings of the Royal College of Surgeons investigation are not primarily a matter for NHS Grampian. Just as the investigation was undertaken by the relevant royal college, so the responsibility for dealing with unprofessional conduct by medical staff is a matter for the General Medical Council. The GMC will not refer matters to NHS Grampian before deciding whether disciplinary action is required in cases of alleged misconduct.
The problem for staff and patients, however, is that it will take time for that all to become clear. If the Royal College of Surgeons investigation had been undertaken in England, the duty of candour on NHS bodies would have led to the publication of the findings of the report. Until they are published, it will continue to be all too easy for the vacuum to be filled with misinformation instead.
Given the Government’s commitment to a duty of candour in the Health (Tobacco, Nicotine etc and Care) (Scotland) Bill, I hope that the cabinet secretary will look again at whether there is a way of making the findings of the report public, in order to protect those who have done no wrong and to let patients know the full facts. Professional reputations are at stake, but there is clearly a balance to be struck in the public interest.
There is an important debate to be had about the future of the NHS across Scotland. I hope that there can continue to be progress in addressing all the issues facing the service in Grampian—and elsewhere—so that the NHS in Grampian can play a full part in that national debate and in delivering for local people.
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