Meeting of the Parliament 02 November 2016
The subject of the debate is, of course, Audit Scotland’s report “NHS in Scotland 2016”. The report is now a week old. The picture that it paints of the NHS in Scotland is, however, much older. That is the true tragedy. As I will discuss later, the problems that are described are the problems that Audit Scotland described 10 years ago. That is 10 lost years, 10 years of inaction and 10 years of delay.
I will remind Parliament of some key points: only one of the eight key performance targets has been met, the number of out-patients waiting for an appointment went up by more than 20,000 in a year, and there is a recruitment crisis with skills gaps across the NHS. Those are just some of the damning statements in the report.
I have always said that we will welcome successes when they arise, and there are small glimmers of light in the report, so it would be churlish not to acknowledge them. Audit Scotland states that NHS Scotland met its drug and alcohol treatment standard, which we welcome, and the cancer target of 31 days between a decision to treat and first treatment was missed by a very marginal 0.1 per cent. There is also recognition that there has been a reduction in bed days lost to delayed discharge.
However, although there are morsels of good news, in any balanced view the report remains a stark indictment of the SNP’s handling of the NHS. Why do we keep hearing that? The SNP Government refuses to acknowledge that after nearly 10 years in its hands the NHS in Scotland is in critical condition. The longer the Government buries its head in the sand, blames other people and talks about a good record, the worse that will get.
Unlike the Government, we want to analyse the problems that are facing our NHS and, more important, talk about the solutions that will make it work not only for patients, but for the front-line staff who care for them. Those staff are one of the many reasons why people have such huge good will—for the moment—towards the NHS. That affection for the NHS does not mean that there are not fundamental problems with the way it is being run here in Scotland. In the report, charge after charge is levelled and proved. It is a forensic critique of a public service that is on its knees, so it would be incredible if the Scottish Government and the Cabinet Secretary for Health and Sport were to describe the report as anything other than deeply alarming.
A politician uses rhetoric at his or her own risk because its currency is devalued by overuse, but the position that we are in is more than “challenging” and “difficult”. It is truly a crisis. If we take targets as one aspect, all but one were missed, as I said, and performance on some is going backwards. Performance on the 18-week referral-to-treatment target is down by 1 per cent on last year, performance on the 12-week treatment time guarantee is down by 2 per cent on last year, and performance on referral to out-patient appointments is down by 3.4 per cent on last year. Those are not mere numbers: they represent real people across Scotland who are relying on our NHS but are being let down—each missed percentage point a person, and each fraction a family.
As I said earlier, and as Ruth Davidson pointed out last week, for the past 10 years Audit Scotland reports have been warning the Scottish Government about the lack of a clear plan to deliver a better NHS. Crucially, they have been warning about the failure to shift the balance of care. When the SNP took office in 2007, Audit Scotland published a report that said that there was
“no evidence that resources are shifting”
from traditional means of delivering services to community-based services.