Meeting of the Parliament 15 May 2019
I, too, extend my thanks to our NHS staff, who work tirelessly to improve our health—too frequently doing so in an extremely pressured environment.
I welcome the fact that we are debating the treatment time guarantee. However, the Green amendment was not selected for debate, which in this instance is particularly frustrating, because neither the motion nor the other amendments outline the problem and potential solutions in a way that the Greens feel would be of greatest benefit to patients.
Alex Cole-Hamilton is right to have described the severity of the problem, but I do not agree that a letter to patients, which has the potential to make them feel like another statistic, is an adequate response.
I appreciate the proposed actions that are set out in the cabinet secretary’s amendment, but I regret that it would delete entirely the text of Alex Cole-Hamilton’s motion.
I agree with the contents of Monica Lennon’s amendment and I agree with Miles Briggs's amendment, but I cannot square his party’s commitment to a great tax cut for the wealthiest people with increased funding for the NHS.
Shorter waiting times can reduce patient anxiety, improve patients’ quality of life and improve clinical outcomes. We are all in agreement that the sooner a patient can access treatment, the better. That is why waiting times are important. However, as we know, there are considerable workforce pressures across NHS Scotland, which is treating patients who have increasingly complex conditions and multiple morbidities.
Of course, Brexit will not help. The British Medical Association has repeatedly raised concerns about the impact of Brexit on the health workforce. I am concerned that, if we cannot recruit sufficient numbers, the onus for improving waiting times will be placed on the existing workforce. The Scottish Government’s waiting times improvement plan states that it will
“Encourage more capacity ... by working with Staff Side and Employers to reduce sickness absence rates with a focus on staff health and wellbeing”.
A recent BMA survey showed that 91 per cent of the doctors who responded were working more than their allotted hours, so I would argue that many NHS workers are already working over capacity.
People who work in the NHS must be able to take a day off when they need to because of their own ill health. It is, of course, hugely upsetting and disappointing for patients when the treatment time guarantee is not adhered to, but we must, because they are working incredibly hard, also ensure that we avoid making staff feel that they have failed.
Opposition parties are right to criticise the Government, but it cannot be beyond us all to find a way forward with constructive steps that can be taken to bolster our struggling health service. The Scottish Government needs to be honest about what level of service the NHS in Scotland can realistically provide, given workforce pressures and current funding.
In its 2018 report, Audit Scotland said:
“The NHS in Scotland is not in a financially sustainable position. NHS boards are struggling to break even, relying increasingly on Scottish Government loans and one-off savings.”
It recommended that the Scottish Government, NHS boards and integration authorities
“work together to develop a clearer understanding of demand ... and capacity ... within primary and secondary care”
and
“publish clear and easy to understand information ... including how much funding was provided, what it was spent on, and the impact”
that it had. I urge the cabinet secretary to take that on board and to hold a national conversation on the NHS—one that would be far broader than the one that Miles Briggs outlined. It should cover what we all expect from the NHS and how much we are all willing to pay to meet those expectations.
Missed targets are a symptom of wider issues, so placing more pressure on boards and staff to meet targets will not solve the problem. Let us ensure that health boards have the resources that they require and that there is a greater focus on the preventative health agenda in order to lessen that strain, which will enable us to meet the treatment time guarantee.