Meeting of the Parliament (Hybrid) 22 September 2021
We all know the statistics by now. We have the worst A and E waiting times on record; we are 1,000 acute beds short ahead of winter; the fire brigade, taxi drivers and our British Army have been called in to help; and the NHS Louisa Jordan field hospital has been closed. All that is happening as our NHS faces its hardest winter in living memory.
Yesterday, the SNP-Green Government announced, finally, that it accepts that our NHS and Scottish Ambulance Service are in crisis. Today, we call for concerted and well thought out action. I say to the cabinet secretary that the days of knee-jerk responses must be over. Of course, at this late stage, the challenge is huge, so today I want to help the cabinet secretary by providing some advice. I also want to ask some of the key questions that I will expect answers to when I read his forthcoming winter action plan. I am not patronising him when I say that; it is simply that our NHS and Ambulance Service are in crisis on the SNP’s watch
Let us start with data. I welcome the cabinet secretary’s announcement a moment ago about ambulance response times, but I ask for the data to be published weekly. If it is, we will be able to keep track of what is happening on the ground and to fine tune the plans, where necessary.
Data also provides us with lessons that enable us to avoid making planning and resourcing mistakes in the future. If we do not measure, we cannot improve. I am calling for that because I want to help; I want to advise. I do not want to see problems spinning out of control. Speaking as a doctor, I can say that we know that early intervention is key to treating disease. The same goes for managing policy in a crisis.
Our Ambulance Service is under enormous pressure. With regard to the valuable assistance of the police, the fire service, taxi firms and our British Army, we also need transparency around the scale of crisis support. From week to week, we need to evaluate how much we depend on that support, how long we will need it and what lessons we can learn and take forward for NHS planning.
Processes and procedures are also important. What exactly is it that the Government is asking the fire service and taxi firms to do? Are the processes and pathways in place for that external support? Can we see them? How is the Scottish Government going to evaluate the work of the fire service, taxi firms, our British Army and police support? What are the Government’s target response times for ambulances and taxis? How can the cabinet secretary ensure the safety of taxi drivers and their passenger patients? There is still a lot of Covid out there. Also, has the Scottish Government started the Disclosure Scotland process for those drivers yet?
The action plan for the NHS and Ambulance Service will not be a credible plan without joined-up thinking across services and departments regarding workforce planning. In order for planning to help, we need that. In a crisis, plans might need to be adapted as the data informs us of the reality on the ground, but we need a well thought out blueprint in the first place. That requires details of clinical pathways.
NHS staff and, indeed, the Scottish people need to know the patient journey, given the reality on the ground of staffing levels, patient waiting times, cancelled operations and the rapid approach of winter. What can patients expect? How will the patient journey evolve? What will need to be changed? We need clarity on those issues and we need to communicate clearly with staff and patients.
Finally, let us consider pop-up wards. Just as the failure over years to plan for and maintain stocks of personal protective equipment exposed clinical staff and patients to danger during the pandemic, the decision to close the NHS Louisa Jordan field hospital is coming back to haunt us. What an example of poor planning and waste that is. We need to act now to establish pop-up wards at hospitals, but I give a word of warning: such wards should not be used to fudge A and E waiting time stats. If patients are waiting in a ward to be seen, that is what is happening: they are waiting.