Meeting of the Parliament 17 January 2024
It is a pleasure to speak in this very short debate on Scotland’s health service. It is important to recognise at the outset the challenges that we face and the successes that have been delivered in the on-going work that the cabinet secretary has outlined, including the fact that Scotland is the only part of the UK that has avoided strikes in our NHS. The service faces challenges, not least the ageing population, inflation in the health sector and the impact of Brexit on workforce availability, but also many others.
It is important to use the short time that we have available, not to, as the Opposition does, throw random talking points into the debate but to make clear proposals for specific improvements in addition to the work that is already being done. In the short time that I have available, I want to focus on a few of those.
First, I want to talk about the adoption of technology, including process improvement, and the leverage of the great work of Scotland’s fabulous life science sector. For example, only 1.5 per cent of operations across Scotland’s NHS are being delivered by robotics, which can deliver higher quality and increased efficiency. I ask the cabinet secretary to look more thoroughly at that, as well as at, for example, the use of artificial intelligence in radiography, sensor technology in falls monitoring and prevention and increased digitisation, not to mention Scotland’s great expertise in booking systems, digital dentistry and many other areas. I pay tribute to the great work that has been done by the accelerated national innovation adoption pathway—ANIA—but so much more can be done in that space.
Secondly, there is the roll-out of that technology and best practice across the health service and health boards across the country, and the once-for-Scotland approach. I know that work is being done there, but I ask the Government to evaluate the potential savings and improvements that could be made so that best practice in each health board is adopted across all health boards.
Thirdly, it was good to have a conversation on shifting resources in yesterday’s evidence session with the Cabinet Secretary for NHS Recovery, Health and Social Care at the Health, Social Care and Sport Committee. We know that prevention is significantly cheaper than cure, working on the Christie principles, and it would be great to see more happening in that space.
We know that there has to be a shift from management layers towards the front line and from high-cost to lower-cost interventions. I ask the Government to take forward some detailed work to help us to understand how we can better measure the resources that are applied in each of those areas and get under the skin of the health budget, so that we know what the potential savings would be and what improvements could be made by moving towards a more front-line service that focuses on prevention rather than on a downstream cure.
The next area is structures. A big-bang solution would be time consuming and expensive, but I do not doubt that there are many opportunities for the duplication of services by health boards in back-office management, administration and bureaucracy to be removed and for health boards to work closer together. We are looking for opportunities for consolidation where it makes sense to take out costs from the back office and reapply them to front-line services.
I also ask that the single-authority model be given more serious attention in certain areas of the country. I know that that is favoured particularly by smaller local authorities, and that it allows for a much more efficient service delivery model. We are looking to join the dots where possible and make delivery easier. There was an example of that in my constituency of Glasgow recently, concerning funding for community link workers. Different parts of the system were unable to agree to continue to fund that cost-effective intervention until the cabinet secretary stepped in to make it happen.
Finally, it is important to recognise the Government’s absolute commitment to the fundamental principles of the health service. This publicly provided service is free at the point of use, and we must resist all efforts towards its privatisation, as has unfortunately happened in other parts of the UK.
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