Meeting of the Parliament 04 June 2024
I think that this debate has been misnamed. It is entitled “A Vision for Health and Social Care in Scotland”, but this SNP Government has not had any vision for health and social care for the past 17 years.
For those who do not believe me, here are the words of Audit Scotland from its damning report on the state of the NHS from earlier this year:
“There are a range of strategies, plans and policies in place ... but no overall vision. The absence of a shared national vision, and a clear strategy to deliver it, makes it more difficult for NHS boards to plan for change.”
There you have it.
Up to now, the SNP’s past two health secretaries have resisted the BMA’s repeated requests for a national conversation. Now that we are on to our third health secretary, I can only assume that the sudden change of heart is because the SNP is indeed bereft of ideas and needs some help.
I say as a matter of record that the Scottish Labour Party is happy to help, because we care too much about the NHS not to do so. However, I gently point out to the cabinet secretary that the BMA, the Royal College of Nursing, Unison, the GMB, all the royal colleges, the social care sector and even we politicians have been offering suggestions for years. Here is the rub: even when we make suggestions, the SNP is incapable of implementing them properly.
I cite the national care service as one such example. It was first proposed by Labour more than a decade ago and was rejected by the SNP; now, suddenly, it is the SNP’s big idea. The problem is that the SNP’s plans are all about structures, not raising quality or improving culture—which is essential. Not one penny is going on care just now, when 9,000 people are waiting to be assessed for care and existing care packages are savagely slashed right across the country.
There is no doubt in anyone’s mind about the scale of the crisis that is faced by the NHS in Scotland. It is profound. Hard-working staff across the health and social care sector are doing their very best to care for us, but they are burnt out and demoralised. Vacancy levels among nurses and doctors are higher than they should be; the use of agency staff to cover shifts in social care is increasing; and GPs are struggling to cope with increasing demand as the promised numbers of new GPs have failed to materialise.
We can all agree that the NHS and social care are nothing without the staff. We owe them a huge debt of gratitude, but we also owe them better workforce planning and an increase in training places. The Government needs to urgently review the process of workforce planning and, while it does so, it needs to make better efforts to retain existing staff. We are happy to make suggestions in that area.
Then there are the lack of access to mental health support, the rise in delayed discharge, the failure to meet cancer treatment targets and the ever-growing waiting lists for treatment. When we add in the £1.4 billion in cuts that the health boards and health and social care partnerships are making, the picture will get even worse. Indeed, when the SNP came to power, spending on health per head of population was 17 per cent higher than in England; now, it is only 3 per cent higher. The SNP has eroded spending over time, so it is little wonder that, on its watch, life expectancy has dropped.