Meeting of the Parliament 04 June 2024
The NHS in Scotland—our publicly owned, publicly run, free-at-the-point-of-use national health service—is one of our country’s greatest assets. For more than seven decades, it has served Scotland through thick and thin, even in a pandemic, looking after folk from the cradle to the grave and aathin in atween.
In years to come, I look forward to being able to talk about it alongside the national care service that is being set up by the SNP Government. The establishment of a national care service is a huge undertaking, but it is just one part of the reforms that we need to consider in health and social care if we want to ensure that it is sustainable in the long term. That sits alongside targeted investments such as the £190 million in multidisciplinary teams to support GPs.
When it comes to health, the answer is not just to throw money at the private sector, or, as Wes Streeting has said that Labour will do, to throw the NHS to the private sector. I firmly believe that at the heart of all the issues that the NHS faces in every part of the UK is Westminster austerity and the £18 billion to £30 billion of cuts that are contained in Labour and Tory spending plans. That threatens the NHS’s future. When it comes to the future of the NHS in Scotland, it is in the best hands possible when it is in public hands, but how we decide to fund the NHS and our spending on a range of other policies that impact folk’s health is a difficult balancing act.
Whether or not we choose to admit it, the question of how much a life is worth runs through many of the decisions that are made in this place, and not just in healthcare. The answer probably varies depending on the policy area that money is being spent in. The nature of what our NHS does means that we can just about identify every life that it saves and every life that it could not save. There is even a measure used in approving treatments that comes as close as you will get to answering that question. It considers quality-adjusted life years when making the most difficult decisions about allocating resources. However, elsewhere in Government, it becomes much harder to pinpoint the individuals affected by those life-and-death decisions. For example, if we invest in improving road safety and road fatalities go down, we will never know who did not crash. Conversely, we know that poverty and poor air quality shorten lives, but would we see those listed on a death certificate?
Initiatives such as the Scottish child payment and low-emission zones may go on to play as much of a role in keeping folk healthy and tackling health inequalities as some parts of our NHS will. Scrapping the child cap would have a similar impact. That would not just give more bairns a better chance at life; it would likely mean that they go on to live longer and healthier lives, too.
I am not suggesting that reform of the NHS be that wide ranging, but as we consider reform, it is worth recognising the role that prevention can play and that not every intervention needs to involve a doctor. I know a lot of folk who view their GP as their only point of contact for everything. That is a reflection of the capabilities of those GPs and the esteem in which they are held. However, some will insist on seeing their GP even when nurses, physiotherapists or other medical professionals are better placed to help them. That multidisciplinary approach is the way forward, and it is starting to become more common and more accepted. It can also be built on.
One example of that good practice is the Grampian eye health network, which works well in my constituency, and which I think other health boards would do well to look at. It is an initiative that sends folk with eye difficulties to an optometrist in the first instance. That takes pressure off GPs and A and E departments, and it means that patients can get a much more appropriate diagnosis or referral from someone who specialises in looking after eyes and deals with them day in, day out.
Nobody is saying that our NHS is perfect. There is work that needs to be done, and there are improvements that can be made. The motion acknowledges that reform is needed, and it looks forward to how those improvements will be delivered. However, let me finish by talking up the state of the NHS in Scotland.
Under SNP Governments, NHS funding has more than doubled, to £19.5 billion this year. We have worked with trade unions to avoid a single day of strike action over pay. NHS staffing is at a record high, with 31,300 more doctors, nurses and other staff than there were in 2007. Compared with England, we have, per head of population, more doctors, more nurses and midwives, more hospital consultants, more GPs, more dentists and more NHS staff overall, and we are continuing to invest in training even more staff, with 880 more junior doctor training posts created since 2014.
The NHS will stay in safe hands and in public hands under this SNP Government.
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