Meeting of the Parliament 13 March 2025
As the member knows, the healthcare system in England—which has been a separate entity from the one in Scotland since its foundation, in 1948—is broadly modelled on a trust system. Scotland experimented with the trust model in the 1990s and moved to health boards in the early 2000s. Therefore, it is not a fair comparator. Scottish Labour’s policy is to rationalise the 14 current territorial boards into three, which would largely mirror the cancer pathways that are currently in existence. We feel that that is a more optimised scaling for the NHS in Scotland. With a population of 5 million or so, that seems like a more optimised balance. A direct comparator is not necessarily clear.
My point is about productivity across the system. We are not fully utilising the benefits that the national health service provides to Scotland and the UK—such as purchasing power and scaling ability—to drive improvements in patient outcomes. At present, the accelerated national innovation adoption pathway talks mostly to Scottish Government bodies and NHS boards. That seems like a very insular ecosystem. We are in danger of creating another echo chamber—one in which the same people with the same vested interests say the same things to the same Government bodies while the nation continues to drift ever further behind.