John Robertson sets out the case for NHS Scotland in the face of media and opposition party criticism
NHS Scotland is demonstrably the best-performing in the UK and among the best in the World: Look at the evidence.
1. Scotland has the best and still improving A&E performance in the World. (Royal College of Emergency Medicine and Holyrood.com 1, 2)
2. Scotland has the most GPs per head of population in the UK and has had so every year since at least 2004. (Nuffield Trust 3)
3. Scotland’s GPs feel the most-satisfied, the least over-worked and the least-stressed in the UK and perhaps in the World. (Commonwealth Foundation of New York 4)
4. Scotland’s GPs are significantly more satisfied with the coordination across multiple sites and providers than in England. (Commonwealth Foundation of New York 4)
5. 94% of Scottish cancer patients rated care as ‘highly positive’ but only 61% of English cancer patients did so. (Gov.scot and NCPES 5, 6)
6. Over 100 000 treatment delays caused by junior doctor strikes in England but none in Scotland (BBC 7)
7. Bed-blocking in Scottish hospitals remains on a downward trend, with 7% fewer delayed discharges than last year. This is in stark comparison to other parts of the UK where the number of people delayed waiting to leave hospital is on the rise. (Herald, Scotsman and Jersey Evening Post! BBC 8, 9)
8. Scotland spends more per capita on health (Nuffield Trust, 10)
9. Scotland, by contrast [with England], has abolished all vestiges of the ‘internal market’. (The King’s Fund 11)
10. There is relatively little cross-border flow of patients from Scotland to England. (The King’s Fund 11)
11. Scotland specifically embraces a philosophy of ‘mutuality’ between the Scottish people and the NHS. Internally it has a highly developed approach to partnership working between the trade unions and management. The partnership’s remit stretches well beyond terms and conditions to broader issues such as quality and the design of services. (The King’s Fund 11)
12. Scotland has a long and honourable tradition of clinical audit that over the years, both before and after devolution, has helped inform the approach of the other countries. (The King’s Fund 11)
13. Scotland appears to have made more progress [in developing integrated care], perhaps in part due to its relative organisational stability over the past decade (The King’s Fund 11)
14. Scotland’s greater and earlier success in getting an electronic and shared summary care record in place, despite England investing vastly greater sums in its National Programme for IT (The King’s Fund 11)
15. Public satisfaction with the Scottish NHS reaches as high as 74% in Scotland but only as high as 63% in England (King’s Fund, 12)
16. Scottish nurses more confident in coping with demand than English nurses (OK I made that one up as I wait for the RCN to come clean on the data and confirm my guess)
Before you explode with righteous anger about a bad experience you or a dear one has had at the hands of the NHS in Scotland, I’m not saying it’s even remotely perfect. I’m not saying every member of staff is a saint. Health care is infinitely improvable. We could spend twice as much as we currently do and some things would still go wrong. I’ve ‘been in’ a few times in recent years and all of my experience, apart from the prostate examination, has been fantastic – caring, efficient and effective – but that proves nothing I know. We have to rely on evidence of the kind I’ve given above after the statements and in the references below.
I’ve been triggered to write this overview by the recent mainstream media coverage of the Royal College of Nursing’s survey of confidence in the NHS regions across the UK, along the lines of: ‘9 out of 10 Scots nurses believe NHS cannot cope with demand’ in the Scotsman on 17th June 2016, widely repeated across the press and on BBC Scotland TV broadcasts. The coverage has been uniformly passive taking the RCN selective media releases at face value. The RCN have refused to provide me with a full report so that I can consider the quality of their research in terms of sample, response rates, regional variations and ‘leading’ questions. I’ve requested the information under the Freedom of Information Act and also on the grounds of ethical responsibility in the use of research from their Chief Executive. I await a response.
I’ve also been motivated to do this by longer memories of media-constructed fake crises in the NHS Scotland used by especially BBC Reporting Scotland in the run-up to the 2015 General and 2016 Holyrood elections. In the three months before the 2015 General Election, Reporting Scotland managed to suggest crises in NHS Scotland 17 times. In the three months before the Holyrood election in 2016, they did it 14 times. Commonly, we heard of failures to meet waiting-time targets which had been set high by the Scottish government itself. We had the BMA and the Royal College of General Practitioners suggesting crises in recruitment without proper contextual information. We even had health correspondent Eleanor Bradford praising an initiative in Torbay which had long-since being castigated as a failure by the local press in that area. Some of you, like me, will have been tempted into abusing our TVs.
So, see above for the truth of the matter. NHS Scotland is flawed but doing pretty well by us and deserving of a lot more recognition by mainstream media still determined in its efforts to save the Union, at any cost, in terms of scared old folk or demoralised staff.