Since being appointed as Health Secretary in September last year, my one and only focus has been to do what is best to deliver safe, effective, world class care for the people of Scotland and to support the hardworking staff of our NHS.
One year on from my appointment, I am proud of what we have achieved in building on the legacy left by my predecessor, Nicola Sturgeon.
There is a contrast between Scotland’s approach to the NHS, based on its founding principles of being free at the point of care, while privatisation in England is growing ever more pronounced and damaging. I want to make it clear that in my view, the mutual NHS model we have in Scotland is the right model for providing the very best care for patients.
We totally reject the approach of the UK government to NHS England. We have legislated to ensure that there is no privatisation of GP services in Scotland, and we banned privatisation of cleaning contracts, supported by more than £18 million of additional resources since 2009 to pay for hundreds of additional cleaning staff. This doesn’t mean turning our backs on innovation.
This does not seem to match the approach of my counterparts at Westminster, whose instinct to privatise is ever more the norm. For example, when the 111 contract was created it divided England into 46 regions. The service was scheduled to launch in April 2013. As of 23 July 2013, 23 areas have yet to launch. NHS Direct is now pulling out of the contracts as it can’t sustain a safe service. In contrast, in Scotland, NHS 24 will operate the 111 service from April next year, following new systems being put in place to ensure it can handle increased call volumes.
The 111 number will be a public service, in public hands – serving the needs of patients rather than private profit. That is at the heart of my vision for health care.
In Scotland, we abolished prescription charges, so all patients get the medications their doctors think they need. In England prescription charges remain, with a recent survey by the Prescription Charges Coalition showing that 36 per cent of patients with long-term conditions had not collected a prescription because of costs and their health had deteriorated as a result. Ten per cent of this group ended up in hospital as a direct consequence of not taking their medication.
We continue to invest in our NHS workforce, with more qualified nurses per head of population in Scotland, eight per 1,000, compared to 5.8 per 1,000 in England. We have some of the safest and best hospitals in the world. Prof Don Berwick, President Obama’s adviser on healthcare, recently produced a report for the UK government on making NHS England “zero harm”. The Berwick review called for safety collaboratives and networks to be established across NHS England. This is precisely what NHS Scotland did in 2008 with the establishment of the Scottish Patient Safety Programme.
Our blueprint for the future of the NHS is a service focused on the needs of patients, not ideology. This is the path we are on and I have put in place a group of experts, the very best from across Scotland’s health service, to form a steering group to oversee delivery of this vision. This will help to achieve our 2020 vision of having a sustainable high-quality healthcare in Scotland.
Over the past 12 months, NHS Scotland has continued to evolve, and there are a number of achievements that I am proud to have been involved in.
We introduced the £50m unscheduled care action plan, to significantly improve access to A&E care, and a mandatory nursing workforce planning tool is now in place to ensure we have the right mix and number of staff in the right place at the right time.
Waiting times continue to be among their lowest ever levels, care is safer than it has ever been, levels of premature mortality have been further reduced and patients continue to rate their care very positively. While I continue to be proud of all that we have achieved in Scotland, there is still more to be done. It is important that as we drive this continuous improvement, we protect the founding principles of our National Health Service. «
• Alex Neil MSP is Cabinet Secretary for Health and Wellbeing