How SNP's nationalist approach to everything is holding back NHS modernisation – Susan Dalgety

The nurse looked shocked. “I have never dealt with this before,” she said. “I don’t know what to do. To be honest, you should not have come for your appointment today.”

Susan Dalgety, who is travelling for a month or so, may not be able to get the results of breast cancer screening in any other way than by post (Picture: Rui Vieira/PA)

I stood there, naked from the waist up, and as is my wont, I apologised. “Well, I am really at a loss,” she continued. “It’s very unusual.”

I apologised again, this time with less enthusiasm. I was suddenly aware of my state of undress, while she was crisp and efficient in her blue NHS tunic.

I had just had my very first breast screening, in a large truck in a supermarket car park. I don’t recall ever being invited before, so when the letter came I was delighted at the opportunity.

Breast cancer is an all-too-common feature of life for older women. Macmillan Cancer Support estimates that by 2040 there will be more than one million women over 65 living with it in the UK. If I had signs of the dreaded disease, I wanted to know as soon as possible.

The screening itself was painless, if a tad uncomfortable, as my breasts were squashed between metal plates and scanned. It was only when I asked when I was likely to get the results that the process became more difficult.

“You will get a letter in two or three weeks,” said the nurse. “Oh, I won’t be at home by then. I am travelling in my van for a month or so. Can you email it to me?” I asked.

Our conversation became even more fraught. Email is not secure enough, it seems. The only way I can get my results is by post. Even a phone call to alert me if there was something of concern on my scan was not possible.

And the killer line, “I have never dealt with this before,” as if women of a certain age are supposed to sit at home waiting for mail about stair lifts, equity release and NHS results, not go gallivanting round the country in a vintage camper van, without even a forwarding address or someone to pick up their post.

I resisted the temptation to tell her that the only mail I receive these days is junk. Everything is online, even my social life. Instead, I meekly accepted her advice to email the generic address on my invitation letter and hope someone in NHS Lothian reads it. Four days later I am still waiting for an acknowledgement that it has even been opened.

We live our lives increasingly online, and that includes our health care. Last year my 80-something mother had to resort to YouTube for tips on how to heal her elbow, broken during lockdown.

All the NHS could offer her was a brief phone call with a physiotherapist, but she found step-by-step video instructions on her iPad. When she finally saw the consultant who had re-set her bone, he was surprised at how well her arm had mended.

Walking home, I wondered why there is not a secure NHS site where I could view my medical records, make appointments, and yes, get routine test results online.

Googling over a cup of coffee, I discovered exactly what I was looking for, an NHS app available to anyone over the age of 13. It allows me to, yes, you’ve guessed it, view my medical records, make appointments, and get routine test results online. I could even decide whether my health data can be used for research purposes, and more services are being developed.

There was one small hitch. It is only available in England. There is one planned for Scotland, as a Scottish Government spokesperson told me later, by email of course. “… it is our intention to develop a safe and secure digital app in order to provide greater choice, control and flexibility over how people interact with health and care services and information.”

So far so good. But first there must be “extensive engagement with the public, including on the common approach required for online identity, where personal data is controlled by the individual and people are able to authenticate their identity”. Fair enough, but these issues have already been solved in England.

The Scottish Government hasn’t had much luck with health apps recently. The cost of its Covid vaccine passport ballooned from £600,000 to almost £7 million, and it was effectively redundant after only a few months.

So I can understand the hesitation in developing an all-singing, all-dancing NHS one, but surely the answer lies south of the Border. In recent years, government ministers have lectured Scotland’s councils about the need to work collaboratively, to save money and provide better services.

So why doesn’t our Health Secretary Humza Yousaf pick up the phone to his counterpart Sajid Javid and ask to share his technology? The hard work has already been done. Humza could slap a few Saltires on the app to prove its Scottishness, and within months we too would be able to check our medical records online, just like our friends and neighbours in Berwick and Carlisle. It would also save our hard-pressed NHS millions that could be invested in frontline services.

But I doubt there will be any collaboration. Everything the Scottish Government does, from vaccine passports to housing refugees, must pass the nationalist test first.

Nicola Sturgeon cannot be seen to be working in harmony with the UK Government on any issue, even one as straightforward as the development of a health app. To do so would be to admit that the United Kingdom exists, that we are one country, and that, sometimes, it is better if we work together.

Far better for Sturgeon to peddle her myth that we are separate states, even if it means the people of Scotland losing out.

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