Leaders: A health warning from an impeccable source

Nicola Sturgeon’s insistence on being judged on her record could come back to bite the SNP after Audit Scotland’s damning report
The list of short-comings in Scotland's NHS identified by Audit Scotland is of real concern. Picture: GettyThe list of short-comings in Scotland's NHS identified by Audit Scotland is of real concern. Picture: Getty
The list of short-comings in Scotland's NHS identified by Audit Scotland is of real concern. Picture: Getty

When faced with figures showing a dramatic rise in the winter death rates earlier this week, we suggested it would be harsh to blame the Scottish Government.

The absence of convincing evidence to link the increase in deaths to the stewardship of the NHS meant finding fault with the SNP administration would be unfair, or at least premature.

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However, today’s Audit Scotland report into the state of the NHS in Scotland is another matter entirely.

The list of shortcomings identified by Audit Scotland is of real concern.

It must be borne in mind that the failings uncovered today do not have their origins in the posturing of opposition politicians anxious to score points against the government – although opposition politicians will, for understandable reasons, be keen to use them to make political capital.

The failings made public today come from Audit Scotland, the public spending watchdog and as neutral an observer as it is possible to get.

Therefore, the findings of today’s NHS in Scotland 2015 report creates a political problem for the SNP.

At the SNP conference on Sunday, Nicola Sturgeon made huge play of her administration being judged on its record in government.

Perhaps the First Minister should be careful what she wishes for, because, by Audit Scotland’s impartial yardstick, her record on health leaves much to be desired.

The picture of an under-funded health service struggling to cope with ever increasing demands – created by people living longer – and missing crucial targets is not a healthy one.

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Audit Scotland found that Scotland’s health budget decreased by 0.7 per cent in real terms in 2014-15. The watchdog identified a general decline in performance, with only two out of nine key performance targets being met on deadline. Moreover, recruitment and staff retention issues have led to a 53 per cent increase in the use of private agency staff and a 22 per cent rise in locum doctors.

It is true that increased longevity is a sign of progress. It should also be acknowledged that Scottish health funding depends to a degree on the Barnett formula, while the imposition of targets creates pressures of its own.

On that basis it is possible to have some sympathy with the Royal College of Nursing’s argument that targets should be abolished.

But if the Scottish Government is to be judged on its record, there must be a way of measuring performance. Under the current measurements, according to Audit Scotland, there are problems. Looking at the big picture, the watchdog warned that not enough progress has been made towards the Scottish Government’s 2020 vision to tip the balance of healthcare to more community-based settings.

For those reasons, the Scottish Government must make health an immediate priority and rethink its strategy for delivering healthcare.

With a Scottish election around the corner, health must be a political priority for the Scottish Government.

But far more importantly action must be taken for the welfare of Scottish patients.