Leaders: Reform may be the key to curing NHS ills | Film budget cut casts city in a bad light

WHEN considering any statistics to do with the National Health Service, it is important to look beyond the mass of numbers and think of each patient as a living, breathing human being – often at their weakest, most vulnerable and afraid.

That is why we must regard the latest statistics about accident and emergency (A&E) departments at Scottish hospitals with the utmost seriousness.

Waiting times at Scottish A&E units are, quite simply, the worst since records began, with 
hundreds of patients waiting more than 12 hours for treatment. Staff are struggling even more than before to see patients within the target period of four hours. This is simply not good enough.

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A&E is the sharp end of the health service, and it should be an exemplar of what the NHS can achieve in terms of quality of care, expedition of treatment and the dignity afforded every single patient. Sadly, inefficiencies in the system suggest our hospitals are performing well short of the mark.

There may be good reasons why the recent winter months proved so much of a challenge for our hospitals. Certainly, the norovirus – also known as the winter vomiting bug – put pressure on beds, despite the efforts of GPs and community health practitioners to have sufferers treated in their own homes. And let’s not forget bugs hit staff, too. But can we really treat this as a one-off? Who is to say another virus will not be a difficulty next winter?

This week, the SNP administration announced £50 million extra for Scottish A&E treatment. A cynic might suggest ministers had an inkling what yesterday’s figures might reveal, and got their response in early. That is as maybe.

The money will, one assumes be judiciously spent on extra staff where and when they are most needed. But it would be a mistake to assume that simply throwing money at the problem will be sufficient to solve it. Failings of this magnitude suggest that what is needed goes beyond simply more capacity in the system. Is the problem, in fact, a lack of 
reform?

South of the Border a profusion of private sector providers has ensured that there has been a constant scrutiny on how basic health services can be delivered to the patient more efficiently and with better clinical outcomes. In key areas, this has seem a marked improvement – albeit from a lower base of provision than is often the case north of the Border.

The English “any qualified provider” doctrine may be a step too far for Scotland – certainly under SNP ministers with a doctrinal opposition to any private sector provision within the NHS. But that does not mean other innovative ways of health reform cannot be explored within the public sector, with greater use of walk-in centres and minor injury units, for example. Remember, every one of these statistics is a person deserving of our best efforts.

Film budget cut casts city in a bad light

Lights. Action. Edinburgh. The capital city sometimes looks like one huge film set. The Georgian grandeur of the New Town; the dark vennels of the medieval Old Town; the vertiginous bridges and split-level cityscapes – all bathed,

on a good day, in the most perfect light.

No wonder cinematographers love to shoot their movies in Edinburgh. In recent years, the city’s cobbles have seen the heels of Tom Hanks, Nicole Kidman, James McAvoy, Stephen Fry and Anne Hathaway, and films as diverse as Cloud Atlas, Hallam Foe, One Day, New Town Killers and The Railway Man.

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Each of these films acts as a recruitment poster for Edinburgh’s tourist industry, helping cement the city in the imagination as somewhere, one day, it would be a great place to explore.

So, it is somewhat dismaying to discover that the agency responsible for attracting such films to Edinburgh is seeing a drastic cut to its funding, which, one must assume, will have an impact on its future rate of success.

Of course, we live in straitened times. Each penny of public funds must be justified, and money spent on anything other than core services is – quite deservedly – scrutinised harder than most.

But this is a cut that is ultimately shortsighted, because it surrenders the opportunity to sell Edinburgh to the world, making it more likely that film-makers will in future choose other cities in Europe and further afield which might be making more of an effort. Cities like Glasgow, in fact, which continues to fund its equivalent agency far more generously.

The authorities should leave this decision on the cutting-room floor.

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