NHS and Police Scotland: How unions are revealing the truth about the state of public services – Brian Wilson

End-of-year interviews with voices from the front line of Scotland’s public services have not been conducive to comfort or joy. Indeed, they confirmed the impression that an appropriate vehicle for our current national journey might be a handcart.

NHS staff are 'exhausted, burnt-out and broken' (Picture: Peter Byrne/PA)

First up was Dr Iain Kennedy, chair of the British Medical Association in Scotland, telling us that health staff are "exhausted, burnt-out and broken", that calls for the Scottish Government to act have fallen on deaf ears, and that the "whole health and social care system in Scotland is broken".

Dr Kennedy called for a "national conversation" about what we should expect from the NHS. He pre-empted the usual response by stressing all this was developing before Covid, so don’t blame that. Neither is it all about money. An "abject failure of workforce planning" means the NHS is now "haemorrhaging" staff.

None of this will surprise anyone who works in the NHS or talks to those who do. Apart from the regular flow of gloomy statistics, anecdotal evidence about experienced staff leaving while those who remain are subject to even greater work pressures is equally consistent in its message.

While NHS and care staff are seeking a decent pay increase, they see around them the cost of agency and locum staff soaring to £230 million last year. The obvious logic likely to be deduced from a national conversation is that paying people decently as employees would be a better use of resources.

This is acutely relevant to plans for a National Care Service, which the Convention of Scottish Local Authorities reckons will cost £1.5 billion to set up in order to transfer responsibilities from councils to a new national board. How can anyone complain about lack of money while embarking upon such an exercise, based on the entirely unproven assumption that “national” will be better than “local”?

Why not put the same money into improving the pay and conditions of the workforce in order to make it a more attractive career option? It is easy to see why the idea of a national conversation around questions like that is unlikely to appeal to Scottish ministers who are driving exactly the opposite approach, regardless of cost.

Next up on my radio was Calum Steele, general secretary of the Scottish Police Federation, with an uncannily similar account of his members’ experiences. Pretty much every incident they are involved in, he said, begins with the words “I’m sorry” because it has taken them so long to get there.

Public confidence in the police is being diminished because it is not delivering the service people are entitled to expect, he said. Staff shortages are exacerbated by the outflow of experienced officers, wearied by the pressures of the job. Less experience means fewer crimes solved, and so the cycle continues.

In contrast, what have we heard from the Scottish Police Authority about the scenario Calum Steele described – whether to support it or dissent? Where is its resistance to cuts in policing budgets or explanation of the fact 1,000 experienced officers walked away in the first nine months of this year alone, many of them incentivised by changes to pension rules?

Indeed, can anyone point to a single benefit in terms of accountability as a result of regional police boards involving elected councillors having been replaced in 2013 by yet another centralised quango, paid not to bark? Would it have gone unchallenged, for example, that one-third of police stations in the old Northern Constabulary area have closed over the past decade?

Every time a public service responsibility transfers from elected hands to those of quango boards, Scotland’s democratic deficit widens further. And the smaller the circle of people who inhabit these boards, flitting from one to the next, conditional on not rocking any boat, the prospect of challenge diminishes further.

The same applies in many aspects of Scottish civic life where silence has been bought very effectively. This leaves unions – including the BMA and Scottish Police Federation – pretty much on their own when it comes to providing home truths about trends in our society which an army of spin doctors cannot conceal indefinitely.