The National Health Service in Scotland is clearly in trouble and the Scottish Government has to come up with radical solutions.
With four of Scotland’s health boards now officially at the second-highest level of ‘escalation’ – one step away from being declared “unable to deliver effective care” – the Conservatives are quite right to say the NHS in Scotland is in “crisis”. Indeed, given the myriad of problems affecting the health service, this has been true for some time.
Tory shadow Health Secretary Miles Briggs claimed this was proof that the Scottish Government was “utterly unfit to run the health service” and that people were “sick” of SNP politicians blaming health boards. This could be true, but apportioning blame is hard to do without a major inquiry to get to the heart of the problems.
Health Secretary Jeane Freeman is under pressure, facing calls from some to “consider her position”. And if she is not urgently exploring ways to improve the NHS, she’s unlikely to last for long.
A lack of cash for frontline services, which has seen vacancies in key specialisms left unfilled, seems obvious, so ways of saving money on bureaucracy should be an obvious priority.
According to the SNP, the merger of Scotland’s regional constabularies into Police Scotland – a decision not without its critics – has helped prevent some of the budgetary problems that have affected forces south of the Border.
So it surely must be at least an option to consider abolishing regional health boards too. There would be downsides, such as the loss of whatever degree of local accountability these boards provide. However, perhaps the clue is in the title and there might be benefits to having a genuinely ‘National’ Health Service.
Not to denigrate the quality of health board officials, but it seems fairly obvious that those in charge of a Scotland-wide health board would be the pick of the bunch, the best and the brightest. And that could make a significant difference when dealing with building hospitals at a cost of hundreds of millions of pounds of public money.
Expertise would be concentrated and able to focus on the country’s biggest issues, not divided up by region. And, as former SNP Health Secretary Alex Neil suggested last week, presumably there would also be savings to be made from a reduction in the number of office staff and economies of scale. But whatever solution is found, it needs to be found quickly, for all our sakes.