Before I was elected to Parliament, I had long laboured under a couple of false assumptions. The first was that we lived in a parliamentary democracy. It turns out that the Scottish Parliament can pass votes, but the Scottish Government can, in turn choose, to ignore them. And it frequently does.
The second was my belief that whilst local government budgets across Scotland were being decimated by the SNP Government, NHS spending was at least afforded protection. So I was surprised when I turned up to my first MSPs’ and MPs’ briefing at NHS Lanarkshire in the summer of 2016 to be informed by the Board’s chief executive, in the passing, that over £20 million worth of “savings” had to be found by the Health Board. For savings, read cuts.
But this re-education is why I am no longer surprised at the kind of damning indictment of the Scottish Government’s management of the National Health Service contained in this week’s Audit Scotland report.
This independent investigation shows the SNP’s underfunding of the NHS “is not sustainable”.
It shows that patients are being repeatedly failed, with the number of people waiting more than 12 weeks for an inpatient appointment up by 26 per cent on last year. For an outpatient appointment, it is up by six per cent.
It shows that vacancies for nurses, midwives, consultants and GPs – the beating heart of our health service – are all up.
It shows that performance declined against all eight key national targets between 2016/17 and 2017/18. In fact, the number of boards meeting all key national performance targets sits at zero. And the number of key national performance targets met is just one.
Inevitably, such condemnatory evidence is met with much denial and diversion from the Scottish Government.
And so it goes that ministers claim they are spending more on the NHS than the Tories. They argue that the NHS in Scotland is better managed than the NHS in England.
While there is no doubt Tory austerity has hurt the NHS in Scotland – as it has in England – this blame game gets nurses, doctors and patients – us, as a country – nowhere.
Indeed, it is nationalism at its narrowest when the SNP chooses to measure success not by what works for working people in Scotland, but by what is not working for working people in England.
That is the sort of political outlook that leads the Scottish Government to detach our health service from the people it is designed to serve.
And while the Audit Scotland report is damning, its findings are all the worse because it accurately reflects people’s day-to-day experience of the NHS.
Since 2012, more than 150,000 patients have not been treated under the Treatment Time Guarantee, despite a legal obligation – signed into law by Nicola Sturgeon – for the SNP to ensure they are.
If that alone were not enough, earlier this week, the new Cabinet Secretary for Health was forced to admit the SNP would not be able to start fully meeting this legal guarantee until 2021 – a further three years, and almost a full decade on from when Nicola Sturgeon initially made her promise.
That is an abject failure that should shame this Government and its ministers, although it is increasingly clear they are long past shame.
Indeed, not only are they content to brazenly fail patients, they are content to fail communities and the hardworking staff of the NHS too.
Last week, Scottish Labour research findings harvested from Freedom of Information requests to every health board in Scotland revealed that the number of absences due to NHS staff suffering stress has soared in recent years. Between 2015/16 and 2017/18, the number of stress-led staff absences has rocketed by 17.6 per cent. As a result, the equivalent of more than one million working days have been lost during this period, heaping further pressure on under-resourced hospitals, health services and those staff picking up the strain. These workers care for us but we are letting them down in our duty of care to them.
It is notable that one passage in Audit Scotland’s report highlights another concern. “It is not clear to what extent the public, staff, and NHS boards have been involved in some decisions to change how services are accessed and delivered,” says the report. So there continue to be question marks over the governance and democratic accountability of vital local services.
In communities across the country, local action groups are springing up to defend local health services and all because the Government does not want to face the most basic truth: that our NHS is desperately short of vital funds, given the level of demand that it now faces. And that is the crucial lesson of this week, the week that has once again shown how the NHS is being let down. If it is to thrive into the 21st century – as it did in the 20th – it needs real change.
Not in the hard work of its doctors and nurses, or its porters and support staff, but in its funding and resources.
Throughout the 70-year history of the NHS only Labour has had the ideas – and, crucially, the will – to properly resource and fund our health service. Once again, only Labour will ensure the richest pay their fair share to get the NHS fit for the future and free at the point of need.
In the end, the challenge for us all is to understand that public health is not merely the absence of disease but the overall physical, mental and social well-being of the whole population. And for that we all share a collective responsibility, not least in tackling the huge health inequalities which still scar our society.
This article has been corrected to say “since 2012, more than 150,000 patients have not been treated under the Treatment Time Guarantee”, rather than “more than 150,000 people have not been treated for cancer on time”.