Think tank: The UK's national health services should work together to bridge health equality gap

The UK’s four national health services should work together and build on efficiencies established during the pandemic, the author of a wide-ranging report into the reform of Scotland’s healthcare system has claimed.

Nurse Eleanor Pinkerton prepares a coronavirus vaccine to be given to a health and care staff member at the NHS Louisa Jordan Hospital in Glasgow.

The report, co-authored by Professor David Kerr – the author of the 2005 Kerr Report commissioned by former First Minister Jack McConnell – and senior physician Sir Muir Gray and published by think tank Our Scottish Future, says that the Covid-19 crisis has “demonstrated the need for an integrated and coordinated approach to healthcare” across the UK.

It says that data presented in many published articles have shown that considerable variation exists across the United Kingdom in clinical outcomes or rates of treatment that cannot be explained by disease prevalence, evidence-based care or patients’ illnesses and comorbidities.

The report said: “Using systems across all four nations of the United Kingdom permits a deeper understanding of this variation, permits benchmarking of key clinical outcomes and therefore drives an agenda to bridge the ever-widening health equity gap, elevating the least well performing towards the best.

"Although health is politically devolved, we believe that there are major benefits for all citizens if we could create systems that span the United Kingdom. Indeed the outcomes for asthma should be the same in Manchester, Motherwell, or even Melbourne and Manitoba.”

The authors said that sharing of PPE and joint decisions surrounding expertise and vaccine roll-out had demonstrated the need for a coordinated approach to the NHS.

The report added: The roll-out of the vaccine demonstrated how a UK wide system and a local delivery plan can combine to provide high quality and equitable outcomes for communities across the country. Few people have had cause to complain either about the standard of service, or about some parts of the country receiving their vaccine later than others.

“In real-time, we have seen how it can work. A new integrated approach for many other diseases and symptoms should now be considered by the four nations of the UK to ensure greater quality of healthcare for all.”

Professor Jim Gallagher, chair of Our Scottish Future, founded by former Prime Minister Gordon Brown, said: “People across Britain expect the same for their NHS, health care free at the point of need, to meet their specific needs. In this fascinating paper, two immensely distinguished clinicians sidestep the old arguments about politics and endless reorganisation and argue instead for common approaches throughout the country for the same health needs as a more efficient and responsive way of delivering what the population expects."

"This new and potentially very radical set of ideas deserves to be taken very seriously but all the UK’s governments.”

Professor Kerr's 2005 report addressed existing and future challenges such as Scotland' s overall poor health, health inequalities and the ageing population. He recommended new a network of community hospitals to deliver treatment by GPs, nurses and paramedics.

A Scottish Government spokesperson said: “Health is rightly a devolved area but we have, of course, always worked closely with the other devolved administrations and the UK Government in the interests of public health - both before the pandemic and during it - and we will continue to do so.”

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