A pandemic-style plan is needed to protect the crisis-hit Scottish NHS this winter, a new report by Our Scottish Future says today.
The paper, entitled “A Fractured Service”, says Ministers should implement a series of emergency measures to protect the NHS from potential collapse – and where possibly, do so on a “four nations” basis, with England, Wales and Northern Ireland.
It also warns that, even before winter hits, rocketing waiting times in NHS Scotland are contributing to the rise in long-term sickness and excess deaths.
Among the proposals, the report says the UK health leaders should come together to urge the public to reduce demand on hospitals this winter – for example, by using minor injury units rather than A+E.
It also proposes mask-wearing on public transport, says carers should be given a statutory right to leave of absence to help them look after vulnerable people, and calls for the creation of “rapid support teams” made up of police, care workers and firefighters who can support elderly people in need and prevent them from going into hospital.
It says government ministers may need to draft in military personnel to support the ambulance service or even to provide back up in wards.
But the report also warns that either long-term deep-seated reform is implemented, or Scotland will end up with a two-tier service, in which the better off pay for quicker treatment.
Among its findings, the report says:
- If current trends were to continue, barely more than half of patients turning up in Scottish A+E would be seen within the four-hour target by the end of this decade.
- Long waiting times are contributing to a rise in long-term sickness, with 21,700 more people now off on the sick compared to pre-pandemic levels. This costs £700m a year to the Scottish economy.
- Between April and September this year, there were nearly 1,500 excess non-Covid deaths in Scotland compared to the pre-pandemic 5 year average
- Scotland’s ageing population means that, if hospital stays to not reduce in time, Scotland would need to build a new 450 bed hospital every 2 and half years for the next 20 years to cope – and find an extra 2,300 doctors and 17,000 nurses.
The report comes after Health Secretary Humza Yousaf warned this winter will be “the most challenging in the history of the NHS” and BMA Scotland described the situation facing the service this winter as potentially “terrifying.”
"The true power of knowledge is in its sharing and using it to hold up a mirror to Scotland’s NHS, revealing all that is good, but also showing those imperfections that need to be examined, understood and corrected."
Writing in the foreword, Professor David Kerr – the author of a major report backing reform of NHS Scotland nearly twenty years ago – declares:
“We hope to demonstrate in this report that the true power of knowledge is in its sharing and using it to hold up a mirror to Scotland’s NHS, revealing all that is good, but also showing those imperfections that need to be examined, understood and corrected.”
"Scottish clinicians we have spoken to in producing this report are clear. Without radical action, the founding principle of the NHS – of high-quality treatment free at the point of use – is going to end, and end quickly."
Report authors Andrew Mooney and Eddie Barnes write in their introduction:
“Scottish clinicians we have spoken to in producing this report are clear. Without radical action, the founding principle of the NHS – of high-quality treatment free at the point of use – is going to end, and end quickly. The NHS will be replaced with a two-tier healthcare system, in which a booming private sector caters for better off people to receive treatment more quickly. This will widen Scotland’s already gaping health inequalities. For those poorer families who are unable to pay, they will have to accept a second-class service.”
They add: “During the pandemic, our four Chief Medical Officers collaborated to amplify key public health messages. This collaboration already happens widely and is to be welcomed. We believe that, as the NHS faces a crisis of similarly deep proportions to the pandemic, the same cooperative approach should be taken to help the NHS survive the coming months.”
Andrew Mooney is a researcher based in Cumbernauld. A graduate from the University of Cambridge, he studied a Masters in Population Health Sciences. Prior to this, he worked in a variety of analytical roles both within the NHS and private sector. During his time at the NHS, he developed numerous data products currently used by clinicians across the country. He also holds a Masters in Mathematics and Physics from the University of Glasgow.
