Yesterday, my colleagues and I used Labour’s debating time in the chamber to highlight concerns about the NHS.
The debate was, in large part, prompted by the publication of a report from Audit Scotland which the Auditor General has described as an amber warning for the finances of the NHS.
Over the last two years, I have seen the impacts that these financial warnings are having at NHS Lothian through quarterly briefings with the health board. You can watch my speech in the above video at 1:37.15.
Perhaps the most significant issue has been the emergence of the waiting times scandal. From initial reports of patients being offered unreasonable appointments in England, a series of revelations emerged detailing systematic doctoring of waiting time stats and the existence of a bullying culture which has undermined the work staff are doing to care for patients.
As work has got underway to address these cultural failings, the true extent of waiting time pressures has become apparent. The health board has been forced to consider sending patients to mainland Europe for treatment to meet the Scottish Government’s targets. It was recently revealed that the cost in this financial year of addressing waiting times in the Lothians has jumped from £20m to over £26m.
Waiting times are important, but unless targets are backed by the resources to allow health boards to implement them they will not provide any comfort to patients currently awaiting treatment.
This is just one of the many examples which demonstrate that there simply is not the capacity to meet demand. Over the last two years, the equivalent of over 600 staff, including 260 full time nursing posts, have been lost to NHS Lothian.
The staff that remain are working flat out to try and support patients and pick up the slack. The pressure that they are under can be seen from recent inspections which have shown that things like care plans for elderly patients are beginning to fall through the cracks. There are simply not enough hours in the day for remaining staff to provide the level of care that people expect and, against this backdrop, the number of complaints at NHS Lothian has rocketed by a third.
I have been backing calls for a whistleblowing hotline to allow staff to confidentially report concerns where a lack of resources is affecting patient care. This is a practical step that would avoid issues being swept under the carpet as has previously happened.
However, it is not only the workforce that is being stretched – the estimated maintenance backlog for NHS Lothian’s estate is over £140m and the majority of that work is of high or significant risk.
Delay to the new Sick Kids Hospital is doing little to help this situation. When the health board began talking seriously about the project in 2007, it was earmarked for opening in 2012. Now, following a change in the funding arrangements by the Scottish Government, it will not open until 2017 at the earliest. In the meantime, the existing hospital at Sciennes is continuing to operate despite being declared not fit for purpose in 2003.
The lack of resources was demonstrated clearly when it emerged in November that the Royal Victoria Hospital would have to re-open to tackle a shortage of beds across the region. The rushed nature of the announcement suggested that this was not a pre-planned contingency. It is clear that there simply are not the resources to deal with the demands on the health service and action is needed.
My view is that the Health Secretary needs to examine the issue of pressure on bed numbers – its not good enough simply to say as he did yesterday that the SNP were not in power when the ERI was built. There are increasing pressures from demographic change. We’ve a growing population in Lothian generally, and will have increasing numbers of people living longer who will not just need high quality hospital care, but nursing care and support at home too.
The Scottish Government’s Cabinet Secretary for Health recently described NHS Lothian as being in the second division. His challenge is to ensure that adequate resources are made available to enable investment not just to deal with the waiting times backlog, but to prevent its repeat and to support investment in improves services so that we see the best use of our staff and facilities within the NHS. I will be continuing to press for that investment.
Today health rightly continued to dominate our discussions as the issue of access to appropriate cancer medicines was raised at First Ministers Questions by Labour Leader Johann Lamont MSP. She argued for a proper debate about the pressures the NHS is facing and for problems to be addressed by the Scottish Government openly so that we develop solutions and improved services.