The NHS in Scotland

2 May 2018

I thank Miles Briggs and his colleagues for bringing this important and pressing matter for debate this afternoon.

This has been a well-informed debate, with passionate and interesting speeches from members of all parties.

In a spirit of consensus, let me say that Labour endorses Liz Smith’s comments about the management of integration joint boards.

She made an excellent point and I put on record that we fully support what she said.

Of course, this debate is not about numbers on a spreadsheet, but about the conditions that are faced by staff and patients in our hospitals and communities.

As Anas Sarwar, Neil Findlay and Jackie Baillie said, NHS staff in Scotland have been underpaid, undervalued and underresourced, and patients have been feeling the pain of that, with A and E targets being missed, planned operations being cancelled, bed days being lost to delayed discharge, social care budgets being slashed and seven out of eight key targets being missed for two years, according to Audit Scotland.

Like every member in this chamber, I am passionate about the NHS.

It is not just another issue, another debate or another headline.

Again, like many members, I have family and personal connections with the service. My brother-in-law is a mental health nurse, my neighbour is a midwife, and my close friend is a senior staff nurse.

Members talked about the history of the NHS, and I, too, am aware of its creation, although I was not there at the time.

On 5 July 1948, Sylvia Beckingham was admitted to hospital to be treated for a liver condition.

That was a big event in her life but it was an even bigger event in British history.

The 13-year-old was the first patient to be treated by the national health service. The NHS—our NHS—will be 70 years old in July.

As we all know, the Labour Party created the NHS. Three score years and 10 later, we are still defending it.

In 1948, when the service faced a shortage of nurses early on—a familiar story—Nye Bevan pushed up nurses’ wages to attract recruits.

That is a solution that I recommend to the cabinet secretary.

The 1960s saw the first British heart, liver and kidney transplants.

Indeed, the first kidney transplant took place in Edinburgh royal infirmary.

The 1970s saw the first test-tube babies, as well as computerised tomography scans, which revolutionised how doctors examine patients.

Like everyone in this chamber, I am proud of what the NHS achieves.

I am prouder still of its hard-working front-line staff—the junior doctors, nurses, midwives, consultants, GPs, allied health professionals, porters and receptionists.

Despite the hard work and commitment of its staff, the NHS faces challenges.

Alison Johnstone, Alex Cole-Hamilton, Liz Smith, Ash Denham, Edward Mountain, Annie Wells, Miles Briggs and Brian Whittle talked about challenges such as our ageing population, the pressures on social care, the need for robust workforce planning now and post-Brexit, and the growing mental health crisis.

Such public health challenges may look modern, but, under the surface, the root causes are the same old story: poverty, social deprivation and inequality are significant contributors to poor health expectations, and it is the least well-off who are most at risk.

We need to reverse the inverse care law, under which patients who are most in need of healthcare have the least access to it.

Back in 1948, the NHS represented the advance of egalitarianism in our nation.

There was great hope for the new future that it heralded.

A news article in the Manchester Guardian from the time noted that the changes were

“designed to offset as far as they can the inequalities that arise from the chances of life, to ensure that a ‘bad start’ or a stroke of bad luck, illness or accident or loss of work, does not carry the heavy, often crippling, economic penalty it has carried In the past.”

Inequality in health was a serious issue then and, sadly, it remains one now.

Life expectancy in the UK has stalled and, in the past 50 years, the chasm between the health outcomes of the rich and the poor has widened.

Is it not an outrage that, in the 21st century, individuals’ health expectations are intrinsically tied to their postcodes?

The theme of the debate has been NHS financial accountability and the need for change.

However, members should not just take my word that change is needed.

As Professor Sir Harry Burns said to the Health and Sport Committee this week, we need “complex system change” in the NHS.

Elsewhere, Dr Peter Bennie, the chair of the BMA’s Scottish council, said that the NHS workforce was stretched to breaking point.

In a survey, RCN Scotland showed that nine out of 10 nurses say that their workload has got a lot worse.

In a brief to our Health and Sport Committee, NHS Lothian said:

“Over the last 3 years NHS Lothian has not been able to present a balanced financial plan at the start of each financial year and has increasingly relied on non-recurrent resources to achieve financial balance.”

I close by reminding members that Nye Bevan famously said:

“The NHS will last as long as there’s folk left with faith to fight for it.”

At 5 o’clock, let us put our faith in front-line NHS staff across Scotland.


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