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Is the NHS in Scotland about to ‘fall over’?

by Ozva Admin

Will NHS Scotland weather the winter? According to draft minutes of a meeting of the chief executives of each health board in September, there is growing concern that the health service may not be able to operate normally during the winter months. “It’s not possible to continue running the range of programs,” he says, before stating that “unscheduled care is going to go down anytime soon before planned care goes down.”

The warning follows a pattern. Over the summer, the head of the Milton Keynes University Hospital Foundation Trust, Joe Harrison, made headlines when he said in a meeting with the Health Service Journal that ‘we are in danger of all of us sitting around the campfire singing ‘kumbaya’ as the Titanic sinks’, referring to the appalling state of England’s NHS services in the months before the winter hardships.

The data supports reports from NHS chiefs that the situation is rapidly deteriorating. Wait times for A&E Scotland have plummeted since the pandemic, only falling further since life returned to normal from the target of 95 per cent of patients to be seen within four hours.

Leaked minutes from the NHS Scotland health board raise the idea of ​​a shift towards a “two-tier” system, where wealthy residents could pay for their treatment, leaving national service provisions to those in need, as well as recognition that ‘fundamental reform’ of NHS care ‘must be on the table’. The Scottish government has immediately backed down, arguing against any reform that breaks with Bevan’s ‘fundamental principles: public ownership, public operation and free at the point of need.

This highlights the growing tension between health professionals and politicians, as the problems with the NHS become clearer. The health board minutes even note “concern” about how the Scottish government is “divorced from reality” when it comes to what the NHS can offer post-pandemic. The patient experience in both NHS England and NHS Scotland will worsen significantly, with waiting lists at a record 7 million cases and 451,000 cases respectively, a problem ministers acknowledge but for which they have no solution. , apart from grouping the targets completely.

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It also raises questions about what exactly those NHS “fundamental principles” are and how they are best implemented in a modern health service. The ideas floating around in the minutes reflect the skeletons of something like the German health system: one that offers universal access to health care, using tiers and more market arrangements for health services (a system that is also known for obtaining much better outcomes for patients in areas such as cancer and recovery from stroke and heart attack than in the UK). But if the principles of the NHS are to be strictly defined as a taxpayer-funded service for all, including the wealthy, there will be little room for manoeuvre.

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