Scottish Conservative rejects UK Conservative principles to ask NHS Scotland to be even less like NHS England

In the Herald today, from David Bol:

A SENIOR Tory MSP has called for clinical health experts to “call the shots” in the NHS amid proposals to implement a “much greater culture of collaboration”. Miles Briggs, the Scottish Conservatives’ health spokesperson, has set out his ideas for reforming the NHS in Scotland in light of problems the institution has faced during the Covid-19 outbreak.

Senior Conservatives across the UK have been shocked by this radical socialist language from Briggs and wish to remind him of their proud history of undermining the NHS at every opportunity:

Tories resent the NHS’

In recent years, Conservative governments have overseen a massive increase in NHS privatisation, with billions of pounds of contracts handed out to private providers. Meanwhile, waiting times in NHS hospitals are now at their worst level since records began – earlier this year numbers showed tens of thousands of patients waited more than four hours for a bed. That’s quite a distance from the party’s pledge that the NHS would be “safe in our hands.”

This shouldn’t be a surprise – Tory resentment for the NHS has been there from the beginning. When Labour minister (and Tribune editor) Aneurin Bevan founded the NHS in the 1940s, Winston Churchill condemned him as a “squalid nuisance.” Churchill’s Conservative Party voted against the NHS’ creation twenty-two times, including at Second and Third Reading, alleging that the legislation “undermines the freedom and independence of the medical profession to the detriment of the nation.”

To this day, the Tories resent the NHS. They don’t like that it is big, efficient and popular: it undermines their arguments that market methods are preferable to public service. They have tended to both underfund the NHS and to try break up state provision by handing as much of the NHS as possible to private firms. And if this wasn’t bad enough – top Tories have repeatedly tried to profit from privatisation of NHS services.

https://tribunemag.co.uk/2019/11/the-tories-war-on-the-nhs

Meanwhile in Scotland where Briggs is still a Tory: NHS Scotland makes sense to clinicians.

Scotland has a unique system of improving the quality of health care. It focuses on engaging the altruistic professional motivations of frontline staff to do better, and building their skills to improve. Success is defined based on specific measurements of safety and effectiveness that make sense to clinicians.

Scotland’s smaller size as a country supports a more personalised, less formal approach than in England. The Scottish NHS has also benefited from a continuous focus on quality improvement over many years. It uses a consistent, coherent method where better ways of working are tested on a small scale, quickly changed, and then rolled out. Unlike in the rest of the UK, this is overseen by a single organisation that both monitors the quality of care and also helps staff to improve it.

Research Report, July 2017, Learning from Scotland’s NHS at: https://www.nuffieldtrust.org.uk/files/2017-07/learning-from-scotland-s-nhs-final.pdf

The existing close working relationship between the SNP government and the clinical community

Working with the Scottish government and national procurement, we were able to provide the potential for more than 700 ventilated ICU beds, four times the base capacity across Scotland. Scotland has much to be proud of in the way that the pandemic has been managed. I have no doubt that the death toll would have been greater without the unwavering support and close working relationship between the government and the clinical community. Dr Dr Stephen Cole, the president of the Scottish Intensive Care Society

https://www.bbc.co.uk/news/uk-scotland-52922818

2 thoughts on “Scottish Conservative rejects UK Conservative principles to ask NHS Scotland to be even less like NHS England”

  1. I never thought I’d write something like this, but at long last a Tory seems to understand that their blind faith in ideology over common sense doesn’t produce efficient outcomes. Who knew? The Tories’ meddling in the UK-wide NHS in the 1990s in pursuit of their notions of the “internal market” resulted in the splitting up of area-wide management, giving individual hospitals autonomy, causing massive disruption at every level and the recruitment of huge numbers of managerial and admin staff, with ridiculous duplication of job functions.

    In turn this produced massive increases in costs and impairment of clinical performance. It also produced a fetish for targets and a tick-box mentality. It also meant inventing costing systems to evaluate each clinical procedure so that each individual Trust could tout for “business” on a financial basis, not just clinical excellence, from GPs and the Primary Care functions. I saw first-hand how ludicrous these ideologies were in practice when I did some work for a rural Scottish health authority. There was just one Acute hospital in the area, so competition in their “local internal market” was non-existent, while the duplication of admin functions meant that invoices went back and forth between the Health Board, the Acute Trust and the Primary Care Trust. Inevitably 3 separate Credit Control functions chased up overdue invoices and, in time, cheques were written and paid into banks. All this had previously been managed internally in one Accounts Dep’t in the Health Board via book entries with no need for money to change hands or banks to to take a cut.

    The old system certainly could have been improved and it certainly produced less metadata, but it’s a moot point whether those inefficiencies came with a higher cost penalty than the Tories’ grand plans. Fortunately, once devolution returned control of Health to Scotland, the NHS here reverted to a more common-sense structure based on how clinical needs can better be met and then structuring admin functions to support clinicians with pertinent systems and data, thereby streamlining reporting, data flows, systems and functions in admin.

    Meanwhile, NHS in England plodded on with its highly dispersed approach. When Covid19 hit, this, coupled with clearly incompetent government leadership in Westminster, resulted in England having significantly poorer Covid outcomes than Scotland, Wales and N Ireland.

    Like

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