‘Ex-health chief’ doesn’t seem to know what he’s talking about

The Scotsman

Prof Gray was appointed Director General Health and Social Care at the Scottish Government and Chief Executive of NHS Scotland in 2013, a role he held until late 2018. Prior to this he held a number of roles at the Scottish Government, including, Director General of Governance and Communities, Director General Environment and Director General Rural Affairs, Environment and Services. Until 2009, Prof Gray was the Scottish Government’s Director of Change and Corporate Services, with responsibility for senior staff development and deployment; human resources; information services; accommodation and estates services; corporate learning; employee engagement; and the Scottish Government’s business improvement and change programmes.

Professor Paul Gray

This call for radical reform is by one of those generalist civil servants who move around and come to understand things in detached general terms based on committee papers. Prof Gray is one of those honorary, ie not real, profs who have done no research themselves and who wouldn’t know a research method if it came up and bit them in their well-upholstered bums.

Yes, I have got a thing about the proliferation of undeserved profs, having done it the hard, real, way.

Anyhow, Gray’s lack of real understanding shows in his apparent acceptance that there is a crisis in NHS Scotland and that it is being overwhelmed. Needless to say no evidence is offered, so apologies regulars here, but here is some to counter the ‘prof’:

UK people per hospital bed

Scotland has a hospital bed for every 265 people whereas England only has one for every 413. If there are bed shortages in Scotland and the graph below suggests not, then they are nearly twice as bad in England.

Either way, are their shortages? See this:


Admissions have been falling for 7 days now, from a peak that was only half of that in February 2021 and ICU cases have been falling for 5 days, in the wake of cases plummeting by 50%.

So, that’s beds, what about staff?


Astonishingly, NHS Scotland has 50% more nurses than NHS England. Could the Scottish Government have played any part in this?

Perhaps they’re all off sick? Nope. The absence rate among NHS Scotland nurses and midwives has fallen again in week-ending 21st September to just over half that at the most recent peak in January 2021: https://www.gov.scot/publications/coronavirus-covid-19-trends-in-daily-data/

What about GPs?

Before the pandemic, Scotland had far more doctors per head of population than any of the other part of the UK.

I know this data is from 2019, but I’m not aware of a more recent report and, anyway, it’s more than likely that the gap has widened further in Scotland’s favour, after two more years of Tory-rule:

GP numbers by UK region

What about A&E? Crisis, what crisis?

In July 2021, NHS Scotland’s Accident & Emergency services saw 81.5% of patients within 4 hours. Only 2.8% waited more than 8 hours and only 0.6% waited more than 12 hours.

In the same period, NHS England’s performance fell to the lowest figure ever recorded – 67.7%. They do not seem to publish the percentages for those waiting longer but simple arithmetic estimation suggests many more do.

Also, attendance at Scotland’s A&E departments was much higher with 132 595 compared to 847 679. With 10 times the population, NHS England should be receiving 1 320 000, roughly, 50% more.




Finally, an even more comprehensive list from 2019:


The Scotsman

11 thoughts on “‘Ex-health chief’ doesn’t seem to know what he’s talking about

  1. The facts are not relevant to the ‘NHS in Crisis” trope which the media and the opposition are running just now. It is another of the three-word soundbites that pass for policy: ‘Get Brexit Done’, ‘Build Back Better’, ‘Johnson Tells Lies’

    Liked by 4 people

  2. Perhaps one could contact this ‘prof’ and ask him if he wishes to comment on/debate this article with you!!!!

    But I’m sure it would be beneath your dignity, (and a waste of time!!).

    Liked by 3 people

  3. Just a thought – If this guy was Director General health and Social Care ( Scotland ) for 5 years ( 2013-2018) , and IF there is a ”crisis” in the Health Service as he claims – How much of the blame falls on this ”Prof’s” head ?
    Or does he think that ‘blame’ for a crisis only falls on politicians and not those pulling the day to day strings ?

    Liked by 5 people

  4. You’re correct, of course, that he’s not a professor – but he is a consulting partner at Charlotte Street Partners. The same outfit which is home to market-loving Andrew Wilson, he of the discredited and neoliberal Growth Commission Report.

    So it’s clear where he gets his ideas from about “private sector good”.
    Also, I’ve no doubt that the Third Sector do good work, but suggesting they should play a bigger role in the public sector is another clue to his neoliberal thinking.

    I wonder if he’s also in favour of the NHS Bill that’s being hotly debated in England?

    Liked by 3 people

  5. In comparing Scotland and England’s relative performance for A&E patients seen inside 4 hours, it should never be forgotten that Scotland’s A&Es start the clock when the patient has been admitted at the front desk i.e. before pre-triage wait and the triage assessment.

    On the other hand England’s A&Es don’t start the clock until a specialist logs in to start treatment i.e. after pre-triage wait, after triage assessment and after any wait between triage assessment and the assigned specialist beginning treatment. All of these missing steps result in potentially significant understatement of English A&E performance and render meaningful comparison pointless. Intentional or otherwise?

    Prof John is right to state them as they are since comparable English data are not available and it’s the nearest we’ll get to comparative figures, but it might be worth mentioning the caveat (just in case newbies get the wrong perspective) that the measurement methods are different, so the real disparity will be significantly greater.

    Liked by 2 people

    1. Indeed NHS Scotland is a different organisation to England’s and always has been. There will be differences. Same with COVID19 deaths, Scotland counts all confirmed (and suspected?) Covid deaths on the birth certificate, England records Covid differently, very possibly way understating the actual devastating stats. I can’t remember details but it’s been mentioned many times here.


    2. On performance measurement of A&E, I offer the following information. I think it reveals that there may be a conflation of two quite different metrics in use by NHS England!

      Source: https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2019/07/AE-Attendances-Emergency-Definitions-v4.0-final-July-2019.pdf

      A&E Performance Measures – NHS England

      Measure A2i) ‘Total number of patients who have a total time in A&E over 4 hours from arrival to admission, transfer or discharge – Type 1 A&E department

      ‘The clock starts from the time that the patient arrives in A&E and it stops when the patient leaves the department on admission, transfer from the hospital or discharge.’

      ‘For ambulance cases, arrival time is when hand over occurs or 15 minutes after the ambulance arrives at A&E, whichever is earlier. In other words, if the ambulance crew have been unable to hand over 15 minutes after arrival that patient is nevertheless deemed to have arrived and the total time clock started.’

      ‘Total time in the Department ends when the patient is discharged, transferred, or admitted.’

      Other A&E Performance Measures – NHS England

      Measure A3) ‘Total number of patients who have waited 4-12 hours in A&E from decision to admit to admission’
      Measure A4) ‘Total number of patients who have waited over 12 hours in A&E from decision to admit to admission’

      ‘The following guidance applies to both data items above relating to waits for emergency admissions. Defined as: The waiting time for an emergency admission via A&E is measured from the time when the decision is made to admit, or when treatment in A&E is completed (whichever is later) to the time when the patient is admitted.

      ‘Time of decision to admit is defined as the time when a clinician decides and records a decision to admit the patient or the time when treatment that must be carried out in A&E before admission is complete – whichever is the later.’

      Source: The Kings Fund (25 March 2020) What’s going on with A&E waiting times? – again for NHS England:

      ‘The four-hour standard measures the total time patients spend in A&E rather than the time patients spend ‘waiting’ for treatment to begin or the time before they are ‘seen’. The waiting time clock ‘starts’ from the time that the patient arrives in A&E and stops when they leave the department to be admitted, transferred to another provider (for example, where more specialist clinical care is needed) or discharged. For patients arriving by ambulance, the clock starts when the patient is handed over from the ambulance staff to hospital staff or 15 minutes after the ambulance arrives at A&E (whichever is earlier).’


  6. 1 million people were admitted to hospital in Scotland. 3million outpatients. That is nearly the whole population. How exactly is that a crisis, of people not being seen.

    UK NHS budget is £139Billion. Increasing to £149Billion. Increased put on the less well off. People will get ill, putting up costs.

    That is 1/4 of all taxes raised in the UK. On average £600Billion. Scotland raises £66Billion. Exactly how is that a crisis.

    The crisis is Austerity and Brexit making more people ill.


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