In terms of the total number of cases of Covid 19 in hospital, pro rata, the situation in Scotland remains pretty similar to that in Wales and Northern Ireland and only around 20% lower than in England (below), but in ICU, the contrasts (above) are stark.
All things being equal, England should have around 50 in ICU but actually has more than 4 times that and Wales, with only three-fifths the population, tends to have many more ICU cases than Scotland.
All things are clearly not equal and the reasons are worthy, surely, of a BBC Scotland Disclosure investigation into them. They could investigate factors such as NHS Scotland’s higher staffing and bed supply numbers or that no Scottish hospital has received an unsatisfactory grading after inspection, while 6 in England have. Also, Scotland has vaccinated more of the population and did, especially and more quickly, care home residents and all staff. They could look at compliance rates on mask wearing or isolation and the relationship of that with political messaging.
Remember, this is despite Scotland having lower general health outcomes than England.
Question for Helen McCardle at the Herald or Lisa Summers at Reporting Scotland Down – Is NHS Scotland far more effective than you’re giving it credit for?
3 thoughts on “Public Interest: Why does Scotland have so very few Covid cases in ICU?”
‘Is NHS Scotland far more effective than you’re giving it credit for?’
We know that in many respects NHS Scotland – notwithstanding its undoubted challenges and shortcomings – is performing well RELATIVE to the NHS in England, Wales and NI.
We also know that whilst health is devolved, decisions made in Westminster – on the scale of and growth in financial resources made available for NHS England – make a big difference to the resources available to the governments in Belfast, Cardiff and Edinburgh.
After all, the Department of Health and Social Care is the second-largest area of all Westminster government spending, after welfare spending. So the English funding allocation is important to the overall levels of funding available to the devolved administrations and indirectly, to the resources available to them to spend on health.
This provides further, useful context. The health think-tank, the Nuffield Trust has just published an examination of trends in government spending on the NHS in England. In doing so it acknowledges a complex of factors that impact on the finances required by the NHS over time:
– rising prices – inflation
– rising costs – due to improving quality of care; adopting new treatments, drugs and technologies; reducing risk; and meeting rising patient and public expectations
– rising demand – from growth in population and demographic change i.e. an ageing population.
On NHS England funding from Westminster governments, the article reports: ‘The last 40 years can be characterised as a period of increases averaging 2.1% in the 17 years prior to 1997, followed by 13 years of much higher growth, averaging 5.7% a year between 1997/98 and 2009/10.
‘But in the decade leading up to the pandemic, REAL-TERMS SPENDING INCREASES PER HEAD AVERAGED JUST 0.4% A YEAR AND INCLUDED FOUR YEARS IN WHICH SPENDING PER HEAD ACTUALLY FELL. This has been a period of stagnation in terms of the resources available to the NHS to fund improvements in health care quality, or to expand its horizons of what it is possible to do for patients.’ (my emphasis)
The Nuffield Trust article adds: ‘Looking forward beyond actual spending as reported in the government’s accounts to planned spending from 2021/22 to 2024/25, core spending (excluding Covid) is set to rise to provide an average annual increase of around 2.1% per person, after adjusting for changes in the population (and based on our inflation projections).
‘This will provide more headroom for improving quality and new medical developments than over the last decade, BUT WILL STILL ONLY BRING THE AVERAGE ANNUAL INCREASE BETWEEN 2009/10 AND 2024/25 TO 0.5%. THIS IS FAR BELOW THE LONG-RUN AVERAGE OF 2.6%, and comes against the backdrop of the health service trying to recover from a pandemic.’
Source: Appleby J and Gainsbury S (2022) ‘The past, present and future of government spending on the NHS’. Nuffield Trust blog, 17 October. (https://www.nuffieldtrust.org.uk/news-item/the-past-present-and-future-of-government-spending-on-the-nhs )
There is only so much governments with severely restricted, devolved powers can do to buck resourcing trends in much more than marginal ways when these trends are embedded in England and determined by Westminster government priorities.
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English possibly less likely to shield?
Masks not worn in clinical settings in England?
We have similar incidence according to ons.
I’ve been shielding for 2.5 years due to immunocompromise
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My son just had his jags today, I went to the door with him, told him to wear his mask, most people there were not wearing masks. Sigh.
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