By Professor John Robertson OBA
Helen Puttick, ‘Scottish Health Correspondent’, above, winner the 2023 Sarah Hughes Trust Prize ‘for journalism that exposes misleading health information’ was in the Times on Saturday past with:
SNP’s failure to reform has left NHS in Scotland flatlining. In England Wes Streeting is demanding change in return for extra funding but north of the border the service continues to stagnate under Neil Gray. As Neil Gray, Scottish health secretary, defended his chauffeur-driven trips to watch his favourite football team this week, frontline medical staff in Scotland wondered if there may yet be another changing of the guard.
Scotland is on its third health secretary since Humza Yousaf took the post in May 2021. But while the faces have changed, the long queues for emergency services, planned treatment and social care have remained at crisis levels. There has been talk of reform and wordy documents — but little action.
She has the nerve to imply things are going to be better in England under the dread Wes Streeting but ignores all the actual evidence, not fake but real, other than the dodgy 1 year waiting list claim, everything is better in NHS Scotland than it is in NHS England:
Under Labour NHS Wales hospital waiting list soars to TWICE that per head in Scotland
From BBC Wales two days ago:
Hospital waiting list tops 800,000 for first time 1
Scotland?
From the doctors’ trade union, the BMA, in July 2024:
As of March 2024, more than 690,000 people were on the NHS Scotland waiting list for inpatient and outpatient treatments, which is the highest number ever recorded.2
Shorter in Scotland than in Wales? Yes, but Scotland has a bigger population so the gap per head is even greater.
With 5.44 million to Wales’ 3.16 million, Scotland’s population served by NHS Scotland is 1.7 times greater.
So, for a fair, pro rate, per head, comparison, we need to multiply the Welsh waiting list of 880 by 1.7 to get 1 377, almost exactly twice the Scottish figure, per head.
Sources:
- https://www.bbc.co.uk/news/articles/c20n4yy395zo?xtor=AL-72-%5Bpartner%5D-%5BBBC+England%5D-%5Bheadline%5D-%5Bnews%5D-%5Bbizdev%5D-%5Bisapi%5D&at_link_id=E14EFB6A-91FF-11EF-AF64-AF6FC9BB19C0&at_ptr_name=twitter&at_format=link&at_campaign=Social_Flow&at_link_type=web_link&at_medium=social&at_link_origin=BBCWalesNews&at_campaign_type=owned&at_bbc_team=editorial
- https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-under-pressure-scotland#:~:text=Waiting%20lists%20continue%20to%20grow,elective%20care%20preceded%20the%20pandemic.
THREE times as many wait more than 12 hours in England’s A&E departments
NHS England, Type one A&E, for May 2024, 138 770 waiting more than 4 hours and 42 555 waiting more than 12.
59.7% seen within 4 hours.
NHS Scotland, Type ED full A&E, for May 2024, 9 252 waiting more than 4 hours and 1 350 waiting more than 12.
66.7% seen within 4 hours
So:
All things being equal NHS England with 10 times the population might have been expected to have 92 520 waiting more than 4 hours, but had 138 770, 50% more.
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And 13 500 waiting more than 12 hours but had 42 555, more than THREE times as many.
As for the A&E 4 hour waiting time, NHS Scotland is 11.7% faster.
Sources:
https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/
Scotland’s cancer waiting times dramatically better than England’s
By Professor John Robertson OBA
Today, BBC UK’s Nick Triggle has:
The cancers with longest treatment waits revealed
With the above graph for NHS England data, I’ve added, where possible, equivalent Scottish data. While skin and prostate/kidney waiting times do seem slightly longer in Scotland, in 5 key areas, including breast, lung and liver cancers, NHS Scotland ‘s performance is dramatically better, saving thousands of lives.
Triggle only mentions Scotland once:
See what he’s done there? Scotland, on that measure alone, seems worse than England because he is careful not to tell us how close the two countries were to the target over that period. See these two graphs:
On the 62-day standard (referral to treatment begins), England has had significantly more than 30% waiting longer (less than 70% seen on time), since late 2021, while Scotland has always had less than 30% waiting (more than 70% seen) in the same period.
On the 31-day standard (decision to treat to treatment begins), England has had nearly 10% waiting longer (90% seen on time), since 2023, while Scotland has always had well under 10%, around 5%, waiting (95% seen on time) in the same period.
Sources:
https://www.bbc.co.uk/news/articles/cwy948p4j5wo
Significant increase in those seen within 18 weeks to remain 14% better than NHS England
From Public Health Scotland, today, we see that 68.1% of patients waiting for treatment, in the quarter ending 30 June 2024, were seen within 18 weeks, up from 65.1% in the previous quarter.1
From the BBC in May 2024 (most recent data), we see reported a figure of 57% for NHS England.2
NHS Scotland is thus performing 14.2% on the 18 week waiting list target.
NHS Wales uses the easier 26 week target but still returns a figure of 57% seen within that time.3
Why does this target matter and matter more perhaps than the one-year target often much politicised to attack NHS Scotland?
It’s kind of obvious. If you have a life-threatening condition you really need to be seen quickly and the 18 week target is designed to ensure that happens. If you have a chronic non-life threatening condition, like arthritis, tough though that may be, a resource-strapped health service cannot always be expected to treat that in the shorter term.
Sources:
- https://www.publichealthscotland.scot/publications/nhs-waiting-times-18-weeks-referral-to-treatment/nhs-waiting-times-18-weeks-referral-to-treatment-quarter-ending-30-june-2024
- https://www.bbc.co.uk/news/health-69070207
- https://www.gov.wales/nhs-activity-and-performance-summary-december-2023-and-january-2024-html
Nearly 10% more are on the overall NHS waiting list in England than in Scotland
On the 28th May 2024, according to BBC Scotland:
NHS waiting lists in Scotland have reached a record high, the latest figures show. Public Health Scotland recorded more than 690,000 waits for appointments or treatment for non-urgent care as of 31 March.
According to the Health Service Journal, yesterday:
In April the English referral-to-treatment waiting list grew slightly by 34,000 to 7.57 million patient pathways. These are the last figures to be published before the general election, meaning the pre-election waiting list is 358,000 larger than the figures available when prime minister Rishi Sunak said “NHS waiting lists will fall”.
All things being equal, with 690 000 waiting in Scotland, you’d expect 6 900 000 waiting in England but it was actually 7 570 000, or 8.85% higher.
8.85% of the 7 570 000 is 66 945 so nearly 67 000 people in England would not be on the NHS waiting list if the SNP had been in government there for 17 years.
Sources: https://www.bbc.co.uk/news/articles/cqlly95k5l0o
Support Scots Independent, Scotland’s oldest pro-independence newspaper and host of the OBA (Oliver Brown Award) at: https://scotsindependent.scot/FWShop/shop/
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About Oliver Brown, the first Scottish National Party candidate to save his deposit in a Parliamentary election: https://en.wikipedia.org/wiki/Oliver_Brown_(Scottish_activis
Talking-up Scotland 'Albatraz' 
From the disingenuous article in the Times referred to in the blog post: ‘In England Wes Streeting is demanding change in return for extra funding.’ What change? Something called ‘zero-tolerance’ and the introduction of ‘league tables’!
Source: Nuffield Trust – ‘responds to announcement of new “zero tolerance for failure” NHS reforms‘ Press release November 13.
‘.. there is a danger the actions announced by the Secretary of State will worsen some of the patterns that got us into this mess. We know from the special measures for quality regime that “naming and shaming” NHS trusts can make it harder to recruit staff, which doesn’t help patient care at all. It’s unclear what new league tables will measure – a table based on general waiting times doesn’t add much if you need to know how good heart surgery is.
‘Many of the drivers of poor productivity are systemic – from the dire state of social care stranding people in hospital, to crumbling roofs and worsening population health. They happen across England – which trust is worst affected is often a matter of luck and history as much as leadership. We need a system that encourages leaders to go to the most difficult and challenged trusts to improve patient care – not one that rewards them for choosing easier places to work.’ (my emphasis)
Source: Nuffield Trust – ‘responds to latest NHS performance statistics’. Press release November 14. (‘NHS’ = ‘NHS England’)
‘Yesterday the Secretary of State laid down the gauntlet to the NHS to ensure patients see real improvements in the quality of healthcare. But with systemic issues like crumbling buildings, profound problems in the social care sector and continued pressure on community and primary care, today’s figures underline once more just how far the health service has to go to really turn things around and offer the quick access to care that patients need and deserve.”
Source: The Kings Fund – ‘NHS performance issues are endemic across the country’ Press release November 14.
‘.. league tables alone will not lead to better and faster care this winter and could result in the unintended consequence of health leaders becoming too focused on reporting upwards to national bodies instead of outwards to what their local communities need. The mix of measures will need very careful implementation to avoid perverse incentives.’
In an opinion piece in the Guardian (November 13) under this headline ‘The plan to introduce league tables is a simplistic, retrograde gimmick that will demoralise NHS staff – and sideline their incredible work’ a palliative care doctor wrote:
‘Seriously, Wes Streeting? After 14 wretched years of Tory austerity, stealth privatisation, draconian outsourcing, the Brexit staff drain and the horror and trauma of Covid from which – as you know – staff haven’t remotely recovered, the big NHS plan is to be … naming and shaming? Complete with inflammatory language that’s designed to scapegoat staff, such as the bad managers you’ve branded the NHS’s “guilty secret”? Do you genuinely think this is constructive?’
‘There is colossal cognitive dissonance at the heart of this plan. Streeting himself is the first to acknowledge the impact of structural inequalities on health, recognising that disadvantaged groups in British society are at greater risk of ill health and premature death.
‘Yet his return to hospital league tables presumes that underperformance is all the fault of those deplorable “bad managers” and somehow divorced from the socioeconomic realities of the population they serve.
‘He must know that hospital performance is intricately bound up with the availability (or not) of social care in a region, the prevalence of poverty, the availability of staff, local unemployment levels and innumerable other factors beyond senior hospital managers’ control. Pretending otherwise is disingenuous.’
Helen Puttick, ‘Scottish Health Correspondent’ in her Times article appears to be intent on misinforming readers and voters: she and her ilk in the mainstream media that supposedly ‘serve’ Scotland are working on the basis that persistent, negative framing of stories about NHS Scotland will trump facts, defeat the SNP and by extension help to defeat any move towards independence. To Ms Puttick and her ilk, their journalism is legitimate and ethical as it serves their partisan. political ends.
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So let me see if I’ve got this correct – From the Times of London – “Helen Puttick has been covering news in Scotland for 25 years, developing particular expertise in the fields of education, health and social care. She worked as a health specialist for more than a decade and continues to provide well-informed insight and groundbreaking stories in this field “, only given an award one year ago…
As demonstration of her sheer commitment to journalism, I give you this from Muckrack as example of her prodigious output, or as the Brechin Mercury more aptly decribed it, ” Yet mair pish efter 25 years frae the Puddock ” –
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In fairness, I thought her August 2024 article in the Times “You’ll have had your tea? The dying holiday cottage welcome pack”, was particularly thought provoking. 🙂
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I do not doubt her ability to provide thought provoking perspective on other issues, but churning out the ‘agreed media political angle’ has become most tiresome.
There will be aspects of Scotland’s NHS which can be improved, but frankly I’d settle for ‘flatlining’ rather than accepting ‘close to collapse’ as it is in parts of England – Streeting ‘demanding change’ is one of the oldest political diversion tricks in the book and she knows it, yet dusts down the ‘reform’ fairy for yet another appearance instead of addressing the ‘reduced funding’ ogre of successive governments in Westminster – Knowing the price of everything and the value of nothing is what has caused the UK’s decline, yet they keep on doing it in belief that someday it will somehow ‘work’… Madness…
Yet it’s the all too familiar media default of criticising SG for ‘little action’ which truly grinds, avoiding as it does identification of any ‘action’ taking place in NHS England for comparison, because there is none.
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