Neither the word ‘deadly’ nor the word ‘domino’ appear in Health and care performance and promises: the track record for Scotland’s 2026 election published by the Nuffield Trust, yesterday:
While, I’d argue, with evidence, that there is much good about healthcare in Scotland which is missed by the Trust, far far more is missed by the Express, including the above hugely important evidence of superior GP numbers in Scotland, way above the level elsewhere in the UK.
Also avoided by the Express:
People in Scotland are much more likely than they were five years ago to spend more than four hours, or even more than 12 hours, waiting to be admitted or sent home from A&E. However, as the chart below shows, the same happened across the UK during and after Covid-19, and Scotland’s major A&E departments performed slightly but consistently better before, during and after this slump.
The longest 12-hour waits show a similar pattern. They have risen alarmingly, from practically nobody at all waiting this long in 2021, to around 8,000 people a month over the recent winter – more than one in 15 of all attendees. But even that is a lower level than England, where around one in 10 have recently been waiting that long.
Interestingly, there are signs that the Scottish public may recognise this. In the British Social Attitudes survey, Scottish respondents were significantly more likely to be satisfied with the way A&E services ran – at 40%, compared to 21% in England and 14% in Wales.
and:
People in Scotland are more likely to wait more than four hours in A&E than they were five years ago, though they consistently fare better than the rest of the UK
and it’s quality of delivery, not because we spend significantly more on health:
and:
At 13 in every 1,000 residents, the density of registered nurses in Scotland is higher than in Wales (12) or England (10)
and:
and now far more than England.
Scotland has progressively spent more on social care per head in the last decade, overtaking Wales and rising consistently faster than England. In particular, spend per head on working-age adults with a disability has grown fast, increasing by 37% in 2022/23 compared to 2016/17, presumably driven by the expansion of free personal care to adults under 65 in 2019 taking full effect. Increases in overall spend on social care will also be driven by positive improvements to strengthen terms and conditions for the workforce, including the mandating of the Real Living Wage for staff in the independent sector – with planned increases to the Scottish Real Living Wage this year.
and finally:
The health and care sectors in Scotland have real points for pride, such as relatively good A&E waits and a more comprehensive social care system.
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The Nuffield Trust has published a companion briefing, for the NHS in Wales. It concludes (with my emphasis):
‘The new Welsh government, of whatever party or coalition, has a particularly difficult inheritance in health and social care. Waiting times are poor and the public deeply unhappy.
‘Wales’s older, more deprived population means that needs for care are elevated, and sustained high levels of health funding reflect that.
‘The incoming ministers will know that there is not enough money in the coffers to simply spend their way to success. Improvements in delayed discharges and waiting lists provide a glimmer of hope. Sustaining this is likely to require planning out spending carefully with a seriousness not present in election manifestos, and balancing the case for more grip and accountability with avoiding the flurry of unachievable targets that has long blighted the English NHS.
‘It is likely to require confronting difficult questions such as why Wales has a surprisingly low number of GPs and consultant doctors per capita compared to England and Scotland, given its high spending, and why plans to focus planned care on fewer sites have moved so slowly so far.
‘Recovery from the pandemic has been slow, but it has clearly begun, in Wales, across the UK and in many other countries. The new government’s task will be to keep inching forwards so that by the date of the next election, in 2031, those glimmers of hope have started to grow.’
So this is the inheritance from decades of the British Labour Party governing from Cardiff with just devolved powers. This Party’s credentials for its and its MSM allies’ claims Labour would govern Scotland better than the incumbent are threadbare!
Source: https://www.nuffieldtrust.org.uk/resource/wales-health-and-care-issues-for-the-2026-election
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