1. Impact of Referendum Attacks by the Better Together Campaign
a. I expected, “Bitter Together to hit back at the, “Yes” campaigners’ with a few scare stories in the last few days before the referendum and I was not surprised when the, (heavily biased) BBC and The Herald, selectively released information from confidential papers supposedly passed them by a senior NHS whistle-blower, who said they had become frustrated by the argument of the “Yes” campaign that the biggest threat to the NHS comes from the UK government.
2. The Health Service Budget for 2015-2016
a. The Scottish government remains committed to, “protecting and increasing the NHS budget” despite yet another reduction in the Block Funding Grant from the UK Government, in Westminster,(for the 5th consecutive year) of 7.2%. The NHS budget will be further increased in the next financial year meaning that, in real terms the budget will have been increased by £1 Million+ since the government took office.
b. Integration of services is particularly important so as to ensure the nations elderly population is kept well and provided with care in the best setting for their well being. The Health Service is always developing so that it is able to meet the changing demands of the people of Scotland, and that is the reason for the new legislation which is designed to integrate health and social care, (currently split) in Scotland from April next year.
c. Retention of status quo and preservation of existing models of care are no longer options given the pressing challenges the Service faces and in order to meet the goals health boards will be set an efficiency saving target of 3%+ so that funds of between £400-£450 can be accrued over the next 2 financial years.
d. Progress towards the agreed goals has been slower than anticipated due to a shortage of, “pump priming finance” needed to run dual care systems for a time and a need to purchase additional capital equipment meeting existing and recently enhanced patient care systems and consumables.
e. Radical and urgent decisions will need to be made regarding the shape and configuration of services and there can be no, “sacred cows” in terms of savings. All options are open for discussion but there is to be no implementation of any major change without the authorization of the Minister. It is of great importance that there is an unqualified commitment (on the part of health Board Chief Executives) to these priorities and full acceptance that significant changes will require to be implemented.
3. The Whistle-Blower and the BBC / Herald
a. In their analysis of the content of the confidential papers, (assisted no doubt by the senior Health Service Whistle-Blower clearly pursuing his/her own anti, “Yes” campaign agenda) a view was formed that there would be a £400 Million funding gap suggesting a radical cost-saving plan involving sweeping changes would need to be implemented in the Scottish NHS after the referendum so that boards would break even. This is not in dispute since details were already included in the papers
b. The Whistle-Blower is reported to have told the BBC, “Services are unsustainable right across Scotland from three emergency Centres in Lanarkshire, to emergency care at the Vale (of Leven) to Paediatrics at St John’s (in Livingston), and with particular issues for more rural boards, hence the problems at Grampian. “The current pattern of services is fully funded and underpinned but short-term money and fixes won’t stack up going into next year. Again this is not in dispute since details were already in the papers. He/she is flying a kite here. He/she cannot presume to speak for Health Boards other than his own since he/she has no direct knowledge of operational routine other than his own area. of expertise.
c. There is a complete gap between policy announcements about care in the community and more money for primary care, and the announcements and commitments which continually increase the cost of acute care. Clearly he/she is unable to read and understand the content of the papers. There is no new money at this time available for primary care. Savings will need to be identified and made so that finance released can be reallocated to these areas.
4. The Scottish Governments Reply
a. The Scottish government informed the BBC and the Herald that the, “consultation papers” formed the first part of a series of regular discussions routinely conducted among NHS leaders providing a vehicle affording time to plan NHS Scotland’s future strategy.
b. Health Secretary Alex Neil said, “We’ve protected Scotland’s NHS from the Tories” cuts, and with independence we can ensure that it is never again under threat from Westminster’s dangerous obsession with austerity.
c. He added, “To ensure we can continue to develop the NHS, it’s important that NHS boards regularly discuss their future plans to inform budget discussions with Scottish government officials, and to identify how we will continue to deliver quality care and treatment.”