Former health chief calls for NHS reforms

The former chief of NHS Scotland says the public could be asked to “pay quite a lot more tax” unless the government radically reforms the under-pressure health service.

Paul Gray, who served in the role from 2013-19, warns the health and care service in Scotland is “overwhelmed” and cannot meet current and emerging demands.

He reveals that if radical reform does not happen, governments could decide the public should pay more tax to “build up” the current system.

Mr Gray also says that unless changes are made, waiting times will not improve and health outcomes for patients will not be “as good as they could be”.

The former NHS boss adds there needs to be a “transparent and rational discussion” on the role of private healthcare and that “people need to be open to the thought that there may be more they (the private sector) could offer”. He is clear he does not want his call for “fundamental reform” of the system to come as criticism to either staff in the service or politicians but rather a “plea to think differently”.

He believes the NHS was always going to be “overwhelmed” without reform and that the coronavirus pandemic has “simply brought the date of that event forward”.

The former civil servant says the situation is not unique to Scotland and that “most health services in the developed world are under pressure”, with the situation even more acute in less developed nations.

He adds: “The intersection of the pandemic, demographics and demand have created problems quite widely.”

In terms of how fundamental reform should be approached, Mr Gray says it comes down to investing more in community care to prevent the situation where people must enter hospital for treatment. He admits to asking himself if he “should have done more” when he was in the top job, to which he said “the answer to that is yes”.

But the former chief executive said those in control – both civil servants and politicians – are “always being pushed for solutions of today even although these might not be the best solutions for the long term”.

Mr Gray said: “I wish I put more emphasis on community care and prevention.

“My plea is we don’t focus solely on immediate interventions, otherwise we will simply be keeping a creaking system going rather than reforming it to what we need.”

Reform is already happening in some quarters with moves already being made to change the way care is delivered in Scotland.

A consultation was launched last month on plans to create a National Care Service, in what has been described by Nicola Sturgeon as a “fitting legacy from the trauma of Covid”.

WARNING: Ex-NHS boss Paul Gray says Scottish health care system is overwhelmed.