Take politics out of the NHS and focus on delivering excellent care
A column for outside contributors. Contact: agenda@theherald.co.uk
HEALTH care professionals have a responsibility to provide the public with accurate information in regard to issues related to health and disease. We know our colleagues in politics support this. They would also acknowledge thousands of health professionals who give dedicated service to the sick and extend the boundaries of health care with the resultant improvement in life expectancy and quality of life.
Political parties in Scotland have made a substantial contribution to this success story through their leadership in such issues as smoking cessation and minimum pricing of alcohol. In addition, Health Secretary Shona Robison has set the tone for more of a consensus approach to the NHS. There has been support from at least one other political party to work with the government in the best interests of the NHS.
However there remains a substantial political dimension to the NHS. This results in the public being faced with conflicting information from political parties about staff numbers, waiting lists and healthcare delivery. This causes understandable confusion among patients, the public and staff and undermines their confidence in the NHS.
Responsibility for information about the NHS does not solely rest with politicians. The media sometimes appear to be more focussed on negative aspects and this can fuel political disagreements. Doctors too must accept responsibility for seeking to safeguard their professional interests – often for good reason – but nonetheless inhibiting better solutions.
Financial responsibility must be grasped by NHS staff as well as by the government. It is clear healthcare will continue to claim a prominent interest in the life of the nation.
Scotland is one of many countries where there is a major political dimension to health. It is a key issue in elections because of its importance and this was seen graphically in the run-up to the independence referendum and the UK election.
Understandably, political parties have differing views on how the NHS should be run and indeed there are ideological differences. This leads to service having to undergo reorganisation as the government changes. Examples of this include fund holding status for GPs, awarding hospitals trust status, private funding initiatives and the use of the private sector to deliver services.
Politicians are very much aware any suggestion their local hospital might lose acute services can result in the loss of votes. Other plans – even when they are well thought through and have professional support – will be mothballed if there is any electoral risk. Therefore, in every four to fiveyear cycle there is a planning blight for a period of time in the run-up to elections. This is a feature of all governing parties irrespective of their political allegiance.
At a recent meeting of leading UK surgeons on the future of district general hospitals, one of the issues raised was the political dimension to changes in service delivery and the frustrations associated with this. There was unanimity that long-term health service plans were problematic because of the term-driven nature of our politics and potential change in the party or parties who form the government.
The NHS is one of the most fundamental components in our modern complex society and, not surprisingly it has also become a major political and election issue. It would certainly be a radical change if health could be depoliticised. There may be a way forward and there is support from a number of areas for setting up a health committee comprising representatives of the political parties and health advisers and chaired by Ms Robison. This would be the executive decisionmaking body. The finance for this would be the current arrangement and the delivery would be the responsibility of the government of the day.
Scotland has shown itself to be a world leader in many areas. Recent governments are to be applauded for the many areas of success in improving the health of this country. There is an opportunity to show leadership again by taking politics out of healthcare and ensuring our health service is driven solely by delivering excellence in healthcare for patients. Professor Frank Dunn CBE is President of the Royal College of Physicians and Surgeons of Glasgow.