Tough questions about the NHS that loom over us all
HE NHS – in Scotland as elsewhere in the UK – is all too aware of the continuing mismatch between patient expectations and what the service is actually able to provide. Further painful evidence of this widening gap emerged yesterday.
New figures show that patients in Scotland are having to wait longer than ever for treatment, key diagnostic tests and outpatient appointments. The figures do not make palatable reading and most of our health boards are failing to meet key targets. The Scottish Government has exerted pressure on them to strive to eliminate waits in excess of 16 weeks. It all brings to mind an evocative phrase uttered last September by the president of the Royal College of Surgeons – that the NHS was missing so many of its key performance targets that it had entered “the perpetual winter of Narnia”.
We must, however, bear in mind the words of Simon Barker, chairman of the BMA’s Scottish Consultants Committee, that the Scottish NHS’s deteriorating resources are being stretched – by an ageing population, by new technologies in drugs and healthcare and by the growing number of patients who, equipped with the results of their Google searches, know precisely what treatments are available to them.
Encouragingly, the Scottish Government has announced a programme of investment and reform to reshape the delivery of care and improve NHS performance. More resources will be channelled in the direction of social care and community care, the aim being to keeping people healthy at home for as long as possible. Yet does more need to be done? The report, Realising Realistic Medicine, by Dr Catherine Calderwood, the Chief Medical Officer, which is laden with insights that are worth pursuing, might be an excellent place to start.
Mr Barker raises a telling point, though. Which would we rather see? Increased healthcare investment to meet demand, or a more limited, more selective, NHS? It is an unappetising choice, but it is a question that must be debated as a matter of urgency.