More money for the NHS is needed, but so is reform

Public may be happy to fund the health service, but this crisis doesn’t just need cash, it needs current resources to be properly targeted

Any complacency that the NHS in Scotland is immune from the crisis that has hit hospitals south of the Border this winter will be dispelled by the intervention yesterday from Dr Peter Bennie, chairman of the British Medical Association in Scotland.

He spoke of a health service in Scotland stretched to breaking point and in need of more staff in all posts. Figures claiming that doctor numbers are at a record high are not relevant, he argued, when there are vacancies across the country.

His intervention followed heated exchanges at First Minister’s Questions last week when the SNP’S stewardship of the NHS came under fire from the Scottish Conservatives and Labour. Dr Bennie pointed to vacancies “right across the country – urban, rural, hospital, GP… We’re stretched pretty much to breaking point, just trying to keep things going.”

After a torrent of reports in recent days highlighting queues at accident and emergency centres across England, it is clear the NHS is struggling with the surge in demand over the winter period. And, as if that was not enough, now come reports south of the Border that cancer patients are having their operations cancelled amid “tremendous pressure” faced by the NHS. A shortage of beds is cited as one of the causes. With total health spending down south at £120 billion, such a basic shortcoming seems astonishing.

But for Scotland, where health spending has also hit a record high, and as the UK as a whole is faced with an ageing population, demand for NHS services is rising inexorably. It is inevitable that, yet again, winter weather headlines are accompanied by reports of “NHS in crisis” and a political spat over funding.

Confronted with distressing TV images of patients on trolleys lining hospital corridors as they await treatment, many now say they would support an increase in tax to help relieve pressures on the NHS. But there also needs to be a critical review of how and where extra money would be spent.

More resources at GP surgeries might alleviate the pressure at A&E centres. And the continuing drive to build super hospitals and close local cottage hospitals surely requires a serious rethink.

Higher spending on social care is also being urged, with greater emphasis on convalescence at home so that hospital patients can be discharged more quickly. Calls for modest patient charges to be introduced, together with fines for missed appointments, are also fast climbing the political agenda.

But voters would be much readier to agree to an increase in taxation were they reassured that this would be accompanied by reforms that would help ease the pressure at the doors of A&E units. More money handed over to an already colossal NHS budget will not allay concerns over unwieldy administration and bureaucracy and that the service is responding in the most efficient and appropriate manner.

At the very least, Dr Bennie’s remarks serve as a warning that NHS Scotland is far from free of the problems now besieging health care across the UK.