Patients not getting right care in right place at right time, says Swinney

Patients in Scotland are not getting “the right care in the right place at the right time”, John Swinney has said.

The First Minister laid out a plan to improve Scotland’s ailing health service in a speech in Edinburgh on Monday, where he said waiting times for treatment were a “canary in the coal mine”.

Scotland has struggled with high waiting times in recent years, exacerbated by the pandemic, including in A&E, outpatient procedures and other hospital treatment – where hundreds of thousands are languishing on waiting lists.

Mr Swinney told an audience at the National Robotarium there were “crises” facing parts of the NHS, but refused to say later when asked by journalists if the whole service itself was in crisis.

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The First Minister announced plans to provide 150,000 more appointments and procedures, as well as a £10.5 million increase in funding for GPs as well as a pledge to give more funding to primary care in the future, and pledging the creation of “frailty teams” to be at every A&E in the country to help those who could “bypass” emergency departments and free up capacity.

In his speech, the First Minister said: “The first and most important thing on many people’s minds is how long it can take to access services: delays in access with waiting times too long, and delays in discharge because appropriate at-home or in-community care is not available.

“The two, of course, are fundamentally connected.

“Last year, I referred to delayed discharge as the canary in the coal mine of our National Health Service – I think of waiting times in much the same way.

“Both of these delays tell us that the flow of people through the health system is not happening as it should.

“Put more simply – people are not getting the right care in the right place at the right time.

“That is not acceptable to me, it is not acceptable to my Government.”

He added: “It is the very definition of a vicious circle and it has to come to an end.”

The proposals he laid out on Monday, the First Minister said, were “tangible improvements that we can and will deliver”.

As part of the plans to reduce waiting lists, Mr Swinney suggested turning some facilities: including Stracathro Hospital in Brechin; Gartnavel Hospital in Glasgow; and the Queen Margaret Hospital in Dunfermline; into “centres of excellence” in certain procedures such as cataracts or orthopaedics, providing transport support to patients to access the facilities, if necessary.

With the waiting list for procedures or tests sitting at more than 600,000 as of September 30, the First Minister told reporters after the speech he believed the backlog could be eliminated.

“It will be cleared,” he said.

“We will get the health service into a state of sustainability.”

In its budget announced in December, the Scottish Government pledged to reduce waiting times to less than 12 months for every Scot by 2026.

An app will also be created for the NHS in Scotland under the plans, which he described as the “digital front door” to the health service.

“Over time, it will become an ever more central, ever more important access and managing point for care in Scotland,” he said.

The service will be trialled in NHS Lanarkshire first before a full rollout.

The First Minister, who again called for MSPs to back his Government’s budget despite it being all but assured to pass due to the abstention of Scottish Labour, told NHS staff that while they will be the ones delivering NHS reforms, “it must also work for you” as he cautioned that “more laps of the track” will be required.

Scottish Labour deputy leader Jackie Baillie hit out at the First Minister after the speech, saying: “John Swinney talks about the pressure on Scotland’s NHS like he’s just noticed it – but he’s had nearly 18 years to improve conditions in our GP surgeries and hospitals.

“Indeed, this speech only shows how clearly the 2021 SNP Recovery Plan has failed.”

While Scottish Tory health spokesman Dr Sandesh Gulhane said the health service was in “permanent crisis mode”.

“(The First Minister) has been at the heart of an SNP government for the last 18 years who have grossly mismanaged the health service, yet now he expects suffering patients and overwhelmed staff to believe he has all the answers to fix this crisis,” he said.

“That simply won’t wash with them. The failures by John Swinney and successive health secretaries mean that patients’ lives are being put at risk every single day, hundreds of thousands of Scots are stuck on waiting lists and SNP promises in relation to the NHS have been broken time and time again.”

BMA Scotland chairman Dr Iain Kennedy added there is still a lack of detail in the plan, adding: “Previous pledges to increase capacity have not come to fruition, not least because such plans need the staff in place to deliver them.

“Yet at the moment, doctors are struggling to cope with simply keeping up with demand.

“It shows yet again that no plan for the NHS will work without a proper long-term workforce plan to ensure we have the staff needed to deliver it.”

While trade union Unison accused the First Minister of delivering the “same old promises”.

“The First Minister’s renewal framework, launched today, doesn’t begin to tackle the social care crisis, and staff will be angry after he said they ‘need to do more laps of the track’,” said the union’s co-lead for health Matt McLaughlin.

“NHS staff are working flat out, and they want to know what the Government will do now to tackle short staffing, over capacity and workforce stress – so they can get on delivering for patients.”