The retiring convener of Holyrood’s Health and Sport Committee has criticised the pace of reforms to integrate health and social care five years on from their introduction.

In his final committee report before standing down at the May elections after more than twenty years in the Scottish Parliament, Labour MSP Lewis Macdonald said ‘meaningful progress’ with integration continues to be ‘slow, inconsistent and fragile’.

This echoes previous findings by Audit Scotland in 2019, as well as this year’s independent review of adult social care.  

Following the review Health and Social Care Scotland chair Vicky Irons admitted the funding system in the current model had led to “tension” between NHS boards and local authorities.

The nine-member Holyrood Committee is responsible for scrutinising more than £16bn of health spending pencilled in for the 2021/22 financial year.

But in a report produced to mark the end of the current five-year term of Parliament, the MSPs say it is “beyond the scope” of one committee to oversee more than 50 public bodies in its remit.

This includes 31 integration authorities and more than 20 national and regional health boards, as well as regulatory and improvement bodies and local councils.

They recommend ‘the whole area of social care’ should be split off and given to a new committee to ease workload.

In his own reflections, Lewis Macdonald accused the Scottish government and public bodies of a “defensive response” when faced with criticism and said they hid behind processes to the “almost complete exclusion of outcomes and the views of the public”.

Commenting on today’s report, Lewis Macdonald said: “This pandemic offers a once in a lifetime opportunity to reform and modernise the health service and it is one that must be grasped.

“We’ve seen more rapid change in the last few months due to the pandemic than we’ve seen in many years, but there is still so much more to be done. Across the sector, everyone agrees that integration of health and care is the way forward but progress has been chronically slow.

“Our Committee is frustrated that despite repeated promises over the last five years to modernise and improve IT systems, which would allow for better data sharing and improved service across the health service, nothing useful to users has been delivered.”

A 2020 report from the Health Committee that heavily criticised NHS Scotland’s approach to medicines for not being patient-centred proved controversial, with GPs and hospital pharmacists pushing back against the claims.

Speaking at online seminar convened by healthandcare.scot to discuss the 2020 report’s findings, senior GP Dr Andrew Buist, Community Pharmacy Scotland’s Matt Barclay and committee representatives agreed more needed to be done to improve out-of-date prescription systems and introduce a promised single digital platform that health professionals could access.

Mr Lewis added: “We have been struck in a number of our inquiries by a lack of leadership across the public sector, barring a few notable exceptions and real leadership is what we will need if we are to see the systemic change required.”

Read more: MSPs accused of undermining trust in NHS; Committee calls for end to “crisis driven” care; MSPs demand end of 9-to-5 GP services

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