National bargaining in social care, £10bn to modernise NHS infrastructure and legally enshrined visiting rights for care home relatives are among the key announcements included in Nicola Sturgeon’s first post-election Programme for Government.

Ms Sturgeon set out her administration’s stall on the same day the Prime Minister delivered a statement on health and care reforms south of the border, including a tax rise to pay for extra health and care spending affecting employers and everyone in a job across the UK that has provoked a significant backlash.

The first programme for government since being re-elected in May, it comes as the First Minister is in many ways facing a mountain to climb when it comes to health and social care.

The latest statistics show delayed discharges reached pre-pandemic levels in July; nearly 1,800 children have been waiting over a year for mental health treatment as CAMHS waiting lists have hit their highest point on record; and nursing and midwifery vacancies have reached record highs as over 4,800 posts remained unfilled.

A new report published yesterday concluded around 7,800 deaths a year could be prevented through public health action on alcohol, tobacco and junk food, but that progress was being held back by fears over ‘unpopular’ policy decisions.

Covid-19

Just as public services continue to endure unprecedented strain, Scotland remains “riven by inequalities”, according to the nation’s Auditor General Stephen Boyle in a blog post released just hours before the Programme for Government.

He says there is a consistent and “major” implementation gap between policy ambitions and delivery on the ground, and that a radical rethink was needed to ensure public sector leaders feel accountable for delivering change.

Nicola Sturgeon however promised today that a covid recovery bill would be introduced to embed reforms in public services to help build resilience against future health threats.

She said a wider covid recovery strategy was due for publication soon focusing on those hardest hit by the pandemic.

While Scotland experiences a surge in covid cases as autumn and winter loom, the First Minister promised to continue the drive to vaccinate all eligible Scots and introduce a self-isolation bill that she said would ensure health boards could focus on key services, while local and national government supports those asked to self-isolate. The government is also committed to broadening the range of healthcare staff who can deliver vaccinations in future.

A National Care Service

As a remedy to historically low rates of pay within the care sector, Ms Sturgeon said government would look to deliver national bargaining within social care.

Little more new information was provided by today’s statement on the “most significant public service reform since the NHS”, as the First Minister reaffirmed that a National Care Service Bill would be introduced within the parliamentary year, with the intention that the NCS will be operational by the end of the parliamentary term. Non-residential care charges would be abolished under a national service.

Reform is to be accompanied by investment she said, including £800m for social care as part of a 25% rise in spending over the next five years.

Care Home Visiting

A particularly harrowing issue for many over the course of the pandemic has been a lack of contact between elderly and vulnerable care home residents and their loved ones.

Today’s programme includes a commitment to Anne’s law, that would give nominated friends or relatives the same access rights to care homes as staff in a bid to avoid any repetition of the isolation experienced since covid struck.

The NHS

Nicola Sturgeon today reaffirmed a commitment to implement the NHS recovery plan with its ambition to increase NHS activity to 110% of pre-pandemic levels, which applied to inpatient, day case and outpatient activity – albeit not in the original one year timescale of being re-elected.

The plan will see inpatient and day-case capacity increase by 10% over the next 18 months and by 20% over the next five years.

Outpatient capacity will be increased by 10% by the end of the Parliament, with a “mix of innovation and extra capacity” delivering 90,000 more diagnostic procedures.

The recovery plan is backed by over £1bn of funding with Ms Sturgeon confirming today an increase in investment in frontline health services of 20% over the next five years, meaning by 2026-27 the frontline health budget will be £2.5bn higher than it is at the moment.

Primary care investment will rise by 25% by end of the current Parliament, with over half of frontline funding to be spent in community care so more care delivered closer to home.

Ministers are promising to spend any additional funds from the UK Treasury – as a result of today’s spending announcements down south – only on health and care.

Dentistry

Having removed dental charges for everyone under 26 since re-election, Ms Sturgeon reaffirmed the government would move ahead with plans to abolish dental charges for everyone by 2026.

Mental health

An additional £120m is to be invested in mental health services in the coming year, and direct investment in mental health services is to rise by 25% over the parliamentary term, ensuring mental health commands at least 10% of frontline health spending.

The First Minister outlined an intention to focus on prevention and early intervention as the country deals with the fallout from covid, and to support implementation of the national child and adolescent mental health services (CAMHS) specification and clear historic waiting lists in CAMHS.

NHS estate

As well as confirming support for the replacement of Edinburgh Eye Pavilion, Ms Sturgeon promised investment in the modernisation of the NHS estate with capital investment of £10bn over the next decade, including completion of the national network of treatment centres.

As announced in the recovery plan, 1,500 additional NHS staff members will be recruited to support this network and centres in Fife, Forth Valley and Highland are to open next year.

Public health

When it comes to support action to tackle alcohol misuse, tobacco consumption and obesity, the Programme for Government promises to, over the course of the parliamentary term, double to £100m investment in sport and active living.

The programme also contains a commitment to introduce legislation to restrict junk food price promotions in supermarkets as part of a broader public health bill.

Similar legislation was promised in the 2019 Programme for Government, but was later shelved because of covid and the new proposed public health bill is unlikely to be considered before 2022-23 at the earliest.

Drug deaths

The First Minister has promised to respond to seven years of rising drug deaths “with urgency and a deep sense of responsibility, guided by lived experience”. £250m of additional funding is to be invested across the course of the Parliament to support better treatment, outreach, rehabilitation and aftercare “in every part of Scotland”.

Ensuring access to same-day treatment as well as a wider range of treatment options will be the focus going forward, Ms Sturgeon said, alongside guaranteed funding for community grassroots organisations.

Palliative and end of life care

The Scottish government says it will develop and publish a new national strategy for palliative and end of life care that ‘takes a whole system, public health approach’. There will also be investment of £7m in being able to deliver paediatric palliative care in all parts of Scotland.

National Pharmaceutical Agency

A new NHS National Pharmaceutical Agency is to come into being by 2025, with work beginning this year, which the government says could include expanding manufacturing capabilities for both generic medicines and medicines that are specially manufactured to meet the needs of individual patients, as well as supporting investment in research and development “to bring new medicines and jobs to Scotland”.

 

Read more: Where is the social care recovery plan?; Care Service plans ‘attack on local democracy’; Manifesto to mandate: the SNP on health & social care; Comment: Can we afford a national care service?

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