A retired consultant surgeon and former president of the Royal College of Physicians and Surgeons of Glasgow is calling for “serious change” in the direction and leadership of the NHS in Scotland.

Mike McKirdy was commissioned by the Scottish Labour Party to undertake an independent review into the state of Scotland’s NHS, adopting a similar approach to that taken by Lord Ara Darzi in his assessment of the NHS in England for the UK government.

In his report, Mr McKirdy concludes that “more of the same will not be enough” to save the NHS for future generations.

He points to a mismatch between new policy initiatives and change on the ground – calculating that there have been more than 130 major health strategies published since 2007, the equivalent, he says, of one every seven weeks.

The report warns that the founding principles of the NHS in Scotland “are becoming strained and frayed” and current trends risk “entrenching a two tier system where access depends increasingly on ability to pay rather than clinical need”.

Mr McKirdy says there has been a long-term failure to modernise the NHS in Scotland.

He contends that performance was declining on key measures prior to the pandemic and that challenges in the NHS were not caused by COVID but, instead, the pandemic simply “exposed and enhanced” existing weaknesses.

The report echoes worries raised by health unions of staff burnout, and also a culture that can make it difficult for frontline staff to raise concerns around patient safety,

Mr McKirdy says the challenges “are not insurmountable, but they do require a fundamentally new approach” and that “serious change” is needed in the direction and leadership of NHS Scotland:

“The NHS is a treasured institution,” Mr McKirdy says. “Its founding principle, that care should be free at the point of need, remains deeply valued in Scotland. That it should be there for us at the start of life, all the way to the end, is a unifying and equalising concept.

“Its staff are proud of the work they do and the care they give is valued and respected by the public.

“Yet, as the service comes under increasing pressure, these principles are becoming strained and frayed.

“As confidence in the NHS to be available declines, so too the commitment to the sharing of the risk of ill health and the common good of our shared life is in danger of becoming lost.

“But, before remedy is possible, diagnosis is required.

“Therefore, this report considers many aspects of the NHS in Scotland, from patient access to the quality of services, the governance arrangements and productivity. It considers hospital activity, emergency and repeat admissions, delayed discharges, patient safety, avoidable mortality, preventive health measures, and inequalities in outcomes.

“The health system must operate within its own specific context, so the report also considers the wider health and inequalities within Scotland and the role of prevention.

“To deliver the outcomes needed, serious changes are needed in the direction and leadership of the health service."

Scottish Labour Leader Anas Sarwar said:

"Our NHS is our most precious public service, but as doctors themselves have warned the very existence of the service is in danger.

"The situation uncovered by the McKirdy Report is one of governmental failure with Scots paying the price…

"Enough is enough – we don’t need more undelivered strategies, we need bold and meaningful change to fix our NHS and to tackle the waiting list crisis.

"That's why a Scottish Labour government will declare a waiting times emergency, cut NHS red tape and empower Scotland's doctors and nurses."

Scottish Labour Deputy Leader and health spokesperson, Jackie Baillie added:

"The McKirdy Report is a vital intervention and a major piece of work in uncovering the crisis in our NHS.

"The NHS is Labour's greatest achievement, but the simple fact is that over 18 years of SNP government failure has pushed the service to breaking point.

"We cannot allow the people of Scotland and those who work in our NHS to continue to pay the price of SNP failure.

"This is why the analysis provided by this vital report will play a major role in informing the policy and direction of Scottish Labour's plan to fix our NHS."

 

In the run up to next May’s Scottish election, healthandcare.scot will report periodically on policy initiatives put forward by all the political parties as they affect health, social care and life sciences.

 

Read more: Staff express concern over latest NHS reform plans; New directions to NHS on staffing and deficits; Labour: We’ll fix the NHS, starting with GPs

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