Health Checks – the NHS and Scottish economy

Two health checks were published today. One focuses on the NHS, the other on Scotland’s fragile economy and, as with all health M.O.T.s, there’s good news and bad.

First up, the annual report of NHSScotland. The Chief Executive Dr Kevin Wood took great pleasure in disclosing what he called a record of “achievement and improvement”.

And yes, there’s much to celebrate. A raft of targets have been met: heart disease mortality in deprived areas; cancer waiting times; the number of kids registered at dentists.

But in others areas there’s cause for concern – particularly on staff absence. The 4% target was missed – again – with the rate last year coming it at 4.95%.  That sounds like a near miss, but it means more than 13 million hours were lost from the frontline due to sickness last year alone.

In other areas it’s seems the concept of a target is, to put it kindly, somewhat fuzzy.

Take ambulance response times. The Scottish Ambulance Service aims to respond to 75% of life-threatening calls within eight minutes – thus maximising the patient’s chances of survival. (Why it’s 8 minutes, not say 5, 6 or 7 minutes I can’t say.) Today’s report states proudly: “target delivered”.  

Really? Well, yes in March of this year (the last month of the financial year) the rate did indeed hit 77%. Job done. But look closer and that was the only month over the entire year in which the threshold was reached – is one out of 12 really pass marks?

In fact the average over the year was just 70.7% – well below target. By my calculations that means 43,000 category A – life threatening – incidents weren’t reached within the eight minute target – that’s 120 per day. Now progress is undoubtedly being made – but tell that to the relative of someone who died while waiting for an ambulance to arrive.

And so, on to the second health check of the day: the 2nd annual report of the Scottish Council of Economic Advisers.

Appointed in 2007 – these ‘wise men’ were appointed as Alex Salmond’s gurus on the economy.  Today they delivered their latest prognosis – a difficult period lies ahead, they say, with slow growth at best.

That was the good news for Mr Salmond.  The Council went on to flatly contradict the Scottish Government’s approach to driving up standards in Scotland’s schools.

The advisers are “sceptical that the simple objective of reducing class size, as a method of improving teaching, will prove sufficient”. It comes at the end of a week in which Fiona Hyslop was sacked as Education Secretary in part due to a lack of progress in cutting class sizes.

Ironic then that, just days later, the Council says teacher quality is far more important than the number of pupils per class. Not that a change in government policy is likely – the concept of cutting class sizes is now too deeply engrained across Holyrood.

There was some better news for the FM. The Council restated its demand for Holyrood be get borrowing powers (to fund projects like the replacement Forth Crossing).

It also states that while Scotland’s reputation for “prudent” financial management has been damaged over the last year (see RBS and HBOS), it can be rebuilt. To do so, the Council’s says a more interventionist approach is needed – it blames the UK’s “laissez-faire” approach for the reduction in corporate HQs in Scotland.

The Council says if that doesn’t change Scotland risks being relegated “to the periphery in Europe” for high value activities – and therefore jobs.  All useful sentiment for Mr Salmond in the debate over independence. 

So mixed news for both the NHS and Scotland’s economy – it’ll be a while before either gets the all clear.