Kate Forbes: I back ‘national conversation’ on NHS but it must lead to results

Former finance secretary Kate Forbes backed calls for a “national conversation” on the NHS, saying “without urgent interventions there might not be an NHS to reform in a few decades”.

The SNP MSP said only NHS workers kept the health service from “keeling over” in 2023 and despite their “herculean efforts” patients are “waiting too long for almost every service”.

Writing for the think tank, Reform Scotland, she said NHS staff were “plumbing new depths of fatigue and pressure”, adding that she knew doctors and nurses who work over their hours every shift.

The Skye, Lochaber and Badenoch MSP supported the idea of a “national conversation” about the service and its funding, but stressed it must lead to results.

Dr Iain Kennedy, chairman of the British Medical Association (BMA) in Scotland, previously warned the NHS in Scotland may not survive the next 25 years without such action.

Former NHS Scotland chief executive, Professor Paul Gray, has also called for a conversation on the NHS – leaving open the possibility that some services could become paid for in the future.

Ms Forbes wrote: “In principle, who could disagree with the need for a frank debate? But only if it leads to results. We’ve heard talk of reform in the NHS for years – but without urgent interventions there might not be an NHS to reform in a few decades.

“The greatest risk, however, is the wrong diagnosis of the root causes, which will be inevitably followed by incorrect treatment.

“Everybody can list the symptoms: waiting times; a shortage of workers; bed blocking. The problem comes when politicians and commentators immediately jump to conclusions and suggest certain treatments which would almost certainly exacerbate the symptoms.

“You hear some insist that it’s the public sector to blame – if it were privatised it would become more efficient. Others condemn the shortage of money – if every penny of the devolved settlement was expended on the NHS, we’d wave away the problems. Both are ridiculous suggestions.”

She set out four parameters for the conversation: “zero tolerance” of moving away from the founding principles of the NHS; a focus on patients and need for government to take “tough decisions”; no extra bureaucracy; and the need for “simpler changes” regardless of structural reform, such as freeing up management money for frontline staff.

Health Secretary Michael Matheson said: “NHS Scotland staffing is at record levels and December’s Budget provided funding of more than £19.5 billion – protecting health and social care delivery in the face of unprecedented fiscal pressure.

“Under this Scottish Government, Scotland’s NHS will always remain in the hands of the public and be free at the point of use.

“We know our approach to planning and delivering health and care services needs to change to enable recovery. Our Policy Prospectus and Programme for Government is explicitly clear: reform is required.”

He said the fundamentals of Scotland’s NHS will not change and shared long-term planning work for health and social care continues.