The ongoing delay to the new Edinburgh Sick Kids Hospital is a scandal but one with no ready political remedy.
Ordinarily, the health secretary responsible could be expected to resign, but Nicola Sturgeon shows no sign of turning in her ticket.
The First Minister was cabinet secretary for health back in 2012, when she first announced then failed to deliver the new children’s health facility. The most recent opening date for the £150m centre was July, but that had to be postponed too after inspectors discovered faults in the critical care unit’s ventilation system at the last minute.
While health secretary Jeane Freeman is now in charge of the NHS — nominally, at least — the problems with the Edinburgh Sick Kids began with her boss. Freeman can’t very well point the finger in that direction but nor can Sturgeon throw her subordinate to the wolves without inviting scrutiny of her own role. They’re in this together, for now.
Last week, Freeman admitted a further £16m worth of repairs were needed to the Sick Kids and would take at least a year. Sturgeon told First Minister’s Questions: ‘The situation is unacceptable. To say that the health secretary and I are angry about it would be an understatement.’
If emoting could be prescribed on the NHS, the First Minister would give GlaxoSmithKline a run for its money.
Last week also saw the General Medical Council take the rare step of placing the internal medicine department at Glasgow’s Queen Elizabeth University Hospital under ‘enhanced monitoring’ amid fears a shortage of doctors has made the site an ‘unsafe working environment’. The move could result in junior doctors being withdrawn from the department altogether.
There are now calls for a public inquiry into the scandal-plagued hospital, where earlier this year two patients, one of them a child, died from an infection caused by pigeon droppings. The twin rows over healthcare in Scotland’s two biggest cities raise critical questions about the ability of the SNP government to run Scotland’s NHS and cast a cloud over Jeane Freeman’s long-term political future.
In their 2015 election manifesto, the Nationalists rebranded the NHS, ‘NHSNP’, depicting a nurse’s uniform with the NHS logo replaced by their new partisan acronym. We can only imagine the baying outrage if Boris Johnson’s Tories tried this but, then, the SNP is held to a different standard.
Still, if they want NHS Scotland to be known by that monicker, it would be impolite not to oblige when we come to consider its performance. Not only has the NHSNP delivered two hospitals where you risk coming out sicker than you went in, Scottish Government statistics show it is letting patients down across the board.
The NHSNP is missing its 12-week treatment target for inpatients, its 12-week treatment target for outpatients, its 18-week referral-to-treatment target for all patients, and its six-week target for diagnostic test results.
Ninety per cent of patients referred to psychological therapies are supposed to begin treatment within 18 weeks of referral, a target the NHSNP introduced for itself in December 2014 and which it has failed to meet in every single quarter since. Today, more than one-in-five patients suffering mental ill-health are waiting longer than 18 weeks for help.
Almost a fifth of patients referred with suspected cancer wait longer than the 62-day ‘maximum’ to begin treatment. Less than two-thirds of those in chronic pain are seen within 18 weeks of referral. Between July 2018 and 2019, the first year of Jeane Freeman’s ministry, more than 7,000 operations were cancelled by hospitals for lack of capacity or other non-clinical reasons.
This is the reality of the NHSNP, an indicting snapshot of a health service for which Nationalists want to take all of the credit and none of the responsibility. (It is also pretty damning of Miles Briggs and Monica Lennon, the Tory and Labour health spokespersons, that they struggle to land a blow on a government with a record this dismal.)
NHS Scotland has always been dogged by problems, not least the short-termist practice of appointing troubleshooter health secretaries rather than reformers. Until a government comes along that is brave enough to question some of the fundamentals of the NHS, the service will continue to stagger on in sentimental mediocrity.
Labour’s weakness was that it loved the NHS too much to reform it but the SNP’s problem is apathy. The Nationalists had nothing to do with the founding of the health service and its birth is not hardwired into the story of their party. They consider the NHS a good thing and recognise its untouchable popularity with the voters but it is not what got SNP ministers into politics and not what gets them out of bed in the morning.
Rebranding the health service NHSNP wasn’t just about linking the NHS with the SNP in the minds of the voters, it was about trying to crowbar it into the party’s defining mission: independence. It is no coincidence that 2012, when the Edinburgh Sick Kids missed its first opening date, is the same year the Nationalists launched their independence drive.
It is also when health secretary Sturgeon was parachuted into a new role as infrastructure secretary, a position so made-up it doesn’t even exist anymore. In truth, her ministerial burdens were lessened so she could take over the day-to-day running of the nascent campaign for separation.
The NHS could not compete with independence in the affections of the SNP and after almost a decade with the constitution as their sole priority, the Nationalists are starting to grasp the disrepair into which they have allowed the health service to slide. Jeane Freeman was brought in last year to ‘firefight’, a term management types use when trying to fix the mistakes of other management types, all of whom consider delivering basic competence akin to running into burning buildings for a living.
Freeman’s efforts thus far have had all the impact of a leaky water pistol. The average tenure of a Holyrood health secretary is 35 months; Freeman has been in post for 15. Fairness requires that she get the same chance to turn things around, not least because she inherited the wreckage of the Shona Robison years.
The signs, however, are not good. Twelve years of SNP government and none of their ministers seems half as capable of running the NHS as they do renaming it. If Freeman proves similarly inadequate, she will eventually follow her predecessors out the door. Who would follow her, though, and would they be any better?
David Cameron is back in the news, though if you count things he’s responsible for, he never went away. He has penned a book about that time he became Prime Minister and plunged the country into its worst crisis in a century that didn’t involve the Luftwaffe or an Egyptian waterway.
For the Record is his account and, if snippets in the Press and his promotional interviews are anything to go by, it will be a self-exonerating spin exercise. Boris Johnson and Michael Gove are said to be lumped with much of the blame for the outcome of the EU referendum and its destruction of Cameron’s premiership.
It wasn’t Boris who called the referendum. It wasn’t Gove who talked up the prospects of a deal from Brussels before the vote. Neither is responsible for the limp, aloof Remain campaign. David Cameron was the author of his own downfall and no pity-me autobiography is going to change that. His book is destined to fly off the shelves — and straight into the remainder bin.
Boris Johnson had to step in and save his rescue pup Dilyn from the claws of Downing Street feline, Larry. Larry was recruited by David Cameron but was perhaps put out when Boris brought in a Mogg of his own. The Tory tabby’s views on Brexit are unknown but we can’t rule out a defection to the Liberal Democats.