Aren't there too many bureaucrats in the NHS?

Meeting the needs of patients
The NHS is still run to suit the targets and demands of politicians and bureaucrats. Whether it is complaints over treatment or reduced levels of service it is clear the current culture creates barriers for patients, staff and local communities. The people who matter are the ones with the least say. But there are simple steps we can take.

First of all, our health service requires a patients’ champion, someone who will act in the interest of patients at all times. We will replace NHS Quality Improvement Scotland with a National Health Inspectorate, independent of government, to do this job. It will conduct regular inspections of general standards within hospitals, including cleanliness, hygiene, nutrition, standards of accommodation, fabric of buildings, and the general environment for patients and make clear recommendations for improvement.

Under the SNP, patients will come before profits. We will bring all hospital cleaning contracts back in-house to the NHS. Too many of our hospitals don’t meet acceptable hygiene standards and too many patients pick up life threatening infections while in hospital.

We will introduce a new Code of Practice for Health Boards to govern the way they inform patients when mistakes occur, and bring greater democracy through a directly elected element to Health Boards and Local Health Care Co-operatives.

We will make local health councils independent of the NHS and create a statutory independent patient body at national level to serve as the ‘voice of the patient’.

While we believe in the local delivery of health care, we will not tolerate postcode prescription. It is not acceptable for someone living in one Health Board area to access a drug, while someone in a neighbouring Health Board cannot. Therefore we will take steps to ensure that drugs which are deemed clinically effective are accessed equitably across the country.

Getting the structure right
There are also some vital structural reforms to undertake which will strengthen the delivery of healthcare nationwide. We want to simplify the structure and create a more accountable and transparent service, with devolved powers to allow communities to shape services according to their needs.

As first steps in that process, we will introduce three key reforms. We will introduce early legislation to abolish health trusts. We will review the number of Health Boards and we will give the remaining boards the lead role in strategic planning, budget holding and commissioning of services. And we will strengthen Local Health Care Co-operatives, by requiring Health Boards to devolve budgets and commissioning powers.

The SNP will also establish a National Healthcare Commission, chaired by the Health Minister, and comprising a range of professional and patient interests appointed by Parliament.

The job of the Commission will be to advise the Health Minister on the strategic direction of the NHS, and to subject the decisions of government to the kind of rigorous scrutiny that can only come from people who know, from experience, what works in the real world of health care.

Those who know best what is needed in the health service are those who work at its sharp end, and those who use its services. These voices need to be heard much more loudly when decisions are being taken.

Taken together our plans offer a new direction for the NHS in Scotland. A direction where patients and staff come first. And where your priorities are the priorities of our government.

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