None of this Sturgeon’s 100 days in Office pish from me. It’s a total media fabrication that means nothing. I am asking though if we can do politics differently for a change and actually improve public services.
The NHS ‘crisis’ is a case in point. Here we see the classic ritual dance – you go left and I’ll match you, lean the other way, and I’ll follow. Then we go round in circles and eventually fall down exhausted with no advance on understanding or development of delivery to the paying public. (The answer if you’re John McTernan in Murphy’s office is to privatise the lot and leave it to the market…brilliant)
There is no NHS crisis, I’m sorry to have to tell you doom-mongers. But there are lots of mini crises in doctors’ surgeries, clinics, hospitals and outpatients’ and very definitely in the management executive offices of the administrators charged with steering the runaway train.
There have always been such crises and there will always be crises because the NHS is an anthill teeming with activity, constantly reassessing in light of events, learning by mistakes and determined to try and get it right. It is also infected with low morale and downright callous people of a kind you might encounter just about anywhere in our routinely inarticulate and occasionally fierce wee country. (Like the nurses who told a woman in her nineties to ‘clean it yourself’ when she said the toilets needed washed).
Everybody in the health service knows this and deals with it as best they can. What they don’t do automatically is blame the government because they don’t have time to spend with a needy patient or because they’re on-shift at the weekend again. They wrestle instead with heads of department and managers and expect it to be run more smoothly but, like drivers in a jam on the A9, they don’t immediately think it’s the fault of the Transport Minister.
Ultimately the chain of command leads back to St Andrews House, it’s true but there are in the region of 25,000 admin staff in the Scottish NHS http://www.isdscotland.org/Health-Topics/Workforce/Publications/2013-11-26/2013-11-26-Workforce-Report.pdf?10242861510 with salaries ranging from £43,400 to £174,000 http://www.sehd.scot.nhs.uk/pcs/PCS2013(ESM)03.pdf
whose job is to make it run efficiently before a report drops on Shona Robison’s desk.
I worked in the public sector and rarely did I blame the Culture Minister for arranging inconvenient shifts at BBC Scotland. I don’t mean it’s not the government’s responsibility (in England they’ve specifically said it ISN’T the minister’s job, a la McTernan) but that the government lays out the strategy and it’s up to managers and staff to get on with it, including allocating beds.
If winter conditions cause a flood of confinements, whose job is it to unearth an extra 20 beds at short notice – the minister’s? You can argue the funds should be there although I doubt if anybody can properly predict need except basing it on precedent. But surely allocating budget need is why there are accountants in the admin block and executives with big desks…
Is missing targets guaranteed by legislation a crisis or a self-imposed PR gaffe created by a politician’s desperation to be seen acting in the public interest?
The point is that these are all long-term, unavoidable issues that have recently been conflated into a bigger ‘crisis’. It’s in the Record, it’s asked at FMQs and the Labour canvassers are handing out the leaflets on the doorstep all bigging up the NHS failure.
Labour’s strategy was ruthlessly exposed when they rushed in to attack the NHS with inaccurate figures on cancelled operations. It’s a scam and public confidence in the NHS and the SNP’s credibility to run it prove the point. I sometimes wonder what the staff make of it all.
What to do? Well, instead of putting on her starey eyes and her ‘Ah’m no kidding’ voice, Kezia Dugdale at FMQs might like to offer a solution. So far we’ve heard an extra 1000 nurses – a nice round sum, no? Why not 500? Why not 2000? Where would they go? Would they get specialist training? Why not 500 nurses and a few dozen consultants that we need? What’s the priority? Would they have a mobile bed centre for the winter seasonal rush? Or build more care homes for those well enough to leave but unable to fend independently? How would they deal with poor decision-making by managers? Would they toughen the disciplinary regime to make it easier to sack poor performers? What would they do when the whining stopped? Is stamping a foot really all she can do…or is there a young/feminist/progressive angle that one of her generation can finally bring to our debate.
Just as the SNP endlessly praise the service, giving the sense that there’s no need to worry, so Labour destroy the currency by running it down.
I suggest we stop the Carry on Nurse routine and invite Labour into the decision-making process. Seriously. The opposition nominates a representative, presumably Jenny Marra, who is invited to take part in all government discussions about the drift and range of health provision in a cooperative spirit to have Labour input at an early stage of policy planning. That way they get a chance to influence, they can see precisely where the challenges are and can appreciate where and why they disagree and can refine their arguments accordingly. No opposition person can be held responsible for any decisions made and is in no way held accountable. It’s a no-lose proposition. And it’s constructive.
It provides dialogue and perspective and deepens understanding. It might lead to the end of the shroud-waving embarrassment of Labour’s PR offensive. Think Labour would go for it?
It would be a nice way to mark 100 days of Sturgeon. Better than: You done OK, henby