Sturgeon: cuts will make NHS better
In the first of a series of interviews with people who have an impact on health and health services in Scotland, Jennifer Trueland talks booze, tears and quality of care with health secretary Nicola Sturgeon.
- Cuts will make health boards more efficient
- NHS patient experience survey imminent
- Sturgeon detects shift in attitudes on alcohol
- She cried over hospital infections
Oh to have been a fly on the wall at a meeting last week between Nicola Sturgeon and the top managers of Scotland’s health boards.
She was, she said, quite prepared to tell them of her view that tightening NHS budgets could actually be good for care.
Having less money to play with might even help them achieve tough new targets, such as the 18-week referral-to-treatment time, she says.
Nevertheless, she confesses that the biggest challenge facing the health service is probably money.
“I suppose the overarching [challenge] is the tightening budget,” she says. “There are lots of challenges that the NHS faces but the fact that it will be facing them with tighter budgets is an issue.”
Certainly for the next financial year, she says, the health service budget is increasing (albeit not by much) but no-one knows what will happen after that. “We’re not in a cuts scenario,” she says. “You need to keep that sense of context about it, but it’s not growing as fast as it has been, so the NHS will face some tight times and all the challenges that come with that.”
The NHS is making progress, she says, citing the reduction in waiting times as an example. But much more needs to be done if the service achieves the next target of an 18-week maximum patient journey from GP referral to treatment.
This target, which is just under two years away (December 2011) will mean huge improvements on existing targets, which were to reduce waits to 15 weeks from GP referral to out-patient appointment (by 2009, reducing to 12 weeks in March 2010) and the same again from out-patient appointment to treatment. “They are delivering ahead of schedule,” she says. “The programme is ahead of itself. That’s not to say the remaining part of the journey won’t be challenging, but I’m pretty confident that we’ll get there.”
Even with expected budget squeeze? “I know it’s looking for a silver lining in a cloud,” she says, not particularly apologetically. “The budget is tough, but it does force boards to look at how things can be done better and in a more efficient way.
“It’s not economical for boards to have lots of patients sitting on waiting lists for longer. It’s not economical or efficient to have different parts of the patient journey measured separately, with gaps between them. So it actually makes sense from an efficiency point of view to have a referral to treatment target, to have the patient journey measured in a more seamless way.
“There are elements to which the tightened financial circumstances, although it’s going to be difficult, and not just for the NHS, will force a pace on to some of the reforms and efficiencies that perhaps in times of plenty, there’s not the same appetite or momentum around.”
I tell her I’d love to hear her tell NHS chief executives that. “I’m seeing them tomorrow, and that’s exactly what I’ll be telling them,” she laughs. “I’ll say: ‘See these tightened budgets, it’s the best thing that’s ever happened!’.”
It’s a refreshing thought isn’t it. We all know that having less to waste makes is do more with what we have.
That understanding seems to disappear the minute we talk about public spending. Personally I put that down to Brown the clown who’s spent 12 years trying to con the British public with money he never had in the first place.