Doctors' diagnosis for devolution 2004 - Scotland

Main Category: Public Health
Article Date: 30 Dec 2004 - 14:00 PDT

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In a year when health services have once again dominated the headlines in Scotland, Dr Peter Terry, chairman of the BMA in Scotland considers the challenges that lie ahead for devolution and health in 2005:

"Our Scottish Parliament is maturing into an effective mechanism for creating legislation tailored to the needs of the Scottish people. We have already led the way for the rest of the UK, creating mental health and incapacity legislation that places the needs of the patient firmly at the centre. And now we can look forward to leading the way by making public places in Scotland smoke free by 2006. The BMA will now work to help our politicians produce good legislation and ensure that they are not influenced by the flawed arguments of the tobacco industry.

"We still have a number of public health challenges to face that can be resolved without banning them. Scotland still has an unhealthy relationship with alcohol, a love of foods that are bad for us and an aversion to exercise. We can still do much more to improve the health of our nation.

"There is a need to open up debate on increasing the capacity of the health service and work underway by both the Scottish Executive and Parliamentary Health Committee on workforce and service design will help to inform that debate. But as well as considering supply of services we must engage with the public and politicians to consider how we might modify demand in a way that is socially acceptable. Improvements in public health is one long term approach, but health education and self management of minor ailments are other methods that should be considered."

The reconfiguration of hospital services has stimulated public interest in the delivery of health services in local communities. This issue has attracted the attentions of MPs at Westminster and while the BMA recognises the need for them to be aware of constituency issues, Dr Terry warned against the involvement of UK politicians on devolved matters:

"With a Westminster election looming, it is vital that the Scottish Parliament doesn't roll over on devolved issues to satisfy the political security of MPs at Westminster. Devolution is not something that can be put away every fourth year but is something that politicians across the UK must embrace. While we can and should learn from successful initiatives in health service delivery in other countries, including England, we must consider distinctly Scottish solutions for our own health service. What works in Wolverhampton may not necessarily apply to Wick.

"One of the fundamental causes of ill health and pressure on the NHS is the increasing morbidity and mortality that results from the deprivation and poverty in our society. This is where we would like to see Westminster MPs focusing their attention."

The BMA is keen to highlight the strengths of devolution and welcomes many of the opportunities it creates. Dr David Love, deputy chairman of the BMA in Scotland said:

"This year we have seen that the Scottish parliament is prepared to pursue quite different health policies from the rest of the UK. The passing of the NHS Reform (Scotland) Act signalled a complete divergence from health service policy in England with the abolition of Trusts and the emphasis on regional planning. While debates on issues such as Physician Assisted Suicide which, through a quirk in the Scotland Act is a devolved matter, have raised public awareness on such vital matters. In this respect, the Parliament is working effectively.

"However, there are disadvantages to devolution. Health spending dominates the Scottish budget and therefore the political agenda. There is a real danger that change, for the benefit of patients, is delayed or prevented by narrow political interests."

Dr Love, also joint chairman of the BMA's Scottish General Practitioners Committee, spoke of the impact that new contracts for GPs would have on the health of Scots:

"I have no doubt that the new GP contract, which has been implemented this year, will produce positive results for the health of the people of Scotland. Investment in the provision of high quality care for all patients through the quality and outcomes framework of the contract provides a focus on ill health prevention and improved care for patients.

The flexibility contained within the contract should help to modernise general practice and improve recruitment and retention, particularly in remote and rural parts of Scotland."

Ends

For more information please contact:
Scottish Press Office
Tel: 0131 247 3050/3052 Mobile: 07979 510421
Fax: 0131 247 3051
Email: press.scotland@bma.org.uk

BMA Scottish Office
14 Queen Street
Edinburgh
EH2 1LL
Tel: (0131) 247 3000
Fax: (0131) 247 3001
email: info.edinburgh@bma.org.uk
Web: http://www.bma.org.uk/scotland
After 6.00 pm and weekends:
07979 510421

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