National Health Service Resource Allocation Formula

– in the Scottish Parliament at on 4 October 2017.

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Photo of Liam Kerr Liam Kerr Conservative

4. To ask the Scottish Government what plans it has to review the NHS resource allocation formula. (S5O-01318)

Photo of Shona Robison Shona Robison Scottish National Party

The national resource allocation formula is updated every year to take account of changing demographics across Scotland. The most recent review, relating to the morbidity and life circumstances adjustment for the acute care programme, was reflected in the NRAC shares issued for 2017-18 onwards.

Photo of Liam Kerr Liam Kerr Conservative

Vacancies and long waiting lists are leading to NHS Grampian patients potentially being sent as far as Newcastle for surgery. Under the allocation formula, NHS Grampian receives only 89p per head, compared with the national average of £1, which is a smaller share than it received a decade ago. The board also lost £15 million in the last financial year. Does the cabinet secretary accept that funding decisions made by the Government are causing delays and crisis in the north-east? When will the Scottish Government fund NHS Grampian at the level that the Government’s own allocation formula requires?

Photo of Shona Robison Shona Robison Scottish National Party

NHS Grampian’s resource budget for 2017-18 has increased to £898.6 million, which includes an additional £3 million of NRAC parity funding. Such funding ensures that no board is further than 1 per cent from its target share of funding. Since 2015-16, NHS Grampian has received additional funding of £47 million for the specific purpose of accelerating funding parity in line with the NRAC formula. Grampian has been one of the biggest gainers from the formula in recent years.

On the point about patients being sent to Newcastle, that arrangement is clearly part of a process of boards helping one another. Glasgow and Edinburgh are the first ports of call for patients from Grampian, to support Grampian while it recruits and works its way through some of its difficulties. Newcastle is the third option. I am sure that neither Liam Kerr nor anyone else in the chamber would suggest that we should not utilise resources wherever they are offered. This is not the first time that mutual aid has been given north and south of the border. That approach is to be welcomed and I certainly applaud Grampian’s efforts in doing that while it sorts out the recruitment issues in its area.

Photo of Anas Sarwar Anas Sarwar Labour

The health secretary must recognise that resource is not meeting demand in the NHS. Health boards are telling us that they are having to make more than £1 billion-worth of cuts over the next four years, and that is having devastating consequences on the workforce and on patient care.

One shocking example of that is the revelation that women in Glasgow who suffer a miscarriage are having to wait up to five weeks to have a surgical removal of the foetus. That is a shocking and heartbreaking revelation. What will it take for the cabinet secretary to wake up, realise that there is a problem in the NHS and give patients and NHS staff the treatment that they deserve?

Photo of Shona Robison Shona Robison Scottish National Party

Anas Sarwar raises two very different issues, and I will take the first one first. He will be aware that there are more resources going into the NHS than there ever have been before. Of course, under Labour’s proposals in its 2016 election manifesto, less money would be going into the NHS than we are delivering. However, he makes a point with which I would agree, which is that demand for the NHS continues to grow and put pressure on services, which is why we need to reform the way in which services are organised. We are working through the integration partnerships to ensure that more people avoid admission and are kept out of hospital, which is very important, given the growing frail elderly population.

Anas Sarwar spoke about a very serious case in NHS Greater Glasgow and Clyde that has been raised over recent days. I understand that a complaint has been raised about the case and a full investigation is going on, and I have asked the chief medical officer to look into the issue in Glasgow and the rest of Scotland. The initial indications from Glasgow and Clyde are that it is an isolated case. It is totally unacceptable and I am determined that we will absolutely not accept that standard of healthcare for anybody anywhere in Scotland, but it is not reflective of the rest of the service in Glasgow and Clyde. The chief medical officer is seeking assurance on the issue not just in Glasgow and Clyde but elsewhere, because I want to ensure that women across Scotland get the highest level of care, particularly in very sensitive circumstances such as this.