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National Health Service (Use of Private Sector)

– in the Scottish Parliament on 21st November 2019.

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Photo of Richard Leonard Richard Leonard Labour

2. Yesterday, the Minister for Public Health, Sport and Wellbeing told Parliament:

“This Government is absolutely committed to a publicly owned, operated and commissioned NHS in Scotland.”—[

Official Report

, 20 November 2019; c 70.]

Does the First Minister agree with her minister?

Photo of Richard Leonard Richard Leonard Labour

The uncomfortable truth is that private firms are being brought in by this Government to carry out routine operations at the heart of our public health service. Last night, I spoke to a national health service clinician. He had contacted us to raise his concerns about a plan to contract out to a private healthcare provider knee and hip operations at Gartnavel hospital in Glasgow. He told me that the hospital’s own clinicians have been cut out of the planning of that, that the health board has presented it as a “fait accompli” and that it was “directed from Edinburgh”.

There is anger among NHS clinicians and local NHS staff who work at Gartnavel. They are concerned that they have not been involved in the setting of clinical priorities or in carrying out those procedures. However, if there are complications, they will be expected to step in. Continuity of care is critical. No wonder the clinician to whom I spoke said to me last night that he was “deeply uneasy” about this. Is the First Minister at all uneasy about this?

The First Minister:

I will point out some facts to Richard Leonard. First, we listen to the concerns of clinicians whenever they express them and we act on those concerns. However, I will address the issue of spend on the use of the private sector in NHS Scotland. In Scotland, that spend represents right now 0.6 per cent of the front-line health budget; in England, the corresponding figure is 7.3 per cent. The independent private sector is used in Scotland at the very margins; that is fully set out transparently in our waiting times improvement plan.

It was the case, if memory serves me correctly—I am happy to stand corrected if I am wrong about this—that the independent private sector was used in NHS Scotland to a greater extent under the previous Labour Administration. Further, I heard Jeremy Corbyn and the shadow health secretary of United Kingdom Labour say that they would continue to have that kind of approach in NHS England.

How do I know about the record of the previous Labour Administration in Scotland? That, of course, is because I was the health minister who nationalised Stracathro hospital, which had been earmarked for use by the independent sector by a Labour health minister in the previous Administration.

I will take no lectures from Labour on those issues, particularly after last night. Richard Leonard wants to talk about what happened in the chamber yesterday, so I point out that, last night in the chamber, Labour voted with the Conservatives against an NHS protection bill that would safeguard our NHS from trade deals with Donald Trump. Shame on Labour for that.

Photo of Richard Leonard Richard Leonard Labour

The First Minister said that she would use the so-called independent sector in a structured way based on clinical priorities. How can she do that without the involvement of the clinicians in the hospital where the procedures are being carried out?

That is not the only example of a private company being brought in regularly to carry out clinical procedures at Gartnavel hospital. Medinet, which is a business that is funded by venture capitalists, is also used to carry out operations there. The First Minister must take responsibility, because that is a result of failures in resource and workforce planning. It is nobody else’s legacy—it is the First Minister’s legacy. It is a legacy that has led to private not public provision.

It is a matter of record that NHS Greater Glasgow and Clyde has been allocated £34 million of Scottish Government funds to bail out the Government’s waiting time failures. For the record, will the First Minister today tell us how much of the £34 million for the NHS is being hived off to private sector providers, their profit margins and their shareholder dividend payments?

The First Minister:

In my answer to Richard Leonard’s previous question, I said that total spend on the use of the private sector in NHS Scotland is 0.6 per cent of the budget. If that answer is not good enough for him, here is another piece of information: in 2018-19, the most recent year of data, the number of procedures undertaken by non-NHS providers represented less than 0.3 per cent of all recorded NHS Scotland procedures.

Will I take responsibility for the fact that, in Scotland—in sharp contrast to England under the Tories and the previous Labour UK Government—less than 1 per cent of the spend goes to the private sector, and less than 0.5 per cent of procedures are done by the private sector? Yes, I will take responsibility for that, because I am committed to a publicly owned, publicly delivered health service, and Scotland now has one of those far more than when Labour was in office in Scotland or the UK. I am proud of that, and Richard Leonard still has to explain why he voted with the Tories against an NHS protection bill.

Photo of Kenneth Macintosh Kenneth Macintosh Labour

There are some constituency supplementary questions.