Mudcat Café message #3660772 The Mudcat Café TM
Thread #155459   Message #3660772
Posted By: Musket
16-Sep-14 - 08:45 AM
Thread Name: BS: scottish independence
Subject: RE: BS: scottish independence
The problem is, and no political posturing or even money is going to alter these two basic facts;

The health inequalities of Scotland are far greater than the rest of The UK. Whilst you can look at a council ward in say, New Town of Edinburgh and compare it to Tower Hamlets or Middlesborough favourably, the overall health in Scotland is lower than the the overall health in England. Wales and NI are between the two.

Whilst policy and practice can help overcome this long term, it is a generational issue.

The other huge cost for much of Scotland is rurality. There are high cost small patient number services based out of Elgin as an example that a district general hospital in England with three times the served population wouldn't be viable to provide. The Royal Colleges are concerned that some consultants do not see enough cases to keep up to date with practice.

The NHS is a bit of a red herring here in this debate because the Scottish system is organised, run and governed under Scottish law and always has been. There are huge differences between how each country within The UK provide NHS care. An independent Scotland would be subject to the same Royal College guidelines, NICE and accreditation. Regulatory bodies such as GMC, NMC etc would remain as they are in an independent Scotland, as no doctor would wish to train where their training and experience was not recognised. This has been acknowledged by the Scottish government.

I was at a Royal Medical Society dinner in Edinburgh recently and there is huge concern that continuity is not enough. The universities are concerned they might not attract medical students as they do hitherto and consultants are considering how peer group and clinical networks will be affected, making the lack of doctors even more acute.

At present, the spending per head in Scotland is higher than the UK average, and the call on that is also higher.

There are legitimate concerns over NHS Scotland regardless of the vote, and neither camp is in a position to make the problems go away.