I would like to start by saying sorry to all of the patients and their relatives in Lothian who have been affected by this major waiting times problem.
The scale of the problem is unprecedented in Scotland and therefore the recovery is undoubtedly one of the biggest challenges that NHS Lothian or any other health board has had to face.
I last worked in NHS Lothian as a young manager in the 1980s and despite the current difficult circumstances in which I find the board, and the rather daunting scale of the problem, I am confident that we can turn the situation around and I am actually very glad to have been asked to help to deliver the solution.
In situations like this, there is often a tendency to look only at the numbers affected in any problem and see them as statistics. But I can reassure you that, although there is a backlog of thousands of people to see and treat, we know that each patient has individual needs and we will do our utmost to ensure they are met.
There are two strands to NHS Lothian’s recovery. The first is to clear the backlog of the thousands of patients who are still waiting for treatment. The second is to build up the core internal capacity within the health board so that we can cope with the hundreds of thousands of new referrals we get every year without a new backlog developing in the future.
This clearly cannot be done overnight. I estimate it could take as much as a year or two to develop some of our core capacity in some key specialties to a suitable level. But in the meantime people in Lothian will still require treatment.
Although there were clearly elements of poor practice in the previous management of waiting times, for which we apologise, the fundamental problem is that our internal NHS capacity is simply insufficient in a number of key specialties to meet the rising demand for assessment and treatment, which is made more difficult by a very significantly growing older population.
As a result we have no other option but to work with external providers to clear the backlog over the next six months or so while we begin to plan and recruit to increase our own internal NHS capacity in Lothian.
We recently announced that as part of our £20 million investment this year, we will offer many Lothian patients the opportunity to have their treatment provided faster by travelling to one of several hospitals outwith Lothian.
It may be that some patients will choose not to take up the offer and will want an appointment locally. Unfortunately this means that they may have to wait longer for an appointment in NHS Lothian until we begin to increase our local capacity in the coming months.
Over the next six months, the use of external providers is likely to peak as we clear the current backlog of patients waiting for an operation.
Our use of external providers will then begin to tail off over the next year or two as we invest in resources, staff and facilities to grow our core services from within.
We have already begun creating that plan of much-needed investment across a number of services. We need to make them bigger and better to ensure they are not only able to meet the current healthcare needs, but also those in the future. Therefore the expansion of our core services has to be our strategic objective.
I am lucky that NHS Lothian has some of the most talented and hardworking staff in the NHS among its ranks and together we are already working towards that vision.
I would like to reiterate my apology to all of those affected. But as I have outlined, we have a short and long-term plan to overcome the initial challenges of providing immediate care and then growing a service to meet future needs and preventing a repeat.
I am sorry that this will take longer than we would want and I hope that our patients and their families will bear with us while we remedy this unacceptable situation.
• Tim Davison is interim chief executive of NHS Lothian
£10m to clear backlog
NHS Lothian recently agreed to spend more than £10 million treating patients in private hospitals in a bid to clear its current backlog.
It will also bring private doctors in to its own hospitals to carry out operations.
The health board is aiming to clear a waiting list backlog of 7200 patients by October; however, health chiefs say they will be forced to continue relying on the private sector for at least the next two to three years to stop waiting lists immediately shooting back up.
The extent of such a reliance on private hospitals has raised concerns about “privatisation by the back door”.