Kezia Dugdale: SNP can cure health service ills '“ but won't

There was a 0.2 per cent real-terms decrease in spending on the NHS in Scotland in 2017/18. Picture: Getty

Not only is there no Brexit dividend, it’s estimated it’s already costing the economy more than £400million-a-week – and we haven’t even left yet.

By the time you read this, Philip Hammond will have unveiled his final pre-Brexit Budget.

It was widely trailed that there would be an extra cash boost for the NHS, albeit still less than the average rise the health service has received since 1948. What was kept under wraps was how it would be paid for – but it certainly wasn’t because of a mythical Brexit boost.

More money for the NHS is naturally welcome, and long overdue. It will generate more money for the Scottish Government, and I hope Ministers pass that on in full to our fully-devolved health service.

Because, as the independent experts at Audit Scotland revealed last week, the SNP is starving our NHS of cash.

There was a 0.2 per cent real-terms decrease in spending in 2017/18, and the NHS struggled to break even. It’s unsustainable, according to Audit Scotland. When you starve our NHS of resources like this, there is a very real impact for staff and patients.

Dedicated doctors and nurses are working harder than ever, and are being placed under increasing pressure, struggling with growing demand and staff. They deserve our thanks for everything they do in unacceptable circumstances.

For patients, the impact of SNP mismanagement is stark. Boards struggled to hit national performance standards last year – and nowhere is the crisis worse than right here in Edinburgh. NHS Lothian failed to meet any of the eight key national performance standards. What does that mean?

It means there are patients waiting in pain in the A&E department at the Edinburgh Royal Infirmary; it means people with cancer are anxiously waiting at home for weeks on end; and it means young people at school are struggling with mental health difficulties while waiting weeks to be seen by a specialist.

A task force has been sent in to NHS Lothian to improve performance, headed by an NHS chief from England. For this decision to be taken by a government which repeatedly makes political capital out of the failures in the English NHS, that tells you there is something very wrong indeed.

So, yes, a cash injection for our NHS is vital – and the SNP could choose to use Holyrood’s tax-raising powers to make the rich pay their fair share if it so desired.

But we must also accept there isn’t a bottomless pit of money, and pressure will only increase on the NHS because of an ageing and growing population.

The kind of one-off savings that boards are resorting to in a desperate bid to balance the books are not sustainable.

What would make a difference is addressing the causes of so many hospital admissions. In the Lothian region there is only capacity for around 1,100 lung rehab places for an estimated 9,000 people who would benefit. If patients have access to this care, they will have a stronger recovery and are far less likely to end up back in a hospital bed, which frees up resources for the NHS. There needs to be a wholescale rethink about how we manage the NHS if we are to make it sustainable for years to come. A key part of that is also better workforce planning. It was, after all, Nicola Sturgeon herself who unforgivably cut nurse training places when she was Health Secretary.

But it’s going to be even harder to properly plan for the workforce thanks to Brexit. Many of the NHS staff working to save lives are skilled European migrants, who are now leaving the UK. What a catastrophic situation we find ourselves in when the health service itself fails its own check-up.