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Letters / Impressive improvements

Sadly, Gerry McGarvey shows himself to be the most tawdry kind of spin-doctor (Answers please; SN, 01/05/15).

I have never said or implied that “everything is rosy” in the NHS here or anywhere else. My remarks that he quotes never pretended to be about GP recruitment problems or any of the other difficulties about which he then chooses to be gleeful.

In politics, Gerry, I do not do posturing, ridicule or hollowness, as you allege. Democratic politics is about trying to secure principled allocation of public resources and effective accountable management of them.

Having the patience and integrity for rational dialogue might help you to contribute to the process. But let’s take your questions to me as a way of opening up what the issues are:

1) Does Mr Skene acknowledge that there is a problem with the local NHS?

The NHS in Orkney and Shetland faces the same challenges as other boards in Scotland and corresponding organisations across the UK. Caring for an ageing population brings increasing complexity and demand for care.

This increase in lifespan is a direct result of the success of the health service assisting people to live longer and survive conditions, which in earlier times would have limited their lives.

The local health service has played a full part in delivering these improved outcomes and continues to respond positively to the challenges it faces.

Evidence of high performance can be found in published statistics and in the annual accountability reviews which detail performance against a broad range of indicators. The hard and effective work and dedication of all staff deserves the respect of us all.

Does this mean everything is perfect? Of course not. The overall allocation of funding to the NHS in Scotland and its place in the Barnett formula and its consequentials indicates that Westminster is failing to prioritise adequately the overall need of the health service in the UK and so in Scotland.

Any moves by the Westminster government to privatise aspects of the English NHS will further reduce government spending on the Health Service. This would result in a further cut to the overall allocation for health purposes to Scotland, and should be resisted.

These ongoing threats and cost pressures have not been helped by the economic meltdown overseen by the previous Labour government, the legacy of which has been pressure on public spending.

It is this legacy and the current austerity policies at Westminster and failure to address inequalities in our communities that largely drive the funding pressures that make health service delivery a challenge.

In Scotland, within the money available to it, the SNP government has worked hard to resist these funding pressures and to seek to protect health spending, and there is clear evidence to demonstrate this. The allocations to the isles health boards with further recognition of our particular costs is evidence of the Government’s good faith.

2) Does Mr Skene acknowledge that there is a problem with recruitment and retention of GPs turning into a crisis?

GP recruitment and retention is an issue of concern across the whole of the UK. GP contracts, historically negotiated at UK level, have not delivered the incentives to attract people to train or become GPs in the way they once did.

The current efforts by the Scottish SNP Government to seek to negotiate a better deal for and with GPs in Scotland is a positive initiative that should be welcomed and supported.

Locally, the ongoing challenges of recruitment and retention in Shetland are being tackled in innovative ways in partnership with GPs and early indications are positive. The challenge remains significant.

Measured steps appear to be being taken to continue to support all GP practices, and specific actions are in hand with respect to at least four practices.

The longer term solution however will be to attract more GPs to train especially for remote and rural community careers and the SNP government is actively seeking to influence this in Scotland.

3) Can Mr Skene tell us how many GPs are set to leave Shetland in the next few months?

No, I do not have a crystal ball, but I am aware of three probable impending departures, none of which appear to have any basis in negative views of the NHS.

It is true that life as a GP in a community like Shetland brings a unique range of attractions but also burdens and pressures when you may have to be providing significant out of hours and on-call cover due to the dispersed population or nature of your practice. This lifestyle can be very challenging to cope with.

4) Will Mr Skene tell us what is going to be the result on patient services?

I would expect the local health board to continue to manage these pressures with support from Scottish Government, as they have up until now, and ensure that service to patients continues to be delivered safely and within the performance framework expected of them.

5) How would Mr Skene as an SNP local activist (never mind as a potential parliamentarian) influence the SNP Government in addressing this?

…. by helping the SNP government to understand the additional and unique challenges of delivering health services in small island health boards, and by seeking to support initiatives to ensure local services continue to get a fair funding allocation.

More importantly, I would seek to influence policy in a Westminster context to prevent reduction in health funding and increasing recognition of the need to tackle inequalities through measures other than austerity!!

Meanwhile, progress overseen specifically by NHS Shetland since 2011 has been impressive. Whether it be the new Scalloway health centre, improved community psychiatric nursing provision, the excellence of our A&E provision, or a number of other improvements, management and staff in NHS Shetland deserve great credit, as does the Scottish Government whose commitment to fairness is getting all the resources it can to them.

Danus Skene
SNP parliamentary candidate for Orkney & Shetland