When the SNP came to power in 2007, it declared that it would clamp down on spending NHS resources on private healthcare and last year the then health secretary Alex Neil repeated the promise.
The use of the independent sector by the NHS was a temporary phenomenon, he said, such spending should be kept to an absolute minimum and the use of private providers should be a last resort only. It should not be the norm, said Mr Neil.
So how are we to judge the Scottish Government on its declaration? In fairness, the proportion of the NHS budget that is spent on private healthcare is, and always has been, very small and it still stands at less than one per cent of the total. However, we are still a long way off from anything that could be described as a clamp down - in some recent years, spending in the private sector has increased significantly and even though it appears to be dropping recently, it is still a significant amount of money at around £20million a year.
The most recent figures, obtained by The Herald, show that in 2014-15, at least 7,800 patients were sent into the private sector. Most health boards provided figures up to the end of December or January, meaning the final total for the year will be higher, but we know that the cost has been at least £16.8 million, and is on course to rise further to almost £20million by the end the financial year in March.
Although these figures are not final, comparing them to 2013-14, when health boards spent around £26.5 million on sending patients to private hospitals, would appear to show that the number of NHS patients being sent to private hospitals is dropping. But the fact that thousands of patients are still being diverted into the private sector is a sign of the deeper problem about NHS hospitals' attempt to keep to waiting time targets.
In principle, the goal of cutting waiting times for patients who need medical procedures is a worthy one and one on which the Scottish Government has made good progress, but the fact that many are still missing them, or having to use private hospitals to help meet them, is evidence that NHS boards imply do not have the capacity to meet the demand that exists for their services - a demand that is growing quickly.
In the short term, using private hospitals to treat patients will help NHS hospitals meet the demand, but in the longer term the money that is spent on private healthcare could be better spent on improving, expanding and developing the NHS. The most important question facing the modern service is how to organise health and social care so that older patients can be well cared for and spending money on private healthcare does nothing to provide an answer. As long as NHS hospitals do not have the resources they need, the SNP's clamp down on the use of the private sector will remain a long way off.
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