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NHS still in need of treatment

ANOTHER day, another poor set of figures for NHS waiting times in Scotland.

The latest statistics for queues at Accident and Emergency are the worst in five years, even though thus far this winter has not experienced a flu epidemic.

With his customary ebullience, Scottish Health Secretary Alex Neil insisted that the vast majority of patients are seen within four hours. The minister blamed the disappointing figures on "the additional complexity of an early norovirus season", though attendances were not unusually high for December, which witnessed the worst figures (90.3%).

The plain facts are these: only four of Scotland's 14 health boards met the waiting time target in December. In Lanarkshire the figure was just 84.4%. In fact, across Scotland compliance fell in each month of the second half of last year. And 323 unfortunate patients spent more than 12 hours in A&E, raising the spectre of old and ill patients left on trolleys in corridors, while staff mount a desperate search for a free bed.

Yesterday's figures come less than a week after the damning report from Audit Scotland, which suggested the practice of hidden waiting lists for treatment that was exposed in Lothian was also commonplace elsewhere.

Much has been made of the ring-fencing of the NHS budget but the latest A&E figures suggest that an ageing population, along with the proliferation of treatments and reductions in bed numbers, may be squeezing capacity beyond what is acceptable.

And while the SNP boasts that the number of nurses and midwives is 1.8% higher than in 2006, that is a politically convenient reference point. As the Scottish Conservatives observed yesterday, it is still 1800 fewer than in September 2009. Meanwhile, around 1600 posts are vacant.

The figures released yesterday also contain the results of the so-called "legally enforceable" guarantee that no patient will wait more than 12 weeks to receive planned treatment. The guarantee came into effect on October 1 and yet at the end of December, 78 patients had waited longer than that. The Scottish Government made much of its legal guarantee of treatment within 12 weeks but it is hard to see what is legally enforceable about a guarantee broken in 78 cases.

The Scottish people hold the NHS dear. Free at the point of delivery, it remains the most consistently popular British institution and many return to the UK with relief after experiencing health care elsewhere. All politicians want to be able to claim that the NHS is safe in their hands. In general the SNP can make that claim, especially when contrasted with the huge ructions imposed on services south of the Border. But recent assurances suggesting all is well might well be said to smack of a degree of complacency. The new waiting times figures are a reminder that there is still work to be done to deliver a service that works for all patients.

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