THE Scottish Government has been accused of hypocrisy after handing a health board more than £500,000 to send NHS patients to private hospitals just weeks after announcing a clampdown on the practice.
In mid-January, Health Secretary Alex Neil said he had issued new guidance that made it clear the "vast majority" of patients should be treated by the NHS and arrangements to use the private sector should "only be used in the margins and should not be the norm".
However, three weeks later, NHS Lothian was given £540,000 to spend over just six-and-a-half weeks to increase its use of independent hospitals and ensure fewer patients breached the Government's Treatment Time Guarantee, which offers a legal right to treatment within 12 weeks for many inpatient procedures.
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The Scottish Government admitted it had made the payment after a letter sent from NHS Lothian chief executive Tim Davison and chairman Brian Houston, expressing gratitude for "additional non-recurring allocation of resources to procure additional independent sector support", was made public through the Freedom of Information Act.
Labour's health spokesman Neil Findlay said: "The hypocrisy of Alex Neil beggars belief. He publicly states that NHS boards must reduce the use of private sector healthcare, meanwhile, behind closed doors, he endorses the use of extra funds for NHS Lothian to utilise the private sector to help meet waiting time targets.
"Health boards wouldn't be in the position of going cap in hand to the Government if their resources hadn't been cut in the first place. It's a sticking plaster approach to healthcare that just isn't working and it's not good enough that Alex Neil is saying one thing in public but doing another in private."
NHS Lothian, along with NHS Grampian, has struggled to meet the Treatment Time Guarantee and has admitted that thousands of patients are likely to have their legal right breached this year. It has said it aims to be compliant with the law by January next year.
In the letter, NHS Lothian's most senior figures warn that "any further additional use of the independent sector to bring forward recovery would therefore require additional resource".
The health board plans to spend £21 million in the private sector between 2014/15 and 2016/17, although it is planned that reliance on external providers will gradually reduce due to investments in internal capacity.
Government figures state that, in 2012/13, £28m was spent by health boards across Scotland in the private sector to meet waiting-time targets, or 0.8% of the total budget. Figures obtained from individual health boards through the Freedom of Information Act suggest £40m in total was spent on private healthcare in the period, a 60% rise on the previous 12 months.
When announcing its clampdown on private sector use, the Government said the amount spent on private providers to meet waiting times was on course to drop to £25m in the current financial year and the practice was far less prevalent than in the English NHS.
A Scottish Government spokeswoman said: "The Cabinet Secretary for Health and Wellbeing has been very clear with all health boards they are expected to take every action possible to ensure the private sector is only used in exceptional circumstances. However, he has also recognised there will be times where it is not possible for the patient to be treated by the NHS within a reasonable timescale, but that these arrangements should not be the norm.
"Scottish Government policy is that long-term investment inside the NHS is the only way forward and NHS Lothian has agreed a plan that will see it invest in a multimillion-pound expansion over the next year. We have provided NHS Lothian with an additional allocation to support it until the end of March while it puts in place additional internal initiatives and gear up towards investment in additional staff and theatres. This is a short-term approach designed to help alleviate waiting time pressures at the health board."