ONE of Scotland's top surgeons has warned of the creeping privatisation of the NHS as he claimed a year-round bed crisis means health boards are no longer able to treat patients in their local hospitals.


Colin Howie, president of the British Orthopaedic Association, said that patients with pre-planned surgery were routinely being turned away due to a lack of capacity and increasingly being sent instead to private hospitals or the NHS-run Golden Jubilee national facility in Clydebank.

In a claim that was strongly rejected by the Scottish Government, he said that a process of health privatisation seen south of the border was already well under way in Scotland, as a reduction in surgical bed numbers meant health boards were no longer self-sufficient.

Mr Howie spoke out after it emerged that more than 800 patients had their pre-planned operations cancelled at short notice in the first six weeks of this year due to winter pressure facing the NHS. It also came as Ministers unveiled plans to send increasing numbers of patients to the Golden Jubilee hospital, which already carries out a quarter of hip and knee replacements in Scotland.

"We no longer have a short winter bed crisis," Mr Howie said. "Surgical cancellations happen throughout the year because of a lack of facility. It is a bed crisis.

"The use of private hospitals and the Golden Jubilee is becoming routine and significant for many mainland boards throughout Scotland because the system can't cope with the pressure following bed reductions."

The Scottish Government said it was unable to provide figures for the amount spent on sending cases to private hospitals in recent months but in 2013/14, fewer than 7,500 out of 1.5 million inpatient or day cases were treated externally.

However, Mr Howie said that in key specialities such as orthopaedics and urology the proportion was far higher.

The health service is said to be under far greater pressure than at the same time last year, and NHS Ayrshire and Arran admitted that 50 orthopaedic cases had been referred to a private hospital recently as a result of pressure over beds.

"Most private hospitals in Scotland have a substantial proportion of their work coming from the NHS at short notice," Mr Howie said.

"Many patients travel from one city or town to another for surgery because of local capacity issues, patients from Aberdeen coming to Edinburgh; patients from Edinburgh going to Glasgow.

"The volumes of patients leaving their home area has increased significantly in an attempt to maintain reasonable waiting time targets," the Edinburgh-based surgeon said. "This is not a safe, sustainable cost-effective pattern of healthcare delivery."

While he backed standards at Golden Jubilee, Mr Howie said that specialist care should be on offer throughout the country. Instead, he claimed that patients were regularly turning up at their local hospital only to see their procedure cancelled, while several units have suspended planned admissions altogether.

He said that some patients desperate for operations refused to leave hospitals or went straight to A&E to demand treatment after being told that their operation would not take place.

"We should not place our patients, or staff, in this situation," he said. "In most Scottish hospitals, patients turn up on the day of surgery, starved, often from early in the morning, and are told to go home again, in pain, to await a further date.

"Planned care in a dedicated facility is cost-effective, life-changing and what our patients rightly demand."

He added: "Each missed admission costs the health service double the amount of money necessary to deliver that item of care because of the missed opportunity and the cost of purchasing alternate care in the private sector. An unnecessary expenditure at a time of fiscal austerity.

"This is exactly what happened in England at the beginning of the privatisation of the health service. The process has started in Scotland."

Health Secretary Shona Robison said last week that the number of surgical beds had been cut as a result of a shift towards day surgery, which does not require overnight admission. It was announced yesterday that an additional 300 joint replacements a year would be carried out at Golden Jubilee, at a cost of £1 million, taking to total number of procedures carried out annually at the national hospital to 4,500.

The number of inpatient and day case surgical procedures carried out on the NHS has increased drastically in recent years. Inpatient cases rose by almost 20 per cent, to almost 1.1 million, between 2007 and 2014. Day cases were up 11 per cent, to 450,000 in the same period.

A spokeswoman for the Scottish Government said: "This Government has repeatedly stated our commitment to keeping the NHS in public hands, free at the point of use, as demonstrated by our action to bring Stracathro Hospital back into public hands.

"In 2013/14 over 1.5 million inpatients and day cases were seen by NHS Scotland - and fewer than half a per cent of these cases were treated in the private sector. In fact, Audit Scotland recently recognised that the spending in the private sector have reduced over the last year - falling by nearly £5 million between 2012/13 and 2013/14."