THERE is a question which must be on the minds of members of the Scottish Government's health department: How will our NHS cope this winter?
The last few Decembers and Januarys, it has more or less managed - although there were excessive waiting times in A&E departments and the issue dominated the health agenda in Holyrood for weeks.
But the weather has been mild. The snow which closed the M8 in 2010 and exacerbated backlogs in orthopaedic departments is a dim memory. There has not been a very nasty flu season for more than a decade.
Yet in 2012-13 chaotic scenes of patients lying on trolleys for hours in corridors, waiting for beds raised serious questions about the pressures on the Scottish NHS. It later emerged A&E consultants had warned ministers about the pressure they were under months beforehand. The crisis sparked The Herald's NHS: Time for Action campaign and I spent a lot of time talking to people and analysing information which would help explain why the 2012-13 winter was so difficult. I came to the conclusion that the NHS was hovering close to a tipping point, so it took a relatively small increase in illness to push the system close to meltdown. High levels of the vomiting bug norovirus were sometimes blamed, and it did close more wards than usual in the early part of winter, but it was not the whole story - and anyway you can't have a health system which collapses from a stomach bug.
The number of beds being occupied by patients waiting for care packages was also cited - and indeed I remember seeing bed statistics which showed there were less hospital beds on wards overall that year.
So, where are in autumn 2016? Well, the latest delayed discharge figures show the number of people held-up in hospital rising every month since May. In August 1472 people were stuck in hospital when they could - if the community services were available - be at home. Data showing the total number of hospital beds in Scotland in 2015-16, released last week, revealed they were down 600 on the year before and down by more than 5000 since 2006/07.
The Scottish Government announced £9m to help health boards manage the winter months in September. Opposition politicians questioned why it was less than the 10.7m dished-out the year before. Another question might have been why health boards were being given this money now, when it might have been helpful if they had known earlier what they had to invest in their winter plans. Remember the actual NHS budget settlement itself for this financial year ran late, with a lot of confusion about how cash was being divided between the new care boards who have just taken on responsibility for GP and social care services.
The scale of cuts being outlined in board papers around the country does not suggest there is a lot of flexibility when it comes to meeting winter need and some of the new care boards themselves have highlighted a conflict between their obligations and their available resources.
So is the NHS close to a tipping point this winter? Almost certainly. Will it tip? It might - the weather and the swirl of viruses are things noone can control.
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules hereLast Updated:
Report this comment Cancel