There must surely come a time when the Scottish Government stops using Covid-19 as its favoured bail-out option.

In the early stages of the pandemic the Scottish people were happy to suspend scrutiny of the SNP’s management of wider issues as it sought to lead us through this contagion. Nicola Sturgeon’s no-nonsense honesty then and her refusal to apply a gloss to the numbers in her daily briefings seemed to embody the essence of strong leadership. Those days seem a long time ago.

The First Minister seems much less keen on detailed scrutiny now. Is this because her government’s five-year recovery plan simply couldn’t bear it? Douglas Ross, leader of the Scottish Conservatives, attempted this last week when he suggested that the Government was sheltering behind Covid to avoid criticism of spiralling waiting times and its handling of the ambulance crisis.

Predictably, Ms Sturgeon chose ridicule over substance in her response: it was all about the pandemic, stupid. If the Tory leader had really been on the ball, or been properly briefed by his advisers, he might have pointed out to the First Minister that pre-Covid Scotland was already in a very dark place concerning delivery of health and social care. Several Audit Scotland reports, showing numerous missed targets – including waiting times – attested to this. Covid-19 has merely exacerbated these; it is not the cause.  

Mr Ross and the Labour leader, Anas Sarwar might also have asked why senior health professionals were hearing several weeks ago that the Scottish Government was considering plans for the army to be drafted in to ease the ambulance crisis. So, why did they wait until there had been a death following a 40-hour wait to expedite this?

Astonishingly, none of our health board chief executives were given prior knowledge of the Recovery Plan prior to the Scottish Government’s announcement of it. Thus, we have a five-year plan that wasn’t validated by the main people working in the field because no-one in government wanted to engage with them on it. “There’s nothing strategic in it,” one senior health professional told me, echoing concerns expressed by senior clinicians about Government policy throughout the health crisis. 

READ MORE: Mark Smith: Scotland’s schools are about to get gayer. About time too

The prevailing sentiment among health executives is that the Recovery Plan has neither detail nor ambition; that it simply isn’t fit for purpose and that the health boards are being set up to fail and to take the blame when it fails to deliver. 

The plan deals almost exclusively with the NHS – hospitals, ambulances and waiting times. At a time when the meaningful integration of health social care is so key, the Scottish Government appear to have missed having a plan for half of the system. Is this because the Government are only paying lip-service to the concept of care or that they don’t know how to address the challenges, beyond setting up a new National Care Service, which will take many years?

So long as people buy the Recovery Plan and its £1m-worth of spin doctors do their jobs and the usual party lickspittles do their bit on social media then who cares. This is about clinging to power unscrutinised for as long as possible before they’re found out. 

The National Care Service is, well … nothing of the sort. What’s being proposed goes way beyond the scope of the changes recommended by the Feeley Review on adult social care with no rationale on why all other aspects of care, such as children’s, is included. Thus far it’s proven virtually impossible for NHS and local authority chiefs to obtain answers from the Scottish Government to some fundamental questions. The first one governs the rest: what is this new service supposed to look like?

“We’re being asked to respond to a consultation without work being undertaken on the detail of how the new Care Service will work,” a front-line executive told me

The almost complete absence of anything resembling communication or engagement is something with which education chiefs are all too familiar. They too were side-lined when the Scottish Government was deciding when pupils could return to the classroom in April and only learned of the plans when they were being announced at televised news briefings.  

Having pledged a bill within first 100 days in the Programme for Government, a consultation and a Bill had to materialise rapidly. There are 95 questions on the ‘consultation’, yet these are presumptive, seeking responses to ideas already pre-determined. An authentic consultation requires you to engage with the people who actually deliver the services and those who actually use it. Health and Care professionals are all asking the same question: how can you properly respond to a care plan that’s directionless; lacks detail and was dreamt up by people with no professional health experience?

The Scottish Government have been trying for years to shift the balance of care so that more people are cared for in the community rather than hospitalisation. To make this work, the right questions have to be asked and this means engaging with the public, rather than designing a service based merely on what the managers think. “Why are you going straight to A&E; why did you not go to your GP or your pharmacy?”

Among the proposals is the establishment of 31 new community health and care social boards. What do these portend though, for the 31 existing Integrated Joint Boards? Is this an admission that health and social care integration isn’t working? If so, why not work to find a solution for the original problem by engagement with the professionals and the users?

This is an acute example of the absence of strategic thinking that’s driving the entire sector to despair. Does this government ever pause to consider that there might be a cultural problem here rather than a structural one?

The Recovery Plan is storing up a multitude of problems, but as with much else it bears the classic imprint of the Scottish Government’s style: it’s a proclamation designed to buy time but bearing little scrutiny

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