20th. February, 2016.
Keeping Healthcare Local: But not where it counts.
Before anyone starts jumping up and down about what we're going to say, we accept that practice makes perfect. Specialist treatment centres where medics work repeatedly within their specialty deliver better results. That's been known since the Bristol paediatric heart surgery scandal decades ago.
But there are wider issues here.
We are being sold a pup, yet again, on the grounds of political expediency. And, dare we say it, to suit the ambitions of the higher echelons of the medical profession.
The SNP, they of the "keeping healthcare local" banner, are delivering a sell-out. And the reason is simple. They have shown a lack of resolve to tackle the thornier issues with the health service in Scotland.
Poor nursing: they won't criticise. Bullying and aggressive consultants: they dare not tackle. Bad management by Boards: they simply acquiesce in. Whistleblowers: they avert their eyes as the good and honest get hung out to dry. Funding: they promise more, and deliver less.
It is the last point that is the problem for the SNP.
Since 2007, the SNP have continually told us how NHS funding is ring fenced. It is, and ought to be so. They tell us that they increase spending in real terms above the rate of inflation. And that is also (almost) quite true. But as with most things, statistics can say what you want them to.
The underlying problem is the intended shift of responsibility for the delivery of care. More "local" services will place further strain on councils' already stretched budgets. The blame for any failure in future will surely fall on the councils.
As for acute care, the specialist centres are promised, but we have yet to see the blueprints, never mind the small print.
It is highly likely that the SNP will do much the same as politicians before them. They will listen to the various competing professions, tokenise public consultation, and come up with something akin to a bastardisation of the current system. Why? Because they won't be able to help themselves meddling on behalf of vested interests. They've done it before (Nicola's constituency) and they'll do it again.
What drives such mismanagement of public finances in Scotland's NHS? Well, you'd have to ask Mr. Swinney that question, but be aware: the future holds worse in store if we continue to centralise acute services, while leaving the rest to local councils to provide a large part of the delivery mechanism, but is starved of funding.
We've tolerated over-priced car parks at the RIE, and elsewhere before the charges were removed. We've tolerated long journeys and disgraceful road conditions surrounding Scotland's capital. But for the poorest of our people, travelling will simply not be an option. The Golden Jubillee may be wonderful, but the NHS doesn't currently pay enough to cover fuel costs for those travelling to it!
Worse may be in store in the SNP's "low tax for the big guys" Scotland. By making Scotland a low corporate tax economy, tax receipts might increase. Or they may, like oil, drop through the floor.
And, like so much more with the SNP, when the proverbial hits the fan for the long-suffering public, the fact they have sold out on their principles won't bother them in the slightest.