Report to the People
22nd May 2006

One Size Doesn’t Fit All

If you had two shops, one of which was queued out the door while the other was just ticking over, would you put the same number of staff in both?  Of course not.  So why does the NHS have the same number of doctors looking after the healthiest people as looking after the sickest?

It doesn’t make sense.  And it results in the poorest and sickest people having the least chance of seeing a doctor.  They are also more likely to see an inexperienced, overburdened doctor; less likely to see a consultant; and more likely to die younger.

To counter this, Professor David Kerr’s report on the future shape of the NHS, to which many of you contributed, argues that services should be designed to suit need.  And, when MSPs debated the progress being made in implementing his report on Thursday, I made the point that this “one-size-fits-all” approach has seen the gap between rich and poor growing rather than shrinking.

I also put this to Scotland’s Chief Medical Officer, Dr Harry Burns, when he appeared before the Health Committee.  To his credit, Dr Burns made it clear that, “if we are to tackle the increased prevalence of disease in deprived communities, we must match that increased prevalence with an increased number of GPs.”

That, however, means taking some bold funding decisions - putting an end to ploughing money into making the healthiest healthier, while people in Greenock and elsewhere are still dying in their 50s and 60s.

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