NHS Tayside spirals into crisis

By an NHS worker

The crisis in Scotland’s National Health Service is claiming many casualties. Treatment has been limited, staff have been cut, facilities relocated, wards closed, care removed from some hospitals.

The scale of deficit in Scotland’s health boards runs into the hundreds of millions of pounds, a weight of debt that impacts on services day and daily.

Surgical procedures were cancelled across the country during the so called winter crisis, in reality a year round situation of allocating care in a permanent state of scarce resources.

resignations

The specific crisis in NHS Tayside has, however, claimed other casualties in the forced resignation of board chair John Connell, the apparent suspension of chief executive Lesley McLay, and the early retirement of finance director Lindsay Bedford.

These changes in senior personnel appear to be the result of financial indiscretions at the highest level of the health board. A health board that gave itself bonuses only last year, despite a deficit in its budget requiring £200m of savings over the next 4 years.

This health board has forced through the centralisation of services in mental health, claiming an improved service can be delivered with less resources.

NHS Tayside spends more on agency staff than any equivalent health authority in Scotland, it also has historic liabilities with private finance initiative facilities costing £14m a year until 2042.

Expected to deliver a 5% cut in its budget for the next 5 years on top of a spiralling deficit based on loans that have been deferred from the Scottish Government.

These loans were seen as temporary sticking plasters, and would be repaid once NHS Tayside sold off closed hospitals to residential developers.

In the absence of a single sale the loans have mounted up and been recycled to keep the health authority in financial balance. A strategy of financial plate spinning that has crashed to the ground in recent weeks.

Creative accounting appears to have obscured the full extent of financial pressure in NHS Tayside. Monies allocated for digital healthcare(£5.3m) was inappropriately hidden for 6 years, as part of a £23m fund for deferred expenditure.

Money for a rainy day that was dipped into as the health board tried to bring the deficit down, unfortunately massaging the figures has not hidden the fact that Tayside is £12m over budget, owes £33m in brokerage loans to Holyrood, and is now seeking a further £12m.

Further revelations has shown that endowment funds, charitable donations to the health board made in good faith mostly by relatives who wish to show material gratitude for care given, have been raided to the tune of £2m to cover general running costs.

At the same time performance based pay increment bonuses were given to a host of senior managers, including the retired finance director, who is implicated in the mismanagement of public funds.

The pressure on the Scottish government to act has ratcheted up. More so because cabinet secretary for health is local MSP Shona Robison. All health authorities in Scotland report budgetary deficits, all health boards face the same financial crisis, it is systemic.

trade union action

The SNP government are underfunding health, fuelling cuts across the service.

Whilst they have devolved responsibility to local health board managers, they know budgets are stretched, they know the service is retracting, they want to avoid responsibility for their national policy decisions and will gladly blame local health managers if it suits.

The crisis in Tayside is not unique. As such it should be a call to arms for all, particularly the NHS unions who have a huge responsibility to act in organising coordinated strike action, to defend the NHS.