Healthcare in Scotland

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The Queen Elizabeth University Hospital, an NHS Scotland general hospital. It is the largest hospital campus in Europe NS5365 - Queen Elizabeth University Hospital.jpg
The Queen Elizabeth University Hospital, an NHS Scotland general hospital. It is the largest hospital campus in Europe

Healthcare in Scotland is mainly provided by Scotland's public health service, NHS Scotland. It provides healthcare to all permanent residents free at the point of need and paid for from general taxation. Health is a matter that is devolved, and considerable differences have developed between the public healthcare systems in the countries of the United Kingdom, collectively the National Health Service (NHS). [2] Though the public system dominates healthcare provision, private healthcare and a wide variety of alternative and complementary treatments are available for those willing and able to pay. [3]

Contents

Health in Scotland

Overall, Scotland has a healthy population. The average life expectancy in 2013 was 79.1 years. [4] However, because Scotland is a country with large rural expanses (i.e. 20% of the population lives across 94% of the land space), there are parts of the population that find it challenging to access some healthcare services. This problem is compounded by a disproportionate number of people aged 65 and older living in these rural areas. [5] The elderly generally require more specialised and intensive forms of healthcare services, which may not always be able to be provided at the same level in remote rural areas as they are in Scotland's urban areas due to a lack of rural healthcare professionals. [6]

Healthcare services

Public provision

Neil Gray, the incumbent Cabinet Secretary for NHS Recovery, Health and Social Care within the Scottish Government Official portrait of wellbeing economy secretary Neil Gray (cropped 1).jpg
Neil Gray, the incumbent Cabinet Secretary for NHS Recovery, Health and Social Care within the Scottish Government

The National Health Service (NHS) in Scotland was created by the National Health Service (Scotland) Act 1947 in 1948 at the same time the NHS was created for England and Wales. Scotland's NHS remains a separate body from the other public health systems in the UK which can lead to confusion from patients when "cross-border" or emergency care is involved.

Primary and secondary care are integrated in Scotland. Unlike in England, NHS trusts do not exist in Scotland. Instead, healthcare is provided through fourteen regional health boards. These health boards are further subdivided into Health and Social Care Partnerships. The Scottish Ambulance Service is the pan-Scotland board responsible for prehospital care provision and transport of patients between the mainland and the Scottish Islands. The ambulance service is supported by the Emergency Medical Retrieval Service and BASICS Scotland.

Scotland spent over £12 billion on healthcare in 2015/16 which accounted for 40% of the Scottish Government's total budget. [7] The NHS in Scotland consists of approximately 161,000 employees, 9.2% of whom are medical or dental doctors, 42.9% nurses and midwives, 18.2% administrative services, 3.9% healthcare scientists, and the remaining 25.8% in various other medical services. [8] In the past several years, healthcare costs have been rising in Scotland. Despite this, Scots have a generally favorable view of their NHS service with 61% of the population either very or quite satisfied with the service. [9]

Healthcare policy and funding is the responsibility of the Scottish Government's Health Directorates. The current Cabinet Secretary for NHS Recovery, Health and Social Care is Neil Gray. The Director-General (DG) of Health and Social Care, Chief Executive of NHS Scotland is Caroline Lamb. [10]

'NHS Near Me', a video consultation service, was first introduced in NHS Highland in 2018 and became widely used in general practice because of the impact of COVID-19 pandemic. It replaced an earlier service, Pharmacy Anywhere. In May 2020 it began to be used in community pharmacies. [11] 87% of patients and 94% of clinicians thought video consultations should be an option in September 2020. [12]

Private provision

Around 8.5% of people in Scotland are reckoned to have some form of voluntary private health insurance as of 2012. [13] : 53  Private clinics carry out dental and other healthcare services, including non-surgical cosmetic interventions and fertility care. [14]

The number of referrals to private companies by NHS Scotland increased from almost 13,000 in 2013/4 to more than 28,000 in 2014/5 at a cost of £37 million. The biggest increase was in MRI scans in Glasgow. [15]

Nuffield Health runs a private hospital in Glasgow which is a major centre for in vitro fertilisation. It celebrated its 30th anniversary in 2015 with approximately 6,000 babies produced. [16]

Quality monitoring

First Minister Humza Yousaf tours an NHS Scotland National Treatment Centre in Fife, 2024 NTC Fife.jpg
First Minister Humza Yousaf tours an NHS Scotland National Treatment Centre in Fife, 2024

Healthcare Improvement Scotland (HIS) is responsible for scrutiny of NHS hospitals and services, as well as independent healthcare services. [6] Its function is to assess the quality of care in Scottish health facilities and to make recommendations for how to fix various issues.

However, HIS does not impose a formal accreditation system for NHS hospitals and clinics. The philosophy behind this is that setting minimum standards incentivises healthcare facilities to provide only the baseline level care. Formal accreditation can also be seen as burdensome bureaucratic intrusion by healthcare providers. [6] Instead, HIS works in a more informal and collaborative approach with the NHS. This method of oversight differs from most other healthcare systems in the OECD who look to set clear and consistent standards. [6]

The Scottish Government has sought to deflect criticism of performance in A&E by noting that - however bad things are - at least they are not as bad as England. There are 91 A&E services in total, including minor injury units, but statistics published by Public Health Scotland cover only the 30 larger A&Es. They are compared with England’s 170 Type 1 “major” A&Es, but many of the Scottish sites do not take major trauma. Monthly attendances are about 7000-8000 per Type 1 A&E in England against 3000-3,500 per ED in Scotland. If comparison is applied to all A&E services performance in England is slightly better. [17]

Public health

Public Health Scotland, formed in April 2020, [18] responds to infections diseases and environmental hazards, and supports national initiatives in areas such as mental well-being, inequality, and preventing harm from alcohol, tobacco and other drugs. [19]

See also

Related Research Articles

<span class="mw-page-title-main">Health care</span> Prevention of disease and promotion of well-being

Health care, or healthcare, is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. The term includes work done in providing primary care, secondary care, and tertiary care, as well as in public health.

<span class="mw-page-title-main">Publicly funded health care</span> Form of health care financing

Publicly funded healthcare is a form of health care financing designed to meet the cost of all or most healthcare needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are set down in rules applying to the whole population contributing to the fund or receiving benefits from it.

<span class="mw-page-title-main">Healthcare industry</span> Economic sector focused on health

The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It encompasses the creation and commercialization of products and services conducive to the preservation and restoration of well-being. The contemporary healthcare sector comprises three fundamental facets, namely services, products, and finance. It can be further subdivided into numerous sectors and categories and relies on interdisciplinary teams of highly skilled professionals and paraprofessionals to address the healthcare requirements of both individuals and communities.

General practice is the name given in various nations, such as the United Kingdom, India, Australia, New Zealand and South Africa to the services provided by general practitioners. In some nations, such as the US, similar services may be described as family medicine or primary care. The term Primary Care in the UK may also include services provided by community pharmacy, optometrist, dental surgery and community hearing care providers. The balance of care between primary care and secondary care - which usually refers to hospital based services - varies from place to place, and with time. In many countries there are initiatives to move services out of hospitals into the community, in the expectation that this will save money and be more convenient.

<span class="mw-page-title-main">NHS Wales</span> Publicly-funded healthcare system in Wales

NHS Wales is the publicly-funded healthcare system in Wales, and one of the four systems which make up the National Health Service in the United Kingdom.

<span class="mw-page-title-main">NHS Scotland</span> Publicly-funded healthcare system in Scotland

NHS Scotland, sometimes styled NHSScotland, is the publicly–funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.

Health and Social Care (HSC) is the publicly funded healthcare system in Northern Ireland. Although having been created separately to the National Health Service (NHS), it is nonetheless considered a part of the overall national health service in the United Kingdom. The Northern Ireland Executive through its Department of Health is responsible for its funding, while the Public Health Agency is the executive agency responsible for the provision of public health and social care services across Northern Ireland. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom.

<span class="mw-page-title-main">Emergency medical services in the United Kingdom</span>

Emergency medical services in the United Kingdom provide emergency care to people with acute illness or injury and are predominantly provided free at the point of use by the four National Health Services (NHS) of England, Scotland, Wales, and Northern Ireland. Emergency care including ambulance and emergency department treatment is only free to UK residents and a charge may be made to those not entitled to free NHS care.

The health of the Scottish population is, and has been for many years, worse than that of the English. Life expectancy is the lowest in the UK, at 77.1 for men and 81.1 for women, and one of the lowest in the OECD. The gap between Scotland and England has grown since 1980. Some of this is clearly attributable to economic disadvantage, but the differences in health status are more pronounced that would be expected on that basis. It has often been suggested that the Scottish diet is to blame. This is particularly so in Glasgow and the Glasgow effect has been the subject of some academic study.

<span class="mw-page-title-main">Healthcare in the United Kingdom</span> Overview of healthcare in the United Kingdom

Healthcare in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together with smaller private sector and voluntary provision. As a result of each country having different policies and priorities, a variety of differences have developed between these systems since devolution.

<span class="mw-page-title-main">National Health Service (England)</span> Publicly-funded healthcare system in England

The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR).

The Care Quality Commission (CQC) is an executive non-departmental public body of the Department of Health and Social Care of the United Kingdom. It was established in 2009 to regulate and inspect health and social care providers in England.

Healthcare in England is mainly provided by the National Health Service (NHS), a public body that provides healthcare to all permanent residents in England, that is free at the point of use. The body is one of four forming the UK National Health Service as health is a devolved matter; there are differences with the provisions for healthcare elsewhere in the United Kingdom, and in England it is overseen by NHS England. Though the public system dominates healthcare provision in England, private health care and a wide variety of alternative and complementary treatments are available for those willing and able to pay.

<span class="mw-page-title-main">Healthcare in Wales</span> Overview of the health care system in Wales

Healthcare in Wales is mainly provided by the Welsh public health service, NHS Wales. NHS Wales provides healthcare to all permanent residents that is free at the point of need and paid for from general taxation. Health is a matter that is devolved, and considerable differences are now developing between the public healthcare systems in the different countries of the United Kingdom, collectively the National Health Service (NHS). Though the public system dominates healthcare provision, private health care and a wide variety of alternative and complementary treatments are available for those willing to pay.

<span class="mw-page-title-main">National Health Service</span> Publicly-funded healthcare systems in the United Kingdom

The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom, comprising the National Health Service in England, NHS Scotland and NHS Wales. Health and Social Care in Northern Ireland was created separately and is often locally referred to as "the NHS". The original three systems were established in 1948 as part of major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. Each service provides a comprehensive range of health services, provided without charge for people ordinarily resident in the United Kingdom apart from dental treatment and optical care. In England, NHS patients have to pay prescription charges; some, such as those aged over 60, or those on certain state benefits, are exempt.

<span class="mw-page-title-main">Healthcare in Italy</span> Overview of the health care system in Italy

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Healthcare Improvement Scotland (HIS) is the national healthcare improvement organisation for Scotland. It is a public body which is part of the Scottish National Health Service, created in April 2011.

Examples of health care systems of the world, sorted by continent, are as follows.

<span class="mw-page-title-main">Jason Leitch</span> Scottish National Clinical Director

Jason Andrew Leitch is the National Clinical Director of Healthcare Quality and Strategy for the Scottish Government. He is a Senior Clinical Advisor to the Scottish Government and a member of the Health and Social Care Management Board. Leitch was involved in the COVID-19 pandemic response, where his duties included communicating complex scientific information to the public.

References

  1. ↑ "Queen Elizabeth University Hospital". WestOrtho. Retrieved 5 April 2024.
  2. ↑ NHS now four different systems Archived 3 April 2009 at the Wayback Machine BBC January 2, 2008
  3. ↑ Steel D, Cylus J. United Kingdom (Scotland): Health system review. Health Systems in Transition, 2012; 14(9): 1–150.
  4. ↑ "Health of Scotland's population - Life Expectancy". Scottish Government. 2014. Archived from the original on 12 March 2015 – via Internet Archive.
  5. ↑ MacVicar, R; Nicoll, P (August 2013). NHS Education for Scotland: Supporting Remote and Rural Healthcare (PDF) (Report). NHS Education for Scotland. Archived (PDF) from the original on 26 November 2016. Retrieved 25 November 2016.
  6. 1 2 3 4 OECD (2016). OECD Reviews of Health Care Quality, Statistics / OECD Reviews of Health Care Quality / OECD Reviews of Health Care Quality: United Kingdom 2016:Raising Standards. OECD Reviews of Health Care Quality. doi:10.1787/9789264239487-en. ISBN   9789264239418. Archived from the original on 25 November 2016. Retrieved 24 November 2016.
  7. ↑ "NHSScotland Chief Executive's annual report 2015-16". gov.scot. 18 November 2016. p. 49. Archived from the original on 22 May 2023. Retrieved 19 May 2023.
  8. ↑ "Number of Staff in Post=" (PDF). isdscotland.scot.nhs.uk. 6 September 2016. p. 5. Archived (PDF) from the original on 23 November 2016. Retrieved 19 May 2023.
  9. ↑ Watson, Dave (25 June 2014). "Scots NHS satisfaction soars as England's falls" Archived 23 November 2016 at the Wayback Machine . Retrieved 23 November 2016.
  10. ↑ "Strategic Board of the Scottish Government: Director-General Health & Social Care". Scottish Government. 14 January 2016. Archived from the original on 4 January 2017. Retrieved 27 March 2022.
  11. ↑ "Video consultation system could be offered to all Scottish community pharmacies". Pharmaceutical Journal. 21 May 2020. Retrieved 1 July 2020.
  12. ↑ "Survey shows strong support for NHS Near Me video consultations among patients and clinicians". Pharmaceutical Journal. 18 September 2020. Retrieved 26 October 2020.
  13. ↑ Steel, David; Cylus, Jonathan (2012). United Kingdom (Scotland) Health system review (PDF). Health Systems in Transition (Report). Vol. 14. Archived (PDF) from the original on 24 September 2015. Retrieved 24 November 2016.
  14. ↑ "Private clinics to be regulated from next year". Scottish Legal News. 10 July 2015. Archived from the original on 14 July 2015. Retrieved 13 July 2015.
  15. ↑ "Number of NHS patients sent for private care at public expense doubles in a year". Daily Record. 13 August 2015. Archived from the original on 19 August 2015. Retrieved 22 August 2015.
  16. ↑ "Martyn McLaughlin: IVF still transforms lives". Scotsman. 7 July 2015. Archived from the original on 14 July 2015. Retrieved 13 July 2015.
  17. ↑ "The truth about the Scotland-England A&E comparisons". The Herald. 22 October 2022. Archived from the original on 7 November 2022. Retrieved 8 November 2022.
  18. ↑ "Development of Public Health Scotland". publichealthreform.scot. Archived from the original on 25 January 2021. Retrieved 23 August 2020.
  19. ↑ "Our areas of work". Public Health Scotland. Archived from the original on 28 August 2020. Retrieved 23 August 2020.
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