Minister offers no clarity on future of island health boards, McArthur

The Scottish Government has been accused today of proposing change to health boards ‘by stealth’ and ‘talking behind closed doors’. 

The Scottish Government’s Programme for Government states “We will also begin work to examine the number, structure and regulation of health boards, as well as their relationship with local authorities…”

Leading a debate in parliament this afternoon, Mr McArthur made a plea to the Scottish Government to “ensure that this review preserves island health boards, recognising their unique status and the risks inherent in submerging them within a larger, less responsive or accountable set up.”

The debate comes in the same week as NHS Orkney’s AGM, where the local patient group made clear its opposition to centralisation and removal of decision making from the islands’ health board. It also follows acceptance by the Health Secretary that NHS Orkney and NHS Shetland are “experienced in the demands of serving [their] very distinct communities”.

Responding to the Liberal Democrat MSP today, Health Minister Maureen Watt MSP could only confirm “there are no firm proposals on the table” but added “given we have got integrated joint boards, do we now need health boards as well?”

Speaking in the debate, on a motion that received support from MSPs of all parties with the exception of the SNP, Mr McArthur said:

“From my conversations with those directly employed in delivering health and care services in Orkney, as well as the many members of the public who have been in touch over recent days, there can be no doubting the strength of feeling or determination to resist any dilution of local control.

“And that is because all the evidence shows large scale, structural changes inevitably distract attention away from the day to day business of delivering services. They can affect morale and the ability of organisations to recruit and retain staff. And the savings often used to justify them invariably prove elusive if not illusory.

“Anyone doubting this need look no further than what has happened since the government decided to create a single, centralised police force.”

Mr McArthur added:

“Preserving NHS Orkney’s identity is important. For patients and staff, that identity shapes the ethos, priorities and approach. Bringing together different boards with different identities offers no guarantee, or indeed much likelihood, that island needs would be effectively heard, understood, far less met.

“It would also remove the ability to be nimble in responding to local needs; to develop, in conjunction with communities themselves, services that best suit island circumstances; and to enhance the skills of staff in ways that ensure both quality and breadth of provision”.

Following the exchanges in the chamber, Orkney MSP Liam McArthur said:

“The Royal College of Nursing Scotland has claimed that ‘little or no engagement has yet taken place on the Government’s stated intention…leading to a perception that change is being introduced by stealth, by a government talking behind closed doors.

“Today’s debate was an opportunity for SNP Ministers to address that criticism, be upfront about their intentions and reassure island communities that local control over health and care services will be protected.

“Instead, the Health Minister argued that the government has ‘no firm plans’ for health boards, but yet in the same breath questions their need. If alarm bells weren’t ringing before, they surely will be now”.

“There is already considerable collaboration within Orkney and between Orkney and mainland health boards. This can and should continue in future. But local decision-making, tailoring services to the specific needs of island patients and delivering as much as is safely possible in the islands, has to be the way forward. Anything else will drive a coach and horses through any commitment from the First Minister to a process of ‘island proofing’.”


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