SNP leadership candidate Kate Forbes has said she would “look again” at proposals for a National Care Service (NCS) and consider a reorganisation of the NHS if elected first minister.
The NHS has been in crisis in the last year, with waiting times increasing and services struggling.
Some, including senior NHS leaders, have posited the idea of a reorganisation of the service.
Speaking at an online event with Reform Scotland, Finance Secretary Ms Forbes said she would consider calling an independent inquiry – to include senior NHS staff including those on the front lines – to look at the future of the health service.
But she was adamant that any changes should not compromise the NHS principle of being free at the point of need.
“I think it’s an excellent idea to have an independent inquiry that would be looking at the short, the long term and the medium term future of the NHS,” she said.
“Obviously – and I wouldn’t in any way swerve on this one – you would need to have as an absolute foundation stone that it continues to be free at the point of need, that would be an absolute non-negotiable.
“But that long-term future, I think, needs to be considered and I think it’s very attractive for it to be considered by senior thought leaders from within the health service, ideally people that are on the front line.”
Any change, the Finance Secretary said, would need to be “radical”, akin to steps taken in the early days of the pandemic.
“We were able to transform elements of the health service during Covid, because we were creative and we were urgent,” she said.
“We did manage to reduce delayed discharge almost overnight, now that brought with it other issues which we don’t need to go into, but we did do it and I think we could do something again.”
Delayed discharge was alleviated in the early days of the pandemic by releasing patients from hospital into care homes, but more than 100 were sent to facilities after having contracted the virus and before testing negative.
Around 82% of patients discharged into care homes were not tested for the virus.
Asked if she would “look again” at controversial plans for a National Care Service, Ms Forbes said she would, claiming care in Scotland needs to “be more nimble” but not necessarily subject to centralisation.
The NCS proposals – which would take social care out of the hands of local authorities, with responsibility given to regional care boards ultimately accountable to ministers – have been slated by opposition parties, Holyrood committees, unions and councils over cost and the lack of clarity over what the service will include.
“I don’t think a scheme can be effectively delivered unless it has the confidence of the people that are either going to be implementing it, managing it, or forming how its run,” the Finance Secretary said.
Ms Forbes went on to say the Government should focus on fixing the problems in social care – namely “that it’s a postcode lottery and there isn’t a universal standard of care” – rather than “creating something that’s massive”.
She added: “I think it’s simpler than that. (Fixing the problems) may not require a National Care Service, it may require us to be a little bit more nimble and able to plug the gaps in care, and I think anything that disempowers and centralises power is not going to fix the problem.”
