Talking-up Scotland

Today as part of its wider proxy war on behalf of the opposition parties and against the SNP, the Scotsman reported:

‘NHS Lothian ‘bed-blocking’ figures 10% higher after error. One of Scotland’s largest health boards recorded ‘bed-blocking’ figures that were 10 percent higher than previously submitted due to a reporting error.  NHS Lothian posted statistics that were incorrect with data omitted that had to subsequently be revised by the Information Services Division.’

https://www.scotsman.com/news/uk/nhs-lothian-bed-blocking-figures-10-higher-after-error-1-4731120

The revised figure for ‘beds days occupied by delayed discharges, all delays, 2017/18, to February 2018’, in NHS Lothian, was 10 428 days. No context is given in the report. We don’t know whether this 10% matters because it is 10% of a worrying figure in a wider UK context or whether it is 10% of a figure that is quite low in a UK context.

http://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Publications/data-tables2017.asp?id=2140#2140

Bed-blocking is the result of delayed discharges where the patient is otherwise well-enough to be discharged but cannot be because arrangements for their continuing care or recuperation in the community, are not yet in place. The situation in England is more serious:

‘In 2016/17 there were 2.3 million delayed transfer days in England, an average of around 6,200 per day. The average number of delayed days for 2016/17 was 25% higher than the previous year.’

England has a population of 54.3 million. Lothian Health board covers a population of 890 000 (including Edinburgh) or 1/60^th of that of NHS England. So, if bed-blocking was a comparable problem in Lothian, it would have 1/60th of the English figure of 2.3 million, or 38 333 days of bed-blocking, but it only had 10 428, in the same year, 2016/17. Bed-blocking in England is, thus, more than three times as bad.

https://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Publications/2018-04-03/2018-04-03-DelayedDischarges-Summary.pdf?98556154967

Briefing Paper: Number 7415, 20 June 2017: Delayed transfers of care in the NHS:

researchbriefings.files.parliament.uk/documents/CBP-7415/CBP-7415.pdf

Editor of ?? (c) noplaceforsheep.com

Spread, literally, across all the Scottish media this morning, we have a terminally ill cancer patient calling on the Health Secretary to resign. I’m not going to share any of the frankly morbid, distasteful and utterly cynical use of the story by Richard Leonard and the Unionist press as they circle the Health Secretary slavering like a pack of mangy hyenas desperate to feed on her political corpse.

This incident, tragic but single, is just the latest in a series of attempts to undermine the Health Secretary and score a point over the SNP. No consequent improvement in NHS Scotland is really expected or indeed really possible given the superiority of NHS Scotland over the others in the UK where resignations would actually make sense but are not being called for with any enthusiasm or expectation. Here’s a reminder of the nature of this dirty strategy so far and of the evidence an award would make more sense than a resignation:

Scotsman under fire over dishonest reporting of four-doctor protest, against NHS England, but at Holyrood (?), in latest round weaponizing NHS in proxy war against SNP

BBC Scotland and Herald warn that paediatricians can’t carry on despite 64% increase in paediatric specialists under SNP administration and 8.7% fall in the birth rate.

In the Scotsman today, 93% of Scottish patients get appointment with GP within 2 days!

Pressure on Herald editor to resign over misrepresentation of NHS successes as Health Secretary is nominated for award as most successful in UK

Poxy Unionist media unfairly attack NHS in proxy war against SNP

I hope there is no question of them getting their way on this?

© ALAMY

Regular readers will have seen earlier reports here of the mainstream media’s proxy war on the SNP misusing the NHS as a weapon to do so. See:

Poxy Unionist media unfairly attack NHS in proxy war against SNP

Pressure on Herald editor to resign over misrepresentation of NHS successes as Health Secretary is nominated for award as most successful in UK

Here’s the headline and some text:

‘Shona Robison under fire over ‘snub’ to doctors discussing pressures of NHS’

‘Doctors gathered to protest about working conditions in the NHS at Holyrood yesterday amid claims by opposition parties that Health Secretary Shona Robison had “snubbed” their meeting. A small group demonstrated outside the Scottish ­Parliament saying the demands of the job have left many of them feeling “stressed and exhausted”. They were there to raise to discuss staffing and workload pressures, “burnout” and a potential blame culture of overworked NHS staff.’

Two things, in particular, made the report ‘dishonest journalism’.

First and most obvious, the use of the term ‘doctors’, in the headline, and ‘small’, in the text, seeks to hide the fact that there were only 4 doctors there out of a total population, in Scotland’s hospitals and practices, of more than 20 000! So, 0.02% of the profession makes for a very unrepresentative sample.

Second, perhaps explaining the teeny size of the protest and the failure of the Health Secretary to find the time for them, the doctors were actually there to show support for a doctor struck off in England. See:

‘The doctors raised the case of Dr Hadiza Bawa-Garba, who was struck off the medical register after being convicted of manslaughter on the grounds of gross negligence for the death of a patient. Wearing T-shirts with the slogan I Am Hadiza, ­campaigners from the Scottish Action for Dr Hadiza Bawa-Garba group argued her case should have been treated as corporate ­failure rather than that of an individual doctor. Six-year-old Jack Adcock died while under her care in England in 2011, while she was working a 13-hour shift in an understaffed paediatric unit [In Leicester, England]. Doctors have expressed fears that a culture of stress and overwork could lead to mistakes being made in Scotland.’

https://www.scotsman.com/news/uk/shona-robison-under-fire-over-snub-to-doctors-discussing-pressures-of-nhs-1-4730562

Should ‘Scottish Action for Dr Hadiza Bawa-Garba’ have gone south to make their protest?

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2018-03-06/2018-03-06-Workforce-Report.pdf?49929445982

BBC Scotland made much, this morning, of the warning from the trades union, the Royal College of Paediatrics and Child Health (in Scotland?), that ‘paediatricians in Scotland are under too much pressure and need more resources.’ In a remarkably long piece for a two to three-minute insert in BBC1 Breakfast, the fake crisis warning was then repeated a further five times before 9am. We also heard, in most of these, that they want the number of consultants quadrupled (more on this below) and that they can’t carry on.

The Scottish Government was able to respond in the longer of these reports however the longer-term perspective, shown in the graph above, was not offered for context. The 64% increase in paediatrics staffing is on page 15 of the report. The change in 2017 alone where we saw paediatrics specialities staffing increase by 2.9% was also not offered.

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2018-03-06/2018-03-06-Workforce-Report.pdf?49929445982

The Herald had pretty much the same uncritical use of a trades union comment as if it were evidence of anything meaningful.

Returning to the RCPCH, two facts seem relevant in reacting to this demand.

First, from the RCPCH’s UK report in January 2018:

‘Policies that will improve childhood obesity rates, breastfeeding rates, women’s health during pregnancy, child poverty and child and adolescent mental health have all been welcomed in the new scorecard, which sees the Scottish Government performing far better than the Westminster Government when it comes to its focus on child health.’

We then see an impressive list of achievements, recognised in the report:

‘Key recommendations from State of Child Health that have been adopted include:

• An announcement to expand the number of health visitors by an additional 500 by the end of 2018 through the full roll-out of the Family Nurse Partnership programme.
• A commitment from Scottish Government to ensure specialist breastfeeding advice and support is delivered to women
• A commitment from Scottish Government to review statutory sex and relationships education in all schools
• A commitment from Scottish Government to create a system to ensure that child deaths are properly reviewed
• A commitment to deliver a Child and Adolescent Health and Wellbeing Action Plan
• A commitment from Scottish Government to tackle obesity by supporting families to lead active lives, encouraging more women and girls to take up sport and launching a consultation with the view to publishing a strategy later this year’

And there’s more praise from RCPCH UK:

‘Dr Steve Turner, Royal College of Paediatrics and Child Health’s Officer for Scotland, said: It’s heartening that the child health and wellbeing agenda is moving forward in Scotland. At the end of 2017 the Child Poverty (Scotland) Act was passed by the Scottish Parliament, providing a positive first step towards reducing child poverty. The Scottish Government has led the way nationally by setting a minimum unit price on alcohol, it has committed to deliver a child and adolescent health and well-being action plan in 2018, an obesity strategy and has committed to adopt a ‘child health in all policies’ approach. All of these developments indicate how serious Scottish Government is taking child health and they will help Scotland become a healthier country for children. “Considering only a year has passed since the launch of our State of Child Health report, it is encouraging that so many commitments to child health have been made. The key now is to make sure these commitments are delivered effectively.’

https://www.rcpch.ac.uk/what-we-do/rcpch-uk-and-roi/rcpch-scotland/state-child-health-one-year/child-health-agenda-moving-fo

This looks like a ‘rogue’ pro-Union element in the wider RCPCH which clearly recognises the superiority of SNP management of NHS Scotland.

Second, the birth rate in Scotland is falling and has been falling for some time. In the period 2007 to 2017 when we have had a 64% increase in the number of paediatricians, we have seen an 8.7% reduction in the number of births and thus the number of young patients requiring their care.

The proxy war against the SNP via the NHS continues. See these for more detail:

Poxy Unionist media unfairly attack NHS in proxy war against SNP

Pressure on Herald editor to resign over misrepresentation of NHS successes as Health Secretary is nominated for award as most successful in UK

I heard the above on BBC Scotland’s 2 minute news insert at 06:26 am! They’ve been mostly positive about Scotland and the Scottish Government for the last 5 or six days. What’s going on? Are they trying to queer my pitch? Can I still say that? I’ll try to see if they repeat it in Reporting Scotland at 1pm or 6.30pm.

I’ve searched for other mention of it in the Scottish media but could only find it in an excellent piece in the Orkney News:

‘We have always been clear we will support carers and our guarantee to increase Carer’s Allowance by 13% to bring it into line with UK Jobseeker’s Allowance will be introduced this summer and backdated to April. This is an investment of more than £30 million to support carers, in addition to the new rights introduced under the 2016 Carers (Scotland) Act, and the new Young Carer Grant announced by the First Minister last year.’

Scotland’s Social Security System Takes Shape

It’s well worth reading the whole piece. It’s complete, informative and utterly free of nippy grudging comment by local Lib-Dems.

For the other three interventions, disabled Scots will not face the unnecessary and often humiliating medical checks before claiming benefits, improved terms for the terminally ill and the funding of frontline work with the hardcore of street homeless, see:

As Ruth Davidson’s party bombs Damascus, evicts loyal West Indians and slashes the welfare state, the Scottish Government makes its third humanitarian intervention in three days

No, that wasn’t their headline. The Scotsman today, continued its Labour/Lib Dem-assisted campaign against NHS Scotland, the Health Secretary and of course the SNP, with this:

‘Fewer patients reporting positive GP experiences, says survey. The Scottish Government’s 2017/18 Health and Care Experience survey found that 83 per cent of those questioned rated their care positively, a decrease of two percentage points compared to 2015/16 and a decrease of seven percentage points compared to 2009/10.’

That’s a 2% fall over 2 years and so, statistically meaningless. Whether the 7% fall over 8 years means a worsening in the actual service or is part of other of a wider and more complex socio-cultural shift in attitudes to professionals among a changing population would require serious sociological study.

I’m not saying that there is definitely no issue here, worthy of further research, but rather that it requires a more sophisticated study than this simple opinion poll. Needless to say the Scotsman took this opportunity to conflate any NHS-related issue with the survey to construct a crisis:

‘Labour and the Lib Dems have called for her [Health Secretary] to quit amid controversy over funding decisions taken by NHS Tayside, which saw more than £2 million endowment cash used for spending on routine services.’

Deep in the piece, after many readers have skimmed off somewhere else, we get a snippet of good news with:

‘More encouragingly, it also found 87 per cent of people found it easy to contact their GP practice, while more than nine out ten (93 per cent) were able to get an appointment within two days.’

As always, Liberal Democrat health spokesman Alex Cole-Hamilton was there to warn that patients were feeling the impact of a GP crisis. See below for some contradictory facts.

https://www.scotsman.com/news/politics/fewer-patients-reporting-positive-gp-experiences-says-survey-1-4729842

Of course, the Scotsman piece had no contextual information so here’s some:

The latest figures for the number of GPs in the UK are:

• 41 985 GPs in England – last published in Sept 2016
• 4 953 GPs in Scotland (does not include locums) – last published Jan 2017 (350 locums in 2015)
• 2 887 GPs in Wales (includes 634 locums) – last published 30 Mar 2016
• 1 274 GPs in Northern Ireland (does not include locums) – last published Oct 2015

The number of locums in Scotland in 2015 was 350.

http://www.isdscotland.org/Health-Topics/General-Practice/Publications/2016-06-14/2016-06-14-PrimaryCareWorkforceSurveyScotland2015-Report.pdf

So, the ratio of GPs to overall population is:

• England 1 GP for every 1262 people
• Scotland 1 GP for every 999 people
• Wales 1 GP for every 1060 people
• N Ireland 1 GP for every 1421 people

The number of GP practices is:

• 7 613 in England – last published in Sept 2016
• 958 in Scotland – last published Jan 2017
• 454 in Wales – last published 30 Mar 2016
• 349 in Northern Ireland – last published Oct 2015

The number of practices is a less meaningful statistic than the number of GPs per capita as these vary in size considerably but the number, nevertheless, could give an indication of access in terms of geography.

The ratio of practices to overall population is:

• England 1 practice for every 6962 people
• Scotland 1 practice for every 5532 people
• Wales 1 practice for every 6746 people
• N Ireland 1 practice for every 5189 people

The relatively large number of practices in Northern Ireland, despite having the worst ratio of GPs to population might suggest a tendency only for smaller practices there. In contrast, Scotland having the best ratio of GPs to population along with a relatively high number of practices suggest better geographical access.

Above figures are from the BMA’s General practice in the UK – background briefing 2017

(c) keepcalm-o-matic

From Insider, today:

‘New research has found that Scotland’s SMEs are the least likely targets for fraud compared to anywhere else in the UK, with 31 per cent of those surveyed saying they had been targeted, compared to the national average of 44 per cent. The figures from Barclays, part of a UK-wide survey, reveal that online fraud has resulted in the loss of more than 50,000 British jobs to date as SMEs had to make redundancies to recover costs.’

https://www.insider.co.uk/news/smes-fraud-barclays-scotland-percentage-12420191

I’ll leave it to readers to suggest reasons for this other than inherited ca’ cannyism.

Footnote:

Scottish National Dictionary (1700–)

CA’ CANNY, v.phr. To proceed warily, to be moderate. Gen.Sc. Also as adj.phr., gen. with policy; now in gen. use in Eng. and Western America as applied to the trade-union policy of limiting output; and as n.phrs.: ca’-cannyism, ca’ cannyness, moderation, caution, “ca’ canny” policy.

http://www.dsl.ac.uk/entry/snd/ca_canny

(c) Daily Telegraph

STV News, today, reported:

‘Scottish hotels were the UK’s best-performing in 2017. Success is attributed to influx of overseas visitors caused by a weak pound.’

I’ll come back this basic misunderstanding which has the effect of downplaying the real strengths of the tourism industry, below. Average hotel revenue in Scotland was up 5% compared with 4% in Wales, 2.2% in Northern Ireland and under 2% in England.

https://stv.tv/news/east-central/1413056-scottish-hotels-were-the-uk-s-best-performing-in-2017/

While the weak pound has no doubt played a part in increased tourism across the UK, this does not explain the differential, with Scottish tourism numbers and revenue soaring above that of the rest of the UK, due to the increased quality of our attractions, perceived safety away from the terrorism-affected centres such as Paris and London, whisky and the particular appeal of locations used in the Outlander series and other historical dramas. See these for fuller accounts:

Scottish tourism growth outpaces that in UK

Whisky tourism boom expected to add to record year for Scottish tourism in 2018

‘BLOODY HELL Robert the Bruce movie Outlaw King will feature some of the bloodiest battle scenes in cinema history’, put Braveheart in the shade and boost tourism like Outlander.

‘Scotland enjoys tourism boost thanks to interest in Gaelic’

North Americans lead surge in Scottish tourism because they feel safer here

17% increase in visits to Scotland’s historic attractions with massive Outlander effect

414% increase in Chinese tourist spending since 2007!

 

(c) Reuters

We’ve just heard of the Scottish Government’s improved terms for the terminally ill and their funding of frontline work with the hardcore of street homeless. See these for more detail:

Another little difference that tells us something: SNP to improve disability terms for terminally ill.

SNP Government to fund frontline efforts to help hardcore of street homeless while Ruth Davidson goes from baking show to celebrity list membership games and our media rats sniff the sewer air for SNP-bad aroma

Today, we hear that Scotland’s new Social Security bill includes changes to legislation so that disabled Scots will not face the unnecessary and often humiliating medical checks before claiming benefits. Based on an amendment from the Green’s Alison Johnstone, the new requirement is that assessments will only be carried out when there is not enough pre-existing medical evidence for the claim by an applicant.

Despite the constraints of this union, Scotland continues to move toward becoming a better nation. See these earlier examples:

More evidence of becoming a better nation as SNP ‘future-proof’ social security

Another step on the way to becoming a ‘Living Wage Nation’ and a ‘Better Nation?’

In a year of terrible events, we can still feel that this wee country is getting better as it drifts away from the callous, post-imperial, values of Tory Britain

(c) PA

Once more, the Scottish Government acts to help the most vulnerable in our society in a way utterly alien to the thinking of Tories in England or Scotland. Ruth Davidson’s Boris-like, bullishness may have got her into a list of the supposed influential in British society, but she has no influence on matters of real concern in a modern compassionate society.

Homelessness is falling in Scotland as it rises in England under the malign ‘leadership of Theresa ‘Windrush’ May. See these for more detail:

Homelessness falls in Scotland as it rises in England, mainly driven by heartless Tory welfare reforms

Could Scotland end homelessness?

Having begun to tackle the wider problem of homelessness with the successful Priority Needs Test in 2012/13 and currently piloting the Housing First strategy, the SNP Government has now taken steps to deal with ‘the hard core of street homeless who refuse to engage with services or access any accommodation on offer.’

See this, from the Guardian today, but ignored by the Scottish media:

‘Outreach workers in Scottish cities can make instant pay-outs of up to £200 for anything from haircuts to hotel rooms as part of a radical approach to entrenched rough sleeping. The funding, directly from the Scottish government, is being made available to frontline staff working with the hard core of street homeless who refuse to engage with services or access any accommodation on offer.’

https://www.theguardian.com/uk-news/2018/apr/22/instant-payouts-offer-lifeline-scotland-rough-sleepers-homelessness

Some say the measure of a society is how it treats its elderly, sick and poor. This seems an even tougher test. This hard core of rough sleepers and, perhaps, daytime beggars, represent a group for whom many in our society have no compassion. I doubt there are many votes to be won from this so the SNP leadership is to be commended for reminding us how different we and they can be from Tory England.

I’m not a believer, but ‘the book’ is full of evidence that our Tory kirk and church-going neighbours might want to recognise the efforts of this government:

Matthew 25:40

And the King will answer them, ‘Truly, I say to you, as you did it to one of the least of these my brothers, you did it to me.’