Published: 31/03/2005, Volume II5, No. 5948 Page 8
A greatly anticipated report on the future shape of the NHS in Scotland is expected to press the 15 boards towards more effective collaboration in planning regional and national services.
Professor David Kerr, who is heading the Advisory Group on Service Change in NHS Scotland, told HSJ that current national planning structures were not working.
He also criticised NHS boards generally for failing to engage properly with staff and the public on service change, saying that proper consultation could have taken the 'heat' out of some of the most angry confrontations.
But the Oxford-based cancer specialist also acknowledged that the competition-based culture in the NHS in England would not transfer to Scotland.
Speaking at the end of a consultation process which has involved public meetings with NHS staff and the public, he said: 'It has come through very strongly that the English model, that competition, is not the Scottish way, ' he said.
'I am not just being sentimental as an ex-Scot - people really seem to believe that we stand together shoulder to shoulder and help each other out.' Professor Kerr, Rhodes professor of cancer therapeutics and clinical pharmacology at Oxford University, who was involved in reshaping cancer services in England, was asked to head the advisory group last year.
At that time there was unprecedented public protest across Scotland about proposed changes to services, in both rural areas and the 'central belt' around Glasgow and Edinburgh.
When the advisory group was set up, there were calls for a moratorium on service change until it reported.
Although there was no moratorium, some NHS boards have postponed decisions, pending the group's report.
'I think health boards have been mindful of what's going on [with the review] and have been wise and thoughtful. It is not about delaying decisions, but some decisions do not need to be taken straight away.' Some criticism of proposed service change has focused on perceived centralisation. This is a particular issue in rural areas, where even a small hospital such as Belford Hospital in Fort William is the 'local' district general hospital for patients 70 miles away.
But these types of services would only be sustainable within proper care networks - and would require better regional and national planning, he said.
'There are great institutions and great services - the building stones are there, ' he said, 'but they need to be better connected.' Professor Kerr said he could not say what would be in the report as he had not written it yet. But he said there had been 'exciting work' in areas including tele-medicine, caring for the young and elderly, unscheduled care and looking after people with chronic conditions in the community. The report is also expected to recommend a split between emergency and elective services and provide new impetus for diagnostic centres.
Expectations of the report are high, but Professor Kerr is aware that some people are bound to be disappointed.
'I know the report will not please everyone, ' he said. 'But We have been looking at ways of making services better, safer, quicker and sustainable. This is about designing services for the future.'
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