The Scottish National Party listened to healthcare staff, patients and pressure groups at its 'people's assembly', but with elections to the Scottish parliament approaching, it is yet to create a health policy of its own. Barbara Millar reports

The Scottish National Party does not yet have a health policy.

But, says health and social policy spokeswoman Kay Ullrich, it is working on it. Last week the party held its first 'people's assembly' to kick-start the process.

With elections to the Scottish parliament just a few months away, the SNP is riding high in the opinion polls.

The assembly, held in the debating chamber of the old Royal High School in Edinburgh, which had originally been expected to house the new parliament, brought together a range of interest groups.

It was, insisted Ms Ullrich, a serious attempt to make policy, 'not a political jamboree or stunt'.

Those represented included the Institute of Health Services Management, the British Medical Association, Unison, the Royal College of Nursing, charities, voluntary organisations, pressure groups and 'concerned citizens'.

The SNP is committed to establishing a permanent people's assembly to 'tap the expertise in Scottish society to scrutinise policy at the pre-legislative stage', Ms Ullrich told participants.

Health and social welfare was chosen to kick off the process because it will consume a third of the new parliament's budget.

But Ms Ullrich promised that, should the SNP be in control, it would not impose still more sweeping changes on the NHS. 'Change will come by consultation, not diktat.'

The party's first objective would be to raise the morale of healthcare workers, 'by including those who know more about what is needed in decisions about what needs to be done'.

The Scottish health white paper, Designed to Care , was seriously flawed because it left patients out of the decision making process, she said. 'We are determined that, at every level in the health delivery process, democracy, not quangos, will be the basis on which decisions are made.'

To this end the SNP would set up a national healthcare commission, chaired by the Scottish health minister and including members of the Scottish parliament, healthcare professionals, voluntary organisations 'and people from the community'.

The SNP is also pledged to have a public health minister, and wants greater democracy and accountability for health boards and local healthcare co-operatives.

On community care, the SNP would bring agencies together to develop a national strategy and set national standards. It would establish 'a transparent national framework' for the transfer of resources between health and social services, she said.

Scottish BMA secretary Brian Potter said doctors wanted a constructive partnership with the Scottish government to tackle problems at source. 'We will support efforts to achieve the attainable goal of good health for all the Scottish people.'

But a future Scottish government had to talk rationally to other interested parties, Dr Potter added. 'We need a system which is sensitive enough that, if a mistake is made, we can go back and correct it.'

Scottish doctors want an urgent review of prescription charges, an end to private finance initiative projects and a different method of costing consultants in public health medicine, taking them out of NHS management costs.

Unison's George McGregor expressed interest in the SNP idea of a healthcare commission, but wanted to know how its members would be appointed.

'There is merit in taking decisions as close as possible to local communities, ' said Mr McGregor, 'but we don't want to substitute one quango for another.'

He said health boards should, in future, have one-third of their members elected by the local community, one-third elected by healthcare professionals and one-third made up of representatives from local authorities.

Donald McNeill, secretary of the Scottish Institute of Health Service Managers, noted that life expectancy in Scotland remained significantly below that of England, Wales and Ireland, and Scotland continued to head league tables for heart disease, cancers and stroke.

On some housing estates in Glasgow it was easier to buy a bottle of Buckfast (fortified wine) than a brown loaf, he said, and the NHS had to be better at positive health promotion. He hoped the Scottish parliament would 'engineer positive changes to the lifestyles of Scottish people'.

But ill health was linked to poverty, he added, so the parliament had to ensure people had the chance to have a satisfactory income and decent housing.

'Health has to be top of its agenda and significant progress will only be made if we harness all elements of Scottish life to this task.'