FIGURES from the World Health Organisation (WHO) last week showed that of the ten European locations with the highest seven-day Covid-19 infection rates, five were in Scotland.
Tayside had the highest case rate in Europe, with 661 per 100,000 people; Lothian came next, with 567 per 100,000. Greater Glasgow and Clyde, Fife, and Grampian also featured.
Interviewed on BBC Politics Live, SNP MP David Linden said: ‘One of the reasons that we are in this league table, perhaps, for the first time is that we don’t have those levels of natural immunity that perhaps other people in the UK might have.’
Health is a devolved matter, and the SNP government are accountable. Since long before Covid, Scotland has been blighted by poor health. For decades, the Scottish National Health Service (SNHS) has underperformed compared with the rest of the UK and its European neighbours, regularly missing performance targets such as emergency admission times and stroke recovery rates, and breaching the statutory 12-week maximum waiting time limit for cancer treatment.
Scots suffer from a disproportionately high incidence of diabetes, cancer, cardiac disease, asthma, and lung disease: they are prone to extreme levels of alcoholism, drug addiction, and suicide. This was true before Covid.
Increasing numbers of Scots live with multiple long-term conditions and disability: the likelihood of the population having strong healthy immune systems capable of dealing with viral infection is low.
Taken together, all these factors result ordinarily in poor health outcomes for Scots: add in lockdowns, the withdrawal of medical services, job losses, increased poverty, anxiety, and isolation and no one should be surprised that Covid case rates are high.
The SNHS has essentially closed its doors to all but Covid patients during the past 16 months: the number of Scots waiting a year or more for planned hospital treatment has almost doubled. Data from Public Health Scotland published at the end of end May 2021 shows that 28,203 patients spent at least 52 weeks on a waiting list, up 86.4 per cent from December 2020.
Public Health Scotland said these dismal outcomes were caused by the suspension of non-urgent care in some hospitals, but acknowledged that the ‘long-term trend demonstrates the total number of patients waiting for treatment has been gradually increasing over time prior to the pandemic’.
Nonetheless, in an STV pre-election debate Nicola Sturgeon, first minister for several years, and a previous health minister, said that she was ‘proud of the record’ and blamed coronavirus for the service’s failures.
She promised that in future half of all spending on frontline NHS care would go to GPs and that there would be a ‘full-scale post-pandemic remobilisation of the NHS’. She pledged to increase in-patient, day case and out-patient activity to 10 percent above pre-coronavirus levels within a year and maintain that level for the rest of the five-year parliamentary term. If promises were performance, the SNHS would be world beating.
Meanwhile in the real world, GP practices continue with reduced access and hospitals are closing wards due to ‘Covid patient strain’ and record-breaking absences of doctors and nurses ‘self-isolating’ or dealing with ‘long Covid’.
Ms Sturgeon’s appointment as Health Secretary of Humza Yousaf, fresh from his successes as Justice Minister, does not augur well for those waiting in line for treatment. One of his first public statements was to contradict his Great Leader and to admit that it will be years before the SNHS returns to even pre-pandemic levels of diagnoses and planned operations.
Before the coming of the SNP, medical researchers had considered why there was such poor health and excess mortality in Scotland. They described a legacy of deindustrialisation which explained trends in mortality in Scotland and other parts of post-industrial Europe and coined two phrases, ‘The Scottish Effect’ and ‘The Glasgow Effect’.
The scale of Scottish ‘excess deaths’ has worsened during SNP rule with approximately 5,000 additional ‘unexplained’ deaths per year. These contribute to other mortality ‘phenomena’ in Scotland: the lowest and most slowly improving life expectancy in Western Europe; the widest mortality inequalities in Western Europe; and the persistently high rates of mortality among those of younger working ages.
The SNP’s ‘improved and approved’ health advisers have published a ‘synthesis report,’ entitled ‘History, politics and vulnerability: explaining excess mortality in Scotland and Glasgow’ which clarifies that Scots are made more vulnerable to the negative influences on population health (poverty, deprivation, deindustrialisation, and economic policy ) by – you guessed it – decisions taken at UK government level.
Yet Scotland is paradoxically well-served for medical services compared with the rest of the UK, having the highest ratio of hospital consultants, doctors, and general practitioners per person, and the highest per capita health spend, according to the National Audit Office (NAO). Health and social care spending accounts for over 50 percent of the Scottish budget.
There are record numbers of employees too; the NES Turas Data Intelligence platform shows 171,577 staff employed by NHS Scotland in 2021, the highest reported to date. This is a 4.9 per cent annual increase and an 8.3 per cent increase over the decade. This makes the NHS Scotland’s largest single employer, with approximately 5 per cent of the Scottish working age population on its payroll.
Covid, and the SNP government’s reaction to it, has provided convenient cover for their longstanding deficiencies in providing basic physical and mental health, sound health infrastructure, and preventative care for the most vulnerable. Nationalist rant and cant will no longer suffice.