BMJ 2001;322:10 (
6 January )
Bryan Christie, Edinburgh
Every patient in Scotland has been given a guarantee that, from 2003, they will wait no longer than nine months for NHS hospital treatment. The pledge, which cuts the present maximum waiting time limit by three months, is contained in the Scottish NHS Plan, published last month. The plan contains additional commitments to speed up the diagnosis and treatment of conditions such as cancer and heart disease.
Women with breast cancer who need urgent attention will be treated within a month from October 2001, says the report, and by 2005 no cancer patient will wait longer than two months when referred urgently for treatment. The Scottish document differs substantially from the English NHS Plan, which was released in summer 2000. Patients in England have been promised they will be able to see a GP within 48 hours; in Scotland that guarantee only extends to "an appropriate member of the primary care team."
Other proposals include piloting the use of "smart cards" as patient-held medical records; consulting on making nicotine replacement products available on GP prescriptions; expanding the role of pharmacists and nurses; setting clear national standards on quality of care and cleanliness of health service premises; and strengthening the voice of patients in the health service.
The structure of the NHS in Scotland is also to be streamlined to create 15 decision making health boards to replace the current mix of 43 boards and trusts. There are plans to improve the education and training of all NHS staff; to conduct a fundamental review of medical workforce planning; and to increase the number of consultants in Scotland by 600 over the next five years, although no commitment is being made to increase GP numbers.
The plan has been welcomed by doctors in Scotland. Dr John Garner, chairman of the Scottish Council of the BMA, said: "The health plan delivers a clear set of goals for improving healthcare in Scotland and sets out detailed aspirations that are shared by all. The task ahead is to turn the planís rhetoric into reality and develop practical improvements in patient care."
Professor Jim Petrie, chairman of the Scottish Royal Colleges, said the plan provides a strong strategic direction. "The Scottish Royal Colleges have been to the fore in developing new standards in evidence based care and we particularly welcome the recognition that these guidelines have to be implemented throughout Scotland if we are to address variations in the standard of care."
Our National Health
can be accessed on www.scotland.gov.uk