NHS Scotland Health Boards to be cut from 14 to 2

[Strictlysober]

What do people think of this? I have to say that I'm worried.

NHS Scotland Reform: Health Boards Cut from 14 to 2

The BMA Scotland (British Medical Association Scotland) has come out strongly against. It seems that doctors were not consulted with before the Government made its decision.
BMA Scotland urges the Scottish Government to “withdraw and rethink” plans to reduce health boards - BMA media centre - BMA

Why would you not consult doctors and the other health care professionals who work in the organisations? Who did inform this decision?

Crazy.

The NHS does need significant reform but I’m not sure this will help.

The BMA lost all my respect with its rabid pay demands and their TWAW schtick. What’s to say they give a damn about the public?

Doesn't bode well for those in remote areas in need of healthcare. I know you can't offer a full range of specialist services in every corner of Scotland but this creeping centralisation is worrisome. The bean counters in the central belt have no understanding of this.

100% this. Surely this needs consultation, and genuine consultation before any kind of decision is made. As they've made the decision without consulting, then even if they consult now, they won't backtrack. Because they never do. They'd see it as losing face. I just can't conceive of making that kind of massive decision, impacting the whole population and costing a vast amount of money, without speaking to those involved in the system. You know - the experts.

Why though? Would you consult big 4 accountants before merging 2 accountancy firms? Would you consult train drivers before merging 2 train companies? Doctors are the workers. The management are the people who highlight the issues with the merger, ensure there are no gaps in service provision etc. what’s it got to do with the workers?

@OllyBJollyThey never consult the people at the chalk face. Education, Police, Fire, etc. are never consulted.

It would probably be interesting to foi the analysis behind the decision. Suspect it's more a political posturing decision than an evidence based one.

@Millerner Who do you think they consulted? Do you think they've gone through exhaustive consultation with the senior and middle managers? Presumably, the aim of moving from 14 Boards to 2 Boards is to get rid of a lot of those senior and middle managers.

There are lots of comments online about how disastrous doing the same thing with the police has been.

The Scottish Health Service is now going to be bogged down with this for years. And it'll cost a fortune.

Having these politicians in charge of the country is genuinely terrifying at times.

I've a feeling that the unions are expected to be consulted in this kind of situation that will lead to a lot of redundancies, yes.

The plan is also to significantly reduce local authorities. No consultation there either.

I hadn't heard about that. Is that just about cost-saving? Or are they trying to centralise?

https://www.google.com/goto?url=CAESaQHrOzAV32y-jiBJ-EVUKvCNgeCX3zxlh9waUaMPTwIL7f_hvDPNXT2mnTf9od3WybFOPsq_d-Mz-gUydvhqhFtGJ2Nvv9qYxA8Fepd1XDbWe34IxutMfmC20SR0CPezSrw7WTUJpfWzdQ

A rationalisation, although the proposals look very complicated. Tbf the local authorities vary considerably in size, and some could feasibly combine i.e. N & S Lanarkshire, the Ayrshires etc

The size of those reforms is shocking. I mean, reducing from 14 to 2, and from 32 to 6. And aiming to carry out both massive reforms at the same time? Madness. Surely the country's going to be in chaos (and let's face it, NHS Scotland is already chaotic).

On local government: "Ministers say they want to agree changes with local government and others within a few months - that's lightning speed for reforms of this sort."

Yes the plan is for implementation incredibly quickly. Not sure how that’s going to be possible. And not much talk about reforms that might be helpful such as coterminosity of LAs and health boards. Will create huge issues around terms and conditions for LA staff who are all paid at different rates currently.

Can imagine the snp are just getting extremely excited too about the amount of money they’ll get to spend rebranding all the badges, uniforms, fleet vehicles again….

Great! I hate the way public sector workers think they ought to be immune from redundancies just because. I want efficient public services. If there are people with no job to do we shouldn’t keep employing them.

So you would rather unemployment? How’s that good for the economy?

Take a workforce of 100, in England 17 of them would be public sector workers. In Scotland it would be 22. That’s appalling. That’s why we’re looking at a £5bn black hole. We have DOUBLE the number of nurses per head of population than England. This is how inefficient things are in Scotland.

Then look at thee way unaffordable pay rises are just thrown at the NHS here like sweeties. The increases in NHS budgets year on year are entirely consumed by pay rises, which the IFS and Fraser of Allander Institute pointed to as one of the many reasons why SNHS has failed to recover from the covid pandemic whereas England has.

Oh my goodness!!!!

Tell me you know nothing about public finances without telling me….

Public sector jobs are only a good thing if those people are meaningfully employed. If people are doing nothing, it is FAR better we pay them unemployment benefit than a full salary, because IT COSTS LESS! We can spend money on other things, other departments, creating jobs maybe that need to be done. Providing incentives for companies to base themselves here. Investing in growing the economy.

The Scottish government has always said that there would be loads of civil service jobs after Indy as though that’s a good thing and not a drain you’d be throwing money down. It shows their laughablely poor understanding of economics.

sure it’s much better for whole swathes of people to be put on unemployment benefit. Sounds brilliant.

What’s the cost to the NHS when the impact of mental health becomes apparent? There’s a whole bunch of negative outcomes to unemployment which ARE bad for the economy and you know people in general. There are alternatives to mass unemployment such as redeployment, retraining and restructuring.

Not to mention the lost tax revenue.

You don’t lose tax revenue when tax revenue is being used to pay these people a salary. You gain it. Do you think it’s better for these people to be in work as a civil servant doing nothing all day, or go through a period of redundancy then go into a job where they have the satisfaction of feeling like they’re DOING something for society, earning money eetc.

Each band 5 nurse after taking in salary, e’er NICs, e’er pension contributions less tax paid by the nurse costs the state about £38k a year. Making them redundancy, if they’d been there 10 years would be about £25-30k. Cheaper by far to make them redundant.

BMA is a union. Their focus is not on patient outcomes, it is on maximising pay and rewards for doctors.