I was at a meeting of the Scottish Labour Party's Health Commission last night. Under the policy process the Commission is tasked with drafting the health section of the the party programme for consideration by the Scottish Policy Forum and then Party Conference.
The second stage consultation ended at the end of July. Over 100 submissions have been received and many of these cover some aspect of health policy. I stress health policy, not simply NHS Scotland.
In view of the debate in England over the ConDem health reforms, what strikes me about the submissions is that virtually no one is arguing that we should copy these in Scotland. Not even a line of support for the more modest New Labour reforms that have been introduced in recent years. In Scotland there is a very broad consensus that the NHS is about collective provision and that competition has no place in that ethos.
That is not to say that our model cannot be improved. There are difficult issues to be addressed around better integration of health and social care; how personal care can be person centred without the difficulties of the direct payments approach; and how we can finance improvements to the NHS estate. However, important though these issues are, we must not lose sight of health inequality as the number one cause of poor health in Scotland.
We need to focus on the poverty and inequality that underlies poor health. Inadequate housing, low confidence and wellbeing, low pay and unemployment all impact on health. This is evidenced by the fact that children from poor backgrounds are more likely to leave school with no positive destination and this also affects their health. Furthermore, smoking, poor diets, excessive alcohol intake and drug use are more prevalent in areas of deprivation. We therefore need to take co-ordinated partnership working across policy areas if we are to make a real impact on Scotland’s most persistent health problems.