By Maura Bowman

THOUGH SCOTLAND will be one of the highest spenders on health in Europe within the next three years, urgent action is needed to prevent the continued ineffecient use of resources and below standard outcomes, according to a paper published by the Scottish-based Policy Institute.

The paper sets out a number of steps to create a world-class, high-quality service.

In “A Healthy Future For Scotland—Symptoms, Diagnosis And Cure For The NHS In Scotland,” Professor Nick Bosanquet says that much cash is poorly directed and, though funding is 20% higher than in England, effectiveness in the use of medical time is 55% lower.

Scotland has more hospital beds than the UK average and hospital stays tend to be longer, according to the study.

In addition, there is not enough investment in primary care, there is lower access to new therapies in Scotland and there are likely to be problems in retaining experienced staff.

“Scotland’s health service is well financed and can call on excellent and dedicated staff,” the paper says. “However, despite some recent improvements, resources are used inefficiently and outcomes are below standard.”

Professor Bosanquet, professor of health policy at Imperial College, London, maintains that Scotland should learn from reforms in Scandinavia and elsewhere to introduce greater patient choice to lower waiting lists.

While Scotland’s health services have much to be proud of—including pioneering telemedicine and special access programmes for rural areas and improving stroke care and screening for cancer and heart disease—“there is little in the current policy mix set for the next crucial five years which will have any impact at all on the underlying problem of productivity, which appears to be the great unmentionable of Scottish health politics,” he says.

“There is a golden opportunity over the next three years for radical improvement in access and quality to health services for the people of Scotland.

“Scotland has the people and the resources required to make this happen. Can it find the motivation and drive to improve results and maximise value for patients from the Scottish health pound?”

The paper recommends that GPs be given the power to refer patients “wherever service is best and quickest.” It also calls for a more dramatic programme to improve diet and lifestyle, devolved budgets for health boards and more funding for voluntary organisations.