Angela Constance has written in The Scotsman than ‘we run the risk of losing everything’ if the NHS is not radically reformed.
A leading doctor says clinicians are no longer able to provide safe care in emergency departments as the health secretary says corridor care is “not acceptable”.
Dr Fiona Hunter from the Royal College of Emergency Medicine says she is “completely terrified” of this upcoming winter, and the “toxic normalisation” of corridor care means patients are at a great risk of dying.
Speaking yesterday, Dr Hunter said: “I am completely terrified, to be clear about the situation.
“There is a toxic normalisation of corridor care. We accept it on a daily basis, with departments stacked up with ambulances and trolleys up and down corridors.
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“These trolleys are designed to hold patients for up to four hours, but we are keeping them there for up to three days, and we know excess mortality happens when someone is left languishing on a corridor trolley beyond 12 hours.
“I don’t want to scare patients away from emergency departments - if you need A&E we will be there, our doors are never closed - but we are not able to provide safe care because staff are being asked to deal with a ward’s worth of extra patients while also seeing every patient that comes through the front door.
“Some departments are at 500 per cent capacity but without 500 per cent extra staff, so we have high levels of sickness and burnout before viruses even hit.
“We want to isolate patients, but when you have a waiting room stowed out it is impossible, you cannot appropriately apply infection control procedures like you can in a ward.”
She added that A&E staff are “being asked to do a completely impossible task”.
Currently the government does not hold statistics on the levels of corridor care in hospitals, and Ms Constance said this is something she wants to fix.
She told the programme: “I want to remedy that. What I am absolutely clear about is that corridor care isn’t acceptable. It’s not acceptable for patients or their families.”
She admitted corridor care makes the job of NHS staff “harder” and added: “We cannot accept corridor care.”
When discussing hospital capacity, she added: “The bigger issue is around reducing avoidable hospital admissions.
“Hence, we have to have a laser focus on building capacity in the community, ensuring people know which service to approach at the right time.”
Ms Constance also said that bed blocking continues to be a major issue in hospitals up and down the country, and is having knock-on effects on other departments such as A&E.
She said: “Delayed discharge is a significant factor, and is particularly acute in particular hospitals in some areas.
“That’s why one of the reasons we are pushing forward with reforming our national health service is there is evidence that assessing the frailty of people coming into hospital means they can be signposted to other services and cared for in a different way.
“We need far more replication of this good evidence.”
She added the Scottish Government is investing £2.3 billion into social care to make sure health and social care is “better connected”, but also said there are still issues around austerity, Brexit and the cost-of-living crisis to deal with.
Writing for The Scotsman, Ms Constance said the NHS is “tangled in bureaucracy” and is preventing clinicians from being able to do their jobs properly. She said this is one of the main reasons the SNP is proposing reducing the number of mainland health boards to just two.
She said: “That is not a system designed around people. It is a system designed around structures, and it is costing us dearly.
“Delayed discharge alone is estimated to cost at least £440 million a year - money that should be going into care, not into managing complexity.”
She said the proposals do not mean centralisation and are not a cover for job losses, reiterating the promise of no compulsory redundancies.
Ms Constance said: “This is not just about an organisational chart. Fundamentally, this is about improving services for people.
“It is about making sure that a patient calling NHS 24 does not have to repeat their story because their local board’s data cannot be seen by anyone else.
“It is about giving people one continuous journey through health and care, instead of passing them from pillar to post.”
She added: “We owe it to patients and to the extraordinary people who work in health and social care to build something more sustainable that we can pass onto the next generation with confidence.
“Our NHS was a hard-won gain of the post-war era. It is precious, to me and to this country, but if we do not change, we run the risk of losing everything we have worked so hard to build.
“Simply put, the status quo is not an option. The NHS was created for the people, and it is time to put people first.”