Healthier Scotland the E-Bulletin of the Socialist Health Association Scotland

Alcohol Policy

The Alcohol (Minimum Pricing) (Scotland) Act has now received Royal Assent. While we support minimum pricing we recognise that it is only part of the solution. Further measures are in a consultation from Scottish Labour MSP’s Richard Simpson and Graham Pearson on their proposed Alcohol (Public Health & Criminal Justice) (Scotland) Bill.

SHA Scotland‟s response to that consultation can be viewed here and a summary is on the blog. The consultation paper states that the objective of the legislation is to shift the culture of drinking in Scotland. However, the measures are almost entirely about control and inhibition. While we agree this is needed, we question if this will be fully effective in changing the culture. A greater focus on the inequality that is at the root of the problem would be a better approach.

Health Inequalities

Tayside Health Board has made a valuable contribution to the debate about personal financial incentives to achieve healthy behaviour. A Dundee programme – called quit4u – offering payment of £12.50 a week (in supermarket food vouchers) to encourage people living in deprived circumstances to quit smoking has been shown to work. The two year evaluation, demonstrates improved quit rates at 3 months and even 12 months.

The ground breaking book on inequality „The Spirit Level’ is becoming a documentary. The fundraising target has been met and so cameras are rolling. Should be a great contribution to the campaign. Richard Wilkinson‟s latest book, Unhealthy Societies, shows that among the developed countries it is not the richest societies which have the best health, but those which have the smallest income differences between rich and poor.

Alf Young‟s article on entrenched inequality in the Scotsman. Oxfam offers a different approach to measuring output with its Humankind Index. This would also give a higher priority to health.

The number of abortions carried out on women from the most deprived areas was more than double the number on those from the most affluent places. Inequality not behavior as some argued.

A new study looks at the ’causes of the causes’ of Scotland’s health problems. Led by Dr Gerry McCartney, who spoke at the SHA meeting in Edinburgh, it argues that “It is increasingly recognized that it is insufficient to try to explain health trends by simply looking at the proximal causes such as smoking or alcohol.” McCartney said in a statement. “Income inequality, welfare policy and unemployment do not occur by accident, but as a product of the politics pursued by the government of the day.”

NHS Scotland

NHS Lothian has rarely been out of the news in recent months. The Chief Executive was a casualty of the waiting times scandal and then he was involved in the strange case of a contract with the private sector, as Dave Watson highlighted. The health board also demonstrated that targets distort clinical priorities.

NHS Scotland spent £94million on temporary nursing staff last year – to fill the gaps left after they axed 2500 nurses. Further 102 wte less staff in first quarter‟s staffing statistics. Staffing cuts at Yorkhill result in cancelled operations. Further cuts highlighted in Scottish Labour‟s survey.

Suicide is more prevalent in Scotland among people between the ages of 15 and 44. Study found Scots in this age group are almost twice as likely to kill themselves as their English counterparts. Need for effective interventions argued by Kirsty Keay in the Guardian.

Scottish Government launches new mental health strategy. The recession is also killing us as Richard Murphy shows. Patients may be dying unnecessarily as cuts in the number of acute beds mean they are routinely transferred into wards with less specialist care. Consultants surveyed by the Royal College of Physicians of Edinburgh (RCPE) say the practice, known as “boarding” – has become the norm.

Interesting overview of NHS developments in coming decade. But insufficient recognition of inequality.

Internationally recognised NHS Scotland Staff Governance standard gets a revamp.

Ian Gray highlights audit review of GP services in relation to life expectancy and heart treatment.

Social Care

The Scottish Government is consulting over their plans for the integration of adult health and social care. Proposals include changes to how adult health and social care services are planned and delivered, aiming towards a seamless experience from the perspective of the patient, service user or carer. Dave Watson highlights some areas of concern and urges everyone to consider the plans carefully. More detail in this UNISON Scotland position statement.

Social Care (Self-directed Support) (Scotland) Bill has started its parliamentary progress. The legislation seeks to lay the foundations for self-directed support to become a mainstream choice for people receiving care.

Carers Week survey, found that caring had a negative impact on the health of almost nine in 10 carers (87%) in Scotland.

NHS Highland warns that UK Government welfare cuts could have impact on health. Increased use of inadequate housing and bad diet, warning people may eat cheaper, high-fat, high-sugar foods while cutting back on fresh fruit and vegetables