Public health: Health Secretary speech

Speech by Cabinet Secretary for Health Neil Gray given at the Usher Institute, Edinburgh on 28 May 2024.

Good morning everybody,

It is an absolute pleasure to be here with you all at the Usher Institute and I thank you for hosting me today.

I am looking forward to being given a tour of the wonderful facilities on offer here.

This facility is emblematic of the extraordinary infrastructure and research excellence here in Scotland, which will play a crucial role in driving forward improvements in our public health.
As you know, I was appointed Health Secretary a few months ago.

This is an immense privilege – I would argue that there is no more important and no more impactful role in government.

During my first weeks in office I’ve had the opportunity to travel the length and breadth of Scotland to meet with healthcare professionals and patients.

I’ve seen the extraordinary skill, dedication and compassion of our doctors and nurses, first hand across health and social care.

And I’ve seen some of the exciting technologies that will deliver a healthier future not just for people in Scotland, but for people around the world.

I think we all know that our NHS is under huge pressure. I do not shy away from that fact.

Almost a decade and a half of restrained spending, ongoing recovery from the pandemic and an ageing population are just some of the issues we have to grapple with.

Meeting the immediate challenges in our health service will of course be my foremost priority.

But as Cabinet Secretary, I also feel a duty to lift my head to look to the future – to consider exactly what we want our health service to look like several years – or even decades - from now.

I am no longer happy for our NHS to simply be getting by, year on year.

I want us to have a shared, collective, national vision for what a thriving NHS looks like in the years and decades to come.

Next week I’ll be leading a debate in parliament about healthcare reform, to allow MSPs from all parties to put their ideas forward.

But I do not want this discussion to be limited to political parties. I want this to be a truly national debate – hearing directly from patients, the NHS workforce and everyone with an interest in making our health service the best it can be.

So I am very keen to involve people like you – the researchers and innovators who can play such a crucial role in driving Scotland’s healthier future.

As we approach this debate – and develop this shared, national vision - we have to be clear on the values that will underpin it.

So let me be very clear at the outset – our NHS must always remain true to its founding principles. Publicly owned and free at the point of need.

The Scottish Government will stand against any and all attempts to privatise the NHS by stealth – our health service in Scotland will always be in public hands.

As many of you will know, the First Minister has set out four overarching priorities for his government – improving public services, like our NHS, eradicating child poverty, tackling the climate emergency and driving growth in our economy.

Each of these strongly interconnect with the goal I have set for us today of an NHS that thrives in the decades to come.

We know that it is simply impossible to improve our public services without a vibrant, successful economy. It is growth that will pay for the investment we need in the health service – and our economy will not grow without a healthy workforce. That is the very essence of what a wellbeing economy means.

We know that child poverty is a central driver of poorer health outcomes, not just in childhood but throughout life. Its eradication would have a transformational impact on public health.

Similarly, we know that climate change could have serious health impacts – so tackling it is a moral, economic, environmental and a health imperative.

These four priorities will run through the heart of our actions in government – and for me, the NHS is central to each.

As I have said, we face significant challenges in our NHS and in our public health more generally.

We know that Scotland’s health is not where it should be.

The causes of this are complex, but they are clear.

The Covid pandemic has obviously taken a devastating toll not just on our health but also our services.

Health and social care services are under unprecedented pressure.  That’s true for healthcare systems around the world.  

But it goes beyond Covid. 

The financial context and the cost of living crisis are creating a perfect storm. 

Migration policy continues to make it challenging to attract international staff to our NHS.

Scotland continues to suffer the impact of deep historical inequality.

Even before Covid those in our richest areas were living over 20 years longer in good health than those in poorest areas in our most deprived areas, people live more than a third of their life in poor health.    

So as well as improving NHS services our work must involve radical action on population health, improving health behaviours and ensuring people are empowered to look after their own health.

These issues – along with the opportunities presented by the technological innovations, some of which I have the opportunity to see here today – must all be viewed in the round as we seek to drive improvements.

On the issue of funding, I am proud of my government’s record in office.

Frontline health spending in Scotland is – and has consistently been – higher per head than south of the border.

And we are continuing to prioritise investment in our NHS, in what are incredibly tough times financially right across the public sector.

That is not to say we would not like to invest more – of course I would be willing to invest more.

But the reality is we operate in a financial context, which is set by the UK Government.

As Health Secretary, I will never shirk responsibility or try to pass the buck – to be clear, the buck stops with me.

But we cannot ignore the wider financial context which has a direct impact on our health service.

I will continue to do everything I can to protect and improve our NHS.

But we can never overlook the wider financial context.

Another issue that will be crucial both now and in the years to come is staffing.

Now, in Scotland, we have a positive record – NHS staffing here is the highest in the UK with 29.3 WTE staff per 1000 people.

But I don’t want us just to compare ourselves to others.

I want us to be the best we can possibly be.

However, we already know that health and social care worker visa applications are down by 76 per cent.

International workers play a deeply important role in the health service. To see them choose not to come here is deeply worrying.

We need to be able to take any and all necessary steps to attract talented, hard-working people to Scotland to work in our health service.

And on staffing, it is vital that we continue to support the staff that we have in our NHS now.

They were treated as heroes during the pandemic – and we should treat them as heroes now.

I am incredibly proud that in Scotland, we have not lost a day to strike action.

My commitment today to our NHS workforce is that we will continue to value you in the way you deserve.

I would also like to talk about the opportunity presented to our health service by innovation and new technologies, some of which I have seen here today.

It is clear medical research is moving faster than ever and new preventative technologies facilitated by the NHS are supporting individuals to better manage their own health and prevent and mitigate impacts of disease.

For example, wearable devices are helping people to take more ownership over their own health.

New diagnostics and screening methods are being introduced, such as the NHS-Galleri trial for pre-symptomatic detection of cancer and digital therapies such as our diabetes remission programme can help thousands of people to lose weight.

There is also huge future potential in personalised and precision medicines and gene therapies, AI diagnostics predictive data analytics, and robotic surgery.

These are all examples where we are already making progress and can go further to help us improve outcomes for the patient and make the NHS more productive.

Better use of data and digital technology is critical to how we drive improvements in healthcare and is a key part of our plans to reform services.
I am pleased to announced today an investment of £1.2 million this year in Theatre Scheduling software to reduce hospital waiting times and enhance operating theatre efficiency which will be rolled out in NHS boards across Scotland over the next year.

This technology is backed by more than five years’ worth of NHS operating times data and is just one of the initiatives that will help enable us to schedule 1.5 million procedures per year - while improving data quality to help safely increase productivity.

This will help maximise capacity, productivity and build greater resilience and reduce waiting lists.

I am also committed to improving treatment and care for everyone in Scotland affected by diabetes.

Type 1 diabetes is a lifelong condition which affects over 35,000 people in Scotland.

We need to provide tailored solutions, designed and delivered to meet the individual needs, and it is imperative that we harness technology and innovation to help us do this.

That said, we know there is a long way to go in terms of our care models and many people right now are facing long waits for life changing technologies like insulin pumps and Hybrid Closed Loop Systems.

I am delighted today to announce that this year, we will be investing up to £8.8 million to improve access to diabetes technologies.

This funding will provide access to all children and young people that want it and will also allow us to continue increasing provision to adults living with Type 1 diabetes. The key focus of this investment will be to develop a care model for the future – in partnership with those living with diabetes.

These are further steps forward in harnessing the transformative power of scientific innovation and technological progress for our NHS.

I know that is a shared goal for each of us in this room.

As our NHS faces new challenges and new opportunities, that is a goal that I want us all to continue to work to, together.

An NHS with the funding to thrive, with a valued and supported workforce delivering on the potential of the technological revolution.

And crucially – an NHS true to its founding principles. Free at the point of need and always in public hands.

Together, we can strengthen our NHS and ensure it thrives for decades to come.

I look forward to working with you all to deliver exactly that.



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