Neil Gray: I'm in this job to deliver - not to take the credit

Rarely does a week go by without another damning set of statistics on the performance of Scotland’s NHS. Last week it was figures showing an increase in the number of people waiting more than eight hours to be seen in A&E. But for health secretary Neil Gray, in post since early last year, Scotland’s NHS is about to turn a corner, finally emerging from the difficulties wrought by the pandemic.

“I want to see faster progress – that’s undeniable,” he says. “I want to see faster progress for our patients and our staff. The greatest gift that I can give to staff in terms of their needs over the coming year and beyond is an improvement in the way they are able to do their jobs, and remove the frustration and potential moral injury that’s been suffered by too many.” 

Gray, who became health secretary following the resignation of Michael Matheson, says he’s confident there will be “demonstrable improvement” on waiting times over the coming year, particularly for patients who have been waiting the longest. Figures published last month by Public Health Scotland showed waits of two years or more for NHS specialist appointments and treatment have actually grown in the past 12 months. The case of Tracey Meechan, 41, who has spent more than 100 weeks on an “urgent” NHS waiting list for surgery on an ovarian cyst was later raised by Labour at First Minister’s Questions. 

“Of course I want to see faster progress,” says Gray. “I’m impatient in that regard and that impatience has been made clear to the system in terms of how I wish to see everybody responding because we owe it to patients and staff to get through long waits in a much faster way.”

Since last year’s general election, a number of new Scottish Labour MPs have sought to draw comparisons with the NHS in England and in Scotland, where they claim the post-pandemic recovery has fallen behind. Last year the Institute for Fiscal Studies (IFS) think tank said Scotland was “lagging behind” England in cutting elective care waiting lists, A&E waiting times and cancer care. 

“We are comparing systems that are at a different place post-Covid,” says Gray. “There were more extensive cancellations of planned care procedures in Scotland than there was elsewhere in the UK during Covid in order to protect the health service. So we are starting from a point of having more to get through than the rest of the UK. 

We know the demographic challenges we are facing. We’ve got an ageing population; the advances in medicine mean we are keeping people healthy for longer... We need to shift the way we do our work and that’s why the population health framework is going to be so important.

“If you look at the most recent data to compare NHS England and NHS Scotland on a percentage of procedures being carried out in the last year, we are seeing a faster increase in the number of procedures being carried out. There was a great heralding of that [NHS England] performance by the UK Labour government – the additional procedures that they were able to do – but we saw a faster percentage increase on the number of procedures we were able to deliver last year.” 

Gray is preparing to publish a population health framework, which is about preventing ill-health and reducing overall pressure on the health service. He says much of the increase in the burden of disease over the next 20 years is preventable. His plan for “reform and renewal” of the health service also includes shifting more care from hospital settings into the community, closer to people’s homes.   

Asked if it’s a frustration of being health secretary that the current holder doesn’t receive plaudits for long-term interventions that take many years to bear fruit, Gray says: “I’m not in this job to take credit. I’m in this job to deliver the best that is possible for patients and staff. I’m in the business of bringing forward plans and delivery that is going to benefit the people of Scotland now and into the future. 

“We know the demographic challenges we are facing. We’ve got an ageing population; the advances in medicine mean we are keeping people healthy for longer... We need to shift the way we do our work and that’s why the population health framework is going to be so important.”

One of the most significant pieces of legislation currently going through parliament – one which has implications for the NHS – is the assisted dying bill. High-profile SNP figures including First Minister John Swinney and his predecessors Nicola Sturgeon and Humza Yousaf voted against the bill at stage one. Gray, however, abstained and says he wants to remain “demonstrably objective” as the legislation progresses.

“It was my decision to abstain. Firstly, to honour the government’s position – as I was representing the government in the debate – of neutrality on the bill. The government did not have a position on the general principles of the bill. 

“The second reason I took the decision to abstain was in the event that the general principles were accepted at stage one, I would be responsible in leading for the government on amendments – either to introduce amendments on the government’s behalf or to respond to amendments from across the chamber. I felt that in order to provide the greatest objectivity, I should remain neutral on the general principles so that in the debates around stage two, [I would be] demonstrably objective.” 

Gray says he expects the government to be setting out the “practical implications” of the bill as it makes it way through parliament. 

Earlier this year when the first minister pledged to become more involved in the NHS amid surging numbers of flu cases putting pressure on hospitals, it was interpreted in some quarters as a rebuke for the health secretary. Gray kept his job in last week’s mini-reshuffle,  but would he now welcome the opportunity to do something else?

“I see it as an honour and a privilege to do the job I do,” he says. “I am the political and government custodian of the most cherished institution in our society. The lifesaving, life-changing work carried out by our staff is an inspiration to see.”