Q&A: Alison Johnstone on the health of the nation
Dealing with COVID-19 and its knock-on effects will continue to be the priority for the health service for the foreseeable future. But what do you think is the most pressing concern in terms of the country’s health at this particular stage of the pandemic?
It’s difficult to rank concerns in order when the public health implications of this crisis are widespread. We don’t yet know the full impact COVID-19 has on the body of someone who survives it, and we already have an ageing population who live into old age with multiple conditions. On top of that, the impacts of lockdown are numerous. Many of our most vulnerable citizens have lost income or their home. Temporary measures to protect people such as furlough are being lifted and there is a danger that we face rising poverty levels, which is very bad for health. The mental health impact is also a serious worry – this is a collective trauma and we don’t know the full implications it will have. Many thousands of people have lost loved ones at a time when funerals are restricted as is the opportunity to grieve together and comfort one another. My other worry is how many people have not attended NHS services during this period when perhaps they should, because they didn’t want to be a burden.
What are the key questions you believe should be addressed by any inquiry into the Scottish Government’s handling of COVID-19?
Throughout this crisis I have called for more rigorous and regular testing, especially for our front-line staff. It was introduced for care workers and care home residents far too late, and still isn’t routinely available for hospital workers or teachers. This was the first priority in advice from the World Health Organisation from the get go, and pursued by the nations who were most successful at tackling the virus, such as New Zealand. It was therefore extremely concerning to hear the Scottish clinical director claim that regular testing ‘doesn’t work’ on the radio. An inquiry should explore what advice was given to ministers that allowed Scotland to follow the UK-wide four nation approach when it was clear other countries were handling this better.
The NHS is treasured across the country by people of all political persuasions but does that put it beyond criticism and can you see areas that need to change?
People treasure the ethos and principles of the NHS, they are proud of the fact that it is publicly-owned and the hard work of its staff, but there is plenty of evidence that people will raise complaints and call for action and change where services have let people down. We can see that in the response the cases of infections at new hospitals, in the response to the shocking building failures and in the demands for justice for the families affected and for mesh scandal survivors. What’s important is that any criticism is constructive and leads to learning and real improvements, rather than simply scoring political points.
What should the future of elderly care look like?
I think we should look at social care in the same way we do the NHS – available to all. Clearly that is a massive cultural shift and requires proper integration of services into a single system. Health and social care integration is the right policy, commenced years ago and much discussed, but we’re clearly nowhere near that yet.
Mental health issues have clearly come to the fore in recent times and only exacerbated by the pandemic, do you think more could be done to bring parity of care for mental health in line with physical health?
The science shows that mental and physical health are intrinsically linked, so to think of them as competing services is the wrong approach. Every treatment must balance the impact on both, just like every preventative measure also benefits both.
Before the pandemic, the drug death crisis was regarded as one of the most urgent health challenges facing the country. What can be done to make up for lost time in addressing this?
The Greens have always maintained that drug addiction must be treated as a public health problem rather than a criminal justice issue. A large number of those who are dying are people who have been taking drugs for decades, and criminalising them has not made them safer. Thankfully, more and more people are now realising that harm reduction is the way to bring these deaths down. It will require a big shift in mindset at Westminster though.
The pandemic has shown how compliant Scots can be in terms of public health messaging, do you think we should use that lesson to know address issues such as obesity?
I think one of the reasons we’ve seen such high compliance in Scotland is because people recognise this was a temporary measure to get us through a tough time. It was a collective effort, not targeted at a few people. That is why people were outraged at Dominic Cummings.
We need to start talking about a collective effort to embed our gains so that we shift that into a longer-term mindset. We’ve already seen an unhealthy return of traffic to our roads, so it’s vital the new normal encourages active travel and protects public transport.
Also, the supermarkets have made a lot of money from this crisis. That power needs to come with more responsibility when it comes to price, promotion, plastics and social responsibilities, including looking after Scotland’s food supply chain. Tackling obesity, smoking and alcohol means taking on industry, not just public health messaging. Scottish Government action on price promotions on unhealthy foods mustn’t be shelved.