Angela Constance: Scotland must be ‘far more joined up’ to meet health challenges

The Scottish Government must “practice what it preaches” on service redesign, health secretary Angela Constance has said.

Speaking at a Holyrood fringe event at SNP conference, Constance said “far more” must be done on interventions that prevent people from falling into ill-health.

She said patients are “still passed from pillar to post”, with “frustrations” around diagnosis and treatment.

Constance is leading on work to overhaul health and care systems, amalgamating mainland health boards into just two.

She told the audience: “The Scottish Government needs to practice what it preaches. We need to be far more joined up, and certainly under the stewardship of the first minister, I can tell you that is happening.”

Constance was speaking on a panel which also included Kenryck Lloyd-Jones of the Chartered Society of Physiotherapy, Macmillan Cancer Support’s Peter Hastie, and Arthritis UK Scotland’s Alan McGinley.

Lloyd-Jones warned that the challenges of an aging population mean that “this winter will be worse than last winter, and the next winter crisis in the NHS will be worse than this winter crisis”.

He said: “The only way out of this is by preventative care, moving services upstream, and essentially delivering healthy communities. That's what we have to achieve.

“An awful lot of what we hear around shifting the balance of care, moving services upstream, early intervention, this isn't new, this is something that we've been talking about year in, year out for a decade and more.”

He went on: “Part of the problem is that, as we've often said, if you put the same people in the same room with the same problem, they're going to come up with the same solution. And we have a system that is quite hierarchical and is very much shaped around the medical model, and all around the world health systems are having to change to a biopsychosocial model of care. And if we're going to do that, we need those experts in the biopsychosocial field of healthcare in the decision making.

“That is something which we're yet to see, but I think it's going to need to happen if we're going to get that shift, because it's not just about structures; it's actually about a cultural shift and bringing hearts and minds.”