Editorial - NHS gap between England and Scotland grows

The first LMCs conference of the year took place in Wales last week. The event was dominated by concerns about the impact of funding cuts and rising workload in general practice.

Scotland’s health minister Nicola Sturgeon believes the NHS in Scotland will ‘outperform the privatised experiment south of the border’ (Photograph: D Robertson)
Scotland’s health minister Nicola Sturgeon believes the NHS in Scotland will ‘outperform the privatised experiment south of the border’ (Photograph: D Robertson)

These are clearly worries shared by GPs in Scotland, England and Northern Ireland. They mirror many of the local, regional and UK-wide stories GP has published in 2012. Nobody expects these problems to abate any time soon and they will no doubt feature prominently at other LMCs conferences over the coming months.

In this age of austerity, it is now a fact of life that healthcare systems are expected to do more with less. Efficiency savings are the name of the game, wherever in the UK you practise. However, how each UK country has approached this challenge varies wildly and we are beginning to see the emergence of a very distinctive NHS in each country.

This week, GP reports that Scotland's deputy first minister and health minister Nicola Sturgeon believes the NHS in Scotland will 'outperform the privatised experiment south of the border'.

Unlike England, Scotland's approach is not based on competition or involving more private providers. The Scottish model is clearly favoured by the BMA and would also be supported by many English GPs unhappy with current health reforms and wanting to ensure the NHS remains a public service.

However, there is little chance of England adopting anything other than a competitive model. Politicians from all major parties support the concept of the market and back a greater role for alternative providers, including the private sector.

Of course, it will take a number of years to determine which approach has been best for health outcomes, but many GPs already fear that unless the changes south of the border can be stopped or sufficiently altered, they will spell the end of the NHS.

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