Who are these folk up the hill?

On the 5th of December 2017 the Scottish Parliament considered two matters relating to NHS Scotland. In the morning, Sir Harry Burns presented his review on Targets to the Health and Sport Committee; and in the afternoon there was a debate in the Parliamentary Chamber on Polypropylene Mesh Devices.

I have since reflected on these excellent examples of Parliamentary scrutiny of NHS Scotland. Several themes seemed to emerge. One of these, at least to my mind, related to ‘duty of candour’.

Sir Harry Burns is a doctor and deep thinker who has always impressed me for his steadfast dedication to help make the lives of others better. My view is that he is kind of wonderful and all his qualities and humanity came across in the evidence that he gave to the Health and Sports Committee. After his opening statement to the committee, the convener stated:

Having read the Review on Targets I have to say that I shared this sense of disappointment. Before the Review was published I gave this perspective on one of the NHS Scotland Targets, which was incentivised, for the early diagnosis of dementia. In this perspective I outlined how this Target has resulted in harmful consequences.

Towards the end of the session, the Convener asked:

There was laughter at this stage in the Parliamentary Committee room. I must admit that I laughed too.

[The "folk up the hill" reference is to St Andrew's House 
and senior Government officials working for the Scottish Government]

There is perhaps a serious question lying behind this laughter. What is the influence of the “folk up the hill” in terms of directives such as National Targets that may significantly determine the outcome of any individual doctor-patient consultation? Given that a committee of the Scottish Parliament did not seem sure who these “folk” may be, can the Scottish public be assured that there is sufficient transparency?

Nicola Surgeon, stated on the 26th November 2014: “I intend that we will be an open and accessible Government”


In the afternoon of the 5th December, in the Chamber of the Scottish Parliament, there was a debate on Polypropylene Mesh Devices.

Jackson Carlaw, MSP, made this comment about the Mesh survivors:

In one of the closing speeches, Anas Sarwar, MSP  considered a most candid contribution made by Alex Neil, Scotland’s former Cabinet Secretary for Health:


Statutory Duty of Candour is set to be introduced in April of 2018 for NHS and social care staff:


In reflection:

Given the considerations made in the Scottish Parliament on the 5th December 2017 I am wondering why there seems to be no such equivalent Duty of Candour for officials working for the Scottish Government?

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