Election to Health Boards in Scotland.

The Scottish Health Campaigns Network came into being in a climate of unrest among communities throughout many parts of the country where people felt that Health Boards were implementing changes to the delivery of health care with little involvement by those who would be affected by their decisions.  Shortly after taking office, the current Scottish Government reversed some of the  contentious decisions made by the previous administration and took steps to improve meaningful consultation with communities.

In an attempt to introduce more democracy to the structure of Health Boards, a Bill was drafted in March 2005 in which it was proposed that a number of members be elected to Health Boards in addition to those appointed by the Cabinet Secretary of Health and  Wellbeing.  The proposal was put out for consultation and there were 160 responses from individuals and organisations.  The proposals were supported by 85% of those which responded, amongst which was The Scottish Health Campaigns Network.—indeed the Chairman, Dr Robert Cumming, was selected to give evidence to the Health Committee of the Scottish Parliament in support of the proposal.

Those which opposed the proposals accepted the need for improvements to be made in communication between the Boards and the public, but Dr Dean Marshall, of the BMA Scotland, took the view that an alternative approach to this end would be more cost effective than diverting money from patient care.  Others were concerned that Boards would experience difficulty in implementing national policies in the face of local issues and it may come as no surprise to learn that of the 14 Boards in Scotland, five were opposed to the proposals and a further five expressed reservations.  Would ‘single issue’ candidates prove to be a problem?  Would there be sufficient interest to produce suitable candidates and should there be a majority of elected members?  These were only some of the views expressed in responses to the consultation document.

The initial Bill which was introduced as a Private Member’s Bill by a Labour member was originally defeated by the Lib. Dem/Lab coalition but reintroduced by the current SNP Government which decided to trial the exercise.  Two pilot elections are taking place in May/June of this year, by postal ballot (to reduce cost), one in Fife* and the other in Dumfries and Galloway.  Will there be sufficient interest?  In Fife, 61 candidates have entered the field for 12 elected places, while no less than 70 have put themselves forward for the 10 places on NHS Dumfries and Galloway.  A delegate from Fife, and who forms part of the SHCN, has put himself forward as a candidate for NHS Fife.  Local Councillors, along with publicly elected members, will form the majority in these Boards.  The Boards will remain accountable to the Cabinet Secretary.

Some details about the elections.

The two pilot trials are expected to cost £2.6m

People aged sixteen and over will be eligible to vote and to stand as candidates.

No candidate is required to make a financial deposit

Candidates may produce a ‘profile statement’ not exceeding 250 words.

No candidate or his/her agent may spend more than £250 in the electioneering process.

Voting will be concluded by 10th June and successful candidates will take their places on the respective Boards with immediate effect.

A single transferable voting system will apply.

The pilot Boards are expected to last for at least two years.

Members will receive an annual remuneration of £8008 plus travel and sustenance expenses and are expected to commit at least eight hours each week to Board activities.

Among the information supplied to potential candidates it was stated that members are expected to balance national policies with local interests.  Members will receive training at national and local levels and will be involved in ‘decision making’ rather than in operational matters.

Boards are to ensure that the patient experience is at the centre of NHS work and that patients and the public are engaged and involved in decision making-particularly in those decisions which affect major designs.

Members are also expected to conform to the UK level on standards in public life (as per the Nolan Committee)

Additionally, they are expected to conform to six standards of good governance as defined in the commission on Good Governance in Public Service (chaired by Sir Alan Langlands in 2005).

Many in Scotland (and beyond) will be interested to see the effects of the extension of democracy to the decision making process within the NHS.

It may help to reduce confrontation but at what price?  *NHS Fife Serves approximately 360,000 people. Employs 8600 people and has a budget of £500m. There will be 25 members on the Board of NHS Fife.  12 hospitals, 64 GP practices, 78 pharmacies, 55 dental surgeries, 43 opticians.

A final note about health care budget in Scotland:  Of approximately £33bn controlled by the Scottish Government, around £10.6bn is spent on health- £10.1bn on the NHS.


Malcolm Allan

Secretary and media contact, Scottish Health Campaigns Network