Calls to merge health boards as winter pressure hits NHS
Opposition parties have called for Scotland's health boards to be merged as winter puts the NHS under pressure.
Scottish Labour has proposed reducing the number of boards from 14 to three in order to cut through "bureaucracy".
The Tories agreed that amalgamation could be discussed but not at the expense of services in rural areas.
It comes amid warnings of hospitals at capacity and staff shortages - though the government says the situation is better than previous winters.
On Friday Borders General Hospital cautioned people against attending A&E as it was at capacity and its emergency department was "exceptionally busy".
Meanwhile BMA Scotland - Scotland's doctors' union - recently said it was deeply concerned about the impact short staffing will have on the level of care provided for patients.
It said the government must urgently publish a workforce plan to address the high level of medical vacancies.
Scottish Labour has said the incompetent running of Scotland's NHS has resulted in a devastating rise in excess deaths.
Speaking to BBC Radio Scotland's Sunday Show, Scottish Labour MSP Paul Sweeney cited the case of a patient who was unable to leave hospital due to issues with transporting her home in an ambulance.
Mr Sweeney said the patient contracted an infection during her wait and died. He said he was shocked at the scale of the bureaucracy in the health service.
"We've got 14 territorial health boards across Scotland - for a country of five and a half million, it's way too cluttered," he said.
"Labour has proposed to rationalise that down to three. Speaking to clinical professionals on the front line, they're saying systems don't talk to each another, there's different procurement systems, there's way too much duplication.
"It needs to be much more simple and a much more agile system for sharing data."
Mr Sweeney added this proposal would not mean cutting staff, but "re-utilising people in the right roles, in the right places" with more logical systems.
'Unique' rural health needs
Maree Todd, the Scottish government minister for social care, mental wellbeing and sport, told the programme that an amalgamation of boards is an idea "being bounced around" and she was open to discussing the subject.
However she said areas like the Highlands and islands were "cautious" about a system that does not work for rural areas as "unique needs" could be overlooked.
She added: "The whole health system is experiencing sustained pressure as it has over the last few winters - but actually we're coping well.
"We're managing to maintain at capacity for planned care, we haven't stopped operations, there are signs we're coping better than previous pandemic winters."
Scottish Conservative MSP and GP, Dr Sandesh Gulhane, agreed that amalgamation of boards should be looked at - and whether they "provide value for money".
He said the most important issue for him was the regulation of NHS managers - who are not currently regulated, while doctors and nurses are.
He said: "There's nothing here for people who make decisions that affect entire boards, millions of people.
"They're not accountable for their decision making and you can see that through scandals at the Queen Elizabeth. There's no accountability at board level. The other thing is if we were to look at amalgamating boards, we need to make sure those who live in rural or island areas aren't overlooked."
Are health boards struggling to cope?
Following on from NHS Borders' warning on attending A&E, BBC Scotland News asked other health boards what pressures they were facing.
NHS Lothian has been running a campaign since the beginning of December reminding people only to come to A&E if it is an emergency.
They said they are aware that there may be an influx of people who have held off from seeing the GP over Christmas and New Year.
NHS Highland said there is nothing too unexpected at the moment in terms of winter pressures.
NHS Forth Valley said on social media it was "extremely busy".
NHS Ayrshire & Arran said emergency departments have become even busier with patients waiting for admissions into the hospital.
They urged people to only attend the A&E if they have a critical emergency or require urgent care.
NHS Greater Glasgow and Clyde also said its A&Es are busy due to winter pressures.
The health board said people should follow the ABC Winter Campaign as it aims to help ease pressures across the health board.
"A&E is still there to help people with life-threatening conditions or the most serious injuries, and we would still like to stress that anyone in those circumstances should call 999 or attend A&E immediately," a spokesperson added.