MSPs find serious failings in medicines system which does not put patients first


A Scottish Parliament Committee inquiry into the supply and demand for medicines found an incoherent system which fails to put patients first. The inquiry, which makes 129 recommendations, highlights the dismal failure of NHS Scotland to modernise systems, collect and share data, or provide any meaningful analysis of the impact of medicines on individual patients.

The Health and Sport Committee’s report describes a system ‘burdened by market forces, public sector administrative bureaucracy and under resourcing, inconsistent leadership and a lack of comprehensive, strategic thinking and imagination, allied to an almost complete absence of useable data.’

An urgent overhaul of the system is needed to allow for the robust collection and analysis of data, which would ensure the best possible patient outcomes and cost savings for the NHS.

The Committee also highlight a failure of senior leadership to take on the challenge of transforming the system. The report makes clear the Committee’s frustration that those charged with solving these problems, instead bemoaned the system’s myriad failings without seeking to address them. They have called on senior leaders across the health service to show the leadership needed to bring forward strategies and solutions to tackle these issues urgently.

Lewis Macdonald MSP, Health and Sport Committee Convener, said:

“The failure to adapt, improve and modernise the current system goes beyond the supply and demand for medicines.

“We found the lack of care taken to understand people's experience of taking medicines impacted the system at every stage. The almost complete absence of data collection, or data sharing across the health service before the current Covid-19 crisis, or analysis of a medicine’s impact on patients, is staggering. Quite simply, patients deserve a better system than this.

“Our evidence has made clear once again the profound failings of current health IT systems. These need to be completely overhauled so that data can be gathered, analysed and shared in a systematic way across the NHS. The scale of this task is undoubtedly great, but it is essential to quickly deliver a fit for purpose system which would improve patient outcomes, increase efficiency and reduce costs.”

He added:

 “Again and again throughout this inquiry we have seen that the default position of medical professionals is to reach for their prescription pad rather than consider lifestyle-focussed alternatives to medicines, and this cannot continue. Our report last year detailed the value of social prescribing but it’s clear that despite its many benefits, it is still considered a second-class option, if it is considered at all. This must change as a matter of urgency.”

The limited accountability of GPs as external contractors is also called into question by the Committee. They say the current approach, which pays GPs from the public purse with no monitoring or evaluation of their actions, is not acceptable.

The Committee also wants to see community pharmacists play a far greater role in patient care, saying a lack of formal structure means their skills and knowledge often go to waste. The report expresses alarm that discussions by community pharmacists with patients on the effectiveness of medicines, and whether they were being taken, were at best recorded on Post It Notes and at worst disappearing without record.

You can listen to our podcast with the Convener on this report here: 


The full report can be found here.

The Health and Sport Committee agreed to hold an inquiry into the supply and demand for medicines given the frequency the issue was raised with the Committee by representatives of health boards and special health boards as part of their scrutiny programme.

The inquiry focused on four distinct areas:

  • Purchasing (including procurement and medicine price regulation, a
  • reserved area undertaken at a UK level);
  • Prescribing (covering all those licensed to write prescriptions);
  • Dispensing (covering hospital, pharmacy and GP); and
  • Consumption (looking at effectiveness, monitoring and wastage).

For more information on the inquiry visit the Scottish Parliament website.

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