22 January 2015

S4M-12120 National Health Service 2020 Vision

The Presiding Officer (Tricia Marwick): Good afternoon. The next item of business is a debate on motion S4M-12120, in the name of Shona Robison, on the 2020 vision, the strategic forward direction of the national health service.

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Stewart Stevenson (Banffshire and Buchan Coast) (SNP):

One of the great achievements of the Labour Party was the bringing into being of the national health service in 1948. However we should not forget the genesis of that achievement. It started with David Lloyd George's National Insurance Act 1911; indeed, to this day-I have actually heard the expression used in a doctor's surgery in the past 12 months-the folder in which one's medical records are held is still referred to as a Lloyd George.

Of course, the names of very few politicians go down in history in that way, although just a few hundred metres from here, there is a Belisha beacon, which is named after Hore-Belisha, a transport minister in the 1930s. I commend to NHS Grampian the suggestion that the hospital yet to be named be called L'hôpital Allard, thus immortalising my colleague to my left.

Perhaps most important is the Highlands and Islands (Medical Services) Grant Act 1913, which for 35 years was, in essence, a national health service, centrally funded and managed and free at the point of delivery, for the Highlands and Islands. It put the first resident nurse on St Kilda in 1914, for example. Scotland has actually led the way in how we deliver health services free to people who need them today. Let us hope that we can maintain the consensus that says that that is what we should do.

We should also remember that William Beveridge, author of the "Social Insurance and Allied Services" report of 1942 was a Liberal.

Dennis Robertson: Moving into the 21st century, would Mr Stevenson acknowledge that telehealth medicine is the way for the future in a lot of our remote and rural areas?

Stewart Stevenson: Mr Robertson is absolutely right, and our geography means that we have the opportunity to innovate and the greatest benefit to deliver. It is worth remembering that the first medical air service in Scotland started in 1935, and the first patient travel from Islay to Glasgow on an ad hoc basis in 1933. It is interesting for me to see what has changed since I worked in the health service 51 years ago, when staffing and resources were substantially less than they now are. For example, there has been a 36.2 per cent increase in geriatric consultants between September 2006 and September 2014. I Particularly welcome that because, as you can work out from the information that I was a nurse 51 years ago, that is a matter of considerable personal interest to me. Associated with that is the nearly 30 per cent reduction in senior managers, diverting resources to where they are needed, which is on the front line. That is a process that has been going on for some considerable time, and we all have had our hands on that, but as parliamentarians we must continue to hold ministers to account to ensure that that continues.

Things have changed. My father was a GP, single-handed, rural and urban. As a single-handed GP, he had 2,200 patients. Nowadays it would be inconceivable that a GP could have that number of patients, because what GPs and people on the front line now do is so much greater now. Fifty years ago, what the GP did was important, but it was much more about pastoral care and there was less intervention than we would expect nowadays.

We have had a lot of changes over the years. We have seen a huge focus on workplace health and a reduction in workplace accidents and work-related disease. We know the phrase "mad as a hatter", that came from the use of mercury in the hat-making industry. People who made hats became mad from exposure to mercury. That does not happen any more.

The next challenge for us all is, of course, the personal responsibility that was mentioned by Jackson Carlaw. A health warning in The Herald a week ago stated that lack of exercise may be twice as deadly as obesity. A report from Public Health Wales indicates cot death risk among families with smokers in them-an element of personal responsibility. We get lots of messages through the media. I particularly liked the headline in The Independent on 19 April 2014 that ran:

"A bottle of wine a day is not bad for you and abstaining is worse than drinking, scientist claims."

Richard Lyle: Hear, hear.

Stewart Stevenson: I suspect that that claim is a bit over the top, but my point is that we are all exposed to those messages, and those of us in public life must take some responsibility for ensuring that people get sensible messages.

In conclusion, let me touch on the issue raised by the Labour amendment in relation to staff. The 2014 NHS staff survey shows that 26 out of 29 core questions show an improvement. In particular 90 per cent of staff said that they were happy to go the extra mile at work when required. That is an increase of 3 per cent since the previous survey. At the core of our health service is our staff. Let us continue to support them and congratulate them on a world-beating service at a world-beating price.

The Deputy Presiding Officer: Many Thanks. Another tour de force.


Stewart Stevenson
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