15 December 2004

S2M-2155 NHS Scotland

Scottish Parliament

Wednesday 15 December 2004

[THE DEPUTY PRESIDING OFFICER opened the meeting at 14:30]

… … …

NHS Scotland

The Deputy Presiding Officer (Trish Godman): The next item of business is a debate on motion S2M-2155, in the name of Andy Kerr, on "Fair to All, Personal to Each: The next steps for NHSScotland" and four amendments to the motion.


… … …


Stewart Stevenson (Banff and Buchan) (SNP): I start by welcoming some frank honesty on the part of the Executive. Paragraph 1.2 of "Fair to All, Personal to Each", which I received during the debate, states:

"While health is improving for the vast majority of Scotland's people, it is improving fastest for those who are most affluent."

That is the issue on which Duncan McNeil touched when referring to his constituents. It is an issue about which, after seven years of Labour Government, we should express concern.

In paragraph 1.8, the minister states:

"Services should be as local as possible, and as specialised as necessary."

I suspect that those sentiments will gain wide support. Whether the Executive's plans and practices deliver on them is another issue.

Paragraph 3.18 is about clearer and more consistent definitions and paragraph 3.19 states:

"Patients who fail to turn up for an appointment or admission without prior warning will return to the start of the waiting queue".

We have heard about the welcome abolition of availability status codes, but there is a real difficulty, which I will illustrate with an example from one of my constituents. An elderly frail lady who lives in Fraserburgh was given an appointment in Aberdeen for an afternoon clinic in August. The lady had no transport of her own, so she inquired at patient transport services, only to discover that they could not give her a return trip for an afternoon clinic. Her son—her carer—does not work and has an income in the order of £70 a week. It was suggested that they should take a taxi home and claim the cost back later. On their income, that is not possible. The effect is that, as of this date in December, we still do not know what patient transport might be offered to that lady for which she and her son would not have to pay in advance. She is now off the waiting list.

Mr Kerr rose—

Stewart Stevenson: I will give way, as the minister is itching to comment.

Mr Kerr: The situation that the member describes is unacceptable. That is why I have asked the health service to work harder on patient-focused booking systems. Good examples exist throughout the country, but they are not widespread enough. I hope that that addresses his constituent's concern.

Stewart Stevenson: Nonetheless, that lady has lost her place on the waiting list. That is an important point. However, I am glad to hear that the Executive is addressing the problem. I do not disregard the fact that the minister shares with many in the chamber a commitment to improve the health service. We criticise what the Executive does and ask whether it achieves improvements. [Interruption.] I see Mike Rumbles making some remark from a sedentary position. He should listen up.

Mike Rumbles: Will the member give way?

Stewart Stevenson: No. I do not have time, but if the member keeps listening I might take an intervention from him later.

A little Cinderella has disappeared from the document more or less altogether. Page 5 contains two references to dentistry in a table, but the rest of the document contains not a single word about it. It is a curious fact that, if someone wishes to have dental treatment, the only place where they will have it with reasonable effectiveness is Scotland's prisons, where the average wait is one week. In much of Scotland, the wait is interminable and the document says nothing much more about it.

At the end of the document, we read something of better IT for the health service, but no numbers for the investment in e-health are quoted. It was claimed that we are ahead of the rest of the UK. The health service in England and Wales is spending £8 billion to improve its IT. It is time that we considered whether we can piggyback on what colleagues that deal with many culturally similar issues in the health service are doing. They are making changes in advance, so that the health service is prepared for other initiatives. Too many initiatives that the Executive has taken have reduced the health service's efficiency. That is why we do not see a return for the money that is being provided.

Mike Rumbles: What would the member do?

The Deputy Presiding Officer: Order.

Stewart Stevenson: NHS 24 is an example of such an initiative. Trained nurses are sitting at phone banks to do triage. That takes on average 20 minutes. They use American software that is not even culturally appropriate for many issues here. For example, the third question that is to be asked of someone who has a sore throat—I will turn it into technical language—is whether they have recently indulged in fellatio.

Mike Rumbles: Will the member please tell us what the SNP wants to do?

Stewart Stevenson: I will. However, Mr Rumbles should remember that the debate is about the minister's announcements.

By the same token, under out-of-hours cover, we have more people going to places that have no record of their health. That reduces the health service's overall efficiency, which is why we must put money into IT. The Executive is to do that after the event, not before. It is paying the price of inefficiency when we need greater efficiency.

Private health care is a source of potential inefficiency. In a transfer from one consultant to another in the private sector, an additional consultation is involved or continuity is lost with the person to whom a patient originally presented. Alternatively, the same consultant is used in the private sector. How is that a good idea?

I will describe what we would do—as I promised Mr Rumbles—in the 40 seconds that remain for my speech. We would expand diagnostic and treatment centres. In England, 20 centres operate. It is interesting that that major contribution comes from within the health service. The private sector has made a minimal contribution of two centres so far. That shows what the health service can do.

The debate is entitled "Fair to All, Personal to Each". That is a good title. However, it is not fair to all to waste money on the private sector or personal to each to close hospitals in local communities throughout Scotland. I support the amendment lodged by my colleague Shona Robison.


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