21 September 2016

S5M-01554 NHS Staffing

The Presiding Officer (Ken Macintosh): The next item of business is a debate on motion S5M-01554, in the name of Donald Cameron, on NHS Scotland staffing.

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

I will start on a note of consensus, with which I hope that everyone agrees. There is not a party or a person in the chamber who would say that we should scrap the NHS and have something different. We are having a debate about how we all wish to improve the performance of the NHS to support the people in our country with a free-at-the-point-of-need health service. That is very much the Chinese model of providing healthcare, which goes back thousands of years. People only paid their medical practitioner when they were well, and they had access to their skills when they were ill. In essence, that is what our NHS is about.

The history of how we got here is a long one. If we look at death records from the Victorian era, we find that around 50 per cent of them show that the person concerned died without any medical attendant certifying the cause of death. Access to health services 150 years ago was a privilege available only to the few.

In 1911, Lloyd George introduced an old-age pension for the first time, and that started to lay the basis for the provision of support to people who could not necessarily afford to provide it for themselves. I should also say that my Aunt Stewart registered as a nurse in 1923, a year after the establishment of the nursing register, and her sister registered a year later.

In 1945, my father, at the rather elderly age of 41, graduated—

Neil Findlay: Will the member give way?

Stewart Stevenson: I will, if the member wishes.

Neil Findlay: Perhaps every time the member gives this speech, he should alert me and Jackson Carlaw so that we can leave the chamber. We have heard it umpteen times before, but I am sure that it will entertain the new members. [Laughter.]

The Deputy Presiding Officer (Christine Grahame):
That was a cruel intervention.

Stewart Stevenson: I thought that it was one of Mr Findlay’s kinder interventions; after all, he is a man not known for his passivity in engaging with his opponents. Indeed, I welcome his hostility, as it is a clear indication that I am on the right path. [Laughter.]

My father graduated MB ChB in 1945 at the relatively advanced age of 41. That was, of course, before the health service was established. He very much welcomed its establishment; he was the traditional old-style GP whom we used to have in the 1950s and 1960s. The front room of the house was the surgery; there were no ancillary staff; his working hours were 7.30 in the morning until 9 o’clock at night; and the range of services he provided and the skills he had were probably substantially fewer than those of a nurse practitioner in today’s GP practices. We have come a very long way indeed.

In fact, when I worked as a nurse in 1964, our staffing levels were substantially worse than they are now. I remember one weekend when we worked 13 hours a day on Saturday and Sunday, and there were only two of us on duty in the ward when there should have been six. That was not an uncommon occurrence. Things have therefore got better, although they are yet to achieve perfection.

We have an ageing population. I am not, thanks to Gil Paterson, the oldest person speaking in the debate, but I am one of those who might reasonably expect in the near future to make greater calls on the health service. Like many of my age group, I am benefiting particularly from screening programmes, most recently in my case—and I know that everyone in the chamber wants to know this—from bowel screening. Details will be available at the back of the chamber later. Of course, my wife and others of her age group have for many years experienced different kinds of gender-related screening that are appropriate to them. Brian Whittle is absolutely right: preventative care is a very important part of achieving health for us.

I want to say a word or two about rural services, given that much of my constituency is essentially rural. When I first got elected in 2001, I found it impossible to get either an NHS dentist or even a private dentist, such was the shortage. Now we have a good dental health service, partly because of the actions of the previous Administration, which have been continued and supported by the present one. However, that service is threatened by Brexit, because most of the new dentists come from Poland. They are excellent dentists, and they are highly respected and valued by people in their communities. That pattern is, of course, repeated across the country. I should also say that my first dentist was unqualified, so it is clear that we have made enormous progress in dentistry, too.

It is worth saying that although we have many more GPs, it is increasingly difficult to get them to work in rural practices. The work is harder and more diverse, and it takes more time. I therefore very much welcome the support that has been given by NHS Grampian and the Government in looking for more GPs to work in rural practices. I am thinking in particular of GPs who are in training; we have training practices, and those GPs learn a lot and realise that living in a country location is good for their personal, mental and physical health and presents an opportunity to support people in communities right across rural areas.

I will say a final thing.

Let us get the Tories really on message on preventative care and get them supporting minimum pricing for alcohol. That would be a good start.

I could give members another dozen examples if I had time.


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