Meeting of the Parliament

Meeting date: Tuesday, December 4, 2012

Official Report 752KB pdf

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Topical Question Time

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Waiting Time Targets

1. To ask the Scottish Government what it is doing to ensure that national health service boards do not manipulate waiting time figures in order to meet targets. (S4T-00151)

To ensure that all NHS boards are fully complying with waiting time guidance, earlier this year the Scottish Government instructed all NHS boards to undertake an extensive internal audit of their waiting time practices. We expect those audits to be completed and published by the end of the year.

Yesterday, we learned that two top executives in NHS Tayside have been suspended following the Audit Scotland investigation to which the cabinet secretary referred into discrepancies in waiting time figures. That follows allegations of behaviour in NHS Grampian to massage waiting lists and, of course, the fiasco earlier this year in NHS Lothian. Will he now accept that there is an endemic problem with manipulation of data in NHS boards across Scotland? What urgent steps is he taking to sort out the situation?

To date, only two of the 14 boards have identified problems, namely NHS Lothian and NHS Tayside. I will wait until I receive all 14 audit reports from the 14 health boards before rushing to judgment.

For obvious reasons, I cannot comment in detail on the two suspensions in NHS Tayside, which Mr Fraser mentioned. Apart from anything else, I am not the employer. The health board is the employer.

I think that most reasonable people would think that two out of 14 to date is a pretty serious failure rate for the NHS boards.

We have had cause to question the Scottish National Party Government’s figures in other areas and we have found them wanting. Now we are wondering whether we can trust its NHS waiting times and waiting list figures. Given the seriousness of the situation, will the cabinet secretary request time for an urgent statement to Parliament so that we can have the matter fully discussed and debated?

I will be happy to report back to the Parliament once all the facts are clear, and they will be available when the audit reports are published by the end of the year. I emphasise that they are going to be published. Everything will be in the public domain, so if there are problems in any other health boards apart from NHS Lothian and possibly NHS Tayside, they will come to light with the publication of the audit reports. We are being totally transparent on the issue. The time to make a judgment will be once people have the facts, and not beforehand.

It would appear that the waiting times scandal is indeed not simply confined to NHS Lothian, with reports of figures being fiddled not just in Tayside but also in Grampian. I welcome the fact that the reports will be published in December, although I hope that it will not be just before Christmas. The Presiding Officer will recall that Nicola Sturgeon said to her party conference that all patients are now covered by the waiting time guarantee. Was she wrong?

No, not at all. We have made it absolutely clear that we are making substantial progress on the waiting time targets in a whole range of areas. Unlike the previous Administration, we actually measure these things and we do not have an institutional fiddle like the hidden waiting times that were prominent when Jackie Baillie’s Administration was in charge of the national health service.

Unlike the previous Administration, we have nothing to hide. We will publish all the audit reports, and then a judgment can indeed be made about whether there is a scandal beyond Lothian or possibly Tayside. In relation to Grampian, there are merely allegations that have appeared in one newspaper that I have read, and so far they have not been substantiated.

The cabinet secretary should be aware that tucked away amid the mass of health statistics that ISD Scotland released last week was the news that, compared with the same point last year, 5,809 additional patients are awaiting a key diagnostic test in the NHS and the percentage of patients having to wait for more than four weeks has doubled. Does the cabinet secretary agree that those increases are unacceptable? Can he explain why almost 6,000 extra people are waiting for a key diagnostic test in the NHS?

I think that the member got some of the figures mixed up there. However, where we are not achieving particular targets, action plans are in place to ensure that we achieve them. We have very ambitious targets for waiting times. Clearly, given that there are 5 million hospital consultations in Scotland every year, it is inevitable that, from time to time, something may well go wrong. Where there are any systemic problems, we will deal with them along with our health boards. We are achieving far, far more than was achieved under the previous Labour and Liberal Administration, and we are certainly achieving far, far more than the Tory and Liberal coalition in London.

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Legal Representation

2. To ask the Scottish Government how many people appeared in court without legal representation on 3 December 2012 as a result of protest action by defence solicitors in Aberdeen, Forfar, Arbroath, Dundee, Perth, Alloa, Falkirk and Dunfermline. (S4T-00150)

The total number of people who appeared in custody courts without legal representation on 3 December in Aberdeen, Arbroath, Dundee, Perth, Alloa, Falkirk and Dunfermline while defence solicitors were protesting is 17. There was no strike action in Forfar, but there was in Kirkcaldy, where 16 people appeared without representation, which brings the total to 33. [Kenny MacAskill has corrected this contribution. See end of report].

Normally, people from custody would appear without a solicitor in attendance only in exceptional circumstances, but I should make it clear that no one needed to appear without legal representation as a result of defence solicitor protests. Duty solicitors were available on all the dates in question, as they would usually be, to ensure that access to justice was maintained. However, some clients have appeared in court unrepresented, even though they seem to have had prior conversations with a defence solicitor.

I am grateful for that information. However, it is clear that the impact of the action went beyond those who appeared in court. How many people who were held in cells over the weekend were liberated on Monday morning without having appeared in court? How many police forces instructed officers to consider discretion and other available disposals to avoid detaining people who might otherwise have been detained in preparation for such action?

Those are operational matters for the police. Mr Macdonald would require to approach the chief constable. I cannot possibly provide that information, as it is not routinely provided to the Government.

I am surprised that Mr MacAskill is not interested in the liberation on Monday morning of people who were held over the weekend and that he has made no inquiries about that.

That aside, I am encouraged to note that the cabinet secretary is due to meet the Law Society of Scotland and other representatives of the legal profession tomorrow. Will he approach that meeting with a fresh offer, with a view to resolving the dispute? For example, in line with the question that I asked the First Minister two weeks ago, will he consider the Scottish Legal Aid Board offering to collect all contributions and to charge the legal profession for providing that service?

As I have said previously, I met the Law Society on 20 November. It wished to have further meetings and thought that it would be helpful if I could meet members of the bar association directly. I will meet bar association representatives and the Law Society tomorrow.

We have put two matters to the Law Society. The first is that we are willing to consider an increase in the disposable income threshold, which is a matter that the profession seems to have majored on. I accept that and am willing to increase the threshold from £68 to £82, but that will require to be met from within the existing budget, which would affect fees. That proposal is with the Law Society and I await its response.

As regards collection, I believe that the matter should be dealt with by solicitors. They are the ones who interact and interface with agents. That is what they do when they collect private fees and when they deal with assistance by way of representation. It is what civil agents do. We are seeking to get parity in that regard. I have made the offer that SLAB would be willing to seek to recover contributions from people who have not made payments, but that would have to be done on a commercial basis. That would apply to any other business—large or small—in Scotland.

How long is the strike action likely to last?

That is a matter that I cannot really give advice on. It is for those who are taking part in the action to give us such an indication.

It is rather regrettable that very little intimation of strike action has been given. That has caused considerable inconvenience, not simply for clients who are unrepresented but for the Crown, the Scottish Court Service and sheriffs who are required to preside. I will make it clear to the Law Society that, although members of the legal profession, like other people, are entitled to take action, people usually give some intimation of their proposed action so that preparatory steps can be taken. I will discuss that issue with the Law Society. It is a matter of note that the action that has been taken to date has been restricted to action that will not affect the fees of its members.