Health and Wellbeing
Asylum Seekers
Microphone, please.
We have always been clear that—
On a point of order, Presiding Officer, I do not mean to be contrary—I appreciate, of course, that it is not a point of order—but the microphones in the chamber are not working. Can that be rectified?
Is your microphone up?
Yes. It is lit, but it is not working.
Thank you for that point of order. We now have action. We will move to the minister. Did Michael Matheson hear Mr Doris’s question or does he want him to repeat it?
Take two, Presiding Officer. I heard his question.
I will raise the specific case of one my constituents who is an asylum seeker. I know that Mr Neil, the Cabinet Secretary for Health and Wellbeing, is aware of the case.
There is already guidance available for NHS boards that sets out very clearly that those who are in Scotland as asylum seekers should receive the same healthcare provision as any other resident of Scotland. Clearly, on the issue that the member raises, which he has previously raised with the cabinet secretary, clinical decisions have to be made about whether someone should be put on the transplant list. That is about not only the clinical benefit that they would get from a transplant but whether they are able to meet the treatment requirements following the transplant.
Food Banks
The cabinet secretary and I hold regular meetings with our ministerial colleagues, including the Minister for Housing and Welfare, on a range of issues that affect the health and wellbeing of the Scottish people. Our discussions focus on the most vulnerable groups in our society and how we can help to tackle issues around health inequalities.
I recently visited Dunfermline Foodbank, and this week I heard about increasing demand at the Levenmouth Foodbank Community Support Project. Although benefit changes and delays are a key driver of demand, volunteers report that people with mental health issues are presenting for support. The report on health inequalities that the Scottish Government published last week showed that there is a bigger impact on mental wellbeing in areas of deprivation, which is where inequalities are increasing.
I will correct the member, because we have not rolled back any of our anti-poverty strategies. If anything, we have increased the range of anti-poverty strategies in order to try to tackle the issue. It is important that we keep the issue in context.
I disagree with the minister’s simplistic understanding of the need for food banks. There is a much more complicated situation, which we need to better understand. Will the minister give an undertaking that the Government will commission independent research into why there is an increasing demand for food banks in order to ensure that we understand whether the situation is more complicated than his representation of it?
I am sure that it is not lost on the member that there is a direct correlation between the increasing number of food banks in the country and the welfare changes that his Government at Westminster is introducing, which are causing real difficulties and crisis for many individuals throughout the country. I am sure that he is no different from me and other members, who, on a weekly basis, see constituents at their surgeries who are having difficulties with the changes to the welfare system and experiencing delays in payments being made to them, which is forcing them to get food from food banks.
Question 3 from Malcolm Chisholm has been withdrawn for understandable reasons.
Commonwealth Games (Accessibility)
The Glasgow 2014 organising committee is working to ensure that accessible seating and associated facilities are available for people with mobility issues at Commonwealth games events. To that end, it is currently conducting accessibility audits at all competition venues to understand existing provision and identify areas for improvement.
The minister will be aware that there will be much welcomed new viewing areas for fans with mobility issues during the Commonwealth games. She may also be aware that that is only a temporary measure. Many disabled fans who follow Scotland at the national stadium currently have a choice of only trackside or restricted view seating. Does the minister agree with me and the Scottish Disabled Supporters Association that the new seating should be retained by Hampden Park? Will she meet me and members of the SDSA about that issue?
The organising committee has been working with all competition venues to try to ensure that solutions can be made on a permanent legacy basis wherever possible, although it is recognised that temporary solutions will sometimes be necessary.
Health Visitors
Health visitors play a vital role in contributing to the health and wellbeing of children, young people and families through their focus on early intervention, prevention and provision of universal services. With other members of the multi-agency team, health visitors help to ensure that the wellbeing of every child is at the heart of our public services and that families get the support that they need when they need it.
The Scottish Government has committed to fully fund local authorities to deliver the named person provisions in the Children and Young People (Scotland) Bill. Should the bill be passed, will the Government show equal commitment to children aged zero to five by fully funding health boards to train, recruit and employ health visitors to fulfil the named person role?
The financial considerations around the Children and Young People (Scotland) Bill are in the financial memorandum that sits alongside the bill. The memorandum has already been set out by the Minister for Children and Young People, Aileen Campbell, who is responsible for the bill.
Does the minister agree that, ideally, health visitors should be placed within general practice and primary care as part of the team so that they are closely involved with families in a relatively small locality of their health board area?
It is important to see health visitors as part of that multidisciplinary team, including the general practitioner, the public health nurses and other health professionals who are engaged in working with children, young people and families.
Victoria Hospital A and E
NHS Fife appointed additional consultants to the emergency department in 2012. That enabled the introduction of a fast-track process for the care of patients presenting to the emergency department with minor injuries. It also enabled extended consultant weekend working—there is now consultant weekend working in the department from 9 am to 11 pm each day.
What steps does the Scottish Government intend to take to ensure that the extra resources given to the accident and emergency department at Victoria hospital have a positive impact on helping to reduce waiting times and, in the long term, offer a higher and more effective level of care to the public?
The national unscheduled care team has established a robust performance framework to monitor NHS boards’ delivery of improved and sustained performance across the whole system, including in relation to A and E waiting times. As part of accessing an additional £50 million, boards submitted detailed local unscheduled care action plans, which set out their approaches, described how new service provision and personnel would positively impact on service quality and performance and offered an improvement timeline that showed in detail by month the progress that would be delivered.
Briefly, Claire Baker.
The cabinet secretary will know that I recently wrote to him about concerns over Victoria hospital’s patient care. I thank him for the reply that I received. Given the concerns about A and E and the missed targets in Fife, is he confident that NHS Fife is in a robust position for the winter months and the challenges that are ahead?
I am confident that NHS Fife is in a much better position today than before. We are in constant contact with the board to ensure that, week by week, it is meeting not just A and E turnaround times but other performance targets, such as the treatment time guarantee.
NHS Provision (Visitors and Temporary Migrants)
Figures on the cost of overseas visitors and temporary migrants accessing NHS healthcare in Scotland are not held centrally. Overseas visitors are managed effectively in Scotland through a combination of regulations and Scottish Government guidance for NHS boards.
The minister will be aware that an independent report for the Department of Health estimated that the total cost of visitors and temporary migrants accessing NHS services in England could be about £2 billion per annum. If we extrapolate that on the normal basis, the cost to Scotland could be as much as £200 million a year. Will the minister immediately inquire into the cost in Scotland and how we might recover that money for the NHS?
It is important to recognise the report that was produced on the NHS in England, but the number of migrants and so on in England is different from that in Scotland. We view migrants as an important part of the Scottish economy. They are provided with healthcare in the same way as other individuals in Scotland are.
Community Pharmacies
The review that I announced in September is making steady progress and is nearing completion of its first stage, which has involved identifying the full range of powers that are available in primary and secondary legislation and how the framework can be better constructed to deliver the best possible outcome for patients and NHS pharmaceutical care and primary medical services in rural communities.
I know from previous exchanges in the chamber that the cabinet secretary recognises the impact on medical services in remote and island areas of the opening of community pharmacies. I continue to receive correspondence from North Uist and Benbecula about the proposal there. What further assurances can the cabinet secretary give those communities?
I am very familiar with the situation in Uist and indeed in other parts of Scotland—in particular, in rural Stirlingshire. I explored the possibility of having a moratorium until my review was completed but I do not have the legal powers to impose a moratorium. If I had those legal powers, I would have used them.
I thank the cabinet secretary for the answer that he has already provided. As he is aware, I have taken a close interest in community pharmacies.
I totally agree with Bruce Crawford. We are doing everything that we can to ensure that progress is speedy while, of course, adhering to overall rules and guidelines in terms of consultation.
Many thanks. I call Rhoda Grant—please remember that time is of the essence.
The cabinet secretary will be aware that Andrew Walker, who was a lay member of the pharmacy practices committee in the Western Isles, was asked to step down from that role when it became public that he held it and when he committed to listen to the concerns of the community on the application that was in hand. Surely that flies in the face of transparency and of needing to consult and listen to the views of those affected by decisions that are taken on their behalf. Can the cabinet secretary perhaps advise the Western Isles NHS Board how it should proceed and give interim guidelines until he is in a position to come forward with a proper review?
I am very much aware of the situation that Rhoda Grant describes. I need to be rather judicious in any comments that I make because of the potential implications, but I am keeping a close eye on the situation. If Western Isles NHS Board requires my guidance—if it asks for any guidance—I will be happy to provide it.
GP Casework
The Scottish ministers are fully committed to working with general practice professionals to ensure that the framework within which primary care is delivered is fit for purpose and responsive both to local circumstances and to patient need.
I thank the cabinet secretary for that response. In relation to S4W-16841, I wrote to BMA Scotland questioning the impact on GPs of the United Kingdom Government’s welfare reforms. In the response that I received, BMA Scotland indicated that there is anecdotal evidence that the UK Government’s welfare reforms are increasing GPs’ workloads, as patients are very concerned and confused about health assessments that they are being forced to take.
I agree with all Stuart McMillan’s points. The UK Government’s damaging cuts—which started under Labour and are being continued by the coalition Government—and challenges to the welfare system could reduce benefit expenditure in Scotland by more than £4.5 billion in the five years to 2015, impacting on some of the most vulnerable in our communities, including women, children and disabled people.
I know that the cabinet secretary is aware that many things impact on the workload and case load of GPs. However, I draw his attention to the current difficulties with waiting times in NHS Lanarkshire. Does he recognise and understand that those difficulties cause great frustration for GPs because of the backlog that they build up and their inability—as they see it—to get the best service for their patients?
I am very much aware of the issues to which Linda Fabiani rightly draws attention. I have a meeting later today with the chair of NHS Lanarkshire in which I will highlight those issues, and I will work with the board to try to address the pressures on GP surgeries and the wider issues that are being addressed in the review by HIS.
Will the cabinet secretary acknowledge that GPs who refer cancer patients to the Aberdeen royal infirmary for radiotherapy are concerned at the lack of specialist oncology services and staff at that hospital? Will he acknowledge that patients who travel from Shetland are now being referred to other hospitals throughout Scotland? Will he discuss with NHS Grampian how best to avoid that happening in the very trying circumstances in which patients are finding themselves? It is of great concern to GPs locally in cases in which there is a considerable need for the patient to be treated as quickly as possible and in particular at Aberdeen royal infirmary.
Tavish Scott raises a legitimate question. I am aware of the particular challenges in oncology in Grampian, specifically in colorectal cancer. We are working with the clinicians and the boards to address those issues and, where necessary, we will continue to offer alternative sites for treatment for patients from Shetland and Orkney.
Yesterday I welcomed the cabinet secretary’s announcement that there is to be a new GP contract and a review of access to GP practices. Will he respond today to my party’s request to convene all-party talks on those two very important issues?
I am always delighted to meet members of other parties, particularly when they have something positive to contribute. I look forward to Neil Findlay’s positive contribution as a new departure from his previous contributions.
Stroke Care
Our “Better heart disease and stroke care action plan” is backed by more than £1 million of Scottish Government funding each year. It is aimed at ensuring that people with stroke are able to access effective, safe and person-centred care as quickly as possible. The priorities that the action plan sets out are monitored and updated annually and approved by the national advisory committee on stroke.
I thank the minister for his answer, but does he agree that more must be done to ensure that stroke survivors have adequate access to psychological services, including clinical psychology services in stroke units and psychological support in the community as set out in the original action plan? To what extent is that support available in the community? How many stroke units provide clinical psychology services?
I know that there has been an issue with access to psychological therapies for patients who have experienced a stroke. As part of our wider mental health strategy, we have increased the availability of psychological therapies. That is why there has been an increase in the number of psychologists and in other therapies being made available in the NHS.
Can the minister say what measures are being taken to encourage more blood pressure testing in the workplace and in the wider community, including in community pharmacies, as a preventative measure for strokes?
There is no doubt that having one’s blood pressure checked regularly is an important element in helping to reduce the likelihood of experiencing a stroke. I am aware that in January 2014 the Stroke Association will run a “Know your blood pressure” campaign, which we are more than happy to support and which will be taken into community pharmacies in order to encourage people to get their blood pressure taken.
Dumfries and Galloway Health Services (Seasonal Pressure)
All health boards have plans in place to ensure the quality and continuity of local health services during the winter period. NHS Dumfries and Galloway’s winter plan was endorsed at its October health board meeting and is available on its website. Such plans are informed by national guidance such as “National Unscheduled Care Programme: Preparing for Winter 2013-14”, which was issued to all health boards on 27 September. The plans are supported by additional Scottish Government investment, such as the £50 million unscheduled care action plan that was announced on 25 February to improve accident and emergency performance over the next three years.
According to the annual review of NHS Dumfries and Galloway, wards in Dumfries and Galloway royal infirmary were closed on five separate occasions in 2012-13 due to outbreaks of norovirus. Just last month, two wards had to be closed due to another outbreak. Does the health secretary intend to issue further guidance on the prevention both of the introduction of viral infections to hospitals from the community and of their spread within hospitals? Does he recommend restrictions on visitor numbers and visiting times when such infections are circulating within the wider community?
Already whenever there is an outbreak of such a virus, limitations are placed on visitors and on the availability of particular wards. As part of our unscheduled care plan, every board has been asked to prepare contingencies in the event of something like norovirus breaking out and wards having to be closed, given the knock-on impact on patients, visitors and staff. Some particular challenges that we faced due to the norovirus outbreak last year were that, first, it started earlier than usual and, secondly, as well as the impact on wards and patients, quite a number of staff went off sick after contracting the virus. We are saying clearly to all health boards that they should have in place contingency plans for wards, bed availability, staffing and all other aspects of dealing with an outbreak of a virus such as norovirus, so that if there is an outbreak, the contingency plan can be implemented immediately.
Prescription Charges (Abolition)
The abolition of prescription charges has removed a barrier to good health for many people across Scotland, particularly those on low incomes or those with long-term conditions. Taking the prescriptions that they need, without the worry of cost, will help those people to keep well over the winter months.
The United Kingdom shadow health secretary recently told Holyrood magazine that he wanted to see health policies that can be consistent across England, Scotland and Wales. He said:
I remind the member that when Andy Burnham was the health minister in England, he introduced the £20 billion of cuts in the health service down south that have been taken forward by the coalition Government. Of course, he was also very enthusiastic about privatisation of certain aspects of the health service. Certainly, the last thing that the people of Scotland need is the reimposition of prescription charges at £7.85 for a single prescription or £104 for an annual prepayment certificate. I look forward to the report of the Labour Party in Scotland’s cuts commission and to seeing whether it will reimpose those prescription charges.
On a point of order, Presiding Officer. I was under the impression that question time is about the responsibilities of the Government and not of anyone else. I wonder whether you could rule on that, Presiding Officer.
As you will be well aware, Mr Findlay, that is not a point of order—you have made your point nonetheless.
Will the cabinet secretary consider removing his ban on advertising free prescriptions for minor ailments to those who are most in need in our society, such as single mothers on benefits, who could actually get a cough bottle for their children? They really need prescriptions, but his Government currently has a ban on advertising the service to those in need.
That is a total misrepresentation of the situation, as we have come to expect from Jenny Marra.
Question 13 has not been lodged, and an explanation has been provided.
Aberdeen Maternity Hospital Inspection
NHS Grampian has already put in place an improvement action plan addressing the issues that were raised by the recent very unsatisfactory HEI inspection at Aberdeen maternity hospital. The chief executive has been required to take personal responsibility for delivery of the plan and the board will be held to account against that. The HEI will undertake further announced and unannounced inspections to ensure that there is robust evidence of progress against the actions that have been identified.
Constituents whom I represent in the north-east, including patients and parents of newborn babies, deserve to have confidence in the cleanliness of wards and the quality of care. Which agencies of the Scottish Government have been tasked with supporting NHS Grampian in improving its standards?
Last week, at the Scottish Government’s instruction, Health Protection Scotland visited Aberdeen maternity hospital to determine how the failures occurred, to co-ordinate support for NHS Grampian, to quickly rectify the problems that have been identified and to ensure that NHS Grampian puts in place systems so that those events are not repeated. Health Protection Scotland will co-ordinate support from other national agencies as necessary, including Healthcare Improvement Scotland, Health Facilities Scotland, NHS Education for Scotland and the Information Services Division.
Is it not the case that the need to upgrade maternity services at NHS Grampian has contributed to the problem? What action is the cabinet secretary taking to ensure that the health board has the resources and support that it needs to put in place the much-needed new maternity facilities at the hospital?
I make it absolutely clear that there would be no excuse for what the Healthcare Environment Inspectorate discovered in any hospital, no matter its age. As NHS Grampian has accepted, what was found at Aberdeen maternity hospital was certainly unacceptable. As the member knows, there is an issue about the capital programme for either upgrade or replacement of Aberdeen maternity hospital but, when we receive detailed proposals on that, they will be given due consideration. Of course, it would be easier to confirm that capital programme if our overall capital programme had not been cut by 26 per cent in the coming year.