Plenary, 07 Feb 2002

Meeting date: Thursday, February 7, 2002

Official Report 792KB pdf

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First Minister's Question Time

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SCOTTISH EXECUTIVE

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Prime Minister (Meetings)

To ask the First Minister what issues he intends to raise when he next meets the Prime Minister. (S1F-01627)

I hope to meet the Prime Minister in the near future and to discuss the delivery of first-class public services.

Perhaps the First Minister will address with the Prime Minister the point that I will raise with him now. Can the First Minister tell me how many patients in Scotland have been removed from waiting lists not because they have been treated but because they have been reclassified?

I do not have the precise answer to that question, which is no doubt one of Mr Swinney's regular trick questions about the number of people on our waiting lists. I will be delighted to hear the next part of the question and then to address the issue.

It is not so much my tricks as the First Minister's tricks that I am worried about. When we exposed the previous scandal, of closed waiting lists, the First Minister kindly set up an inquiry. On the very day when he ordered that inquiry, West Lothian Healthcare NHS Trust was meeting to discuss the scandal of reclassified waiting lists.

The minutes of that meeting, which took place on 19 December 2001, say:

"The overall total on the waiting list has decreased. Gastroenterology has been reclassified so this had helped"

to reduce waiting lists. Indeed it did help. In September 2001, there were 290 patients on the waiting list, in October there were 245 and, by December, the waiting list had been struck from the public record.

Will the First Minister guarantee that all the patients in Scotland who have been removed from the official waiting list because of reclassification have been treated, or is the Executive fiddling the figures?

As ever, I will be happy to ensure that Mr Swinney has a precise answer about that particular set of circumstances that cannot in any way be distorted. It is right and proper that, in situations where endoscopy procedures are used, reclassification can take place. That ensures that people achieve a better service, not a worse one, from the national health service.

As such matters proceed, the health service is dealing with a number of different patients and procedures in different ways. It is not always the case that the fact that people are not being operated on in certain places means that individuals are not receiving the treatment that they deserve. On a number of occasions recently—including a few weeks ago in the chamber—I have referred to the example of patients in Falkirk who are now receiving treatment at local clinics on a lower number of visits. That treatment would previously have required a higher number of visits, but those visits would have been in Glasgow. That might seem on paper to be fewer operations, fewer procedures and less treatment, but it is actually better treatment and is more effective and efficient for the patients concerned as well as for the national health service.

The problem is that if people are still waiting for treatment, they should be on a waiting list; they should not be reclassified off that waiting list. That is not just happening in West Lothian. One of my colleagues received the following comments from a consultant in Aberdeen, who—

Mr Swinney, could you put questions to the First Minister?

I certainly will do.

A consultant in Aberdeen has highlighted the fact that

"There has been a flurry of managerial activity here transferring patients from Daycase waiting lists to outpatient lists, apparently following a … central directive."

He speculates:

"one wonders if the waiting lists are going to show a sudden miraculous decline."

As we have exposed the scandal of closed waiting lists, and now the scandal of reclassified waiting lists, does all the evidence not point to the fact that, when it comes to health, the Executive does not muddle, it just fiddles?

No. When it comes to health, the Executive puts patients first and does not play politics with the statistics or individuals concerned. If there is a health board or trust anywhere in Scotland that is not following the right procedures, as I have said before in the chamber, we will investigate that.

I am certain that, in most—if not all—of the cases that Mr Swinney and others quote in the chamber, the classification of particular procedures will have been cleared properly with the proper statistics section at a national level. If that means that people who would in the past have been in-patients are now out-patients and are therefore on a different list somewhere else, it does not mean that they are not receiving treatment from the health service. It does not mean that they are not on the appropriate list; it means that health services in Scotland are being organised—[Interruption.]

Order.

Thank you, Presiding Officer. It is sometimes hard for SNP members to hear the truth, but on this occasion they will.

The health service in Scotland is being modernised. We use new technologies and new procedures and we ensure that people are treated faster, more effectively and more locally. That is the case in community after community all over Scotland. If that means that people are on different waiting lists—the right waiting lists for them—we should not only defend but welcome that, because we have better health services as a result.

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Secretary of State for Scotland (Meetings)

To ask the First Minister when he will next meet the Secretary of State for Scotland and what issues he plans to raise. (S1F-01633)

The Secretary of State for Scotland and I will meet on 12 February. We will continue to discuss the important joint fight against drugs and the improvement of transport services in Scotland.

I thank the First Minister for that answer. Before he and the Secretary of State for Scotland bid au revoir to one another, I hope that they will discuss the different approaches to reform of public services that seem to be emerging north and south of the border. In England, the Prime Minister seems prepared to tackle some of the vested interests, but in Scotland, according to weekend reports, the First Minister is going in the opposite direction. He is cosying up to the unions and signing deals to block reforms in our public services in return for their bankrolling Labour's next election campaign. On that evidence, does the First Minister think that the Prime Minister would regard him as a wrecker or a reformer?

I have absolutely no doubt that the Prime Minister would regard me as a reformer and he would be absolutely right to do so. Mr McLetchie's points on these occasions are clearly an attempt to wind up political debate and that is fair enough, but we should also deal with facts in the chamber. The reality is that in Scotland we are working not just to invest in public services but to seek constant improvement to them. The Prime Minister would praise that and so should every member of the chamber who believes genuinely in public services and not just in making politically posturing points, as seems to be the case with the SNP.

As I keep telling the First Minister at question time, over 18 years there were significant improvements in our public services, but I will not bore him with a repetition of the truth. I simply point out that the First Minister's union—the GMB—is taking out newspaper advertisements to denounce the policies of the Prime Minister. The First Minister calls himself a reformer—what reforms?

I refer the First Minister to the answers that have been given to questions that my colleague Mrs Scanlon asked recently. Will he devolve power to foundation hospitals? No. Will he grant franchises to improve the management of poorly performing hospitals? No. Will he give patients on waiting lists the option of treatment elsewhere in the European Union? No. Will he sign a concordat with the independent sector? No.

Is it not the truth of the matter that there is no programme of reform in Scotland because the First Minister's so-called Scottish solutions are just code for no change and no progress?

That was five questions.

I am glad that Mr McLetchie finds it easier to remember which organisations I am a member of than which organisations he was a member of. [Laughter.] He is a member of a very good golf club and I am sure that we can enjoy that fact.

I want to make crystal clear the commitment, not only of this ministerial team but of the whole partnership, to improvements and reform of our public services. That improvement and reform will not take place against a backdrop of trying to move people legitimately out of our public health service into the private health service simply so that the private sector can make greater profits. It is right and proper that we set up—as we announced today that we will fund fully—a national waiting times unit that will ensure that where there is spare capacity in the private or public sector, we will take it up and put patients first. We will not put politics or profits first; we will put patients first.

That seems to me to be the overriding concern in health, just as it should be in our education service. Mr McLetchie questions my commitment to reform. The rules in Scotland for teacher discipline had been in place since 1918. This time last year, working in a genuine partnership with the teacher associations, the education managers and the local authorities to achieve a consensus, we agreed to reform those rules and to deliver action to deal with poor performance in Scotland's schools. That is the right way forward for Scotland's public services. I make no apology for pursuing reform, but doing so, where possible, on the basis of consensus and partnership.

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Public Services (Trade Unions)

I declare an interest as a member of the GMB.

To ask the First Minister what role trade unions have in improving public services. (S1F-01636)

Trade unions represent the people who work at the sharp end of public services, and their contribution to delivering first-class public services is very important. We are on the side of the pupil, the patient, the passenger and the victim of crime. Scotland's teachers, nurses, doctors and police officers, along with public service staff at all levels, have a pivotal role to play. I am sure that they share our commitment to improving public services through investment and reform.

I am pleased that the First Minister agrees that trade unions are the legitimate representatives of workers in the public sector. Does he agree that unions not only should be consulted about the future delivery of public services, but should be at the heart of developing the agenda for delivery? Does he also agree that the debate on the modernisation of public services is not simply about the role of the private sector, but about other measures that enhance services to the public, involving the work force, through partnership, as can be seen in the national health service?

There are many examples in Scotland of politicians and managers, both national and local, working closely with trade union and staff representatives to deliver real changes that have made a significant difference to public services. The commitment to doing that exists and we should work on it.

As political representatives, we should never forget that our primary duty is not to the providers of the service, but to those whom we represent in the chamber, such as patients, parents, pupils and passengers on our public transport systems. However, we deliver better public services by working in conjunction with the front-line staff who deliver those services. My clear intention as First Minister is that we should continue to do that.

Does the First Minister agree that if the trade union movement were to apply a best-value or value-for-money test to its subsidising of the Labour party or individual members from the Labour party, the Labour party would fail that test, because its policies are more akin to those of the Conservatives than to those of the trade union movement? Does the First Minister also agree with the comments made this week by Bill Speirs, the general secretary of the Scottish Trades Union Congress, who said that the language of the Prime Minister in London was more akin to that of Mrs Thatcher than to the progressive language that is used here in Scotland?

Andrew Wilson has strayed well beyond the First Minister's area of competence, but if the First Minister wants to respond, it is in order for him to do so.

That is very rich coming from a member of the nationalist party, from whose benches this morning we heard classroom assistants described as people who tie laces, wipe noses and sharpen pencils. I am glad to have the opportunity to say that. Last Friday afternoon, I was in a school in Motherwell, the head teacher of which described classroom assistants as the best innovation in Scottish education in her lifetime. Classroom assistants are making a real contribution to increasing standards. If members from the SNP do not condemn Colin Campbell's remarks from this morning's debate, they should be ashamed of themselves.

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MMR Vaccine

To ask the First Minister whether any member of the expert group on the measles, mumps and rubella vaccine has any links with any pharmaceutical company that produces the vaccine. (S1F-01642)

Three members of the MMR expert group have shares in pharmaceutical companies. One member provides expert reports for solicitors representing a company that manufactures the MMR vaccine, and one member is acting as an expert witness for parents groups that are taking legal action against MMR vaccine manufacturers. All 18 members of the group agreed to follow the seven Nolan principles for standards in public life and, on appointment, declared any relevant private interests. That information has been in the public domain since November last year.

I thank the First Minister for his answer and I hope that the Parliament will take some comfort from the assurances that it conveys.

I remind the First Minister and the Parliament that the expert group was set up as a result of Mary Scanlon's MMR report to the Health and Community Care Committee. The report found that, on the basis of the evidence that was available to the committee, the MMR vaccine was safe and the vaccination programme should continue. The report also found that further work was required on the efficacy and viability of the single vaccine and on the impact of the single vaccine on herd immunity.

Does the First Minister agree that politicians should act responsibly at this time and await the conclusions of the expert group's work before making speculative comments on such a sensitive issue? Such comments could have an impact on herd immunity and ultimately put children's lives at risk.

Obviously, I agree with Margaret Smith. However, I also want to take this opportunity to emphasise the importance of a sane and rational public discussion of this issue. As far as I recall, I contracted measles at the age of about six or seven, in about 1967. In 1967, there were 14 deaths from measles-related illnesses in Scotland. The disease did not affect me in the long term, but it affected a number of others in my age group. Such statistics should remind us all of the situation as it used to be. As long as those involved in the expert group have properly declared their interests and as long as the expert group has properly represented the interests of those who require a voice on this issue—as I believe we all accepted at the time—I hope that, when we receive the expert group's report, we will treat it seriously. In the meantime, I strongly urge parents across Scotland to use the vaccine to ensure that not only their children but the children of others, some of whom cannot use the vaccine, have the opportunity to be free from measles, mumps and rubella.

Does the First Minister agree that the decline in MMR vaccine uptake poses a real and immediate threat to children throughout Scotland? I know that he is as worried about child safety as I am, but the statements about MMR vaccine safety, no matter how often repeated, are increasingly failing to reassure parents. What further action will the Scottish Executive take to ensure that, in one way or another, all children in Scotland are vaccinated against those deadly diseases?

I will give a couple of important assurances. It is important that we try to conduct a rational discussion on this matter in the Parliament and that we ensure that the facts are discussed and put across clearly in public life in Scotland. Of course, some individuals who are concerned about the vaccine are expressing alternative points of view. However, a number of others are involved, not least the Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom, the Royal College of Paediatrics and Child Health, the public health medicine environmental group, the Community Practitioners and Health Visitors Association and the Public Health Laboratory Service, which yesterday issued a joint press release that endorsed the continued use of the vaccine. Those professionals, who have a direct interest, are trying to get across the facts. I do not think that politicians should try to second-guess medical advice on this issue as it would be dangerous for us to do so. I hope that the chamber will remain as united as the Health and Community Care Committee was last year when it produced a considered report on this issue and asked an expert group to look at some of the other issues that are involved.

I am grateful to the First Minister for his assurances. Although I recognise parents' real anxieties and the need to win the debate by using persuasive arguments, will he also bear in mind the tremendous importance that the parents of young children—including families in my constituency and me—attach to the integrity of the present, highly successful vaccination programmes? Will he reflect on the concerns that exist about the less effective, more patchy inoculation coverage rates that result from the suggested alternatives, together with the known risks of death and damage to children from measles? Will he work with the health ministers, parents and health professionals to ensure that the increase in child deaths that followed similar scares about whooping cough immunisation in the 1970s is never repeated? Although there might well be many issues that are suitable for political kick-about in the Parliament, let us not play games with children's lives.

It is important not to play games with children's lives. I am sure that Brian Fitzpatrick would accept that it is also important that we understand and empathise with those who have developed genuine concerns because of the nature of comments in the media. I am keen that we deal with the issue rationally, so that we allay concerns in a rational way, without lecturing to those who are involved.

I will make one point to parents who might have some doubt. Up to five per cent of children cannot take the MMR vaccine. That might be because they have leukaemia or other conditions that do not allow them to take it. The higher the number of children who do not have the vaccine, the more dangerous life becomes for the children who cannot take it. As well as the individual interest, there is a wider community interest. I sincerely hope that we will all be involved in providing some reassurance, helping to calm the situation and assuring people across Scotland that they can send their children to play with other children safe in the knowledge that their children will not contract diseases as a result.