The final item of business today is a members’ business debate on motion S4M-13354, in the name of Lewis Macdonald, on a Stonehaven dialysis unit. The debate will be concluded without any question being put.
Motion debated,
That the Parliament commends the efforts of campaigners in Stonehaven and across the north east to raise funds to build a new renal dialysis unit at the Kincardine Community Hospital; understands that patients living south of Aberdeen often have to travel long distances as well as spending all day in the renal dialysis unit at Aberdeen Royal Infirmary and that a new facility in Stonehaven would make it easier for such patients to receive treatment; notes that the cost of starting up the Stonehaven Dialysis Unit, including equipment for a six-bed ward, is estimated at around £800,000; congratulates the efforts of all the local fundraisers, including the Stonehaven Rotary Club and Grampian Kidney Patient Association, and looks forward to the opening of the Stonehaven Dialysis Unit in the near future.
17:05
I am delighted to have the opportunity to celebrate the efforts of local people in raising hundreds of thousands of pounds for a dialysis unit at Kincardine community hospital in Stonehaven. I thank members from across the chamber who have signed my motion, and I welcome the campaigners from the area who are in the public gallery.
As members will know, dialysis is a vital service for those with kidney failure. It involves removing the patient’s blood, cleaning it 10 times over to make it safe and putting it back. Patients undergo dialysis for at least four hours at a time, at least three times a week. Those who are no longer well enough to cope with a transplant will require the treatment for the rest of their lives. It is therefore a radical procedure and it is tough on patients. One patient told me that, after dialysis, he feels as if he has run a marathon. It is daily treatment that saves lives, but it is important to remember that people feel worse after it than they did before.
The staff at Aberdeen royal infirmary’s dialysis unit work hard every day and provide dialysis to upwards of 120 patients several times each week. However, patients who travel into the city for treatment would really like to be treated closer to home, and that is why they have campaigned to have local units established across Grampian. There are now local units in Elgin, Banff, Peterhead and Inverurie, as well as for patients in Orkney and Shetland who would otherwise have to come for dialysis to Aberdeen.
There is no local unit for the south of the region in the historic county of Kincardineshire. That means that patients have to be brought into the city every day by a single patient transport ambulance, which collects patients everywhere from Cove Bay on the edge of the city to St Cyrus in the Mearns. The patient transport has to start with the person furthest away and wait at the hospital for the patient whose treatment takes the longest. Given the distances, that makes for very long days for all concerned.
One woman described how she gets up before dawn every morning to get into Aberdeen for four and a half hours of treatment, and then gets home hours later, feeling dog-tired with much of the day already gone. Her quality of life would be greatly improved if there was a local alternative, and that is what the campaign is all about. Fundraisers in Stonehaven have been inspired by the example of Inverurie, where local people helped to raise the money to pay for a local dialysis unit a few years ago. That example is very relevant to the debate.
In Kincardineshire, Stonehaven Rotary club alone has raised many thousands of pounds, and the social calendar in the area has been greatly enlivened as a result. The campaign has once again been anchored by the Grampian Kidney Patients Association, which has also provided the necessary bridge between fundraising in the community and decision making in the national health service. The vice chair of the association is Dr Ann Humphrey, who has been responsible for the care of many renal patients in Grampian over the years, including my father, Roddy Macdonald, back in the 1990s. She is in the public gallery today. The Grampian Kidney Patients Association continues to be among the most active of such associations in the country, and I have no doubt that that reflects Ann Humphrey’s personal commitment over the years.
Also in the public gallery is local kidney patient Angus Simpson, who first asked me to highlight the campaign. Angus worked as a baker offshore, where he was an active member of Unite the union, speaking up for his fellow workers. Nowadays, he is equally committed to campaigning and speaking up for his fellow patients.
A patient who is fit enough to travel to Holyrood today is likely also to be able to manage his or her condition and to help develop a new model of self-directed care at a satellite unit in a place such as Stonehaven. Not every kidney patient who lives south of the city will be able to do that, as the most acute cases will still need to attend Aberdeen royal infirmary in order to have dialysis with full medical support nearby. However, for non-acute patients, who need safe access to dialysis with the minimum of fuss, the provision of a local service will make a huge difference to their daily lives. Something like 10 per cent of those who currently attend ARI will be able to have dialysis nearer to home instead. That will of course help take pressure off the unit in Aberdeen and thereby benefit all those who attend the dialysis unit there at present.
The support of NHS Grampian for the initiative has been vitally important; if that is true up to now, it will be even more so as the project enters its next phase. NHS Grampian has recognised the project as a strategic priority, which has enabled much else to follow and is in line with the provision of dialysis in satellite units across the region and, of course, with the developing model of self-directed care.
NHS Grampian has provided the site for the new unit at Kincardine community hospital, which is one of the newer hospitals in the region and readily accessible from all parts of the Kincardineshire area. Now that campaigners have raised the bulk of the funding needed to meet the capital costs of the new unit, they are understandably impatient to move on to the next phase. They would like to have a timetable for construction and commissioning, and of course they would like the unit to be up and running as soon as possible.
NHS Grampian is clearly keen to make progress, and it has already taken professional advice on what needs to happen now. It is committed to meeting the future revenue costs of the service. Again, that is critical to the project going forward. Clearly, some additional funding is still required in order to complete the business case. I hope that ministers will support the local NHS as it seeks to bridge the remaining funding gap. The British Kidney Patient Association is willing to help, potentially with a substantial grant, but that support is conditional on the bulk of the necessary funding already being in place.
The fantastic work of local fundraisers continues to this day, and I believe that money is still coming in every weekend from one direction or another. However, in order for the business case to be completed, more needs to be done. I hope that ministers will do whatever they can to help NHS Grampian move the project forward and thereby help patients in the Stonehaven area to obtain access to a local dialysis service.
On that basis, I thank and congratulate again all those who have made things possible. I look forward to the successful conclusion of the campaign at the earliest possible date, with continued support from all concerned.
17:12
I congratulate Lewis Macdonald on bringing the debate to Parliament and thank him most sincerely for his very interesting speech, which covered the subject so comprehensively that he has not left me with much to add. However, that is fine because clarity and simplicity are always the order of the day here.
I start by registering that I first heard about this wonderful fundraising exercise at the Stonehaven feein’ market shortly after I was elected as the local MSP under the new constituency boundaries. I was required to pay some money to toss some balls at some old plates, which I was supposed to smash. I remember that distinctly because I failed to hit any of them at all, never mind smash them. So, I did not cost the fundraising campaign anything and I undoubtedly made a contribution. I think that that activity was typical of things that were being done by fundraisers across the area, but much more significant things were also done, of course. My understanding is that the amount that has been raised so far is £553,000, and that figure is not raised only from the kind of activity in which I participated. The fundraisers are seriously to be congratulated for their efforts over a sustained period.
As Lewis Macdonald pointed out, the proposal is to have a haemodialysis unit at Kincardine community hospital in Stonehaven. I note, as he did, that it is the only area in Grampian that does not have that kind of local renal unit, so having one will clearly fulfil a need.
I will express just one note of concern, however, on a matter of which I was reminded at the Audit Committee this morning. The capital costs are estimated at £800,000. I have no doubt that that is the best estimate that folk can come up with, but I sound a note of caution that it is only when something has finally been designed, has been seriously costed by quantity surveyors and people have quotes in front of them that they know what the real cost is even likely to be. Given that there is probably no underground work to be done, that amount should be the final answer, but let us be sanguine about quoting capital costs until we have gone through that process properly.
I note, as Lewis Macdonald did, that a design team has been appointed by NHS Grampian, so it is clearly committed to the project and to finding the 4.5 whole-time equivalent nurses who will staff it, probably by directly transferring folk from Aberdeen royal infirmary, where they will not now be needed. We seem to have buy-in from NHS Grampian. I, too, will be interested to hear the minister’s comments.
I want to make one other observation as a constituency MSP—of course, my constituency crosses the border. I note that a facility in Stonehaven will be of value to people in Aberdeenshire and historic Kincardineshire, but given its proximity to the railway line, I wonder whether it might also be useful for people from the Montrose area, who are outside Grampian, but only just. We might want to be a little bit cleverer than we sometimes are about whether people can cross borders in order to make use of facilities. It would be a great pity if that point was missed. I mention that in passing. I do not think that the point will be missed, because I am conscious that the maternity facility in Montrose is used by folk from Kincardineshire on exactly the same basis, so I suspect that people will wise up to this. We just need to make sure that, once the facility is there, it is as well used as it can be.
I commend all those who are involved—Stonehaven Rotary Club and Grampian Kidney Patients Association in particular—for carrying out the difficult negotiation process that Lewis Macdonald mentioned. It would have been easy for the project to become just too difficult. Plainly, that has not happened, and on that basis I commend everybody who has been involved and thank Lewis Macdonald again for bringing the debate to Parliament.
17:16
I, too, begin by congratulating Lewis Macdonald on securing this debate and bringing the campaign for a new renal dialysis unit in Stonehaven to the Parliament’s attention. I confess that I was not aware of the campaign until I read the motion, even though Stonehaven is in my region and quite close to home. I hope that any local publicity that Mr Macdonald can get from this debate will help to increase the general public’s awareness of the campaign and help the fundraisers to achieve their goal.
End-stage renal failure is a very trying condition to live with—the only long-term cure being transplantation and the only way of treating it being regular dialysis, which usually has to be undertaken at least two or three times a week and which lasts four to six hours, with a further hour or so before and after for preparation and recovery. That is a huge chunk out of people’s lives. It is bad enough if one lives close to a major renal unit such as those in our cities, but if one lives at a distance, travel time has to be added.
Stonehaven lies in the south of the area that is covered by NHS Grampian and it currently has no dialysis facilities. The nearest unit is at Aberdeen royal infirmary, which is some 15 miles from Stonehaven and, obviously, further for people who live further south. We are told that about 25 patients in the south Grampian area could benefit from a Stonehaven-based unit.
As the motion states, the cost of setting up a new unit at Kincardine community hospital is about £800,000. The fundraising campaign has a target of £150,000—over and above a bequest of £250,000 that has already been received—to cover the capital costs, with staffing and running costs to be met by the health board. I am told that thanks to the stalwart efforts of several local organisations and other fundraisers, the end is in sight and the new Stonehaven dialysis unit will soon be a functioning reality.
Soon after I became an MSP, I became involved with an almost identical campaign to set up a satellite dialysis unit in Inverurie, which Lewis Macdonald mentioned. Inverurie is about the same distance north of Aberdeen as Stonehaven is to the south. I apologise to the Presiding Officer for digressing slightly from the motion, but in that area Gordon Renal Dialysis Charity was set up to fund the capital costs. I was happy to help that organisation in a small way by helping to highlight its work and reinforcing its efforts to persuade the health board to take on responsibility for the staffing and running of the unit, which—from memory—was not on the cards when the organisation was set up. The unit, which was purpose built, opened at Inverurie cottage hospital in 2006, with running costs being shouldered by the health board. The first patients were treated there soon after, allowing the charity to wind up in 2008.
I know that many patients in the north of Aberdeenshire have had a better quality of life since being spared the time-consuming journey to Aberdeen two or three times a week and the hassle of trying to find a parking space close to a busy acute general hospital. A consultant clinic is held in the unit every month, so that patients can be reviewed locally, as well. Moreover, the unit provides an out-patient service for venipuncture and intravenous iron administration for local peritoneal dialysis and low-clearance patients.
I have visited the Inverurie unit and spoken to patients who have benefited from it: there is no doubt that people appreciate their local facility. Not only is it more accessible for patients, but the atmosphere in the unit is much calmer than can be achieved in a bustling major centre.
I had the greatest admiration and respect for all the fundraisers who put so much effort into securing the satellite unit in Inverurie, and not least for their dogged determination to press ahead without the health board’s decision to take the unit over. I feel exactly the same about all the people who are working towards the new unit in Stonehaven, even though their task has perhaps been made easier by the success of the earlier unit, which has no doubt influenced the board’s decision to staff and run the Stonehaven unit. I congratulate everyone on their efforts and I look forward to hearing that the unit is up and running. I hope to see it in action.
17:21
I, too, congratulate Lewis Macdonald on lodging the motion, and I join him in congratulating everyone who has been involved in the fundraising effort, including Angus Simpson—I am glad to see a Simpson featuring.
There are two aspects of the issue that I want to cover: haemodialysis and dialysis in all its forms in Scotland; and community support and the relationship between voluntary and statutory organisations in the context of issues such as we are considering.
Across Europe, some 250,000 patients are on dialysis, and the figure is going up by 4 to 6 per cent annually. In Scotland, we have 35 haemodialysis units, of which 25 are satellite units. That is important, because in the past the units were all centralised in places such as Aberdeen royal infirmary, and we did not have satellite units such as the Inverurie unit and the unit that will be established in Stonehaven.
The addition of satellite units is critical and is part of the approach that the Kerr report strongly recommended. Kerr said that services should be devolved to as close to patients as possible, when that is safe and helpful to patients.
Haemodialysis is a classic example of that. When we got a haemodialysis unit at Forth Valley royal hospital in Larbert, in my area, it was a useful step forward that saved patients from having to travel to Glasgow. It is important that 25 out of the total of 35 units in Scotland are satellite units; I understand that 10 years ago there were only 16 units. In addition, 11 of the 35 units provide home dialysis, which is becoming more common and safer.
There are also 15 peritoneal dialysis units in Scotland. That is of particular interest to me, because I was the first doctor in Scotland to apply peritoneal dialysis, in 1967, when it was a little-known technique. I regret to say that it was not successful for the patient, although they and their consultant had both been keen to try that novel technique. Peritoneal dialysis is an alternative when haemodialysis cannot work.
I think that Nigel Don and Lewis Macdonald alluded to the holiday and visitor dialysis that 31 of the units provide. That is also important, because dialysis tends to tie a patient to their unit. It is good for patients to read on the website that they can get dialysis in another area.
The ability to do that is underpinned by another aspect of the service in Scotland. As far as I know, kidney dialysis patients in Scotland are the only group of patients who have total access to their laboratory results. That was evident when the Glasgow information technology system collapsed and was down for two days—we discussed that issue in the Parliament. At the time, the only group of patients who were totally safe were the kidney dialysis patients, because they could tell their consultants exactly what their results were.
Excellent work is going on in Scotland, including a couple of clinical trials. One trial, an important £2.2 million Europe-wide study on new techniques to improve the performance of the vascular access that underpins haemodialysis, is being co-ordinated in Dundee. Another important, four-year, trial with 2,000 patients is tackling issues to do with iron. We have good research in Scotland—we always do.
On voluntary support, agreement beforehand with the health board is essential. Raising the capital is one thing, but raising the money to meet the continuing costs is another. Communities should agree service development with the health board. That partnership between the voluntary and the statutory is exactly what is proposed in the series of documents by John Elvidge entitled “The Enabling State”, which I have commended in other parliamentary debates. I believe that such partnership is a way forward because it gives the community ownership and a feeling of co-operation and partnership with the statutory body, and that is good for Scottish society as a whole.
17:25
I, too, thank Lewis Macdonald for bringing the matter to the attention of Parliament, and I thank other members for their contributions to the debate. The subject is close to my heart, as constituents of mine may prefer to travel south to Stonehaven rather than go to the ARI. However, tonight I am speaking as the Government minister.
I welcome to the public gallery the people from Stonehaven whose fundraising efforts have been absolutely marvellous. Funds were raised by Stonehaven folk club’s cabaret night, by Stonehaven rotarians—who Lewis Macdonald mentioned—by the July music festival in Mineral Well park and by the harbour festival. A large sum was also donated by the Gammie family. In addition, there was a beer festival and a Christmas lights display by the residents of Malcolm’s Way, and the sea cadets also raised money. That is to name just a few of the fundraisers—I have probably missed some groups out, for which I apologise.
As other members have said, patients who require dialysis must go through continuous life-saving treatment, sometimes for several years, which inevitably means some disruption to their everyday lives. I make it clear that the Scottish Government is committed to ensuring that people with renal conditions are able to access the best possible care and support and that they benefit from healthcare services that are safe and effective and which put the patient at the centre of their care. We are committed to ensuring that patients who require renal dialysis are able to access those facilities as close to home as possible. However, because of the highly specialised nature of dialysis, people often have to travel a fair distance to their nearest renal unit. It is well established in research that renal patients do better when they receive treatment nearer to home with the support of family on hand, with less travel time and where set routines for meal times, for example, are easier to keep to.
An example of how we are seeking to ensure continuous improvement in the area and reduce journey times for patients in more remote areas is a pilot programme that is under way in which NHS Greater Glasgow and Clyde have provided two dialysis chairs in Campbeltown to provide a dialysis service to patients in the Argyll and Bute area. That two-year pilot, which was also co-funded by local fundraising, began in August 2015 and will be evaluated after one year; its progress will be analysed and consideration will be given to whether such a model of care might be workable in other parts of the country. The pilot was also co-funded by local fundraising. I look forward to seeing the results of the pilot and ensuring that any learning can be passed to other NHS boards.
In December 2013, there were nine adult renal units and one paediatric unit in Scotland, with 25 satellite dialysis units. As Dr Simpson said, their number is increasing.
The fundraising that has been done by the groups that I have mentioned is testament to the great work that can be done locally, along with health services, to ensure that services are delivered locally to patients. Indeed, NHS Grampian is committed to establishing a satellite renal dialysis unit in Kincardine and to meeting the staff, running and equipping costs, thereby meeting any difference between the cost and the final fundraising total.
As has been said, a design team has been appointed to work with the local community and the board to agree a cost for the facility, after which a commitment to the timetable for the establishment of the service can be given. That is great news for the 25 patients in the Stonehaven area who regularly travel to Aberdeen for treatment.
Of course, for some—although not for all—patients, dialysis is a precursor to the requirement for a kidney transplant. In 2013, we published “A donation and transplantation plan for Scotland 2013-2020”, which sets out the ways in which we hope to improve donation and transplantation. We want Scotland to be among the best performing countries in that regard. The plan sets out the priority areas of work that we need to tackle over the period up to 2020 to enable us to reach that goal.
The Scottish Government is delighted to be working with Kidney Research UK to deliver a three-year peer educator programme that is specifically designed to raise awareness of kidney disease and the need for organ donation within the black, Asian and minority ethnic communities. I look forward to attending an event that it has organised in Glasgow next month to learn more about that important work.
On services for renal patients, the Scottish Government has, since 2010, funded the renal patientview service. As Dr Simpson said, the service enables patients to view their latest test results and diagnostic information online from anywhere in the world, and to share it with anyone they want to share it with. Information comes directly from existing records—for example, hospital and general practitioner records—although it may be entered directly or via other apps. Secure messaging functionality is also included.
The system provides a vital service to renal patients, allowing them to communicate with their clinician to discuss their test results and the on-going management of their condition. The Scottish Government is working with clinicians and third sector organisations to develop the system for other long-term conditions.
I look forward to visiting the renal unit at the Edinburgh royal infirmary on 4 November to see the vital work that is being carried out there and, importantly, to meet some of the patients who regularly attend the hospital to receive their care.
Again, I commend the excellent fundraising work that has been done in the Stonehaven area. I look forward to hearing about progress—no doubt, members will hear about that in their regular meetings with NHS Grampian and the local community—and how plans are proceeding towards the establishment of a dialysis service at Kincardine community hospital, which will be welcome.
Meeting closed at 17:32.Previous
Decision Time