Health and Wellbeing
Good afternoon, everyone. The first item of business is portfolio questions. In order to get in as many members as possible, I would prefer succinct questions with answers to match, please.
NHS Greater Glasgow and Clyde (Discussions)
To ask the Scottish Government what recent discussions it has had with NHS Greater Glasgow and Clyde. (S4O-02987)
Ministers and Government officials regularly meet representatives of NHS Greater Glasgow and Clyde to discuss matters of importance to local people.
The cabinet secretary will be aware of my personal interest in access to new medicines, particularly for orphan and ultra-orphan conditions. I have a constituent—I will not name them in order to keep their details confidential—who is suffering from Pompe disease. Previously, they have been refused an individual patient treatment request by NHS Greater Glasgow and Clyde. I am worried that the board may not be showing the flexibility that the cabinet secretary has called for with regard to the individual patient treatment request system ahead of the welcome reforms that the Scottish Government is implementing. Will the cabinet secretary use his good office to ensure that the board starts to use that flexibility more consistently to benefit not only everyone but the particular constituent, whose details I can provide to him after portfolio question time?
The Scottish Government has made clear its expectation that boards will be more flexible in their approach to considering individual patient treatment requests for not recommended medicines. However, consultants in Scottish health boards make decisions on the appropriate treatment for their patients. The IPTR decision on Myozyme for the patient in question was made by NHS Greater Glasgow and Clyde.
I encourage Bob Doris to send me the details. I have been in touch with the health board about the evidence given to the Beatson consultants on the issue. I emphasised the flexibility that health boards have with regard to such applications.
The cabinet secretary will be aware of the speculation about conversations that he may have had with NHS Greater Glasgow and Clyde about the Government’s response to the consultation on chronic pain and the possible use of the Glasgow homoeopathic hospital as a permanent centre for the management of chronic pain. In his usual way, will the cabinet secretary be gracious enough to share with the chamber his thinking on those matters?
Ministers are considering the responses to the consultation on chronic pain. We will make an announcement fairly soon on our response to the responses.
Used Needles (Disposal)
To ask the Scottish Government what steps it is taking to ensure that national health service boards have an appropriate policy to ensure the safe disposal of used needles. (S4O-02988)
In 2010, the Scottish Government published national guidelines for services providing injecting equipment. Recommendation 16 of those guidelines specifically states that NHS boards should ensure that all services in their area have robust policies and procedures in place on the safe disposal of used injecting equipment.
The position in Fife is mixed: some health centres and pharmacies accept sharps, while others do not. The matter has become a particular problem since landfill sites have stopped accepting specially made containers because of the risk to site operators. What further support will the Scottish Government offer to health boards to ensure that they make an appropriate policy?
The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 require all employers, including health boards, to have in place policies to ensure the safe disposal of sharps. On 2 May 2013, the Scottish Government wrote to all NHS boards to advise them that the regulations would come into force on 11 May 2013. If there is any evidence that the regulations are not being adhered to, if Rod Campbell—or anyone else for that matter—submits that to the relevant authority, we will investigate.
Question 3 has been withdrawn and an explanation has been provided.
Delayed Discharge (NHS Borders)
To ask the Scottish Government how many bed days were lost due to delayed discharges in the NHS Borders area during the last three quarters of 2013. (S4O-02990)
Between April and December 2013, 5,826 bed days were lost to delayed discharge in NHS Borders—a 6.5 per cent reduction from 2012.
The issue causes huge problems, not only for hospitals but for patients who are fit enough to leave hospital but are forced to wait before being discharged and allowed home. The figures show that the problem is far from being solved. There can be no doubt that something needs to be done to address it. What plan does the Scottish Government have to help to reduce the problem of delayed discharges in the Borders and the rest of Scotland?
Perhaps the member should have waited until after I had given him the answer before writing his press release. The January census in the Borders shows that eight patients were delayed for any duration, with none delayed for more than four weeks. The Borders area is one of the top three best performing boards in the whole of Scotland in terms of delayed discharges. I am sorry to ruin the member’s press release, but those are the facts of the situation.
Delayed discharge is a problem throughout the country, with 15 per cent of care home places in Edinburgh, 15 per cent in Highland and 20 per cent in Glasgow unavailable due to concerns about the level of care being provided. What is being done to address those serious concerns throughout Scotland, including in the Borders?
At the last count, there were 57 homes where the Care Inspectorate has imposed some kind of moratorium because of quality issues and concerns. That has taken nearly 800 beds out of care home capacity in Scotland.
The Government and the Care Inspectorate are working with individual homes to see where quality can be improved. Although some of the homes are the subject of a closure order, most are homes that the Care Inspectorate is working with to get the quality of provision into better shape.
More generally, we have been reviewing the situation with our friends in the Convention of Scottish Local Authorities and we hope to report fairly soon on the outcome of our discussions and our consideration of the quality of Scotland’s care home provision in future.
Complementary Medicines and Therapies
To ask the Scottish Government what its position is on complementary medicines and therapies and on supporting national health service boards in their use. (S4O-02991)
The Scottish Government recognises that complementary and alternative medicines—CAM—and therapies may offer relief to some people living with a wide variety of long-term conditions. Current Scottish Government policy is outlined in Health Department letter (2005)37, which was published in 2005. This guidance sets out the framework for the provision of CAM.
It is for individual NHS boards to decide what complementary and alternative medicines they make available, based on the needs of their resident populations and in line with the national guidance.
I thank the cabinet secretary for that helpful and quite comprehensive answer. I have been approached by constituents in NHS Lothian and Borders and NHS Lanarkshire. As the cabinet secretary will know, there is a review of homoeopathy in Lanarkshire. Although some constituents expressed concerns about the scientific evidence for complementary medicines, there are long traditions of using such medicines in many countries, including here. In fact, some countries’ traditions go back far longer than ours.
The evidence is before our eyes: reflexology is used for sports injuries; and many support groups use complementary therapies. In fact, I have just come from a meeting of the cross-party group on carers—which I convene, along with Joan McAlpine—where we heard about support for carers through the therapy of hand massage.
Will the cabinet secretary give us greater reassurance on the Scottish Government’s commitment to supporting people in that way?
The Scottish Government’s views have been made very clear and are consistent with those of the previous Administration. As I said, it is up to individual health boards to decide for their area exactly what provision they are prepared to make in respect of such services. As the member will know, the medical community is somewhat divided on the issue of homoeopathy. Some take a very positive point of view and others take a very negative one. As a non-medic, I remain neutral on the issue.
National Health Service Boards (Guidance on Public Transport Provision)
To ask the Scottish Government what guidance is given to NHS boards regarding the provision of adequate public transport to and from their facilities. (S4O-02992)
It is a matter for national health service boards to identify any issues and potential solutions in discussion with local authorities and regional transport partnerships, which have funds to support transport services to meet the assessed needs of the market in their area.
Is the minister aware of the reduction in the bus service between Ayr and Crosshouse hospitals following the ending of a subsidy from NHS Ayrshire and Arran, which helped to establish the route? The result is that making journeys from the south of the constituency to Crosshouse is somewhat challenging for patients and their families.
Despite discussions among the health board, Strathclyde partnership for transport and Stagecoach, there seems little prospect of an increase in the service in the foreseeable future. Therefore, I would be grateful if the minister would consider helping to bring together the relevant parties with a view to finding a viable solution and, if required, making funding available to ensure that patients in the south of Ayrshire are not disadvantaged in accessing the care that they need.
I am aware that initial funding was provided by NHS Ayrshire and Arran and SPT to establish transport provision on the particular route that the member referred to. The intention was that the route would become commercially viable. However, I understand that, due to low usage, it did not and Stagecoach was unable to sustain the service at the level that it had originally planned.
At the current time, where a service is not provided by the market, the local transport authority—in this instance, SPT—has the powers and the budget to provide funds to support adequate services, where it thinks that necessary. I am more than happy to meet the member to discuss the matter. However, as I am sure he will appreciate, funding provision would be an issue for the local transport authority.
Could the minister look into the matter more widely, because I suspect that the problem exists throughout Scotland, not just in Adam Ingram’s area? Certainly, it is prevalent in the Highlands and Islands. I have been involved with patient groups in Nairn, where there is no regular bus service between the town centre and the general practitioner practice, which is based at the hospital, which means that patients cannot get back and forth. That is a big issue for elderly patients, who might not be able to walk that distance. It might be helpful if the minister could take an overall look at the issue in order to get health boards to work with their transport partnerships to ensure that people have adequate transport to hospital.
We are always prepared to consider various ways in which we can improve these issues, and it is important that health boards actively seek to forge appropriate partnerships with the right agencies, in order to overcome specific problems in their localities. NHS Highland should be looking to work with the transport authority and the local authority there to identify the best solution to overcome the type of transport problems that individual patients might be experiencing. If the member wants to raise specific examples of situations in which she feels that the board is not adequately engaging with those partners, we would be more than happy to ensure that the health board pays close attention to the issues and engages with the local transport authority in order to find a solution to the matter.
Cancer (Waiting Time Targets)
To ask the Scottish Government for which cancers waiting times targets are not being met. (S4O-02993)
The two cancer access standards are an all-Scotland standard and apply to all cancer types combined.
There is variation in the numbers and complexity of some cancer types, and there are some cases in which good clinical practice means that patients cannot or should not be pushed through a pathway to achieve a target.
The 31-day target has been achieved ever since its introduction and, for the most recent published data, the 31-day standard was exceeded at 98.1 per cent. In the most recent published quarter, 94.5 per cent of patients in Scotland were treated within the 62-day standard. A breakdown of performance by cancer type can be found in the quarterly Information Services Division statistical publications.
I am disappointed that the cabinet secretary has referred me back to the ISD publications to get the answer to the very specific question that I asked. It would be relatively simple to give us the list of the individual cancers for which the targets are not being met. I accept some of the points that the cabinet secretary makes about the wider calculation, but it is a simple question. For each of the individual cancers where targets are not being met, will the cabinet secretary guarantee that the target will be met by the end of December 2014?
The member has not understood my answer. The target is for all cancers combined; there is not a separate target for each cancer type. Indeed, I remind the member that the targets were set in 2001 by an Administration in which he was a minister. We have retained the same targets that are defined in exactly the same way as they were by the previous Administration.
E-cigarettes (Availability and Marketing)
To ask the Scottish Government what its position is on the widening availability and increased marketing of e-cigarettes. (S4O-02994)
Although electronic cigarettes might have the potential to help people quit tobacco, their long-term public health effects are not known. I remain concerned that the promotion of those devices could renormalise smoking behaviour, particularly among young people.
I welcome the revised European tobacco products directive, which sets out a number of measures for the regulation of electronic cigarettes. It includes subjecting non-medical electronic cigarettes to the same advertising restrictions as tobacco products.
The Scottish Government is also committed to considering what additional measures may be required in Scotland to further protect public health, such as restricting age of sale for electronic cigarettes.
The minister probably knows that today is national no smoking day. I note what he says about companies perhaps trying to renormalise smoking. Does he share my concern that the tobacco industry now seems to own most of the e-cigarette manufacturers and that we should be very guarded about its intentions?
I am aware that the tobacco industry has invested heavily in electronic cigarettes, and I am sure that all members will recognise that its business is to ensure that people keep buying its products, particularly cigarettes.
As I have said, properly regulated electronic cigarettes might have the potential to support people who are quitting tobacco. However, we need to take appropriate steps to ensure that those devices are not used to renormalise smoking behaviour or to promote addiction. That is especially important for young people who are not smokers and do not therefore need devices to help them to quit smoking.
It is right that we should also stand against promotion, advertising and sponsorship deals that feed nicotine addiction, especially in the context of being attractive to young people. Those are the principles that will underpin any further work that we do in this area.
I begin by thanking the minister for his robust stance on this issue. It is an extremely important area in which the field is moving very fast.
From the EU decisions, it appears that there will be two classifications of e-cigarette, one above and one below a certain level of content. Those that are below that level of content might have additives that are of considerable concern but will not be subject to medical devices regulation, even if that is introduced.
Will the minister consider referring to the Food Standards Agency the question of the content and safety of the e-cigarettes that are not covered by medical devices regulation? Will he also undertake to look at the possibility of carrying out research into where these things are being sold and to whom so that we can determine whether they are helping people to come off cigarettes, which is the manufacturers’ stated intent, or whether they are encouraging young people in particular to take up smoking?
The member is quite right to highlight the fact that this is a fast-moving agenda and that we need to be proactive in addressing it. He is also correct to say that the EU tobacco directive highlighted a number of different issues that have to be considered. The directive somewhat superseded the Medicines and Healthcare products Regulatory Agency’s recommendation that electronic cigarettes should be classified as a medical device.
The directive has set out the maximum level of nicotine that e-cigarettes should contain, as well as a range of other worthwhile measures that should be all taken forward, including making them child tamper proof. We will consider what further measures need to take place here in Scotland. I am anxious not to undermine the decades of good work that has been undertaken to reduce tobacco use; we do not want that to be unpicked by the tobacco industry using electronic cigarettes almost as a Trojan horse to achieve its objectives. We should consider what measures we need to put in place to ensure that there are adequate safeguards around the use of electronic cigarettes.
I assure the minister that, if he progresses the matter in a responsible, measured way, he will have our support.
I wish to concentrate on the devices themselves, most of which are manufactured in the far east. There is not the necessary public awareness of the fact that some of the devices have been said to melt and to contain formaldehyde, antifreeze and other ingredients. Will the minister ensure that the public are made aware that the issue does not just concern nicotine and that the device itself is potentially a harbourer of other serious conditions?
I agree with the points that the member has made. Part of the challenge is down to the fact that e-cigarettes are unregulated at present. The intention was for them to be regulated as a medical device. The MHRA had made recommendations about pursuing that, and those provisions were set to be introduced in 2016. However, the tobacco products directive has somewhat superseded that approach in that, under it, e-cigarettes should not be regulated on that basis and may be used as a device in their own right. However, in following that, we should adopt a range of measures to regulate the products adequately.
We believe that the approach that we are taking is measured and responsible. It is not about getting on the backs of individuals who are making use of electronic cigarettes to help reduce their tobacco use; it is about ensuring that there are adequate safeguards in place around how and where they can be used.
Consultant Recruitment (Remote Northern and Island Hospitals)
To ask the Scottish Government what recent discussions the Cabinet Secretary for Health and Wellbeing has had with national health service boards regarding recruitment of consultants for remote northern and island hospitals. (S4O-02995)
The Scottish Government has regular discussions on a wide range of matters with all health boards, including NHS Highland, and including the issue that is raised in the question.
I thank the cabinet secretary for that short answer.
In NHS Highland, too high a proportion of mums-to-be feel that they should not have to be hospitalised in Inverness, which is 100 miles from their homes, if they are in the north of my constituency. Can the cabinet secretary help us to maintain maternity consultants at Caithness general hospital in Wick, and to find suitable generalists, who are required to make remote and rural hospital services work?
It was very sad to hear about the recent untimely death of a locum in Caithness, who was providing maternity services cover for a consultant who retired in December 2013.
I am glad to say that NHS Highland is working hard to recruit a substantive consultant to Caithness general hospital. Workforce planning and recruitment is properly a matter for NHS boards, but I assure Rob Gibson that the Scottish Government gives sustainable services high priority. We will continue to work closely with boards across Scotland to ensure that the right people are recruited in the right numbers, in the right places and at the right time. That includes in Caithness and at other rural hospitals in the Highlands and elsewhere.
The matter is an issue not just for the health service, but for the whole public service. The health service could work together with other public service departments to provide career breaks and the like for the partners of people who are being recruited. Sometimes, it is a block to people taking up jobs for which they have to move home that no career pathway is apparent for their partner. If all the public service were to come together and guarantee jobs for partners, that would make the whole situation a lot more attractive, and it would help to retain people in the areas concerned.
That suggestion would require detailed consideration. To give that kind of guarantee would obviously have a huge number of consequences and implications—not least for finance.
In the meantime, we are working with boards—especially in remote and rural areas, including island communities—to fill vacancies as quickly as possible, in particular in maternity and many other essential services. We fundamentally believe that people who live in remote, rural and island communities are entitled to the same quality of care as everybody else in Scotland.
NHS Greater Glasgow and Clyde (Meetings)
To ask the Scottish Government when it last met representatives of the NHS Greater Glasgow and Clyde board and what matters were discussed. (S4O-02996)
Ministers and Government officials regularly meet representatives of NHS Greater Glasgow and Clyde to discuss matters of importance to local people.
Dental practitioners have advised me in recent discussions that there are still concerns about the levels of dental decay among children in my constituency and surrounding constituencies.
Does the minister commend, as I do, the good work of the Gladiator Programme’s Gladigator project—which is based in Easterhouse in my constituency—and its creativity in how it promotes good oral health among young people? Unfortunately, the project has had its funding cut by NHS Greater Glasgow and Clyde. Will the minister agree to meet me to discuss the matter further and to look at ways in which we can ensure that that community project is supported in the good work that it has been doing since 1996?
I join Paul Martin in underlining the importance of dental healthcare, and not just for dental health itself but in terms of the impact that it has on the rest of an individual’s health. I will, of course, be happy to meet him to discuss the local situation in his constituency.
Independence (Cross-border Transplantation of Organs)
To ask the Scottish Government what discussions it has had with NHS Blood and Transplant about cross-border transplantation of organs in an independent Scotland. (S4O-02997)
Government officials are in regular contact with NHS Blood and Transplant on a range of issues. The NHS in Scotland is already fully devolved, and independence will not change the way in which cross-border transplantation of organs is managed. NHS Blood and Transplant agrees with that assessment, and has confirmed in writing that it does not believe that there would be any significant change to the management of organ donation and transplantation in the event of independence.
As a regular blood donor, I thank the minister for his answer. Does he agree with me that the no campaign should confirm that cross-border organ transplantations would be unaffected by a yes vote?
I do not know that I am best placed to advise project fear on how it should lead its campaign, although its attempt to raise fears around the idea that in an independent Scotland people would have difficulty accessing organs for transplantation has taken that campaign to a new low.
Christian Allard is correct, and NHS Blood and Transplant has made it clear to us that it does not believe that there would be any significant change to the management of organ donation and transplantation in the event of Scotland becoming independent—[Interruption.]
Order, please.
Organ donation and transplant activity have always been delivered collaboratively across the UK. When Scotland becomes independent, that will continue to be the case. That position was set out clearly in the Government’s white paper, “Scotland’s Future: Your Guide to an Independent Scotland”.
Like the cabinet secretary—and, I presume, the minister—I am anxious that health does not become a political football in the chamber.
We currently enjoy a reciprocal arrangement because we are part of the United Kingdom; my family has benefited from it. However, in the event that we become independent, would Scottish patients have the same access rights to treatment in England as French patients, for example? Would that put us on a European waiting list for transplant? What changes would there be in that respect, and how much would have to be negotiated?
The arrangements for transplantation would be the same as they are at present, and the reciprocal health arrangements in the European Union would be the same as they are now, right across Europe.
Nanette Milne said that she is keen not to have the issue turned into a political football, but I recall that she was the member who raised the issue with NHS Blood and Transplant last August to ask for clarification on the arrangements.
NHS Blood and Transplant has provided clarification that independence would create no uncertainty. In fact, the Irish Government has an agreement with NHS Blood and Transplant, and other countries work together to share organs through Eurotransplant and Scandiatransplant. That is exactly what will happen when Scotland becomes independent.
Plagiocephaly
To ask the Scottish Government what action it has taken in the last year to assess and address the incidence of plagiocephaly. (S4O-02998)
The Scottish Government and NHS Scotland have not assessed the incidence of plagiocephaly in the past year, but the condition is monitored as part of the Scottish child health programme in the same way as any other condition. The majority of cases of simple postural plagiocephaly resolve themselves without the need for any treatment. The Scottish Government provides information to all new parents that recommends supervised tummy time for all babies. For a very small number of babies, physical therapy and repositioning advice will be provided by the national health service. [Interruption.]
I ask members to ensure that their mobile phones are switched off.
Responses that I have obtained from health boards show gaps in their knowledge and in information provision to parents. Is it not the case that, because of the Scottish Government’s disinterest and inaction, hundreds of severely affected babies every year might be missing out on the treatment that they need?
Information is provided to parents when a baby is born. Individual health boards are responsible for ensuring that that happens. It is important that boards make that information available effectively. We should keep it in mind that very few babies with the condition require any form of clinical intervention and that, for the vast majority of children, the condition resolves itself within the first five years. Where there is a requirement for specific clinical intervention, the child would be referred to a community paediatrician and, if necessary, referred on to a paediatric neurosurgeon for the issue to be considered in more detail. Only a few children require that type of clinical intervention, which the NHS provides across the country as and when necessary.
Private Healthcare (Spending on Operations and Procedures)
To ask the Scottish Government how much the national health service has spent on operations and procedures in the private sector in each of the last three years. (S4O-02999)
Although information is not held centrally specifically in relation to spend on operations and procedures, we have obtained from NHS boards the spend on the use of the private sector to deliver the acute hospital waiting time guarantee and standards in each of the last three years. The figures were £8 million, £11.6 million and £28.5 million
The increase in the use of the private sector in 2012-13 relates mainly to two boards that are currently experiencing capacity issues: NHS Grampian and NHS Lothian. As the member is aware, NHS Lothian is dealing with the challenge that capacity at Edinburgh royal infirmary is 20 per cent lower than required to meet today’s needs. That is why the board has agreed a plan that will see it invest in a multimillion pound expansion over the next year, which will reduce its requirement to use the private sector. NHS Grampian has recently agreed an £18 million investment programme, which will increase capacity by building new theatres and employing more doctors, nurses and support staff. That additional capacity will also significantly reduce the board’s need for the private sector from 2014-15.
The Scottish Government policy on the use of the private sector is clear: we expect boards to build sustainable capacity in the health service, with the private sector used only in the margins.
On 6 June last year, the British Medical Journal published a call from NHS Scotland at national level for expressions of interest from private sector healthcare providers to provide clinical services to the NHS in Scotland. What was the response to that call? More generally, what is the Scottish Government’s role in planning and arranging the provision of private sector clinical services for NHS boards?
Primarily, those services are organised by the boards, but that is often in consultation with us. For example, with NHS Lothian and NHS Grampian, because of the substantial investment programmes that are being put in place to meet the quality and patient safety requirements as well as the waiting time guarantee, such measures have to be agreed by the Scottish Government before they are implemented.
The cabinet secretary might be aware of the increasing number of elective surgeries, such as hip or knee replacements, that are taking place in the private sector south of the border. Is he aware of how waiting times for those surgeries compare to waiting times in Scotland, where they are carried out in the public sector?
I am, indeed—the waiting times in Scotland are far superior to those in England, Wales or Northern Ireland. I am happy to place in the Scottish Parliament information centre more information on waiting times for various procedures in the Scottish health service and comparable figures for each of the other three Administrations in the United Kingdom. That just shows how we are delivering on the health service in Scotland. We have agreement among all the parties in Scotland that we will deliver the health service in the public sector and we will not privatise it by the front door or by the back door, in the way that Andy Burnham set the process alight south of the border.
Community-led Healthy Behaviour Change Projects
To ask the Scottish Government how it supports community-led healthy behaviour change projects. (S4O-03000) [Interruption.]
I am sorry Ms Johnstone; could you read that again? We could not hear you.
Certainly. To ask the Scottish Government how it supports community-led healthy behaviour change projects.
The Government is investing heavily in that agenda. With national outcomes for reducing premature mortality and increasing physical activity we recognise the importance of community participation and ownership. We are committed to a decisive shift to prevention linked to the desire to reform the delivery of public services across Scotland that is founded on an assets-based approach and the principle of co-production in communities.
During the budget process we highlighted the need for a health fund that would be designed to harness the creativity and local knowledge of community groups and organisations. The climate challenge fund uses that model to promote low-carbon projects and we would like to see the same community control approach taken to address obesity and health inequality.
Does the minister agree that, although we can ask people what action they think public bodies should take, putting people and community groups in charge of at least some of the health budget will lead to more innovative and locally relevant activities?
Some activity is already taking place in different parts of the country. For example, a number of months ago I visited a project in Fife, which is being supported by Inspire Scotland, NHS Fife and other partners, that is very much about providing resource to a local community so that it can identify the key issues that it wishes to address and build on local assets effectively. We want to see that type of approach across the country.
We are working with third sector organisations such as Inspire Scotland and others to build on that type of assets-based approach, to empower local communities to use their assets to help their health and wellbeing. We will continue to take that approach.
I am aware that Alison Johnstone and her colleagues discussed this issue with John Swinney during the budget process. She will be aware that Mr Swinney highlighted the financial limitations in which any new fund would have to operate. However, if she has specific ideas that she believes could be scaled up to a national level to better drive forward this agenda, I am more than happy to engage with her and look at the examples of what could be achieved.
National Health Service (Staffing)
To ask the Scottish Government how many whole-time equivalent staff are employed by the national health service. (S4O-03001)
There are 135,016.3 whole-time equivalent people employed by the NHS in Scotland. That figure excludes general practitioners and general dentists and their staff and is greater than it was when this Government came to power by 7,954.4: an increase of more than 6 per cent.
Although it is to be welcomed that there are more NHS staff than ever before, will the cabinet secretary confirm that the staff who work in the NHS must be able to report and feed back any issues that impact on patient safety in a culture that is free from fear, intimidation or bullying? Will he confirm that the NHS confidential alert line will continue and when the Government will publish the findings of its evaluation?
Staff must not only be able to report and feed back any issues, but should as a matter of duty report any malpractice or patient safety issues that they identify in their working environment, and they should be able to do so without fear or favour. I am considering carefully whether to extend the NHS Scotland national confidential alert line beyond the pilot phase and I hope to make an announcement on that soon. Jim Eadie will have noticed that a few days ago I announced that there will be no more confidentiality clauses in severance agreements between the NHS and its employees: a measure that I am sure is welcome throughout the chamber.
Hospital Mortality and Readmission Rates
To ask the Scottish Government whether there is a difference in mortality and readmission rates in hospitals at the weekend compared to weekdays. (S4O-03002)
A recent study of the mortality data provided by national health service boards to the information services division of NHS National Services Scotland in response to a freedom of information request suggested no evidence of significant differences between the mortality rates in hospitals in Scotland at the weekend and those on weekdays.
Briefly, please, Mr Macintosh.
I thank the cabinet secretary for his reply, although I have to say that I am surprised and disappointed that he is not aware of the number of studies that have been carried out over many years and in many countries and which reveal worryingly high death rates in hospitals at weekends.
Is the cabinet secretary aware of the very upsetting case—I have written to him about it—of a constituent dying of cancer, who, when admitted to hospital over a weekend, was subject to very poor levels of care and treatment, despite making his palliative care wishes well known in advance? Does the cabinet secretary agree that if we are to prevent such upsetting cases the staffing levels in our NHS hospitals will need to be substantially increased at weekends and on public holidays?
First, I make it clear that our sympathies lie with anyone who finds themselves in the situation that Ken Macintosh’s constituent and their family found themselves in. However, we cannot generalise from a particular case that there is a systemic problem at weekends with mortality rates in Scottish hospitals.
I am very familiar with the international figures, but I am also familiar with the fact that the Scottish health service is the safest in the world as a result of the patient safety programme. Indeed, the programme is probably a major contributing factor to why the mortality rate at weekends is no higher than it is during the week. Perhaps we should be emphasising the safety of patients in the health service in Scotland instead of trying to scaremonger on the basis of what happened in one case.
That concludes portfolio questions.
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