Older People Living Independently at Home (Support Services)
To ask the Scottish Government what its response is to the latest reports on waiting times to access support services that allow older people to live independently at home. (S4T-00765)
We are aware that a number of areas are experiencing difficulty in providing suitable care in the community. Recently, we allocated £5 million additional funding for 2014-15 to the health boards that face the most significant pressures around delayed discharges. That funding will enable them to accelerate progress towards sustainable change, to drive down delayed discharge numbers and to enhance rehabilitation services and community care capacity.
I thank the cabinet secretary for his answer and acknowledge that he recognises that there is still work to be done. The Scottish Government states on its website that, in order to achieve its 2020 vision for the national health service, there will be a focus on “supported self-management”. However, we have learned that some people are waiting for up to 36 weeks for rehabilitation services—services that the Scottish Government is aiming to deliver within four weeks by the end of 2016. Patients cannot begin their self-management without such intervention.
Can we have a question, Mr Hume?
Of course.
Professor Paul Knight of the British Geriatrics Society stated:
“To make an intervention worthwhile and effective you need to reach the individual as early as you can make it.”
Does the cabinet secretary agree that the Government is failing in its attempts to ensure that elderly but frail people can live more independently?
No. We are putting a record amount of resources into this area. I recognise that there are pressures in parts of the country, particularly in Fife and Glasgow. We are working with the health boards and local authorities to address the issues. We are also working with the Convention of Scottish Local Authorities. With COSLA, we have recently commissioned a follow-up report on the review of residential care to look at care-at-home services because we both reckon that some of the problems that are associated with residential care are similar to the challenges that are faced in parts of the care-at-home sector.
Your next intervention had better be brief, Mr Hume.
It will be.
I acknowledge that that review is under way, but will the cabinet secretary commit to a full review of the provision of rehabilitation services across the country and consider bringing forward his target from 2016 in order to get a grip on the problem?
Part of the review that we have commissioned jointly with COSLA will look at rehabilitation services, because care-at-home services are an important element of rehabilitation.
I absolutely agree with Mr Hume’s concerns about those areas where there are pressures. However, by working with COSLA, local authorities and health boards and by putting in the additional money that we have, we are doing everything that we can to substantially reduce the waiting times where they are far too long.
The cabinet secretary will be aware that there is a lack of funding to provide support and rehabilitation services due to council budget cuts. That has led to bedblocking in many areas, with the NHS struggling to cope. He will also be aware of issues around the inadequacy of care when it is available, with care visits of 15 minutes or less. Although we welcome the additional funding, it is a drop in the ocean of need. Will he agree that we need a comprehensive, Beveridge-style review of the NHS to make sure that adequate care is available for older people to live independently and securely in our communities?
The Beveridge report was not a review but a plan and we will produce a plan for 2020, building on our 2020 vision. At the core of that vision is treating people as much as possible at home or in the community in a homely setting.
As the member knows, I have held discussions with representatives of other parties, including the Labour Party, in which I offered them the opportunity to come up with their ideas on the 2020 plan. To date, I have heard nothing from the Labour Party.
The report, combined with the social care crisis, means that more and more people are stuck in hospital when they should be living independently at home. Why do the figures released today and the standard of care services continue to deteriorate under the cabinet secretary’s stewardship?
As usual, Mr Findlay does not get confused by the facts. The reality is that today’s average hospital stay is at a record low. By definition, that means that people cannot generally be stuck in hospital.
There is a problem with delayed discharges, but we have significantly reduced that problem since getting into power. In fact, we have among the lowest—not the lowest—level of delayed discharges in Scotland historically. There are still challenges to face in order to get to where we want to be. Indeed, if we are able to get discharges to the level that we want them to be at, which we intend to do over the next two or three years, that will release £100 million-worth of additional resources for investment in other priorities either in the community or in the hospital sector.
Mr Findlay should recognise that the challenges that we face are a result of the massive cuts that have been made to our budget by the Westminster Tory Government that he is in cahoots with to get a no vote.
Rural Postbox Collection Times
To ask the Scottish Government what it considers the economic impact will be of Royal Mail’s decision to bring forward rural postbox collection times. (S4T-00764)
Postal services are a vital lifeline for many of Scotland’s businesses and communities, particularly in some of the nation’s more remote rural areas. Many businesses depend on the timely uplift of mail from postboxes. That is why it is worrying to learn of Royal Mail’s plans to bring forward collection times for many postboxes.
I have information to the effect that Royal Mail has been discussing making further cuts in rural services by making postal collections every second day. Can the minister find out whether that is true? If so, it is another example of the undermining of the universal postal service.
We would be very concerned if there were further diminutions to the service, especially for people in rural areas, who already enjoy a lower level of service than they used to enjoy, as Mr Gibson rightly highlighted. I will therefore make inquiries, as he requested, by writing to Royal Mail on the point that he raised.
It seems self-evident that we in this Parliament have no power or control over such matters. The Royal Mail is not accountable directly to this body and therefore we are unable to give vent to and support the wishes of the people of Scotland, 72 per cent of whom opposed the privatisation of the Royal Mail. We are powerless to prevent diminutions to the service, unless or until we have the power and the choice to determine such matters in this place.
If an independent Scotland is able to gain public ownership of the Royal Mail, will postal services to rural and urban addresses be restored to a level that does not disadvantage communities and businesses?
That would be for the first Parliament in an independent Scotland to determine, but I think that any Government in a Scottish Parliament that was elected by the people and accountable to them on such matters would have a stronger desire to ensure that a fairer service was provided to all our customers by a Scottish Royal Mail.
Ebola Virus
To ask the Scottish Government what precautions it is taking to reduce the threat of the Ebola virus. (S4T-00763)
Since the start of the outbreak in western Africa we have been working closely with Health Protection Scotland to minimise the risk of Ebola to Scotland. Health Protection Scotland routinely monitors global disease outbreaks, and the risk from Ebola is currently assessed as very low. No cases have been reported in Scotland or elsewhere in the United Kingdom.
Scotland has well-developed procedures in place to respond to this type of situation. The national health service in Scotland safely managed a case of viral haemorrhagic fever in a patient in Glasgow in 2012, and our recent experience during the Commonwealth games strengthened the procedures. As a result, we are better placed than many other parts of the UK to respond to suspected cases of Ebola virus.
However, given the situation in western Africa, a number of additional steps are being taken. We are liaising with other Governments across the UK to ensure a co-ordinated response, particularly in managing suspected cases. Updated guidance has been provided to United Kingdom Border Agency staff, who might encounter travellers returning from western Africa, and Health Protection Scotland is producing a poster, which will be displayed in airports and ports and will advise travellers about precautions against Ebola should they be travelling to an affected area.
Professional guidance has been updated and revised, and general practitioners and other healthcare workers throughout Scotland have been notified that they must be extra vigilant when dealing with patients who have recently travelled to affected areas. In the past fortnight, we have asked all NHS boards in Scotland to confirm that they have arrangements in place to deal with suspected cases of Ebola. All boards provided assurances that they are prepared.
A short-life working group has been established, which will bring together relevant Scottish agencies, including the Scottish Government, to consider whether more needs to be done. I will meet Health Protection Scotland next week to discuss the matter further. I am confident that the risk to the people of Scotland remains very low and that the NHS stands ready to respond to suspected cases of Ebola.
I thank the minister for his comprehensive answer. Has the issue been discussed in the Cabinet? I suspect that I know the answer to that question. What discussion has taken place between the World Health Organization and the Scottish Government about the risks? What is the Government’s view on the use of the experimental drug ZMapp, should treatment for Ebola be required in Scotland? Has the Scottish intercollegiate guidelines network made any evaluation of ZMapp, in case the drug is required?
I can confirm that the issue of Ebola was discussed at today’s Cabinet meeting, and the Scottish Government continues through Health Protection Scotland to liaise with other international parties, including the WHO, on the required state of preparedness. Of course, the WHO has declared this a public health emergency of international concern, and we are responding to it on that basis.
As for the member’s question about the experimental vaccine, although there are no vaccines for Ebola at this point, the WHO is considering the use of the experimental drug that Mr Scott mentioned for patients who have contracted the disease. We will continue to liaise with the WHO and operate on its advice on this matter. However, because of the drug’s experimental nature, a number of very detailed and complex ethical issues have to be considered and, once the WHO has come to a decision on the matter, we will consider what further steps need to be taken in Scotland.
Where would people be treated if a case or cases of Ebola were found in Scotland, and if that happened, would any special measures be taken to protect medical and hospital staff?
We already have specialist protocols for dealing with significant contagious diseases. As I said in my opening response, NHS Greater Glasgow and Clyde dealt with a case of Crimean-Congo viral haemorrhagic fever in 2012, and in that case the protocol for dealing with such illnesses was utilised. That patient was dealt with at the Brownlee centre for infectious and communicable diseases, which is a specialist unit for contagious diseases.
We have protocols in place for dealing with patients who could have a disease such as Ebola; we have the facilities to treat any patients who might require treatment; and we also have arrangements for ensuring that medical staff who might be treating patients with such a condition are properly protected. As I have said, we have checked the situation with our health boards, and they have all confirmed that they have sufficient personal protection equipment to deal with patients who are suspected of having Ebola.
That ends topical questions.
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