The next item of business is a debate on motion S4M-12325, in the name of Jenny Marra, on protecting Scotland’s communities.
14:41
I start by publicly thanking our national health service staff up and down the country for the service that they give and the care that they deliver to our patients and families. So many of the stories that I hear from our health service talk of the compassion and generosity of NHS staff in the care that they give our loved ones every day. The NHS is our most important public service; it is owned by us and delivered through the caring hands of NHS workers.
It is in the interests of all those staff, the patients and every citizen in Scotland that the Labour Party has brought a motion to Parliament today to lift the veil of secrecy around our NHS in Scotland, for confident, fearless and robust institutions have no fear of openness, transparency and accountability.
Will the member give way?
I ask Mr McDonald to allow me to make a little progress.
Institutions that are open to change and improving their services want the public to know what service they are delivering and how they are measuring up to expectations. Of all the NHS staff I have spoken to, none has feared or dreaded openness and transparency. That is why the Cabinet Secretary for Health, Wellbeing and Sport’s U-turn on publishing statistics is welcome but, at the same time, baffling, for only two weeks ago today she stood up in the chamber and told me that publishing accident and emergency statistics on a weekly basis was political interference.
Will the member give way?
I will take an intervention in a minute.
The cabinet secretary asked whether I was suggesting that she should politically interfere with the publication of statistics. If she would like to tell me whether she still feels that the publication of statistics is political interference, I am happy to take the intervention.
First, it is the chief statistician who has decided to release the statistics on a weekly basis, which of course I welcome. [Interruption.]
Order.
On political interference, will Jenny Marra take the opportunity—she refused to do so this morning—to apologise to the staff of the NHS after her political manipulation of statistics? If she cares about the staff in the NHS, she should apologise to them for that gross misrepresentation of the hard work that they do. Please apologise.
So the chief statistician decides to publish on a three-monthly basis and then on a one-monthly basis but, after pressure from the Scottish Labour Party, the chief statistician decides to publish on a weekly basis. If the cabinet secretary is saying that she had nothing to do with that decision, I suggest that she is not in control of what is going on in her health department.
Less than 24 hours after Shona Robison made her statement on political interference, the First Minister stood up and told us at First Minister’s question time that her civil servants had started to look into the publication of weekly statistics. I must therefore ask whether the health secretary was aware on 4 February that the Government’s policy on publishing A and E statistics was changing.
It is hard to believe that, if Shona Robison had instructed her civil servants to look at publishing the data, she would come to the chamber and forcefully say that such a policy was political interference. Perhaps she did not know what was going on in her department on 4 February. Is it the case that the decision to publish A and E statistics was not hers but the First Minister’s and that decisions are being taken on health that Shona Robison knows nothing about and has no control whatsoever over? The health secretary’s statements strongly suggest that she is not in control of decisions on health and that the First Minister is intervening, where necessary, to clean up the mess.
Will the member give way?
I will give way later.
Just yesterday, Shona Robison had to apologise to more than 800 people who have had their operations cancelled since the new year.
Will the member give way?
No—I have taken an intervention already. [Interruption.]
Cabinet secretary, Ms Marra is not giving way.
Let us be in no doubt about how bad the situation is. Since the new year, NHS Tayside has had to cancel more than double the number of operations that it cancelled in the whole of the past financial year. The number of cancelled operations is increasing exponentially across the country as a result of the pressures on our health service.
We come to the chamber with one of our wishes granted. It is becoming quite easy to get the Government to move, because no sooner was our motion calling for the publication of statistics laid than the health secretary—or the First Minister; who knows?—decided that a new website would be launched to give the public the information that they need on A and E waiting times, with information on cancelled operations to follow in the coming months. I ask the cabinet secretary to explain the delay in publishing the figures for cancelled operations, given that The Herald was able to publish them on Monday.
We will have a new website with information on our health service for the public. That is welcome; it is a great idea. Which aspect of Labour’s five-point plan for the NHS will the cabinet secretary, or the First Minister, adopt next? Point 1 of our plan calls for a review of acute beds. That would be welcome, too. Since 2007, the Scottish National Party has cut beds by nearly 1,200.
Point 2 calls for mandatory annual cleanliness and safety inspections for A and E wards. My colleague Alex Rowley will talk in more detail about the shocking report, which was published last week, on the state of the A and E department at the Victoria hospital in Kirkcaldy. I know that the health secretary will be as concerned as I am that beds, chairs and trolleys in that hospital have been contaminated with blood. Does she, or the First Minister, have a plan to address that?
Under point 3, as the health secretary will have heard at the weekend, Scottish Labour would introduce modern-day matrons in A and E to ease pressure and ensure the highest standards of cleanliness.
Will the member give way?
No.
Point 4 is about sharing best practice. The health secretary knows as well as I do that our local A and E department in Dundee not only hits but goes beyond its targets. How can its arrangements be shared across the country?
Will the member give way?
I want to make progress.
How can areas of excellence help areas of weakness to improve? What will the health secretary do to make that happen?
Point 5 calls for a website. The SNP has adopted that point, which is welcome.
Yesterday, we heard that we are to have the most transparent health service in the world.
In the interests of transparency, will Jenny Marra give way?
No—I want to make progress.
That is a high bar. I will be interested to hear from the cabinet secretary how that will be achieved and what her ambitions are. To have the most transparent health service in the world will not simply be a matter of publishing A and E waiting times. Patients will—rightly—have a higher expectation of the information and of their health service.
What is the patient’s whole journey time to be from lifting the phone to make an appointment with their GP to discharge from hospital? Will the Scottish Government begin to measure and improve that? On each stage of that journey, there are expectations, and sometimes there are delays, stresses and surprises. Can the process be managed better? Will the Government be open about each stage, how long it should take and what patients’ expectations will be? Will the duplicity of social unavailability hidden in waiting times end?
Does Jenny Marra not think that it is duplicitous that Jim Murphy has been caught red-handed fiddling NHS figures? Is it not time for the Labour Party to apologise? In particular, is it not time for Jenny Marra to apologise, which she singularly refused to do earlier today?
I am not sure whether Bruce Crawford’s microphone was on—I could not hear exactly what he said, although I think that I got the gist. Neither any political party nor the British Medical Association would have had to resort to putting in freedom of information requests if the Scottish Government had been open and transparent about the information that it publishes, instead of having to take a lead from David Cameron and have us put pressure on it to publish statistics more frequently.
I suspect that the differences between the Labour Party and the BMA are that, first, the BMA would not have fiddled the statistics and, secondly, the BMA would have had the good grace to apologise if it had misinterpreted the statistics, which the Labour Party has failed to do. I put the question for the third time: will Jenny Marra apologise to the hard-working staff in the NHS for the way in which the Labour Party has used the statistics to run down our health service?
As I told Mark McDonald last night, no one would have had to resort to putting in freedom of information requests if the Government had been open and transparent in the first place.
The health secretary must look at the duplicity of social unavailability hidden in waiting times. I expect that the new period of transparency that she has announced will bring that to an end. I hope that she will address that.
If Scotland is to have the most transparent health service in the world, does the Scottish Government plan to match the transparency of the Scottish Ambulance Service, which updates its performance figures on its website every 15 minutes?
We have not yet heard whether the cabinet secretary intends to publish figures on delayed discharge, the tackling of which she has called her greatest priority, and which we agree is the biggest challenge in our health service. I am surprised that she has not included delayed discharge figures in the transparency project, but she might be able to clear that up.
When the cabinet secretary publishes the figures, will she do so with the same openness and accountability as the Scottish Ambulance Service is demonstrating? Will we be able to find out, hour by hour, how many patients have been discharged, how many beds are occupied and how many are unoccupied? Will we be able to find out how the patient flow through our hospitals is operating throughout the day and on each day of the week? That might sound fanciful but, if we take the aspiration of full openness and accountability to its logical conclusion, it makes absolute sense and should be exactly what we are aspiring to in our most important public service in Scotland.
An international report published by McKinsey has concluded that transparency is one of the most powerful drivers of healthcare improvement. It cites as a powerful example the publication of data on Canadian hospitals. Within a few months of the data’s release, the average length of stay decreased by more than 30 per cent, and the number of unexpected readmissions declined by more than 20 per cent. If data publication could have a similar effect on delayed discharges in Scotland, what a radical improvement that would be.
A study published by The New England Journal of Medicine has shown that public data reporting is as effective an incentive as financial rewards are in convincing providers to improve their clinical performance. None of the NHS staff I have spoken to has any problem with data publication; indeed, openness and transparency are as much in the interests of our hard-working NHS staff as they are in the interests of patients.
If the international evidence is to be taken at face value, the Scottish Government has created an incredible opportunity this week by setting up the website and the project.
You need to bring your remarks to a close.
I will.
The test will be in how open, transparent and up to date the information will be. How innovative and ambitious can the Scottish Government be with the new tool for the success of our health service? I sincerely hope that it will grasp the opportunity and not have to be forced bit by bit into publishing more and more information, as it has been over the past few weeks. The way in which the SNP, the health secretary and the First Minister have come to the publication of weekly statistics has been surprising and disappointing given that they have been at the top of the Government for eight years, but they eventually reached the right conclusion.
You need to wind up.
It is now their ambition that is critical.
I move,
That the Parliament notes that there are serious problems across the country in Scotland’s health service; regrets that there is a veil of secrecy over important statistics on the operation of NHS Scotland, and calls for a culture of transparency and openness with regular publication of statistics and reports so that the Parliament and the people of Scotland can be fully informed about the state of the health service.
14:55
I thank Labour and Jenny Marra in particular for the fantastic timing of this debate. It really could not have been better, on so many levels.
I am sure that I am not alone in the Parliament in my admiration for the work that the staff in our NHS do day in, day out. Both staffing and front-line funding of the NHS are now at record high levels, but I absolutely recognise that our health services face challenges.
I say to Jenny Marra, in answer to her specific questions earlier, that we are already rolling out the best practice for A and E on the Ninewells model to the rest of the A and E estate. If she had been looking at what we are doing, she would have known that. We are already doing that. On matrons, I saw Richard Simpson physically shrink at the concept of the matron. We are not in the 1970s. We are in 2015. We call them senior charge nurses, not matrons. I would have thought that Labour might keep up with what the Royal College of Nursing and the nurses themselves are saying about that.
The NHS currently produces a large volume of data on various aspects of its performance and makes that information available on the ISD website. However, while that information is available, I believe that it could be more accessible for people who do not regularly work with health statistics. That is why I have tasked Scottish Government officials with working with ISD in the coming months to establish a new NHS performs website to give quick and easy access to key NHS statistics either by hospital or by health board, as appropriate. That is something that Labour never did in the eight years for which it was in power. It is good that this SNP Government will be the one that delivers the most open, accountable and transparent NHS anywhere in these islands. If only Wales would follow suit, but I have written to the Welsh health minister suggesting that it may wish to do that. We will lead the way on this.
The service will be developed over time to ensure that information on things such as waiting times performance, cancelled operations, staffing levels and hospital activity rates is readily available. The regular collection of year-round A and E statistics began under this Government, because it was not done at all under the previous Administration. I welcome the chief statistician’s decision to instigate weekly publication of A and E figures, which will make NHS Scotland even more accountable to the public and patients who use its services. The new weekly statistics will contain more detail on the length of waits than is currently published by NHS England.
I have set out in the chamber before that we must plan for an NHS not only for 2020 but beyond that, to ensure that it continues to deliver effective care for the people of Scotland, free at the point of need, long into the future. We are absolutely committed to a preventative programme that tackles the symptoms and causes of poor health and health inequalities, which too many people in Scotland still suffer. Population health improvement, at the same time as reducing demands on the health service in future years, is an absolute priority for us.
I want to try to reach as much consensus as possible on what we want our health and social care systems to look like over the longer timeframe, and the steps that we need to take to get there. That engagement will be on-going, but I would like to have reached broad agreement on the plan by the autumn of this year, as I have said previously. I believe that we can achieve consensus on the future direction of our NHS, and the offer that I have made to parties in the Parliament before still stands.
The people of Scotland deserve no less than our collective endeavours to enhance the NHS for the future. That is why it was so disappointing for the Scottish Labour Party to wilfully and deliberately misinterpret data on the NHS. I hope that, at some point, Jenny Marra will apologise to the staff involved. She asked me about apologising for the cancelled operations and I willingly did so. I am big enough to apologise for the things that I think are wrong. Perhaps Jenny Marra needs to be big enough to apologise for the things that are blatantly wrong that her party has done. It was a desperate attempt to continue to talk down our NHS.
I heard Jenny Marra try to gloss over the issue and claim that Labour had misinterpreted the data that it received from NHS Greater Glasgow and Clyde. Fortunately, in the spate of online deletions, it forgot to remove the actual response it got from Glasgow from its website, although I am sure that it will be gone before the end of the debate. It provides a table that breaks down the reasons for cancellations, and in that table, as clear as day, it says how many were cancelled for clinical reasons. It is there in black and white.
It is exactly that sort of fiddling of the figures by Labour that was so evident in its time in office, when more than 30,000 people were on hidden waiting lists; it is also why more than double the number of people trust the SNP with the NHS than trust Labour. There is little wonder about that after Jenny Marra’s and Jim Murphy’s performance during the past few days. The reality is that the NHS as a whole is performing better today, against tougher targets, than when Labour was in office in Scotland or than in Wales, where it is in office today.
Given that Labour has tried to deride NHS Greater Glasgow and Clyde’s performance on operations this week, I point out that since the introduction of the 12-week treatment time guarantee for in-patients, the board’s performance against that target has been 99.9 per cent. We should congratulate the board on that.
Taking responsibility is hard. Labour’s reaction to being caught red-handed was to blame one of its poor researchers. Labour said that its researcher had miscalculated. I wonder whether it was the same researcher who took the picture of Jenny Marra outside the old, closed down Glenwood health centre and not the shiny new one that is just a few metres away. That was yet another attempt to misrepresent the health service. Labour has been caught out. It cannot be trusted on the NHS and everybody now knows it.
The treatment time guarantee acts as a long stop and helps to ensure that if someone has their operation cancelled, the board works to treat them as quickly as possible. The people of Scotland will find it deeply troubling that Labour, through Richard Simpson, has previously confirmed in the chamber that it would scrap the treatment time guarantee. The Labour Party will live to regret that.
That is absolutely incorrect. I said that the Government has made it a legal guarantee rather than a target, and a legal guarantee means that the Government is breaking the law for 12,000 Scottish patients a year.
While I am on my feet, what about the delayed discharges that are on the standard weekly template? The cabinet secretary has not mentioned publishing them but every board makes them available to the Government every week and the Government is hiding them.
I am happy to publish as much information as possible. The Government is getting to grips with delayed discharges, which is something that the Labour Government never did. Richard Simpson is on the record as saying that he would get rid of the legal treatment time guarantee.
Legal.
He wants to remove patients’ legal rights. That has been confirmed yet again in the chamber today, and I thank Richard Simpson for that.
The progress of the NHS in recent years has been tracked by the progressive increase in the volume of statistics that is available, which allows for comparisons with other health systems. That is why the Wales Audit Office was able to report in January on a comparison between performance on elective surgery within the United Kingdom and concluded that
“Scotland and England are performing better”
than Wales
“against more stringent referral to treatment time targets”.
Will the cabinet secretary give way?
In a minute.
That is also why we can compare accident and emergency performance in Scotland with other parts of the UK and with other health systems. For example, in 2014 Scotland’s A and E departments outperformed those in Canada, New Zealand, and Australia, as well as England, Wales and Northern Ireland.
Will Shona Robison publish delayed discharge figures on the website?
I am happy to publish delayed discharge figures on the website, because this SNP Government will deliver the most open, transparent NHS information system within these islands and we will be proud to do so.
The work of our Scottish patient safety programme has helped to bring real benefits through action in hospitals around the country, utilising performance statistics to monitor progress and identify where action is needed. Yesterday, we saw that the hospital standardised mortality ratios have reduced by over 16 per cent since 2007, which is testament to the work of our patient safety leaders and NHS staff right around the country.
You need to bring your remarks to a close.
I am more than happy to talk about how statistics can improve transparency around the performance of the NHS, because I believe that we can use the NHS performs website to tell a fantastic story about the NHS’s performance—one that the Labour Party wants to talk down. Our staff in the NHS are doing a fantastic job and it behoves politicians of all parties not to talk down the NHS. We will make sure, through NHS performs, that we continue to tell the fantastic story of that performance across the whole country.
I move amendment S4M-12325.3, to leave out from “notes” to end and insert:
“thanks the staff of the NHS for their hard work during the challenging winter period; notes that in recent years there has been a progressive increase in the statistics available on the performance of NHS Scotland; welcomes that, from 3 March 2015, weekly A&E performance statistics will be published on the website, NHS Performs, and that NHS Scotland’s Information Services Division will also be identifying how it can further enhance the accessibility of NHS performance statistics in consultation with the users of statistics and the wider public, and strongly condemns the recent misrepresentation of information on NHS performance, which devalues the work of Scotland’s health service.”
15:06
When I learned that Labour’s debate today was to be about protecting Scotland’s communities, I did not expect the focus to be yet again on the NHS, with an unrelenting emphasis on an alleged lack of transparency and openness regarding the operation of the service in Scotland. A major role of the Opposition is to scrutinise the Government of the day, but I find it utterly abhorrent that the NHS is, at times, being used for party political gain—regrettably, I have to say, by both main parties in the chamber. That is why our amendment refers to
“the use of rhetoric such as ‘weaponising’”
and to claims, which were made during the latter stages of last year’s referendum campaign, that the future of the NHS would be secure only if Scotland became an independent country.
The NHS is a precious institution to all of us, and any threat to it, real or perceived, is of huge public concern. The last thing that people want is to see the NHS being used as a political tool by parties that are seeking victory at forthcoming elections. It is far too important for that. Everyone I speak to outside this place wants that to stop and asks that politicians of all parties and none come together in support of our NHS and in developing it for the future.
Nobody is denying that our health service is currently and increasingly under very severe pressure or that there are times when it struggles to cope with the demands that are placed on it. There have always been added problems during the winter months, but, as the population ages and many more people are living with multiple and complex health conditions, the pressures on NHS services and staff are relentless and they struggle to cope with demand.
My party absolutely agrees that detailed scrutiny of the NHS is essential as the demands on it continue to escalate in an era in which resources are tight. Of course, that requires the regular publication of rigorously produced statistics and reports that give all of us—both parliamentarians and the public—an accurate picture of the operation of the NHS.
There is now undoubtedly more openness about the NHS than I have known in all my years of involvement with it and more involvement of patients in their planned care. That is a good thing and must continue to improve. Every week, the Health and Sport Committee receives a list of published Health Improvement Scotland inspection reports. For instance, this week we were notified of nine such reports covering hospitals in four health board areas. The Care Inspectorate also provides much useful information in its reports, which are aimed at improving standards in Scotland’s many care homes.
Next week, we will discuss with the health secretary the recently published report on the Clostridium difficile outbreaks at the Vale of Leven hospital, which found many faults and made many recommendations that, if carried out, should ensure that there is no repeat in Scotland of the failings that were found in that hospital. Like others, we welcome the Government’s announcement yesterday that it now plans to publish A and E statistics on a weekly basis.
All those measures are extremely important in developing a clear understanding of the pressures on the system and, where the need for improvement is identified, how that can be undertaken quickly and effectively. However, we need to listen to the warning from Dr Peter Bennie, the chairman of BMA Scotland, who says that, although the weekly publishing of statistics can be a useful indicator of pressure in one part of the system, we must avoid reducing the NHS as a whole to a set of weekly performance figures, skewing the public’s perception of the health service and ignoring the system-wide pressures that extend far beyond A and E.
Dr Bennie is absolutely right that pressure on emergency departments is a symptom of wider pressures across the NHS and that problems in one part of the service cannot be addressed without looking at the whole system. That is why we respect coal-face organisations such as the BMA and the RCN when they seek the co-operation of all stakeholders in the NHS, including politicians, in giving thorough and objective consideration to what needs to change to ensure the long-term sustainability of the NHS in Scotland as it faces the inexorable demands that are being placed upon it.
For a start, we need to relieve the pressures on our emergency and acute services by effectively planning and developing primary and social care to keep people within the community, at home or in homely settings, for as long as possible. That is why it is so important that we successfully achieve the integration of health and social care right across the country.
We need serious discussion about and planning for the future of the NHS, and that must involve all health professions that contribute to primary, secondary and tertiary care, as well as the local authority, third and independent sectors on which much community care depends; politicians at a local and national level; and most important, the patients and carers whose wellbeing depends on a well-run service. That sort of planning cannot be achieved by political point-scoring. Not for the first time this year, I must stress the need for co-operation between politicians on all sides and plead that, where the NHS is concerned, we look at agreeing a way forward and working together to find a sustainable future for an NHS that has been the envy of the world and whose staff deserve our full support but are becoming increasingly demoralised by the constant bickering of their elected representatives.
The Scottish Conservatives are willing and ready to co-operate in that way, and we challenge other parties to do the same. That is what our constituents and the NHS staff who work so hard on our behalf expect of us, and that is what they deserve from us.
Will the member give way?
The member is closing.
I look forward to the open debate and, although I do not think that this will happen, I hope that it will be conducted in a constructive manner. I am pleased to move the amendment in Jackson Carlaw’s name and, having studied the Government’s amendment, I can say that we will support that, too, assuming that it is carried at decision time.
I move amendment S4M-12325.2, to leave out from “regrets” to end and insert:
“accepts that these challenges make detailed scrutiny of the NHS in Scotland essential; notes the importance of rigorously produced and publicly available data to the process of that scrutiny; acknowledges the representations from the British Medical Association and the Royal College of Nursing supporting further consideration of the long-term sustainability of NHS Scotland; considers it necessary to ensure effective planning of primary and social care in order to remove pressure from hospital emergency departments, and regrets attempts to misuse the debate on the future of the NHS for political ends, whether by the use of rhetoric such as ‘weaponising’ or through the claims made surrounding this valued and important institution toward the end of last year’s referendum campaign.”
I call Jim Hume. You have a maximum of six minutes, Mr Hume—we are tight for time this afternoon.
15:12
First, I am delighted that the cabinet secretary has chosen to accept in full the Liberal Democrat amendment, which asks for the weekly reporting of A and E figures. It is quite a turnaround—or even, one might say, a U-turn—given the Government’s opposition to this measure up to now. The Lib Dems welcome the Scottish Government’s bending to Opposition pressure to release A and E waiting times weekly; given that the information is already available to ministers, it is only right and in the interests of accountability that it is made fully available.
The move, which has come after considerable pressure from across the political benches, was the sole focus of an earlier Liberal Democrat amendment. We have been calling for this for one day less than four weeks, and I find it curious that we should see such a radical change from the Government in such a short timeframe after such opposition to weekly reporting. Indeed, the cabinet secretary claimed that she had no influence over such a move, saying that that would amount to political interference.
It is a pity, therefore, that the Government announced the news through the press just yesterday afternoon instead of engaging in a meaningful discussion with MSPs and health spokespeople across the benches in a collaborative way. Perhaps this is yet more proof, if proof were needed, of the power of Opposition.
I want to correct Jim Hume. If he had been paying attention, he would have known that the announcement was made through the chief statistician’s office.
I saw your words on a Scottish Government press release on a website just yesterday afternoon—although, having said that, I should make it clear, Presiding Officer, that they were not your words, but the words of the cabinet secretary.
Our dedicated front-line NHS staff strive to provide second-to-none care for every patient and deserve our respect, and it is incumbent on the Scottish Government to look at the waiting times in our A and E units and act swiftly on behalf of our patients and NHS staff. That is why the Lib Dems have been calling on the Government to stand behind the principles of accountability and openness with regard to A and E waiting times.
By releasing weekly figures to the public, the Government will, of course, be subject to tougher and more rigorous scrutiny, but I think that that will ultimately improve areas where we know that some of our A and E units are failing. The benefits for patients will be obvious but, equally, addressing problem areas quickly with support for staff will go a long way towards taking pressure off staff and, I believe, boosting morale.
It is critical that the new-found transparency is accompanied by real action from the Government to support our great NHS staff so that they can continue to provide the best care for patients. That is the crux of the new and revised Lib Dem amendment today. The weekly information will enable us to see the extent of the growing A and E waiting times, and where action is needed. We have seen a growing number of people waiting for more than four hours in some departments. We know about the recent incident at the Royal Alexandra hospital in Paisley, where a special support team was sent to provide help to the A and E section, and the Government claimed that that was a responsible move. In Glasgow two weeks ago, patients had to wait up to 20 hours in a portakabin to be seen at the Victoria infirmary.
We do not want that happening in other areas of Scotland. The severe understaffing and under-resourcing in those situations were hidden in the vast figures of monthly ISD statistics; the health secretary must not be allowed to hide behind a wall of figures. Ultimately, through weekly publishing, the Government will quite rightly be held accountable more swiftly, meaning that staff and patients can have confidence that an open conversation with MSPs, patients and NHS staff can be had in order to identify and target where help and support for workers is most needed, through flexible resources, more accountability and better management of resources.
It is a move supported by health professionals. The BMA stated that the NHS faces pressure in the A and E units because of
“wider pressures across the NHS, which is struggling to cope with rising demand in the face of increasing numbers of elderly people with multiple health conditions, alongside constrained resources.”
It becomes even more necessary to allow for the movement of information, and I urge the health secretary to engage fully on the issues that we know are problem areas in the NHS.
The Royal College of Nursing Scotland’s senior officer said:
“Many nursing staff working in Glasgow have been in contact with us to let us know how worried they are and concerned about how they can care for patients safely when there are so few staff and equipment is in such short supply.”
There are also warnings of delayed discharges and delayed operations.
The Government must improve its record on A and E waiting times. I am sure that we all want that. Westminster has done it recently and I am delighted that the cabinet secretary has now agreed with the Lib Dems to publish weekly figures. However, it should be a reminder to the Scottish Government that it needs to take heed of what those at the front line of the NHS are saying on the wider issues of sustainable staffing and resourcing for the long term. Geriatric beds have been cut by a third since 2010, boarding has soared to 3,000 and our hospitals are being bottle-necked. In the past two years, 16,500 NHS staff have been signed off work with mental health issues.
A and E weekly reporting is one aspect. It is now vital that, going forward, the Scottish Government outline what measures it will take in targeting the pinch points that we know exist in our A and E departments, and long-term staffing and resourcing must be key to that. I look for support for the Liberal Democrat amendment across the chamber.
I move amendment S4M-12325.1, to insert at end:
“; welcomes the Scottish Government’s decision to abandon its objections to the publication of weekly A&E waiting times, after considerable pressure from across the Parliament, and calls on the Scottish Government to set out how it will use the new information, in partnership with local communities, to improve waiting times across Scotland”.
We come now to the open debate. I am afraid that we are already short of time. Speeches must be a maximum of six minutes.
15:18
The Scottish Government has a strong record on increasing transparency and openness in the NHS. After all, it was this Scottish Government that began the routine publishing of treatment time statistics, including progress being made towards the 18-week referral to treatment target and the 12-week treatment time guarantee. That is to be commended; it is not secrecy.
Likewise, it was the current Scottish Government that began to routinely publish statistics on compliance with the four-hour A and E target and on the number of 12-hour breaches. Those statistics were not collected before; Labour preferred to keep them hidden. I ask Parliament to work out, on the balance of probabilities, who is secretive and who is transparent.
I welcome the latest announcement to go further than ever before and to make a significant amount of NHS data easily accessible and available from March 2015 on the Scotland performs website. It will include weekly statistics on A and E performance, and I hope to say a little more about that later.
Across a range of measures, the current Scottish Government has already made far more information available than was available under any previous Labour Administration. For instance, Parliament will remember the farce of Labour’s hidden waiting lists, with around 35,000 people with no guarantee of when treatment would take place and no published statistics to admit that those people existed or say what the length of their wait was likely to be. That is secrecy.
This Scottish Government ended that system when it brought in the new ways system, which ensured that all patient waits were recorded, statistics were published and transparency was brought into the process. Indeed, when the Scottish Government identified that that system had to be improved further during our time in Administration, we acted once more and improved it further.
I want to share some further statistics with the chamber. I assure Scottish Labour that these statistics are accurate—I have actually checked them. If we compare the period from October to December 2007 with the period from July to September 2014—in other words, the lifespan of this current Scottish Government—we see an improvement of more than 16 per cent in mortality ratios in Scotland’s hospitals. The NHS has never been so safe. I am pleased to say that the hospitals in the area that I represent—including the Western infirmary, Gartnavel, Glasgow royal infirmary and the Southern general hospital—do better than the national picture. Despite some bad press they have been subject to recently, that is to be welcomed.
All of that is publicly available information, but we are never going to hear about it from the Labour Party. Labour is silent on that; there is a veil of silence from the Labour Party on all of that. Of course, we all know why. It is because it just does not fit in with its false narrative about an NHS in crisis.
Likewise, I do not see Labour being keen to tell people about the plummeting levels of hospital-acquired infections and the huge progress that has been made in that regard. If I recall rightly, the Labour Party has form in dodgy health statistics in this area. I believe that it was Jackie Baillie who rushed out a press release slamming the level of hospital-acquired infections in Scotland, before realising that the statistics that she was using referred to the time period when Labour was in charge of the NHS. While Jackie Baillie was calling Scotland
“the superbug capital of Europe”
the reality was that, under the Scottish National Party Government, hospital-acquired infections were down 70 per cent and were the lowest since records began. That is a dodgy dossier. That is misleading people. It is this Government that has been open and transparent.
The reason why I draw attention to hospital-acquired infections is that it is the current Scottish Government that established the Healthcare Environment Inspectorate and tasked it to carry out rigorous inspections and to publish findings publicly and in a way that is accessible to all. Sometimes that leads to newspaper headlines that are uncomfortable for the Scottish Government, but it was this Scottish Government that established that inspectorate, is identifying where services have to be improved and is taking action to improve them. That is why mortality rates are improving and hospital-acquired infection rates are falling. The system is open, transparent, public and accountable.
Jenny Marra was on “Good Morning Scotland” this morning. When it was put to her that the SNP Scottish Government publishes more information than was published by any Labour Government, Ms Marra did not deny it. I welcome that. Ms Marra went on to say that there was now a different culture, with different pressures and different challenges, and she identified challenges in relation to delayed discharge. I absolutely agree with her in that regard. However, again we saw selective use of statistics, because the statistics show that, under this Scottish Government, delayed discharge has fallen by two thirds.
I am minded to agree with the words of Dr Peter Bennie, the chair of BMA Scotland, which we heard earlier.
Will the member give way?
I am just finishing.
I welcome the weekly publishing of statistics, but picking one week at any given time can skew the public’s perception of a service. It is important that those statistics are put on the record, but we have to consider the service in the round and think about the improvement over a long period of time. The record shows that it is this Government that has achieved that improvement and this Government that has put more information into the public domain than ever before.
15:24
I was going to start by welcoming the Government’s change of heart with regard to the publication of the A and E data, but I should obviously thank the chief statistician instead. It is good that the statistician has told the cabinet secretary who is boss, stepped up to the plate and taken charge of the NHS. We have been asking for some time that the cabinet secretary do that, and it is really good that somebody has taken on that challenge because it was the right decision.
The NHS belongs to the people and not to the Government. The people have a right to know what is happening and what their expectation should be. We now look forward to the chief statistician making a similar announcement on weekly bedblocking statistics and, indeed, real-time publication of NHS statistics. Only when that happens will we have a transparent service.
Rhoda Grant needs to understand that the chief statistician decided on the weekly statistics because the statistic was already available and he decides on the frequency. In terms of new reporting, we decide on what new measures should be reported if they are not already reported upon. That is why I announced the NHS performs website, which I hope she will welcome.
That is as clear as mud. We have to wait for the chief statistician to decide whether to publish the other statistics weekly. We know who is in charge. Perhaps the cabinet secretary will appeal to him to publish those statistics.
The past few months in the NHS have been a nightmare for patients and staff. We have a national health service that is unable to cope with basic winter pressures due to the Government’s neglect of its duty. It has ignored not only our pleas for action but, what is more, the pleas made by staff in the NHS, their trade unions and their professional bodies. Indeed, it has also ignored pleas made by patients.
The Government is still in denial, suggesting that we are playing politics rather than highlighting the concerns of real people. That is wrong. What is worse is that it appears to ignore the pleas of staff and patients, aided and abetted—most disappointingly—by its friends in the Tory party.
That mismanagement has placed an unacceptable strain on NHS staff. We know that people in the caring professions work above and beyond the call of duty—that is in their nature. [Interruption.] If the SNP MSPs think that that is funny, they should perhaps spend some time on the front line working with staff in the NHS who make up for their neglect of the service. The Government is abusing that good will, and that is totally unacceptable.
Will Rhoda Grant give way?
No, I will not take an intervention. I have already taken one.
Staff shortages throughout the NHS have meant the withdrawal of some services. [Interruption.]
What do the staff think about Labour?
You should hear what they are saying about you, Shona.
Order, please.
They are fed up.
Order!
Perhaps if the cabinet secretary were to listen in silence to some of the real experiences of patients in the NHS, she might take some notice of them. I will highlight some of the issues in my region.
For example, if somebody in Skye has a baby, they had better do it in working hours—otherwise they will spend several hours in the back of an ambulance travelling to maternity services in Inverness because there are no out-of-hours maternity services in Skye any more. That is not a great journey at the best of times, and it is certainly not a great journey when somebody is in labour.
Endoscopy services in Skye have been totally withdrawn, which also means that patients have to travel to Inverness for their procedures. Locums are running the hospital services in Wick and Caithness, which is not sustainable. Because of lack of training, it seems impossible to attract and appoint qualified permanent staff to continue the current service delivery.
The community and local health board, not the Scottish Government, are coming together to work up a sustainable model. It is absolutely unacceptable that, until that model is delivered, people travel more than 100 miles to get procedures that could be carried out on their doorsteps. The Government talks about care in the community and treatment closer to home, but the direction of travel is in the opposite direction.
Operations are being cancelled. A constituent phoned me a couple of weeks ago and told me the story of an elderly woman—a neighbour of hers—who is waiting for a hip replacement. She was in agony and obviously really concerned about her operation, which was cancelled at short notice due to unscheduled care pressures. However, the stress of waiting for that operation continues, with her pain worsening until the operation takes place.
Will Rhoda Grant give way?
If the cabinet secretary will apologise to that woman, I will take the intervention.
As I always say, I regret it if anybody has not had the service that they should expect. However, is it not a great example of what is wrong with Labour’s portrayal of the health service that, particularly given what she said about Skye, Rhoda Grant did not even mention the fact that I have given approval for the new hospital in Skye? Should we not have a balanced view? Will she welcome that decision? It is good for the people of Skye.
I certainly welcome the decision to build the new hospital in Skye, but it has been a long time coming and it does nothing for the mothers who are travelling to Inverness in the back of an ambulance at this moment in time, which the cabinet secretary should be concerning herself with right here and right now.
In Harris, there are no general practitioner out-of-hours services. Patients have to travel to the hospital in Stornoway to access out-of-hours services over the highest road in the islands, which is a dangerous route at any time but is much worse in wintry weather conditions. That is not good enough.
NHS Highland has informed staff that if they require a bank nurse they can only get someone at the nursing assistant grade, not at the grade of the person who they are taking over from. That is totally unacceptable and puts patients at risk.
I am afraid that you need to close.
This Government needs to step up to the plate; it needs to take charge of the NHS; it needs to support the staff who are working extremely hard to make up for its shortcomings; and it needs to give the patients who are suffering under its management the treatment that they deserve.
Thank you. I make it clear to members that they cannot go beyond six minutes.
15:31
We are now almost halfway through the debate and we have still to hear an apology from Scottish Labour after its leader Jim Murphy was caught red-handed fiddling NHS figures and trying to save himself a red face by deleting his false tweets and his YouTube video making those false claims.
Talking of red faces, someone really has to have a brass neck to come to this chamber, as Jenny Marra did today, to praise NHS staff while failing to apologise for undermining their hard work by publishing false statistics about operation times. Labour’s misrepresentation was not a minor matter; out of the 292 cancelled operations that were cited by Jim Murphy, more than 200 were cancelled for clinical reasons—that is more than 70 per cent. Ms Marra is on very shaky ground when she comes here to talk about honesty, transparency and statistics, given Labour’s own appalling record on such matters—on hidden waiting lists, for example, or on that embarrassing photograph of Ms Marra herself outside the Glenrothes health centre that had been replaced by a £5.8 million new facility.
In her speech, Ms Marra introduced another blooper into Labour’s abysmal record on these matters. She cited the consultancy McKinsey to attack the Scottish NHS. If she had done her homework—she might end up blaming her researcher for this; who knows?—Ms Marra would have known that McKinsey is a company that has been regularly exposed for its role in privatising the NHS in England. Dr Phil Hammond, the respected doctor and commentator, said that McKinsey is the firm that “hijacked the NHS” in England. For example, McKinsey drew up many of the clauses in Andrew Lansley’s Health and Social Care Act 2012—the legislation that has taken the NHS in England far down the road towards privatisation; a journey, incidentally, that began with Tony Blair’s Labour Party when it established foundation hospitals in England.
McKinsey is already benefiting from contracts arising from the Health and Social Care Act 2012, according to an extensive investigation by Tamasin Cave of Spinwatch, which monitors the lobbying industry. Serious concerns have been expressed about the revolving door between the marketised English NHS, McKinsey and the Government. Indeed, one of McKinsey’s executives was an adviser to Tony Blair and then went on to head up Monitor, which is the regulator of the NHS south of the border.
McKinsey, of course, worked closely with the last UK Labour Government on health, and in 2009 it produced a report recommending that the NHS in England cut 10 per cent of its staff. Within weeks of the coalition taking power, McKinsey had been awarded a £6 million contract by Mr Lansley’s department. Serious questions have been raised about the fact that McKinsey represents private healthcare companies around the world, which is a serious conflict of interest when it has worked with the NHS in England. Ms Marra should be very careful about who she cites in evidence to trash the Scottish NHS.
Dr Hammond has praised the NHS in Scotland under this Government for rejecting the kind of market competition that has brought the NHS in England close to destruction. This Government has a very good record on health. We have 17,000 more nurses than we had under Labour, and those are real nurses, not the fictitious 1,000-plus nurses of Jim Murphy’s imagination. We have 13,000 more consultants. Perhaps most important of all, patient satisfaction is higher in Scotland than anywhere else in the UK. According to the social attitudes survey, 75 per cent of patients are satisfied with the NHS in Scotland compared with 51 per cent in Wales, where the NHS is in Labour’s hands.
Also significantly, the NHS in Scotland is more trusted in the SNP’s hands, according to a Survation poll taken in January. I have to say that I am not very surprised by that statistic, given what we have seen over the last couple of days and the lies that Labour is prepared to tell in order to gain political advantage in this matter.
15:36
I welcome the opportunity to speak in Scottish Labour’s debate this afternoon about the need for open and transparent information in the challenges that face our national health service.
I want to focus my remarks today specifically on the challenges that are facing the Royal Alexandra hospital in Paisley—the hospital where I was born, the hospital where I have been a patient as a child and an adult, and the hospital where I have visited family and friends. It is, however, a hospital that has recently been in the headlines for all the wrong reasons, and where thousands of patients and staff have been badly let down and have been failed over recent months.
As has been said already this afternoon, we should have full transparency and openness in our national health service. RAH patients want to know what has gone wrong and what will be done to fix the problems that their health service is experiencing. I welcome the fact that the chief statistician and the Scottish Government have listened to the persistent calls from Labour members and have finally agreed to make their weekly A and E statistics public. There should be no veil of secrecy.
Has Neil Bibby had a chance to look at mortality rates for the Royal Alexandra hospital? For clarity, they are combined with the rates for the Vale of Leven hospital. Since this Government has been in power, the mortality rate has fallen—it has improved to the tune of 19.6 per cent. Is that something that the member welcomes under this Government?
I know that there have been issues related to mortality rates at the Royal Alexandra hospital, and I welcome any progress in reducing them.
One statistic that we already know—it is shocking—is that 23 per cent of patients, which is almost one in four people, waited for longer than the four-hour target time for treatment at the RAH in December last year. Last week, after concerns had been raised by staff and patients for months, a support team was finally sent into the RAH, confirming the A and E crisis.
That crisis was apparent to anyone who had spoken to patients and staff over recent months, and it would have been highlighted at an earlier stage had A and E statistics been published more frequently. It is welcome that a crisis team has finally been sent in, but one wonders whether the health secretary has a grip on the situation when she denies on the Monday that there is a crisis but on Tuesday sends in a crisis team to a major hospital.
I do not deny the challenges at the Royal Alexandra hospital, which is why we sent the team in. What I take exception to is Labour’s portrayal, in which every A and E department in Scotland is in crisis. That is clearly and blatantly not the case. Will Neil Bibby accept that?
There are far too many hospitals that are not meeting their A and E waiting-time targets, and the RAH is certainly one of them.
I have been contacted by dozens of patients and staff over recent weeks. I want to share some of their experiences and to ask some questions of the health secretary on their behalf. One woman described to me recently how her mother had a 13 and a half hour wait in A and E with two broken bones in her back. Another told me how her father waited four and a half hours for an ambulance, and when he finally got to the RAH there were no trolleys available and no porters to find one. The health secretary will be aware that other patients have waited for up to 20 hours.
Those are not criticisms of the dedicated and hard-working staff at the RAH. In fact, several people have provided me with examples of the outstanding work that staff are doing in extremely difficult circumstances. One man described how, when he was in the hospital for a knee operation recently, the nursing staff even turned their eating area into a waiting room for patients who could not get a bed. Staff are going above and beyond the call of duty.
I have a significant number of questions for the health secretary on behalf of patients and staff. Given that she wants to be as open and transparent as possible, I hope that she will answer those questions for RAH patients and staff. If she cannot do so in her closing speech, I would welcome a response in writing.
How long does the cabinet secretary envisage the support team being in the hospital? What were the weekly stats for the RAH that she received last Tuesday at noon, which was the day on which she sent in the support team? Does the cabinet secretary agree that there are staff shortages at the RAH? Does she accept what staff and patients have been saying about the shortage of beds to meet current demand and, if so, what does she intend to do about it? Given that the cabinet secretary had so much to say about cancelled operations, can she tell us how many cancelled operations there have been at the RAH in the past few months? I am certainly aware of constituents who have had operations cancelled.
Patients and staff are demanding answers to those questions. We have seen concerns about adverts for volunteers at the RAH’s A and E department. Do the Scottish Government and the cabinet secretary still support the use of volunteers in A and E? The cabinet secretary will know that it was reported in The Herald last week that the Government has been made aware of two critical and very serious incidents in which patients at the RAH were injured while at A and E. People rightly expect such serious incidents to be fully investigated to find out why they occurred and how they can be prevented from happening again. How many other critical incidents has the cabinet secretary been made aware of in the RAH and in other hospitals?
I hope that the health secretary will be able to respond to those questions. My final question to her is simple. She has called on Jenny Marra to apologise, but given that the NHS Scotland chief executive has apologised to patients at the RAH, I ask the cabinet secretary to apologise to patients and staff there, because they have been badly let down by her Government. Our NHS and the RAH in Paisley deserve much better than they are currently getting.
15:42
We need a good sense of humour when we see some of the Labour Party-sponsored motions these days and the way in which they are camouflaged. Labour is not doing Parliament any service through how it words motions in advance, because we end up talking about something that does not fit with the motion that was lodged.
That said, given Labour’s record in the area, who would believe that Labour would bring to Parliament a motion that reads as this one does? When we investigate Labour’s record in comparison with the SNP’s, we might almost laugh if the issue were not so serious, because just about every stat on the SNP’s record knocks Labour’s stat out of the park—through a time when the Scottish budget has been persistently cut by British Governments of all colours.
The SNP is delivering record spending, with a health budget of over £12 billion and an extra £383 billion this year. [Interruption.] The SNP Government is delivering record levels of staff, with 1,300 more consultants, 1,700 more qualified nurses and midwives and 9,600 extra staff overall having been recruited since Labour ran the health service.
The Scottish people are not daft—they see the effects of our total commitment to the national health service. In Scotland, 73 per cent of people are satisfied with the health service, compared with only 63 per cent in England, where the Tories run the health service. However, who would have thought it possible that the Tories, while struggling to match the SNP’s record on NHS satisfaction, would do better than the Labour Party, which runs the health service in Wales, where the satisfaction rate with the NHS is at a disastrous 51 per cent? The Labour Party has some brass neck to come to the Parliament today with this jumped-up motion.
However, let us not just look at the Labour Party in Wales, where it has slashed the budget. Iain Gray said that he would not have ring fenced the health budget if Labour had won the election in 2011. Well, thank goodness that the people re-elected the SNP, or we would now be facing the same problems that people in Wales are facing. That is what you get when you do not ring fence.
It should never be forgotten that when it was in power in Scotland, Labour was closing Monklands hospital and Ayr general hospital at the same time as it was salami-slicing services at the Vale of Leven hospital, with the view to closing it eventually. The Vale of Leven Hospital served and—thanks to the SNP Government—continues to serve a number of people in my constituency, which is one of many reasons why people in the area tell me that they trust the SNP on the NHS. What would waiting times be like now without those hospitals, which would have been closed? More than 1 million patients would not have been able to attend them.
As far as transparency goes, it was the SNP Government that routinely published statistics on four-hour A and E targets and on the number of 12-hour breaches. What did Labour do? Labour buried those statistics and kept them secret. We introduced routine monitoring and reporting of hospital-acquired infections. We created the Healthcare Environment Inspectorate to carry out rigorous inspections and we instructed it—yes: instructed it—to publish those findings.
Not the chief statistician?
Order.
Thank you very much, Presiding Officer.
Jenny Marra should not bother talking to me. She should talk to the BBC, who will put out her mince, whether it has been cooked or not.
When we came to power there was a shortage of dentists in some parts of Scotland—in some locations it was best described as chronic. We brought in an additional 430 dentists. We have increased the number of general practitioners by 7 per cent and reduced the number of service managers by 29 per cent. We are making a difference where it really counts, exceeding the target set in that regard for April this year. Funding is in place to ensure that 500 new health visitor posts will be created in the NHS in Scotland over the next four years. The list goes on and on.
The Labour Party is in the business of talking down the NHS. It claims disaster after disaster in order to paint in the minds of the people of Scotland a false picture of the NHS. It is prepared to do down our health service relentlessly, just to attack the SNP, which is hardly what I would call protecting Scotland’s communities. It is more about protecting Labour Party seats. The health service is expendable for Jim Murphy and the Labour Party. How could it be otherwise, even though all the indicators are that we need to be consistent on the challenges that we face? Labour is trying to take down the SNP by talking down the NHS in Scotland. Labour should be completely ashamed of itself because of how it has used its motion today, and how it has handled itself in the past few days. It is a disgrace.
15:48
Like Gil Paterson, I will say what a shame it is how things have been handled over the past few days.
A few weeks ago I shared my surprise that Labour had lodged for debate a motion about health under the title “Scotland’s Future”. Today, Labour is at it again: under a misleading title—“Protecting Scotland’s Communities”—here we are, talking about health again. If anyone from Labour would like to apologise, please stand up. No? I thought not.
Apologise for what?
For this: for lodging a motion whose title has nothing to do with the motion. It is misleading: nothing else. The only explanation that I can find is that orders are coming from London to weaponise the NHS. No distinct message is allowed in UK Labour plc, so we therefore must debate NHS Scotland again.
However, I will not pretend, as other members have done, that the NHS is a UK organisation. We might face similar challenges, but the way in which we are responding to those challenges is very different.
Let me repeat what I said a few weeks ago: under an SNP Government we have not only protected the NHS budget, but have increased it, despite the cuts to our own budget—Tory cuts that are supported by Labour at Westminster. The picture that the Labour party has been desperate to paint since the beginning of the year is not based on facts. One might think that an election is looming.
The Scottish branch of the Labour Party’s desperate attempts to run the same campaign against the NHS in Scotland as UK Labour is running in England will not work. Labour has been found out time after time. Not only is NHS Scotland performing better than the NHS in England, but the Scottish Government has shown leadership, working in collaboration with NHS boards and local authorities, in setting out a great vision for an integrated health and social care service.
I can report, Presiding Officer, that NHS Grampian is working seamlessly to implement the SNP Government vision, which will address the challenges that all health services in the UK and beyond are experiencing. The pressure on social care services has been recognised and the Scottish Government has put in additional money to deal with delayed discharge.
Part of the problem within NHS Grampian is that Aberdeen City Council has got rid of its care services to an arm’s-length company, which has caused delayed discharges to rise dramatically. The member for Aberdeen Central, Kevin Stewart, reminds Parliament regularly that Bon Accord Care, the arm’s-length company of Aberdeen City Council, has become a smokescreen to hide the failings of the Labour-run administration. On the train journey back to Aberdeen, Kevin Stewart frequently tells me that when he was a councillor there were no delayed discharges. Will Labour in Aberdeen apologise? I think not.
This is my third contribution to a debate about health this year, and in every one of them I thanked the Cabinet Secretary for Health, Wellbeing and Sport and the First Minister for visiting our north-east hospitals. On Monday, the health secretary was in Aberdeen, again, speaking to the board and staff at Aberdeen royal infirmary. I thank her for that.
NHS Grampian is recruiting more nurses, and last Friday I heard at first hand how much better the new board is at investigating and responding to complaints. I suggested to the board and the elected representatives present that we all have a responsibility to highlight not only the complaints, but the many positive feedback comments from patients. We must make sure that the positive feedback is passed on to NHS staff.
I would like to congratulate both the new chair of the health board, Professor Stephen Logan, and the acting chief executive, Malcolm Wright, for deciding to conduct their public board meetings in a new transparent way. That is very important and matches the pace of improvement by the Scottish Government.
There is a lot to celebrate in NHS Grampian and a lot to be positive about. The Scottish Government has allocated a £49.1 million increase to the health board’s budget for the next financial year. That equates to a 6.3 per cent rise. The SNP Government is showing commitment to delivering for North East Scotland; NHS Grampian funding is now within 1 per cent of parity with other NHS boards around Scotland, one year ahead of schedule.
Yesterday, our First Minister met cancer patients when she officially opened the new state-of-the-art £13.6 million radiotherapy department in Aberdeen. I look forward to many more visits from both the cabinet secretary and Scotland’s First Minister.
There is a lot going on and a lot of good news for patients in the region. Two new projects have been unveiled: a new cancer centre and a new hospital—we are still debating what name it should have.
You are in your final minute, Mr Allard.
The two new projects are part of the £120 million from the Scottish Government’s national delivery plan programme. The new hospital will be paid for under the non-profit distributing model and the project will be run under a design, build, finance and maintain contract over 25 years. Again, taxpayers’ money is being used for public health and under a 25-year contract.
Will Labour stand up and apologise for the amount of debts that it has created with private finance initiatives? The cost of PFI repayments is one of the reasons why Labour cannot be trusted with the NHS. Its members should stand up and apologise.
Will someone switch my microphone on?
The member is in his final minute and is closing his speech.
I am closing.
He was taking an intervention.
Be very brief, Dr Simpson.
The Presiding Officer will decide.
The member is closing and we are running out of time.
Labour cannot be trusted with our NHS, and its attacks on NHS Scotland have no public support because NHS staff in Scotland are working tirelessly under pressure to deliver high-quality care to patients.
I have a message for London Labour: bring as many health debates to the Scottish Parliament as you wish. I will be sure to speak in every one of them.
I point out that members can take interventions only if they can do so within their six minutes.
15:54
I am pleased to take part in this important debate on protecting Scotland’s communities. We know that Scotland’s national health service faces significant pressures while, at the same time, it must make major changes to services in order to meet future needs. It pains me to read and hear about the horror stories that have been coming out of the NHS almost daily over the past few weeks, particularly those that come from my region of Glasgow. The recent petition from the Royal College of Nursing, signed by more than 7,000 people, complaining about inadequate staff parking at the new Southern general hospital, should have been predicted. When the new Larbert hospital opened in 2010, the main complaint was lack of parking for cars. Why is the same problem arising again just five years later when the next new hospital is being built?
I hope that Anne McTaggart realises that the application for additional car parking is with Glasgow City Council. Indeed, it is Glasgow City Council’s responsibility to resolve the residents’ parking issue. Surely she would acknowledge that in a more balanced view.
I would have thought that the infrastructure of a new-build hospital would be looked at by more than just Glasgow City Council. The 7,000 people who have signed the petition obviously do not approve of what is currently there.
It is simply unacceptable that our hard-pressed NHS staff should have to worry about parking. Many nurses and doctors work shifts that require them to be in early and leave late in the darkness. Their safety, as well as ease of transport, should be a priority. That should have been monitored by the Scottish Government so that the issue could have been foreseen and tackled.
Figures published recently show that A and E patients across Scotland are being let down. The percentage of patients being treated in A and E in four hours or less dropped from 93.5 per cent in December 2013 to just 89.9 per cent in December 2014. The accident and emergency department in Glasgow’s Western infirmary has the worst figures in Scotland for A and E waiting times: 31 per cent of patients wait for longer than four hours. The waiting time statistics for December 2014 show that the Western met the target for 69 per cent of its patients, which means that 548 patients waited for more than four hours. The stats also show that 242 patients had to wait for more than eight hours and, more worryingly, 13 patients had to wait for more than 12 hours.
The reality is that hospitals are simply understaffed. Scottish Labour has highlighted time and again the daily problems that face hard-working NHS staff across Scotland. More doctors and nurses are needed in our A and E departments. Scottish Labour had one principal demand for the Scottish budget: protect the NHS with an additional £100 million of front-line funds. That would have allowed hospitals that are facing extra pressure to plan surgery at the weekend and diagnostics in the evening. Developing that approach would also allow patients to have a health service that suits their lives—for example, it would enable elective surgery outwith people’s working hours.
Labour members welcome the Scottish Government’s U-turn on the weekly reporting of A and E figures, but it came too late as the current NHS crisis could have been discovered much earlier. Ministers have been aware of the crisis since last autumn, but it has taken until now for them to admit it. It is not good enough that, under the SNP Government, the people of Scotland are forced to get the information that they need on the NHS from freedom of information laws. I call on the Scottish Government to publish the weekly figures for each hospital rather than for each health board.
We can do that.
I am pleased to hear that. The figures would be for both A and E and delayed discharges. They would help us to foresee future crises and allow people to observe the performance of their local hospitals.
There are serious problems in Scotland’s health service and a lot of secrecy about important statistics. Behind each of those statistics, vulnerable patients and their families are suffering. That is why the Government needs to take urgent action right now, as there is no time to waste.
16:00
I am delighted that the cabinet secretary has announced the weekly publication of A and E performance data and that she is continuing—
Will the member take an intervention?
Not as early on in my speech as this.
I am delighted that the cabinet secretary is continuing the trend, established by this Government, of publishing increasingly accurate information on the performance of the health service.
Mike MacKenzie thanked the cabinet secretary for her announcement, but the cabinet secretary was quite clear that it was not her decision, but the decision of the chief statistician, to publish the data weekly.
Thank you, Mr Hume. If the member had paid closer attention to what I was saying rather than to the point that he was endeavouring to make, he would have heard me say that I was delighted that the cabinet secretary has announced the publication of the data. There is no contradiction there whatsoever.
The publication of the data is important in the interest of transparency and in order to provide a reliable guide to our health service’s effectiveness. Perhaps it is also important to help prevent Labour Party members from making fools of themselves. That is not a trivial point, because while the Labour Party is at liberty to bark up the wrong trees as much as it likes, it should take care in its politicisation of health matters. The effect of that is sometimes to place our hard-working health workers under even greater stress; often, the effect is to subject them to a siege, laid on them by the Labour Party, and to criticise them on false premises merely to score a political point. The last thing that our hard-working health workers require is to have their morale sapped in that way.
It is sad, too, that the Labour Party cannot think of a more constructive way of acting in opposition than to endlessly criticise our health service, especially because the facts speak otherwise. Patient satisfaction with the Scottish health service has never been higher. The 2014 British social attitudes survey, which was published only last month, indicates that 75 per cent of people in Scotland are satisfied with the NHS, compared with 65 per cent in England, and only 51 per cent in Labour-run Wales.
Health funding has increased to an all-time high, despite the reduction in the Scottish Government budget. Every penny of Barnett consequentials has been passed on to the health service budget. That is why we have 1,300 more consultants, 1,700 more qualified nurses and midwives and, overall, 9,000 extra NHS staff than we had in 2006.
There is merit in producing the statistics. The public have a right to know how our health service is performing. This Government has done more than any previous Government to publish increasingly meaningful statistics—not to wrongly lay blame at the door of our hard-working health workers but, rightly, to tell the relative success story that is the Scottish national health service.
Our Scottish national health service, despite the many pressures on it, is performing better than it was when Labour was last in office in Scotland. It is also performing much better than the health service in England and much, much better than the Labour-controlled health service in Wales.
The health record of Labour when it was last in office in Scotland is not a good one. It is a story of hidden waiting lists, of lain Gray’s refusal to make a manifesto commitment to maintain the health budget and of the party’s plans to close A and E departments at Monklands and Ayr. The Scottish people spoke loudly and clearly on Labour’s record on health and other issues in 2011, and they will soon have another opportunity to speak. I suspect that they will speak loudly and clearly once again.
The Labour Party seems to think that Mr Murphy is a prophet. In reality, he is a pied piper and he is not leading Labour into the promised land; he is leading it further and deeper into the political wilderness.
16:05
A word that is overused in politics today is the word “crisis”. Opposition politicians use it on almost every issue and in almost every press release that they send out. We have heard it being used in today’s debate, yet it is far from the truth that what we are talking about is a crisis. Admittedly, the first member to use the word was Bob Doris, but he was referring to comments that the Labour Party had made. Anne McTaggart used the word “crisis”. A crisis is what is happening in eastern Ukraine or in the middle east. The issue with health statistics or what is happening in the NHS in Scotland is not a crisis, regardless of whatever version of events Jim Murphy gives by press release, on Twitter or on YouTube.
Dr Simpson said that no one had used the word “crisis”, but Jenny Marra used it yesterday, as did Jim Hume. Gemma Doyle used it in the Daily Record of 18 February, and Jim Murphy used it in the Daily Record on 3 February and 13 February. The Labour Party and the Liberal Democrats have been using the word “crisis” to talk down our NHS.
The budget that the Parliament recently approved will mean that, for the first time ever, more than £12 billion will be spent on the NHS in Scotland. That includes an increase of £383 million this year. That is a staggering amount of money. Even if we were to increase that amount by another £5 billion or £10 billion, there would still be issues that would need to be addressed, such is the size of the NHS—it is a huge organisation. It is how we deal with issues as they arise that is important. We should be looking at ways to minimise problems but, because the NHS is a massive organisation that reaches into every area, every community and every family in Scotland, issues will always arise.
What is not helpful is the almost hysterical level of condemnation, attack and vilification poured on to the NHS by members of the Labour Party. While most Scots see the NHS as an institution to be treasured, respected and supported, Labour sees it as another opportunity to get a cheap shot in the press, to issue another overegged press release and to pile up one stoked-up crisis on top of another, thereby pouring scorn on the NHS and its workforce.
I am listening to the member with awe and interest. How does he think that we are pouring scorn on the NHS? We are asking the Government to support the NHS, its workers and its patients so that we can all enjoy the services that we very much want. It is the neglect of Stuart McMillan’s party’s Government that has led to the problems that we are discussing.
After the condemnation and vilification in the comments that it has put out over the past 24 hours and beyond, I think that the issuing of an apology would be a start for the Labour Party in proving that it likes the NHS.
To Labour members, the worry and concern that they are inflicting on NHS employees, volunteers and even patients are merely collateral damage as they seek to tarnish the NHS to get their spokespeople in prime slots on radio phone-ins, television programmes or breakfast news broadcasts. It is time that Labour stopped talking down the NHS in Scotland. After all, before 18 September 2014, did not Labour tell us that the NHS would be safe if Scotland voted no? It seems that we must now forget those Labour words.
The motion calls for
“a culture of transparency and openness with regular publication of statistics and reports”,
but it makes no mention of the costs of providing that information. Speaking from personal experience—when I worked in the private sector, one of my duties was to analyse statistics and produce regular reports—I know that that does not come with no cost attached. Staff time is needed to record information, compile statistics and produce reports, and there are the costs of publishing the information in either printed or electronic format.
I would hope that Labour politicians are well aware that their calls for increased information—even if it is already being collated—will result in additional costs. I would be grateful if the cabinet secretary could inform the Parliament who will bear the costs. Will it be ISD or the Government’s official statistics group?
I welcome the introduction of the weekly statistics. If it continues the excellent progress of information reporting from the SNP since we came to power, it will be an advantage. It will certainly be an advantage to the NHS and Scotland’s patients.
ISD Scotland already compiles a significant amount of NHS data, which can be accessed easily, but there are other methods. We are all MSPs, and there are other methods for us to obtain information. We can ask parliamentary questions, we can write letters to ministers or cabinet secretaries, and we can ask for meetings with them. We also have the option of using freedom of information requests to access further information. Perhaps some members will take a wee bit of advice on that. When someone submits an FOI request, it is usually helpful if they understand what they are asking for before they run to the press complaining that the information says something else.
Will you draw to a close, please?
It seems strange that Labour politicians who have not got the hang of FOI requests and knowing what information they are after are now running around demanding more information. Do we have any guarantee that they will actually understand it when they receive it?
16:11
They say that the best line of defence is attack, and boy have we seen plenty of that from the SNP benches today. The first step in the ability to tackle a problem is to acknowledge that there is a problem. If we are going to sit in denial while there are issues that have to be addressed in the national health service, we will not make progress.
Joan McAlpine talked about record levels of consultants. The last time I checked, 37.7 consultant posts in Fife were not filled because the NHS was unable to fill them. Companies such as Medinet were flying up consultants from England at the weekends to do homers. I raised with the cabinet secretary’s predecessor, Alex Neil, specific cases where that went wrong. We have heard talk of record numbers, and we are seeing more nurses going into NHS Fife, which I have welcomed, but that is because we have highlighted the issues.
Before I came into this place, I spent two years as the leader of Fife Council, and during those two years I was consistent in raising my concerns about the assumptions that had been made through the previous right of Fife exercise, which put together how our hospitals would be co-ordinated and how health and social care would be run in Fife. Since I came into this place, I have consistently continued to raise those concerns because I regularly meet nurses and other staff in the hospitals and I see the pressures and challenges there. I met the cabinet secretary’s predecessor, Alex Neil, to discuss many of those issues, and I was grateful for the meeting with the cabinet secretary just last week or the week before.
I am also consistent in praising the hard work, care and commitment that certainly I and my family have seen at first hand from NHS staff in Fife. That is why I am so vocal on the issue—it is because I am so passionate about the national health service. It was the greatest creation of the previous century and we have a duty as politicians to ensure that it can move forward and be modernised to meet the needs of this century.
Last week, the Healthcare Environment Inspectorate published a report following an unannounced visit that it carried out to the Victoria hospital in Kirkcaldy. It states:
“In the majority of wards and units inspected, the standard of environmental cleanliness was good”.
That is the starting point, because that is what we would expect within a hospital. However, it goes on to say that the accident and emergency department and ward 15, which is a care of the elderly ward, were exceptions. The report states that in those areas and in the intensive care unit there were “significant levels of dust”. Concern was raised about the cleanliness of equipment. In accident and emergency, trolley frames were contaminated with blood and body fluids, and chairs, blood gas analysers and bed frames were contaminated in accident and emergency and the maternity ward.
I could go on, but the cabinet secretary has obviously read all this so I will not continue. The chief inspector said that the inspectorate was so disappointed that it raised its concerns with the Scottish Government. I do not want to read out every bit of the report, but when such issues are highlighted, surely we parliamentarians have a responsibility and a duty to come to the Parliament and raise them and any other issues of concern about the health service. That should not be seen as somehow attacking the health service or health staff: quite the reverse. We are on the side of the health service and health staff.
I agree with that, but the member is the first speaker from the Labour Party to offer a balanced speech that recognises the good things that are happening as well as highlighting the difficult issues that have to be resolved. The difficulty that we have is that there is no balance from Labour in the main.
To reassure Alex Rowley about the report, the HEI will go back into that hospital and will make sure that those issues that are not good enough are resolved. I give him that assurance.
I thank the cabinet secretary for that. I have consistently called for a review of NHS Fife’s ability to meet the health needs of people in Fife. A couple of weeks ago, there was a report in The Courier about accident and emergency waiting times. It compared Fife with Tayside. I cannot remember whether the report said that Tayside had no problems, but it certainly did not have a lot while NHS Fife had significant problems.
NHS Fife seems to have bounced from one issue to the next to the next, and I come back to the assumptions that were made when health services in Fife were reconfigured. Back in the 1980s, I was studying in this city when the Griffiths report, which meant the start of community care, came out. The Conservative Party, which was in power at that time, commissioned that report. I remember making the point that community care would not be care on the cheap. It means major pressures on health and social care.
I appeal to the Government: let us work together. Let us not pretend that everything is rosy, nor attack everybody who tries to raise issues of concern. Let us be proud of our national health service and work together to build it so that we can be confident that it will deliver for all our citizens.
I call Richard Lyle. You have four minutes or thereby, please.
16:17
Thank you, Presiding Officer. I notice that everyone has taken two minutes off me.
The issues that face the national health service are indeed important. Despite the Labour motion trying to claim otherwise, the SNP Scottish Government is taking on board and addressing those issues. The SNP’s vision for the NHS is that the NHS should remain a publicly-delivered service and as long as the SNP Government is in power, it will remain a publicly-delivered service. Unlike the Westminster Con-Dem Government that is marching the English NHS down the path of privatisation, the SNP has met its commitment to protect the NHS budget in order to facilitate its vision. The health resource budget for the year 2015-16 will be a record £12 billion.
Will the member give way?
No, I do not have time.
The Scottish Government announced that an extra £65 million will be made available to the NHS this year. Those funds will help to alleviate some of the pressures and ensure that the NHS can continue to deliver and sustain care of all patients across Scotland. That is in spite of Westminster’s 10 per cent cut in Scotland’s fiscal resource budget since 2010. I hope that people remember that in May.
Meanwhile, the Scottish Government has increased the health resource by 4.6 per cent in real terms, so it is putting its money where its mouth is. It is a pity that Westminster will not do the same.
Then, of course, we have those on the other side of the chamber in the Labour Party, a party that has a poor record in government and whose handling of the NHS leaves a lot to be desired. We only need to look south of the border at the only part of the UK where Labour in still in power: Wales. The Welsh Labour Party has a poor record of dealing with its national health service. Perhaps Carwyn Jones has taken tips from the Labour Party in Scotland—who knows?
Jenny Marra’s motion highlights an issue with transparency and goes so far as to say that there is a “veil of secrecy”. Is that the same veil that the Labour Party used during its term in government when it came to hidden waiting lists? The SNP Government abolished those—something that Labour failed to do for eight years despite acknowledging that they were not in the interests of patients.
The SNP Government acts in the best interests of patients—so much so that patients in Scotland have a high rate of satisfaction in the NHS and public confidence in looking after and protecting the NHS sits with the Scottish National Party and this Government. Under this Government, there has been a steady increase in the publication of statistics about the performance of the NHS. So, when I hear the Labour Party pontificate from on high, across the chamber, about our lack of transparency, I cannot but think of the hypocrisy that Labour members show, given that a record of openness was sorely lacking during Labour’s administration of Scotland’s NHS.
The NHS belongs to all our citizens, and any suggestions for improvements or views on how we can make it run better are always welcome. That is how this Government acts in all its areas of responsibility and it is, I am sure, how it will continue to do business. The national health service is close to all our hearts, which is why the SNP will never stop doing its best to make Scotland’s NHS ever healthier.
I remember when the Labour Party threatened to close the A and E department at Monklands hospital and I remember the views of the community. It was the SNP Government that saved the A and E department at Monklands and protected it from closure, and it has continued with that service. Since then, hundreds of thousands of patients have been treated at Monklands hospital. Where would those patients have gone if not to Monklands? They would have swamped Wishaw hospital or Hairmyres hospital. That speaks volumes for our NHS and how we protect it.
As far as I am concerned, Presiding Officer, it is better to be with the SNP for our NHS.
We move to the closing speeches. I remind members who have taken part in the debate that we would be grateful for their presence in the chamber. I hope that those who are not here will return soon.
16:22
As I mentioned in my opening speech, the Lib Dems have long called for the weekly publication of A and E waiting times. We believe that such a move will make the system more transparent and that the Government will have nowhere to hide when things go wrong. I am pleased that that will happen, but we cannot sit back and expect more statistics to fix NHS issues. The Scottish Government has tough questions to tackle in creating a more effective A and E service. Ultimately, the NHS could be better supported by the Government in meeting waiting time targets and maintaining smoother patient pathways.
I found the member’s opening remarks about the cabinet secretary hiding behind figures strange. He talked about a wall of statistics, but is that not exactly what he is asking for?
I was referring to the ISD figures that came out once a month on what we called superstats Tuesday. They were a pile of statistics like a wall and they were difficult to get through. Weekly reporting is exactly what we want.
MSPs across the chamber have acknowledged the need for more transparency. As we know from core health sector groups such as the BMA and the Royal College of Nursing, this is only the first step on the right path to a more efficient NHS. As members have noted, it has taken a U-turn to get here, and a welcome one at that. It was not the Government’s previous position—the Government’s position has changed in a short time. I repeat that the Government needs to adopt a policy of working openly across parties on important policy issues such as the NHS, and I am happy to work with it in that way.
Nonetheless, the focus of the Lib Dem amendment is on seeking assurances from the Scottish Government on how it plans to use the information. The goal is not to overwhelm the public, Parliament and health specialists with a flurry of information simply for the sake of obtaining it. We must remember that the ultimate goal is a transparent system in which ministers cannot hide behind the mountain of data that I referred to and in which problem areas in A and E departments are tackled head on through targeted support and resources for our NHS staff.
Relieving the A and E crisis that has developed is a complex task that involves taking into account a number of factors. We know that understaffing and underresourcing are a particular problem.
There have been repeated calls from doctors and nurses, who tell us that increases in A and E waiting times are a result of the compounding effects of pressures in other areas of the NHS. The British Medical Association has warned that
“we must avoid reducing the NHS as a whole to a set of weekly performance figures, skewing the public’s perception of the health service and ignoring the system-wide pressures which stretch far beyond A&E.”
The Lib Dems look to the cabinet secretary to spell out the measures that her Government will take in a bid to remedy the crisis in our A and E departments.
Keeping A and E units open is a move towards ensuring that communities have quicker access to care, but having the infrastructure without having the proper procedures, staff and resources is not sufficient. A case in point that has been mentioned several times is the Royal Alexandra hospital in Paisley. It is not enough for the Government to claim that it is doing something to address problems with A and E; it also needs to show what it is doing.
It is evident that, if we want to truly resolve the A and E issues, we need to ensure that the Scottish Government handles the released information in a way that brings tangible results. The Scottish Government must act on that task and not simply divert the public’s attention by agreeing to publish information. We want the information to be used actively to develop flexibility in the NHS’s resources, with primary input from the experts who deal with patients daily. Whether the issue is staff shortages or material or financial shortages that can be mitigated by better analysis of A and E cases, and whatever the needs of our invaluable NHS staff might be, the weekly information will be of little use or value if it is not properly used and applied to fix the root of the problems.
The Scottish Government can no longer hide behind the wall of stats that are released once a month. We need to see tangible measures to fix the problems in our NHS, and ministers must listen to what NHS staff, health professionals and patients are saying.
This should be a reminder to the Scottish Government that it needs to heed what those at the front line of the NHS are saying on the wider issue of sustainable staffing and resourcing in the long term. As we know, geriatric beds have been cut by a third since 2010; boarding numbers have soared to 3,000; our hospitals are bottlenecked; and in the past two years 16,500 NHS staff have been signed off work with mental health issues.
A and E weekly reporting is only one aspect. It is vital that the Scottish Government outlines the measures that it will take to target the pinch points that we know exist in some of our A and E departments. A long-term approach to staffing and resourcing has to be key to that. This is an opportunity to underline the need for the Scottish Government to look at the issues, and I look to the cabinet secretary for assurances in her summing-up speech that she will set out how she intends to tackle the issue head on. Patients and our dedicated NHS staff deserve and expect nothing less.
16:27
In an afternoon of bloody fratricide as the two parties opposite took lumps out of each other, I thought, “What future for Great Britain were these two parties, desperate to form a coalition at Westminster after the May general election, ever to be allowed to do so?” Were that ghastly fate ever to transpire for the nation, I hope that, in the interests of the transparency that both parties have been so keen to promote this afternoon, they will agree today that they would allow the cameras to follow every step of the negotiations. What we saw was not a pretty sight.
I will start where Jenny Marra and the cabinet secretary began by joining in the congratulations that I think members on all sides of the chamber have given to our NHS staff for their heroic efforts over the winter. Of course, they will not be able to listen to our praise of them, because they will be running around harassed in wards, doing a job in the most trying circumstances.
In all my years in the Parliament, I have never thought of Dr Nanette Milne as an angry woman, but I have to say that, in her speech, she came the nearest to being angry that I have ever heard. The motion was a dispiriting one. This is the third health debate that we have had this year. Although the first was on a ghastly motion, the debate turned out to be slightly more constructive. The second debate was reasonably consensual, but I am afraid that this afternoon’s debate reverted to being wholly unhelpful and deeply destructive.
It is not that the issue at the heart of Jenny Marra’s motion is unimportant or that it is wrong to raise it. The fact is that she effectively raised the issue in a question to the First Minister on 5 February, to which the First Minister responded that she could
“tell the chamber ... that”
she had
“asked officials to look at the possibility of moving to weekly publication.”—[Official Report, 5 February 2015; c 20.]
To characterise that as some great culture of conspiracy to deny us information on the health service—when, as Nanette Milne has detailed, we have more information than we have ever had—is simply to perform the wrong service to the debate.
Under Jim Murphy, the Labour Party has launched into the air all manner of fireworks on health. We have had the mismanaged release this week. We had the nonsense of the mansion tax that will fund phantom nurses. We had the redeployment of moneys into an illusory front-line fund. Today, we had the return of matron, when it was Labour that persuaded us to join a consensus on senior charge nursing, only for us to do so and find that matron is to be brought back. Labour demands an apology a week. I recall that, on 1 January, Jim Murphy asked for 10,000 apologies. After their spectacle, the Labour fireworks leave only the smell of sulphur, as fireworks always do.
There is a suspicion that, at Labour Party group meetings, Jenny Marra—who is keen, diligent and well briefed—is putting her hand up and saying, “We’ll have another debate on health.” Where are all the other Labour front benchers? Have they gone to roost? Are they hiding? The only thing that we seem to be doing is having a Labour Party debate on the NHS that has been wholly destructive, with one honourable exception, to which I will respond.
It is our responsibility to challenge the Government of the day, but we must challenge it to the benefit of the NHS and patients, not to the political advantage of any poll rating ahead of a general election or a Scottish election. Like her predecessor, Shona Robison has talked about arriving at a consensual approach.
Those in the older generation used to say of health that they had had a fright. Sometimes a fright became a shock, and sometimes a shock became a crisis. We have had lots of frights. The NHS is having more shocks more regularly than in the past. I hesitate to say yet that it is in a state of crisis, and I am not blaming SNP members because, although there are lots of occasions on which I have disagreed with them, they have done a lot of good work. However, we are at the point where, if we cannot arrive at a consensus soon on what the strategic way forward to create a sustainable NHS is, it will be too late and we will find ourselves in a crisis that would have been wholly avoidable if we had been prepared to rise to the challenge.
When will that consensus happen? Are we going to rule it out for 2015 because there is an election? Are we going to rule it out in 2016 because there is an election? Are we going to rule it out in 2017 because there is an election? Are we going to have to wait until 2018, when there is not an election, before we are prepared to have the courage to arrive at that consensus?
This is about more than just spending billions. In a slip of the tongue, Gil Paterson said that the SNP would spend an additional £380 billion this year on the NHS. Even if it did, I do not think that that would be enough, because this is about a culture, an attitude and a much more fundamental response to GP primary care, discharge, staffing levels, how we address the preventative agenda and the debate on alcohol that is required.
We are at a point where politicians collectively are on the verge of being held collectively in complete contempt on the NHS by people outside the chamber. Time is running out for us to arrive at the consensus that we have all agreed that we need and which Alex Rowley rather heroically addressed.
16:33
One of the most notable things about the debate is how few Labour members have been here for most of the afternoon, including Jenny Marra for vast parts of it. I wonder whether that reveals an acknowledgement that this week has not been handled particularly well. I hope that Labour learns from that experience.
Alex Rowley was notable and stood out by giving a speech in a very different tone. I absolutely acknowledge that there are challenges with the NHS and that sometimes things do not go as we would want them to go. That will always be the case with an organisation of that size that treats so many people.
However, the issue is about balance. Alex Rowley presented a balanced view of the report on the Victoria hospital in Fife, but we do not hear that balanced view from the rest of the Labour Party; we hear only a negative view, with Labour using information to tell a certain story. Labour needs to take a long, hard look at itself in that regard.
I will turn to issues that various members raised. Jim Hume said that he hoped that we would not hide behind a load of figures after 3 March. We cannot win. On the one hand, we are criticised for not providing enough information and, in the same debate, we are criticised for providing too much. I assure him that we will put as much information as necessary on to the system. However, it is important that we ensure that it is usable by the public. We want the website to be usable by not only politicians but the public.
I was making a point that Christian Allard made as well. Releasing the figures weekly will give all of us a chance to analyse them better than we have been able to under the present system, which has resulted in superstats Tuesday, when we have tried to get over a huge wall or mountain of figures.
That is why NHS performs will tell the story about the performance of the NHS in a way that will be more accessible to the public.
Bob Doris reminded us that the SNP Government ended Labour’s hidden waiting lists. He also reminded us of the good story that there is to tell about the reduction in mortality statistics, which is particularly notable in Glasgow. The Glasgow hospitals have performed extremely well.
Bob Doris talked about the fact that the Government established the Healthcare Environment Inspectorate. It goes into hospitals and produces reports that can make for uncomfortable reading, but that is the right thing to do because, if we do not know what the problems are, we cannot address them.
Rhoda Grant talked about a number of things that I will pick up on. She talked about births in Skye. There have been pressures there. The pressures on midwifery staffing because of illness have caused difficulties that have led to the service being suspended while those issues are resolved. However, it is important to note that the safety of mothers and babies was paramount, and I am sure that Rhoda Grant would not suggest that an unsafe service was provided. I know that the NHS board is working extremely hard to get the service back up and running. I hope that Rhoda Grant will give it her support in doing that.
Rhoda Grant talked about endoscopy in Skye. The new hospital will have new endoscopy services and facilities, but she failed even to welcome the announcement of the new hospital. That proves my point about the lack of balance in the Labour Party’s narrative on the health service. There is another new hospital in Rhoda Grant’s area, in Aviemore, but, again, there was no mention of that whatsoever. That leads us to suspect that Labour has one narrative, which is negative and never positive. Labour has been well and truly found out on that.
Neil Bibby raised a lot of questions that I am sure that he will appreciate that I will have to respond to in writing, given the detail that is required. He has a point about the Royal Alexandra hospital. Its space is tightly constricted, and we have to consider how we can improve the patient flow in the hospital. I assure him that the team that is in there is considering that extremely carefully. I will write to him with some of the detail.
Gil Paterson reminded us of the high levels of patient satisfaction, which we should welcome.
Christian Allard mentioned the visit that I made to Grampian on Monday, when I met the area partnership forum and the staff side. There is a culture of change in Grampian. While recognising that there is a road still to be travelled, the staff talked about a different culture—one of openness—and they are very much engaging in that process. I am optimistic about the progress that will be made in that health board area.
Anne McTaggart talked about transport issues. Transport issues have to be resolved at the new south Glasgow hospital, but the health board is only part of the solution. Glasgow City Council is also a major part of it, but she did not talk about that. Again, there is a lack of balance when addressing issues that we must address.
Stuart McMillan asked about the costs and resources for the statistical analysis on the website. We are supporting ISD Scotland to do that and, of course, if any support is required beyond its current capability, we will consider that.
I have mentioned Alex Rowley. He came to see me to talk about local issues and I hope that he found that meeting as constructive as I did. The thing to remember is that the success of integration in Fife also relies on Fife Council playing its part. It is important to bear it in mind that, from 1 April, NHS Fife and Fife Council will be jointly responsible for many of the issues.
A lot has been said and some constructive points have been made. There has perhaps not been much consensus, but that is because of the tone and context of the motion. I am keen to bring debates to the Parliament and to build a consensus, but that has to be a two-way process; it cannot come just from the Government.
Labour has to take a long, hard look at itself after what has happened this week. If it is serious about being taken seriously on the NHS, it must change its tone, because it is not being taken seriously, not least by the staff in the NHS, who see it as negative, carping and having nothing positive to say about our health service. The one thing that is clear from the debate is that Labour has proven that sorry is the hardest word to say.
I call Dr Richard Simpson. Dr Simpson, you have until 4.43—almost 10 minutes.
16:42
Did you say 4.43 pm or 4.53 pm?
It is 4.53 pm. I will give you a little more.
I will try to hurry up, Presiding Officer.
In the past few months, we have seen a Government that is driven by the realisation that it needs to concentrate on a deteriorating NHS whose hardworking staff are very stressed, as Jackson Carlaw said. Thanks to our staff, progress has undoubtedly been made.
I did not get to intervene on Christian Allard, but I say to him that Audit Scotland calls NPD simply another form of public-private partnership, so he should be careful about what he says.
Planning well ahead is imperative. As Anne McTaggart said, the parking problem at the new Southern general hospital mirrors the problems that we had at the Forth Valley royal hospital in Larbert, which were severe. Nurses complained to me bitterly that they felt unsafe going home at night. The Government has had five years planning the Southern general and parking should have been planned for—as, indeed, should the public transport, which has still not been approved.
Will Richard Simpson give way?
I will not give way at the moment. Let me make a little progress.
Of course there has been progress since 1999 under Labour and the SNP. The HEI and HIS inspections of services for the elderly are welcome and, as Bob Doris said, the patient safety programme has made a big contribution to reducing mortality. I welcome all those things. We started the patient safety programme and the SNP has continued to develop it; it is excellent. We initiated the staff partnership system to which Shona Robison referred in her closing speech. The SNP has continued it and it has been applauded by the King’s Fund as one of the best bits of practice in working with staff.
I have to say to the SNP that, if I had been making this speech in 2010, I might have been more laudatory but, since 2011, many elements have been going backwards. Multiple shocks, as Jackson Carlaw called them, are becoming more frequent. It might not yet be quite a crisis, but it is getting there. Actually, Stuart McMillan used the word “crisis” more than any of us, although it was in a different context.
Alex Rowley reminded us that the problem is not the staff but the Government’s need to listen and not be in denial. One point of agreement that I have with Nanette Milne is that we cannot just consider one part of the system, such as the GP out-of-hours service; we need to consider the whole pathway.
There is a pattern to this Government’s response to issues. First, it blames Labour and it blames us for raising the issues. Secondly, it is becoming adept at playing the whack-a-mole game, which I was not familiar with until my grandchildren told me about it. For those who are not aware of the game, moles pop up at random in a series of holes and have to be hit on the head with a mallet.
There are two aspects of the game that apply to this Government. As soon as it identifies a problem, it throws some money at it in the hope that it will disappear—£50 million for A and E, £40 million for GPs, £40 million for the new medicines fund, and money for delayed discharges. Then the Government turns around looking for applause and for us all to admire its skill in whacking the mole.
Will the member give way?
Not at the moment, but I will later.
The second part of the game, which applies here and is the subject of the debate, is the apparently random nature of the appearance of those moles. The Government sometimes seems astonished that they deign to appear at all. However, the lack of information that the Government has portrayed is, of course, not entirely real, as we have found. That aspect falls into three parts: the first is the information that the Government has but has not given us—that applies to a number of issues; the second is the information that, once revealed, requires action; and finally there is the information that the Government does not have and does not really want to have, as it might provide a more unpalatable truth. Let us examine those in turn.
Labour knew that the boards reported weekly on accident and emergency waiting times. How did we know? We asked the boards in an FOI request and two boards—only two—were honest enough and open enough to provide us with a template of their weekly reports to the Government. It was only once that fact was uncovered, as Jim Hume said, that the Government agreed to publish the A and E figures—sorry, not the Government; the chief statistician.
We also know that the same weekly return includes delayed discharges figures because they were on the same template, so I welcome what I think was the cabinet secretary’s announcement today—without waiting for the chief statistician—that she will indeed publish that information, since delayed discharges are one of her highest priorities.
Then there are the figures that are published sometimes quarterly, sometimes annually, or sometimes even longer in arrears. However, the Government often had that information long before the public. Let me illustrate. There were the problems such as Lanarkshire’s hospital mortality record or the problems in Grampian. Once those statistics finally emerge, the Government says—
Will the member give way?
No. I was not able to make an intervention when Mr Allard was speaking.
Once those statistics are finally published, the Government says, “Look, we have acted. We have sent in Healthcare Improvement Scotland,” and then it wrings its hands and says, “We deplore what happened.” Is that acceptable or not? It is unacceptable.
Will Richard Simpson give way?
Yes, I will.
I note that the animal rights people will no doubt be on Richard Simpson’s back after his mole analogy.
On the one hand, Labour members come to the chamber time and again to demand that we take action on various things but, on the other hand, Richard Simpson seems to be criticising the fact that we gather information in order to be able to take action. Surely it is right that we take action when issues arise.
I thank the cabinet secretary for her intervention but she misses the point. I am saying that the information was available to the Government a long time before it was available to the public.
I welcome the suggestion in the SNP press release that it will look at reporting timeously—as has been confirmed by the cabinet secretary—on all the material that it receives. I ask the cabinet secretary to publish a list in the next 48 hours of all the data that the Government receives so that we can then judge that against her promise of openness and transparency.
There are times when the Government hoped that perhaps we would not notice the data, such as during the waiting times scandal, when the data showed such variation as to beggar belief. The Government delayed and obfuscated when I raised the issue, and it acted only when forced to do so by brave and determined whistleblowers.
Some data is never published and requires FOI requests. The cancelled operation data is one example. I raised that FOI request for one reason. A nurse approached me to say that one of her patients had his amputation operation cancelled within an hour of when he was due to go to surgery. That may have been for clinical reasons; it may have been for non-clinical reasons. However, I ask members to think for a minute about being faced with an operation involving the amputation of a limb, being prepared for surgery, and then, within one hour of going to surgery, being told, “No, you can’t have that operation,” and having to go home and wait for the next operation appointment.
Whether an operation is cancelled for clinical or non-clinical reasons—I do not really see what the difference is—it really is a problem, but now—
Christian Allard rose—
Shona Robison rose—
No, let me finish this bit, and then I will let you in, if I may. Now—[Interruption.]
Let the member finish.
Now, what did we learn? The Government, in rebutting our interpretations of the figures that we got on FOI, has actually produced all the figures for the last six weeks up to the middle of February. It had all that data; we did not. [Interruption.] Yes, members may groan and say “Oh!”, but that is what this debate is about. It is about the revelation of information that the Government had under its hat and did not publish.
There seems to be a failure—
Will the member take an intervention?
Very briefly.
Richard Simpson should understand that there is a big difference between clinical and non-clinical reasons for cancelling operations. Clinical reasons are those that a doctor deems to be so, and to compare those statistics with English statistics that included only non-clinical reasons was absolutely a disgrace. Will you apologise for it?
If the cabinet secretary apologises for the fact that she has been hiding statistics. [Interruption.]
A little bit of order, please.
We turn to the Royal Alexandra hospital, which Neil Bibby asked a series of pertinent questions on. I can tell the cabinet secretary that I talked to the staff there, and they told me that the consultants are having to act down in order to fill gaps in the middle-grade rotas. That is unsustainable and it was always unsustainable. It does not take putting in a support team to recognise it. The managers on the spot should have recognised it and recognised the pressure. If we had had the figures on the A and E problems at RAH on a weekly basis, we would have raised the issue sooner.
The fundamental problem, which I will finish on, is that we are in a situation in which there does not seem to be a complete realisation within the Government’s health department that we have moved from a system in which we collect data and publish it in retrospective form to a situation in which we are in a new world of informatics in which there is real-time data.
As Jenny Marra said, the NHS ambulance service has recognised that, and it updates its website every 15 minutes. NHS 24 is pretty good about publishing its information timeously as well. However, we need to have a full review of what statistics are collected, how they are collected and when they are published. Obviously there will be caveats for some of them—
Oh really?
Yes. Nevertheless, information is needed. It is needed primarily by the clinicians to improve their outcomes, secondly by patients to see what is actually happening, as they are the ones who suffer when operations are cancelled, and thirdly by the politicians so that we can hold the Government to account. We are third in line. This is not about the Labour Party that has been attacked on the issue; this is about all of us raising issues that have been brought to us by patients, staff and the public.
I want to finish on a consensual note by welcoming the fact that we are going to have published statistics that are not just weekly but are also the most public statistics ever. If we get that—we will hold the Government to account on that statement—I welcome it. I have yet to see the proof of that pudding, however, and the Government’s hiding of the delayed discharge information, even when it had announced the A and E issue, is an indication that it has not yet really got the message. I support Labour’s motion.
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