Health and Wellbeing
Respite Care
We should acknowledge that, overall, there has been an increase in respite provision.
The total provision of all forms of respite in Scotland in 2008-09, on a comparable basis with the 2007-08 data, stood at 174,030 weeks. That represents an increase of 1,150 weeks on 2007-08, when provision was 9,240 weeks more than that in 2006-07.
Delayed discharge is at one of its lowest levels ever, but we must of course always work to do more. I assure Helen Eadie that we are doing that.
I will write to Dave Thompson about the specifics of his questions. As for Highland’s contribution to the 10,000 extra weeks of respite provision, the commitment that it has delivered has stayed more or less steady; as is obvious, we encourage the area to do more. The challenge in Highland is delivering innovative respite provision in a rural area with a dispersed population. Future respite provision there is being discussed and I am happy to write to Dave Thompson with more detail about that.
No, there has not for children.
It is true that there has been an increase: we now have 174,030 weeks of respite; in 2006-07, the figure was 163,640 weeks. By anybody’s calculations, that is an increase.
The Scottish Government pledged in the concordat to deliver 2,000 additional respite weeks in 2008-09 and said in its manifesto that an additional 10,000 weeks per year would be provided, yet it delivered 1,150 additional weeks in 2008-09—as the minister said—which is about 50 per cent of what was promised. In the same period, the number of respite weeks for children with disabilities fell by 1,120 weeks, or 4.7 per cent.
What respite provision is made in the Highland Health Board area for carers of people with arthritis and psoriatic arthritis? What role in that does the Highland rheumatology unit in Dingwall play?
I am sure that the minister shares my concern at the drop in the amount of respite care provided for children. I accept and welcome the discussions with COSLA on the general target for respite care, but will she outline what specific action she will take to reverse the decline in respite care for children?
NHS Lanarkshire (Meetings)
My question relates to the norovirus season this year, which appears to be later and much more intense than in previous years. There have been significant ward closures. In the latest report, four closures are reported in the NHS Lanarkshire area, with 53 patients affected out of a Scotland-wide total of 257 affected patients.
Andy Kerr’s nerve knows no bounds. As Cabinet Secretary for Health and Wellbeing, I can stand here and tell him that we have the lowest rates on record of infection in our hospitals. That is not good enough, however—we still have work to do and I am determined that we do it. However, I know that we have the lowest rates of MRSA and Clostridium difficile on record. When Andy Kerr sat in my seat, he could not say that, because for most of his tenure as Minister for Health and Community Care, he did not even bother to collect the data on C difficile. That is the reality. Although I will repeat time and again that tackling infection in hospitals is my top priority, I will not take lessons from Andy Kerr and Labour members.
I meet all health board chairs regularly. The most recent meeting was on 22 February; the next one will take place on 29 March.
Respite (Carer Support)
In the past 12 to 18 months, 127 beds have been removed across NHS Highland, many of which were used for respite care. How can appropriate respite care be met against that background of cuts?
Respite care takes place in a number of settings, and I will certainly look into what has happened with the resources that have been freed up by the reduction in those beds. I know that Mary Scanlon has followed the discussions on the reshaping care for older people agenda, which is very much about moving resource from the acute sector into community provision to ensure that community-based services, whether in home-like settings or the person’s own home, can be provided. I will certainly look into the issue that she raises in more detail.
Given the feeble and patchy progress towards the manifesto commitment to provide an additional 10,000 weeks of respite care, is the minister aware that many carers report problems, such as having been made to jump through hoops to access respite care? Some carers get little or nothing at all, and some carers tell me that they have never had a week’s family holiday. What will the minister do to ensure that the money allocated by the Scottish Government to meet the needs of carers is used for that purpose?
The concordat commitment to extra respite weeks is at a national level rather than at the level of individual councils. That said, I am disappointed at the extent to which significant reductions in provision in a few council areas have offset the good progress that has been made by others. If those authorities had just held their provision steady in 2008-09, the overall provision in Scotland would have increased by a further 6,500 weeks.
First, I recognise Cathy Peattie’s long-standing interest in the issue.
Nurses and Midwives (Employment)
The scheme is welcome and has been in place for eight or 10 years. Is the minister aware of growing concerns over the past six months about health boards not recruiting to nursing and midwifery posts? Does she have access to the most up-to-date information on that and, in particular, does she know how many posts are under review and how many are being actively recruited to?
If Ken Macintosh wants to write to me on that last point with his specific concerns about access to the midwifery bank, I will be more than happy to look into them.
We have a one-year job guarantee scheme for nurses and midwives who, through no fault of their own, have difficulties finding employment. The scheme is designed to ensure that all newly qualified nurses and midwives have the opportunity to build on the clinical experience that they gain during their pre-registration programme.
Junior Doctors (Recruitment in Remote and Rural Areas)
As I said, the application rates for the 2010 round of applications for junior doctor posts are healthy. I will give the member some information on that. For the 423 posts that are recruited for in Scotland—the remainder are recruited for throughout the United Kingdom—there have been 2,854 applications, which equates to a ratio of around five and a half applications per post. I understand Rhoda Grant’s point, but the indications at this stage of the recruitment process are reasonably healthy.
The recruitment of junior doctors into postgraduate training programmes is managed nationally by NHS Education for Scotland. The process for 2010 is under way and application rates are good, at around five applications for each post. NES has developed a marketing strategy that includes material on training and working in remote and rural areas.
I thank the minister for that response, but she will be aware that there are real concerns about the lack of junior doctors and the impact that that will have on health care in remote and rural areas. A shortage of doctors could lead to some services in those areas becoming unsustainable.
The cabinet secretary will be aware of—indeed, she has mentioned—some of the issues around recruiting doctors to some of Scotland’s smallest and most remote practices. Those include island practices such as that in Pairc on Lewis. What will the Scottish Government do to ensure that the particular issues that face island practices are addressed?
Alasdair Allan is right to point to the particular challenges for island health boards. Some of the initiatives that I mentioned in response to Rhoda Grant’s question are as relevant and applicable to island boards as they are to more remote parts of mainland Scotland.
Dounby Community Pharmacy (Decision)
NHS Orkney’s decision last week to reject NorsePharm’s application, which the minister mentioned, has been broadly welcomed in my constituency, although concerns remain in relation to the prospect of an appeal.
Decisions in relation to applications to provide national health service pharmaceutical services are matters for the relevant NHS board. However, I am aware that NHS Orkney issued a news release on 12 March that indicated that the application to which the member refers has been rejected.
I am not aware of any new application at the moment, although that does not mean that there will not be any. Under the current legislation we cannot prevent applications altogether, whether it is for the same premises or for the same neighbourhood, simply on the basis that a previous application has been rejected.
Dentists (Aberdeen)
Responsibility for the overall provision of national health service dental services in the area rests with NHS Grampian. The board is undertaking a range of measures to improve access to NHS dental services in Aberdeen, including the opening of the Aberdeen dental school facility in January this year. The number of dentists has increased from 270, as at September 2007, to 304 as at September 2009.
I thank the minister for informing the Parliament of the increase in the number of people who are now registered with NHS dentists. Can she tell us what further consideration has been given to making it more attractive for dentists to add to their NHS patient lists or to open their lists to NHS patients?
Good progress has been made with the target for the registration of three to five-year-olds. The HEAT target has been exceeded in Aberdeen City, with 94.7 per cent of children aged three to five years registered with a dentist under NHS arrangements.
There are already a number of incentives, including golden hellos, and allowances for areas of deprivation and rurality. We can always consider how to use those allowances to get dentists to go to the areas that remain a challenge.
I welcome the last part of the minister’s comments. Can she tell me whether, in Aberdeen and elsewhere, there is any record of dentists who left the NHS ever returning to the service? Has she given any consideration to how such dentists might be attracted back?
I can certainly find out whether that information exists—I am not sure whether it does—and write to the member about that.
I appreciate some of the positive measures that have been taken by NHS Grampian, and I particularly welcome the opening of Aberdeen dental school, but there remains a dental health crisis in the city of Aberdeen. The Government has a core NHS target—a health improvement, efficiency, access and treatment or HEAT target—that 80 per cent of children aged three to five should be registered with an NHS dentist by 2010-11. The figure in Aberdeen South is currently 31.5 per cent, a worryingly low figure that will alarm many MSPs. That is one of the poorest levels of provision in the whole of Scotland. Does the minister expect the Government’s target to be met in Aberdeen South? If so, how will that be achieved?
Suicide (Young People)
Certainly, the feedback that I have received from travelling the length and breadth of Scotland is that very hard work is being done on the choose life agenda not just by local authorities but by NHS staff and others. Tackling the issue that Richard Simpson has highlighted is certainly a core component of what the choose life programme sets out to do through delivering awareness-raising sessions on self-harm and promoting mental health and wellbeing in schools. In addition, we have just invested in child and adolescent mental health services to ensure that children who require additional support get the service that they need. Richard Simpson will acknowledge that that welcome investment was not made previously.
What specialist training in suicide prevention is currently available to those who work with children and young people, and what is being done to increase the uptake of such services? Also, have any lessons been learned from the targeted national strategy for suicide prevention in the United States?
On the member’s last point, I can assure him that we are always looking at international evidence to see what we can learn from elsewhere. However, many people have been coming to Scotland to look at our choose life programme. For example, Northern Ireland has by and large based its service around the lessons that have been learned from developments here in Scotland.
The minister mentioned the choose life programme. As she will be aware, research by Professor Rory O’Connor of the University of Stirling suggests that 14 per cent of Scottish pupils have already self-harmed and a further 14 per cent have had serious thoughts about doing so. Will she comment on the fact that, since ring fencing ended, funding for choose life programmes has been reduced by some authorities, including Western Isles Council and Highland Council, which have the highest suicide levels not just in Scotland but in the whole of the United Kingdom?
Children and young people have been a priority group for suicide prevention work in Scotland since 2002. We have a number of measures in place to address the issue. We provide grant funding of £130,000 per year to ChildLine Scotland to support its on-going operation, through which trained volunteer counsellors comfort, advise and protect children and young people who may feel they have nowhere else to turn. We are also working closely with NHS boards and other partners to fully implement “The Mental Health of Children and Young People: A Framework for Promotion, Prevention and Care” by 2015. That includes making a named mental health link worker available to every school to ensure that the mental health needs of pupils are identified at the earliest possible opportunity and that links are in place to child and adolescent mental health services.
Dental Care
The minister’s answer seems to have cleared the public gallery of all the young folk who were there. Perhaps they are heading off to the dentist.
I am sure that the oral health of the children who have just left the public gallery is perfect because of the chil- smile investment that we have been making in schools the length and breadth of Scotland.
We are making substantial progress towards meeting the dental action plan target. Figures from “The Scottish Health Survey 2008” show that 88 per cent of adults in 2008 had all or some of their own natural teeth. The 2010 target for 65 per cent of adults aged 55 to 74 to have some of their own teeth has already been exceeded. In 2008, 81 per cent of men and 75 per cent of women had some natural teeth.
Western Isles Hospital (Power Failures)
It is important to be clear that the recent power issues that were experienced at the Western Isles hospital were the result of a faulty circuit breaker on the hospital site as opposed to a fault with the mains power supply. Nonetheless, I know that NHS Western Isles worked assiduously with its partners, including Scottish and Southern Energy, to rectify the problem as quickly as possible. I have been further assured that the board’s contingency measures minimised the impact on patient services while maintaining clinical safety.
Although the power failures did not pose a risk to patients’ health, they raised serious questions about the fragility of the electricity infrastructure in the islands. Will the Government keep up a dialogue with SSE and other agencies to ensure that such problems do not occur again?
I expect NHS Western Isles to do that in the case of its own power supply. The member will be aware that there were four short supply failures at the Western Isles hospital between January and July 2009. In all four instances, the backup generator kicked in and there was no impact. However, more recently, a problem with the circuit breaker was discovered, which meant that, in the event of a mains failure, the hospital would not be able to switch to the emergency generator—that could be done manually, but it would take 15 minutes. That is what required the contingency measures to be put in place.
Asylum Seekers (Housing)
George Foulkes makes a valid point, and I appreciate the initiative that he has taken with Lord West. I am happy to raise the issue at my next regular meeting with COSLA to see whether something more can be done on this issue.
I thank the minister for his helpful reply. My question is also meant to be helpful.
Housing for asylum seekers in Scotland is a matter for the United Kingdom Border Agency and Glasgow City Council, as it is the only local authority in Scotland to have a contract with the UKBA to provide accommodation to asylum seekers. However, Scottish Government officials regularly attend the multiagency move on group, which includes Glasgow City Council, the Convention of Scottish Local Authorities’ strategic migration partnership, Glasgow Housing Association, YMCA Scotland, the Scottish Refugee Council and Jobcentre Plus. The group was initially set up in 2007 to address the issues resulting from the case resolution process. However, it continues to meet to discuss emerging issues in relation to asylum seekers and those recently granted refugee status.
NHS Greater Glasgow and Clyde (Meetings)
I last met representatives of NHS Greater Glasgow and Clyde on 16 March 2010 when I performed the sod-cutting for the new Southern general hospital.
Apologise!
Statement!
In the spirit of the undertaking that the cabinet secretary gave a few weeks ago to adopt a political style that is less judgmental and more collaborative, will she indicate what discussions she has had with NHS Greater Glasgow and Clyde about how to maximise the potential health benefits of the 2014 Commonwealth games? Will her department look positively on working with local schools, such as St Mungo’s academy and Eastbank academy, on ways in which to promote good health and wellbeing across the east end, particularly in relation to young school pupils?
I could say that the Eastbank academy pupils left the gallery in anticipation of Frank McAveety’s question, but that would not be in keeping with my new consensual approach to politics, so I will not go there.
As always, I say that I am sorry to Jack McConnell—for what, I will not go into.
Moving swiftly on, Frank McAveety raises an important point, and I am grateful to him for the way in which he raised it.
NHS Lothian (Meetings)
I met the senior team of NHS Lothian on 5 October 2009, when I chaired the board’s annual review. The board’s performance on key national health targets, including health improvement, efficiency, waiting times and service changes were discussed.
In today’s West Lothian Courier, Scottish National Party councillor and Lothian health board member Peter Johnston says that
I say to Mary Mulligan as consensually as I can that I suspect that what Peter Johnston—the fantastic leader of West Lothian Council—was saying is that a hospital that under the previous Administration was drained of services step by step and drained of its life is now, under the SNP Administration, secured as an acute hospital within NHS Lothian. There have been a number of positive developments at St John’s. To give Mary Mulligan a couple of examples, there has been investment to develop the short-stay surgical centre and the endoscopy unit.