The final item of business is a members’ business debate on motion S6M-19548, in the name of Finlay Carson, on the growing tide of on-going challenges facing rural communities.
The debate will be concluded without any question being put. I encourage members who wish to participate to press their request-to-speak buttons.
Motion debated,
That the Parliament notes the reported ongoing challenges faced by rural communities, including those in Stranraer, Wigtownshire and across Dumfries and Galloway, in accessing timely and high-quality healthcare; believes that people in these areas often experience longer waits for GP appointments, hospital treatment and emergency services, compared with the national average; expresses particular concern about the reported current shortage of GPs in Wigtownshire, which is placing additional strain on practices and impacting patient care; acknowledges the additional pressures on NHS boards and staff in delivering care across large geographic areas; notes the view that every person, regardless of where they live, should have equal access to essential health services; further notes the calls on the Scottish Government to set out clear plans to tackle rural health inequalities, including measures to recruit and retain healthcare professionals, including what it sees as much-needed midwives and dentists, address GP shortages, improve ambulance response times and expand diagnostic and treatment capacity in Galloway Community Hospital and other community health hubs, and notes the calls for both an increased provision of community beds and step-down facilities to reduce delayed discharge and enable care closer to home, and for the Scottish Government to work with communities to ensure that future health policy reflects the needs of rural Scotland.
17:43
I thank all those members from across the chamber who supported the motion.
I will be clear: rural Scotland, in particular areas such as Stranraer and the Rhins in Dumfries and Galloway, have been let down, not by geography but by Government choices. Those choices have stripped away vital health and care services without ensuring that replacements were ready, and they have left families facing a worsening health care crisis.
For years, I have warned that the greatest threat to rural healthcare is not distance; it is a chronic failure to recruit and retain the workforce that is needed to deliver care. That failure lies squarely at the door of the Scottish National Party Government.
What is happening in Wigtownshire? General practitioner shortages are critical. Just recently, the Mull of Galloway practice handed in its notice. Patients in Stranraer wait weeks for an appointment, if they can get one at all. When people cannot access primary care, conditions worsen and hospitals come under greater pressure.
Ambulance response times in the Rhins are longer than the national average, not just because of geography but because crews are stretched to breaking point. Paramedics are hard to recruit locally, and those who join the service face impossible workloads. At Galloway community hospital, diagnostic and treatment capacity is limited, and the birthing suite has gone, so some mothers now have to travel to Dumfries to give birth, fearing that their babies might arrive in the car. That is not progress—that is neglect.
Jason Jordan, who is the assistant general manager at Galloway community hospital, recently said:
“We have an outstanding team of staff working at the Galloway and every effort is being made to deliver a first class service.”
He is right—the staff are outstanding. However, there is still too much reliance on Dumfries and Galloway Royal infirmary, which is almost two hours away. The consequences of poor planning are clear. We have had cottage hospitals close, but promised community hubs and step-down facilities have yet to materialise. The result is delayed discharge and bed blocking.
I spoke to a constituent from Newton Stewart who should have been discharged, but had nowhere to go, because the local cottage hospital had closed and there was no funding for home adaptations. He spent months stuck in an acute ward, blocking a bed that he knew that someone else needed, and he felt guilty about it.
That is what happens when services are dismantled before alternatives exist.
NHS Dumfries and Galloway faces a £58 million funding black hole. Integration joint boards are staring at cuts that make it impossible to invest in community care or recruit staff. Those cuts are not just numbers—they mean fewer services, longer waits and more worry for rural families.
The Government promised 800 new GPs by 2027, but there is no sign of those GPs. Rural practices are struggling—vacancies remain unfilled and community pharmacies are under pressure to try to pick up the slack.
That is not workforce strategy—it is workforce crisis, yet the Government’s response is more reports, more consultations and more talking shops. As Dr Gordon Baird from the Galloway community hospital action group said:
“You can’t fatten a pig by weighing it.”
Scotland does not need more reviews—it needs action.
I make it clear that none of those failures are the fault of our local NHS staff or ambulance crews, who are doing an incredible job under impossible circumstances, working long shifts and driving hundreds of miles to deliver care. They deserve praise, respect and support, not the constant pressure that is caused by poor planning and underfunding. They are heroes, but heroes cannot hold up a broken system forever.
What needs to happen? The motion calls for a clear, funded plan to tackle rural health inequities. That means recruitment and retention incentives, including housing support, relocation packages and career development for rural posts. If we want doctors, nurses, midwives and paramedics to come to rural Scotland, we need to make it attractive and sustainable. We need to restore local capacity and ensure that no service is removed until a replacement is operational and staffed. There should be no more dismantling maternity units, leaving women with few safe alternatives, and no more closing cottage hospital beds without alternative step-down facilities in place. That means investing in community beds and step-down facilities, which would prevent delayed discharge. That is just much about patient dignity as it is about freeing up acute beds.
I acknowledge that there have been improvements to service provision at Galloway community hospital, which have been driven by the wonderful staff, but we need to see evidence of expanded diagnostic and treatment capacity, with the workforce to deliver it. That would restore confidence among local people that they can access care close to home. We need to rural proof planning and staffing, recruiting and training paramedics locally and ensuring that resources match geography to improve ambulance response times.
As a Gallovidian through and through, and a rural Conservative, I, along with my colleagues, have made a commitment. Tomorrow, voters in Stranraer and the Rhins will choose a new representative. Julie Currie, our Conservative candidate, brings NHS experience that will deliver on our Conservative commitment—
Mr Carson, I caution against electioneering in the chamber.
My apologies, Deputy Presiding Officer.
Scottish Conservatives believe in fairness, and where someone lives should never determine the quality of care that they receive.
That is why Scottish Conservatives are calling for a rural health guarantee; equal access to essential services for every patient, regardless of postcode; a workforce action plan that incentivises recruitment and trains staff in rural areas, not just empty promises; and investment in community-based care, because care closer to home or in the home is better for patients and for the NHS.
The Government has had years to fix that—instead, rural communities have been treated as an afterthought. They pay the same taxes as everyone else and they deserve the same standard of care, yet right now, they are being asked to accept less—less access, less choice and less safety.
It is about equality versus equity. Rural communities are not asking for equality—they are demanding equity. Equality assumes that giving everyone the same resource will produce the same outcome, but that ignores the unique challenges that rural areas face, such as long travel times, a limited workforce and smaller hospitals.
Equity means tailoring support so that rural patients have the same chance of getting timely, safe care as those in urban centres. That requires additional investment, flexible service models and a recognition that one-size-fits-all policies perpetuate disadvantage rather than solve it.
I say this clearly: rural Scotland will not be left behind; we will not accept the dismantling of local services without replacements in place; and we will hold the Government to account until every patient, wherever they live, has equitable access to care.
I advise members that there is a lot of demand to speak in the debate. I am conscious that we have already been late in starting, so I will require members to stick very much to their speaking time allocations if I am to get everybody in. I call Christine Grahame, to be followed by Douglas Ross.
Deputy Presiding Officer, can I go after the next speaker? I am having technical difficulties with my Surface laptop.
I think that we can do that.
Thank you.
Assuming that he is ready to go, I call Douglas Ross, to be followed by Christine Grahame.
17:51
I am always happy to accommodate Christine Grahame in any way that I can. I am also delighted to contribute to the debate, which has been brought to the chamber by my friend and colleague, Finlay Carson, who has very ably articulated the problems in his constituency in the south of Scotland.
I will take us up to Moray, in the north-east of Scotland, and talk about some of the problems that we are experiencing there. I could highlight so many issues in the debate, but I will focus on just two.
The first issue concerns the on-going campaign by the save our surgeries Burghead Hopeman group. I have raised this matter time and time again in the chamber, and we have meetings with the Cabinet Secretary for Health and Social Care and with the Minister for Public Health and Women’s Health; I am sorry that neither of them are in the chamber, but I will relay the debate to them and highlight the issue again.
We have a proposal from a campaign group made up of people who want to see a difference in their community. They have been met with challenges—their local surgery has shut down, and they have come up with an alternative, but they continue to come up against obstacles from the Scottish Government, Moray health and social care partnership and others. There is currently a proposal from the group sitting with Scottish Government, but it has had no response. I urge the Minister for Drug and Alcohol Policy and Sport, after the debate, to go back to her officials in the health department to get a response for the save our surgeries Burghead Hopeman group.
I have tried the same with the new chief executive of NHS Grampian—I raised the plight and the campaign of the save our surgeries group with her when I met with her a couple of months ago, and I am still waiting for a response for the group from NHS Grampian. I urge the minister and NHS Grampian to engage constructively with SOS Burghead Hopeman, because it has plans that can improve local healthcare. Those plans are innovative and they could make a real difference to those two communities, and I hope that they are taken seriously.
As ever, Mr Ross is speaking up for his rural constituents.
What do you think that viewers of the debate tonight should read into the fact that not one single SNP member supported the motion that brought the debate to the chamber, and the fact that the SNP and Labour benches are very sparsely attended tonight?
Always through the chair, Mr Hoy.
I think that it is very disappointing. I will listen closely to the speeches from SNP members when we hear them. However, I note that we have members’ business debates to try to get cross-party support. Sometimes we do not always agree with every word in a motion, but I have supported SNP motions to allow a subject to be debated. I am grateful that Finlay Carson was able to get support in order to have this important topic debated in the chamber, but I think that people will look around and see the vast number of empty seats in the middle and on the other side of the chamber, and wonder why those MSPs are not here to raise constituency concerns on healthcare issues.
In my final minute, I will relay the details of a case that I have already articulated to the cabinet secretary; I have provided him with further information. It highlights what we are facing in Moray. A father and husband had a heart attack on Saturday 1 November. He stayed in the accident and emergency department at Dr Gray’s hospital, where he was based, for four days, in completely inappropriate conditions. He was transferred to Aberdeen Royal infirmary on Thursday 6 November. He was told that he needed an angiogram, but the Scottish Government has told NHS Grampian that it will not pay for angiograms to be performed at the weekend. I want to know why, in one of the biggest health boards in Scotland, we are we not performing that important procedure at the weekend.
He had to wait until the following Monday—he got his angiogram, and was released on Tuesday 11 November, well over a week later. Why was that treatment and vital test delayed, and why was he then forced to find his own way home from Aberdeen to Moray? The family has put forward a very sensible solution: that we look to have a shuttle bus between the ARI and Dr Gray’s, or back to Moray, so people can use that type of facility to get to and from those two medical centres, rather than having to rely on the goodwill of friends and family. I think that it would make a real difference if the minister could take forward that solution, too.
I am not getting an indication from Ms Grahame that she is ready just yet, so I will call Craig Hoy, and possibly come back to Christine Grahame after that.
17:56
I thank Finlay Carson for bringing this important debate to the chamber. Today, we are talking about one overarching issue: the SNP’s neglect of rural Scotland. It is a neglect that is based not on geography, history or economics, but on one thing only: constitutional politics, because for years, the SNP has systematically and cynically neglected the rural parts of Scotland that do not support independence. Areas such as Dumfries and Galloway, the Scottish Borders and Aberdeenshire have been forgotten about by a Government that values independence-supporting central belt areas and communities more than it values the communities that I represent.
The numbers speak for themselves. In March, Dumfries and Galloway councillors were forced to find £30 million in savings over three years, blaming what they described as “an unprecedented funding gap”. As has been made clear, NHS Dumfries and Galloway is currently trying to find £58 million in cost savings, otherwise it will be cutting front-line services. I say to the minister that there is no clearer case of SNP neglect of rural areas than the challenges that are currently faced by Dumfries and Galloway Council, but the chickens have now come home to roost, for the council is now run by a minority SNP administration, which is having to clear up the mess that was created by SNP central Government.
That is the reality on the ground. Rural bus funding has been systematically cut, and the SNP council leader is now begging ministers for additional cash as lifeline supported services face the axe. Rural primary schools have been systematically underfunded, with the closure of some village schools and the loss of headteachers, who have been replaced by pool teachers, and the removal of additional support needs provision entirely from rural schools, forcing children into larger town-based settings. They include children such as those in a village who have had to move schools less than three years after their own school was closed.
There is systematic defunding of core services. This year, Dumfries and Galloway’s SNP council is being forced, by this SNP Government, to consider removing funding entirely from the citizens advice bureaux network. That is a saving of £1 million, which could result in the loss of £15 million in social and economic benefits that are delivered by the services that the citizens advice bureaux provide.
The cuts do not end there. Music tuition is at risk in Dumfriesshire schools, which means that only the privileged few whose parents can afford to pay a private tutor will be able to learn a musical instrument. There have been proposed closures of leisure centres, including Hillview leisure centre in Kelloholm, which will strike another blow to rural residents. It means the loss of a space where people can play sports, go to the gym and have community and social gatherings. That is a clear loss to a rural community, and it has been brought about by SNP neglect.
Today, I say to the SNP that enough is enough. It must call a halt to the chronic underfunding of rural public services, and it must stop diverting money elsewhere. The political motivation at the heart of Scotland’s resource allocation has to be brought to an end. Rural health services and rural councils must be properly funded with a fair funding formula, not the pork-barrel politics of John Swinney’s SNP.
Roads such as the A75 and the A76 need urgent action. The state of disrepair on rural roads has reached crisis levels on the SNP’s watch. My constituents—often elderly—are sick and tired of the SNP Government ignoring rural parts of the south of Scotland. They are sick and tired of seeing their services suffer while the SNP pump primes the areas of Scotland where it is buying votes to deliver on its only priority. That kind of SNP pork-barrel politics has to end because, under John Swinney, it is independence at the expense of all else, in particular the rural residents and the rural communities that I represent.
I see that Ms Grahame is still not ready, so I am going to call Rhoda Grant, and then Sharon Dowey.
18:00
I thank Finlay Carson for securing this important debate. His motion speaks about the impact of urban-based policies on Dumfries and Galloway, and that is reflected in my Highlands and Island region, where we suffer very similar challenges; I am sure that any member who represents any part of rural Scotland would say the same.
This week, in the Equalities, Human Rights and Civil Justice Committee, we took evidence from stakeholders from rural Scotland, who talked about access to services. They told us that car ownership is an necessity to enable people to access services, given the lack of public transport. Even where there is public transport, it can be unaffordable.
Accessing the health service is not free at the point of use, because the cost of getting there means that people cannot access the services that they need. Failure to attend can also mean that they come off a waiting list altogether. I was told by a constituent of a case in which an elderly resident could access hospital appointments only if they were made on her GP’s day off, so that her GP could drive her to the appointment. That is an absolutely crazy situation.
We were also told that although running a car costs around £50 per week, which adds to the cost of living in rural Scotland, it is necessary for people to carry that cost because it is the only way that they are able to access services.
I probably do not need to speak again about mothers from Caithness having to drive to Inverness to give birth. That journey is equivalent to driving from Edinburgh to Newcastle. If people do not have a car, they have to take a train or even a bus, and the journey is much longer.
I recently heard of a mother who, just a couple of days after delviering a baby by caesarean section, had to make a four and a half hour journey by train, on her own, carrying her newborn baby. I know that there are similar issues in Stranraer.
Another theme that came across as a major issue when we heard from witnesses in committee was housing. There is little or no affordable housing in rural Scotland for local people, in order to allow them to stay in the areas in which they were brought up, and many are being forced to move away. That was also raised as an issue with regard to recruiting staff to provide essential services. People would apply for posts, and some would even start work, only for them to find that they could not find a home and were forced to leave. Rural health and care services are left to depend on expensive agency staff and, in many cases, those services cannot run at all.
All of that leads people to leave, and the problem becomes a downward spiral of depopulation. Centralisation happens in all aspects of daily life in rural Scotland. We saw it with the centralisation of police and fire services, which have since retreated from those areas. Police stations have closed and retained fire stations are not staffed to a level that allows them to go to an emergency.
Those issues are replicated throughout all of rural Scotland. We need to find solutions that provide people in my region, and in Dumfries and Galloway and elsewhere in rural Scotland, with equitable access to services.
[The Deputy Presiding Officer opened the meeting at 14:00]