Plenary, 24 Jan 2002

Meeting date: Thursday, January 24, 2002

Official Report 747KB pdf

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First Minister's Question Time

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SCOTTISH EXECUTIVE

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Secretary of State for Scotland (Meetings)

To ask the First Minister when he last met the Secretary of State for Scotland and what issues they discussed. (S1F-1576)

I last met the Secretary of State for Scotland on 14 January and we discussed a joint approach to tackling the problem of the illegal use and trade of drugs in Scotland, among other matters.

I thank the First Minister for his answer. As more people die in Scotland as a result of infections acquired from hospitals than as a result of road accidents, and in a week in which dirty hospitals have caused misery to thousands of people, does the First Minister have any intention of restoring the 7,000 hospital cleaning jobs that have been lost in the past 15 years?

The question minimises the considerable action that has been taken since the Parliament was established to deal not only with hospital-acquired infections, but with cleaning standards in our hospitals and health establishments. The establishment of the Clinical Standards Board for Scotland in April 1999 was a significant move forward in the setting of national standards for care and treatment in our hospitals and health establishments. The Executive's decision—which was supported by the Parliament—to ensure that the board had responsibility to see through national standards in cleaning hospitals and in infection control from December 2000 was a significant step forward.

This time last year, Mr Swinney made the pertinent point that we did not have the statistics on infections to monitor the situation properly. The Executive is acting in that area, too, ensuring that there are statistics to allow us to monitor the problem and to take the action that is required to reduce infection and improve cleaning standards in Scotland's hospitals.

We certainly have the statistics. They show that the number of cleaning staff in the national health service has decreased from 11,000 to 4,000 over the period that I mentioned. On Tuesday, the Minister for Health and Community Care said on the radio that many of those contracts were contracted out to the private sector

"on the basis of cost rather than quality".

If the problem is the result of those contracts going out on that basis, the First Minister is not delivering the clinical care and hygiene standards in hospitals. Is not it time that he started to put patients before profit and restored those jobs?

That is an outrageous assertion by the leader of the SNP. In the national health plan that was launched and debated in the Parliament in December 2000, it was clear that there would be a change in the relationship with cleaning contractors and that, from that time, quality and effectiveness would be at least as important as value for money and cost. That was widely supported in the Parliament, although perhaps not by every member. The Administration made a significant and genuine change that will—with the national standards for cleanliness, the national programmes to control and monitor disease and infection in our hospitals and the other measures and resources that are being invested in our national health service—result in significant improvements to the situation that we inherited. The situation is improving, but it is not yet good enough.

The problem is that that is just talk. Since the NHS plan to which the First Minister referred was published, only one contract has been returned from the private sector to the public sector. This week, Scottish hospital patients have been put through misery.

I do not know whether the First Minister had a chance in his reading time to read the Evening Times this week. It had an article from a member of the cleaning staff at the Victoria infirmary, who said:

"the people we work for don't seem to give a damn about patients. It's their job to make money and that's what they have to do."

Is it not time that the First Minister set an example and put patients before profit?

I assure Mr Swinney that if any NHS trusts or boards are putting profit before patients in any of their hospitals or health centres, they will answer to the Executive for their actions. The national health plan is quite clear that any contracts that are established should be based on quality and effectiveness as well as on cost. It is also quite clear that the establishment of the Clinical Standards Board for Scotland in April 1999 and the new standards for cleanliness and control of infections in our hospitals through the health plan in December 2000—as well as the other measures that are now in place not only to deal with the current outbreak but to improve standards, cleanliness and hygiene in our hospitals—are all important. It is simply not good enough to quote figures about jobs or contracts without mentioning standards or quality. We are interested in standards and quality, and will continue to deliver them.

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Prime Minister (Meetings)

To ask the First Minister when he will next meet the Prime Minister and what issues he intends to raise. (S1F-1579)

I expect to see the Prime Minister again soon and our agenda will cover the priorities that we both share.

As we know, the Executive has many priorities; the problem is the confusion about which comes first. Most people would say that the health service should come first and I am sure that the First Minister's discussion with the Prime Minister will centre on the level of public confidence in the NHS in Scotland and elsewhere in the UK.

Last week, I asked the First Minister about the whole direction of the Executive's health policy. One week on, we have seen hospitals closed to new admissions, wards shut, scores of operations cancelled and the spectacle of the Minister for Health and Community Care running around trying to pretend that he can sort out all the problems. Is that approach not indicative of the centralisation of the service under the Scottish Executive's policy and the absolute futility of trying to micromanage an organisation as large and as complex as the NHS?

Not at all. Before I answer the question, which at least specifically relates to this week, I think that we should all extend our sympathy to the individuals and families affected by the recent outbreak of salmonella in Victoria infirmary and show our concern for those affected by the winter vomiting virus. I hope that all members in the chamber will also record their thanks to and admiration for the NHS staff, who have reacted outstandingly to this increased winter pressure. [Applause.]

Those staff are precisely the people to whom I referred in my answer last week. As I said then, since I became First Minister, I have visited nowhere in Scotland where I have heard the staff say, "Please privatise what we do and send us into private hospitals." If I remember rightly, the accusation that was made last week was that we had taken no action to use up any spare capacity that might exist in the private sector in Scotland and that we had taken no action to deliver more operations for patients. In fact, when the figures were released this week, they showed that we had done so and that more than 300 patients had had their operations as a result. That is action rather than rhetoric. Furthermore, the action is based on belief in the principle of a national health service, which I am disappointed to see again this week is not shared by Conservative members.

I am rather surprised that the First Minister can come to that conclusion. We are talking about ensuring that all the resources of our health service benefit all our patients. If the First Minister is talking about the 300 patients who are now going to Health Care International, why have he and his predecessor been so shy about that over the months that I have been asking about putting all the resources together?

I want to address the issue of infections that Mr Swinney partly raised and to illustrate the problem of micromanaging the service from the centre, which was Malcolm Chisholm's approach this week. As part of the response to the viral outbreak, Mr Chisholm told us yet again about the nurses who are being trained to tackle hospital-acquired infections. However, he could not get even the basic facts right. He first said that 40 nurses were already being trained; the next day, that figure fell to 30. It then turned out that the true figure was only 13. We were then told that another 20 nurses would start training within the next few months, but the start date now turns out to be September. It is a year since Susan Deacon first told us that these things would be done in August 2001. No one at the centre appears to know how many nurses there are, where they are, what stage of training they have reached and when they will be in place. Perhaps the micromanaging First Minister can enlighten us about that.

It is surprising to be criticised for increasing the number of nurses and expanding other parts of the health service by a party that was responsible for the decline in those areas. However, such comparisons are not always relevant. It is important that we talk about what is happening here and now in the health service. The reality is that the number of nurses trained to deal with such circumstances will rise by a quarter. That is a significant investment in our health service. Coupled with the national standards to which I referred, that is an important new development.

David McLetchie thinks that the establishment of national standards for cleanliness and hospital-acquired infections is unnecessary micromanagement in our health service, but I disagree. I wish that there had been a Clinical Standards Board for Scotland between 1979 and 1997. I wish that there had been national standards for cleanliness in hospitals and a national system for monitoring infections. If there had been any monitoring of the statistics before 1997, Mr Swinney's question to Mr McLeish last March could have been answered. We are now rectifying those wrongs. That is the right thing to do. The improvement is coming and it is long overdue.

When the First Minister next meets the Prime Minister, will he express the regret of Labour members at the SNP's failure last week to back Scotland's candidate for the presidency of the European Parliament? Will he also join me in condemning the SNP's failure to support Scotland's joint bid with Ireland to host Euro 2008? Does he agree that that is another example of the SNP's putting petty party politics before the interests of the country?

Order. The First Minister is not responsible for SNP policy.

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Hospitals (Control of Infection)

To ask the First Minister what action is being taken to control infections within hospitals. (S1F-1590)

It is good to know that back benchers' questions have been filched by the Opposition leaders this afternoon.

Mr McAveety's question was lodged three days ago, before those of the Opposition leaders.

The Executive is creating a new national system of surveillance of hospital-acquired infection and is investing in infection-control training for nurses. National standards have been set on infection control and the first round of local and independent assessments will lead to a report as soon as possible. We expect the highest standards of cleanliness in our hospitals. Any decline in standards must be dealt with urgently. The new national standard for hospital cleaning services will be set by the end of this month. The Clinical Standards Board for Scotland and Audit Scotland will ensure compliance in a series of hospital visits in the near future.

Does the First Minister agree with me and my constituents in the Gorbals and Govanhill area, who use the Victoria infirmary, that there is concern about the future of the hospital, which the infections have not helped; that no matter who provides the service—whether it is public or private—the standards should be of the highest quality; and that we should intervene if the South Glasgow University Hospitals NHS Trust does not meet those standards?

I want there to be no doubt about this. Responsibility lies with the local trust or the board to ensure that those standards are met. They should act when standards are not met. If the trust and the board do not act, we will act, because we ultimately have responsibility.

I welcome the fact that the Clinical Standards Board for Scotland is to inspect hygiene standards in hospitals. Does the First Minister agree that we must involve in that process a body that, unlike the Clinical Standards Board, has power to take action against hospitals that are failing to meet the national standards? Will he consider giving a specific role to the Health and Safety Executive—a body that would, ultimately, have the power to prosecute hospital managers who run dirty hospitals and put the lives of patients and hospital staff at risk?

Let me be clear about this. Hospital managers who put the lives of patients at risk should be sacked by those who employ them. That would be the appropriate action in those circumstances. The appropriate action of a Government is not to pass the responsibility on to another agency but to establish through the Clinical Standards Board for Scotland the clear standards that we expect in our hospitals and health centres and to ensure that those standards are met. [Interruption.] Ms Sturgeon might want to sit there and shout about this, but if she did her research properly, she would know that the Clinical Standards Board for Scotland already involves the Health and Safety Executive and can do so whenever it feels that that is appropriate. The board sets the standards and helps us to police them and it is the body that should deal with this matter. We will support it in the standards that it sets and in the action that it requires us to take.

What targets have been set to reduce hospital-acquired infections and free up the 1,000 beds that are occupied every day in the NHS in Scotland by patients with hospital-acquired infections?

I do not want to repeat the point about what happened prior to 1997, but, unfortunately, previous Governments did not collect statistics on that matter. We need to get the statistics on the number of hospital-acquired infections before we can set targets. That makes perfect sense. The work initiated by Susan Deacon to ensure that we have that information is well under way. When we have it, we will publish it and ensure that we have a standard against which to monitor future progress.

Does the First Minister agree that we require robust research and statistics to ensure that this matter is tackled properly? Is he aware that some of the suggested statistics that have been published by academics and the UK Department of Health do not equate with the figures that have been used by the Scottish Executive and can be up to five times higher than the Scottish Executive's estimates?

I agree that we have to get the most accurate statistics possible. I believe that those statistics should be published and used to monitor the Executive's performance against our previous performance and against health services elsewhere. Where statistics show discrepancies, it is incumbent on public authorities to resolve those discrepancies and clear up any disagreement that might result.

Does the First Minister agree that we have discussed at length the issue of hospital-acquired infections, which is particularly relevant given the tragic deaths from salmonella that he mentioned? Will he assure me that the Executive is urgently pursuing all avenues of investigation on the salmonella issue and the small round-structured virus outbreak at the Victoria infirmary, so that my constituents who are awaiting admission to that hospital or who might have to go there in the future can be reassured prior to their admission?

I believe that the hospital has confirmed today that some wards will reopen on Monday. That is good news for Janis Hughes's constituents. It is important that we do not leave this matter lying. We will ensure that the preliminary reports that Malcolm Chisholm received last weekend are followed up with a full and comprehensive report. Should any action be required—either to learn lessons or to take action in the hospital—we will make those reports public.

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Football Grounds (Safety and Security)

To ask the First Minister what plans the Scottish Executive has to review safety and security at football grounds. (S1F-1593)

First, I condemn utterly the violence and hooliganism at last weekend's football matches. Like many members, I watched the events unfold on television and was horrified to see what took place. We have asked the football authorities and the police for a copy of the inquiry reports once they are completed and we shall carefully review the findings and take any necessary action on safety and security procedures in football grounds.

I thank the First Minister for his reply and declare an interest as a shareholder in Aberdeen Football Club. I had the dubious pleasure of being present at last Saturday's match. Does the First Minister agree that we need a zero-tolerance approach to football hooliganism? Will he tell the chamber whether ministers or Scottish Executive officials will accompany the Scottish Football Association officials to the Euro 2004 championship draw tomorrow to promote the bid for the Euro 2008 championship? Will he take that opportunity to liaise with the Union of European Football Associations and others on safety and security needs in relation to the 2008 bid?

My answer will take one thing at a time. I share Brian Adam's concern about safety and security. We will follow the progress on the inquiry reports and monitor the situation very closely.

I am pleased that, this season, Brian Adam's shareholding in Aberdeen Football Club is, I presume, worth a little bit more than it was over recent seasons.

Given the autonomous nature of football associations, it is right and proper that the SFA should represent Scotland at the draw tomorrow. The SFA will work with the Football Association of Ireland at the draw to promote the joint bid on which we are working. However, it is critical that Executive ministers and the SFA are not the only ones to promote that bid. I hope that, following yesterday's legitimate exchange in the chamber, in which different views were expressed, all members will as of this afternoon unite to promote the joint bid and to ensure that Scotland and Ireland are successful in securing the European championship in 2008.

I am sorry that we have not reached question 5, but there we are.

On a point of order, Presiding Officer. As we have reached only question 4 of First Minister's questions, will you review the Official Report of today's exchanges and consider the length of the supplementary statements—I use the phrase advisedly—from the leaders of the Opposition, particularly the Conservative leader? Those statements reduce the time that is available to back benchers to ask questions.

I assure you that the Presiding Officers review the Official Report every day and that today will be no exception.

On a point of order, Presiding Officer.

Is it the same point of order?

No, it is a different one. You are no doubt aware that the standing orders lay down a standard of questioning, particularly for written questions, which should be to the point, brief and avoid prejudicial language. I am sure that you would want to advise any member, who, as the Official Report shows, regularly tries to ask supplementary questions that are self-serving, petty and purely political, that that is not the way to behave. Perhaps you would so advise Rhona Brankin, to whom you have given warnings on, I think, half a dozen occasions. [Interruption.]

Order. I ruled that question out of order, so there is no reason to raise another point of order on it.