Health Visitors and Community Nurses (Car Travel)
This afternoon's members' business is a debate on motion S1M-1736, in the name of Robert Brown, on health visitor and community nurse car travel. It will help if members who would like to participate in the debate press their request-to-speak buttons.
Motion debated,
That the Parliament notes the problems faced by health visitors and community nurses when using their cars on NHS business and believes that there should be national arrangements on this matter and that there should be provision of free car parking badges to such key workers together with an urgent review of their car leasing and milage arrangements.
A few weeks ago, several other members and I attended a lobby of the Scottish Parliament by the deals on wheels campaign. All members attend many lobbies. At some, we discover interesting things; at others, we do not. However, that lobby quite impressed me. The more detail that I heard, the more that I became annoyed about the way in which bureaucracy and red tape seems to have disguised and covered up the policy objective that should be operated.
As politicians, we often wax lyrical about public policy objectives, targets and delivery, and about world-beating amounts of money and best-ever numbers of staff recruited. However, in the real world, policy objectives are achieved by people, not by statistics on a policy paper. The targets are met and delivery achieved by public sector and other workers. The money is spent successfully or otherwise by front-line staff and on how they do their jobs.
Our debate centres on people—the health visitors and community nurses who, day by day in their professional working lives, give the commitment that makes care in the community a reality and who strive to improve and sustain public health, not by juggling reports or tweaking budgets, but by working with patients.
Health visitors and community nurses are a central part of the national health service in the community and the home. They are highly qualified. An article in tonight's Glasgow Evening Times points out that it takes longer to train a health visitor than it does to train a basic doctor. Usually, health visitors and community nurses are attached to a primary health care team. Their care duties centre on the very young and very old—the role for specialist geriatric health visitors is growing—but they also support at-risk groups such as families who have handicapped children.
It is obvious that travel is a significant issue for people who visit and care for patients in their homes. Rural nurses might have to travel significant distances in areas where public transport is scarce. The distances that health workers in urban areas need to travel are shorter, but the issue is the same. Whether in a city, small village or town, parking near clients, chemists or clinics is a time-wasting problem and a significant expense.
Most commonly, community nurses and health visitors use their personal cars on NHS business, but there is significant scope to encourage the use of bicycles in some areas. The background to the motion is that the relevant arrangements are unhelpful and exploitative. The deals on wheels campaign, which is being run by the nursing sections of the Manufacturing, Science, Finance union—MSF—throughout the United Kingdom, suggests that health visitors and community nurses each subsidise the NHS in that way to the tune of about £700 a year. The Royal College of Nursing says that the average is £1,000 a year for a rural nurse. Those figures are quite significant.
Not all the issues fall within the Scottish Parliament's power. Taxation is a reserved matter. To be practical, we should note that the way in which mileage allowances are fixed through the General Whitley Council has a large UK component. The question of a free parking sticker for community nurses and car leasing arrangements is in the power of health boards, health trusts and the Scottish Parliament. Boards and trusts deal with those matters and the set-up varies substantially throughout Scotland. I am a strong supporter of local decision making in this field, but I am not sure that some decisions on the matter can be justified. The problem is getting worse as hospitals introduce parking charges to tackle the chronic congestion that they suffer. I cannot believe that a free car-parking scheme for those NHS staff will cost NHS trusts or anyone else an amount that will even register on their budget line.
The Deputy Minister for Health and Community Care confirmed recently, in written answer S1O-3168, that local authorities are able to issue parking passes for their staff. I would appreciate it if, in his closing speech, the minister would elaborate on the arrangements for and implications of that decision. It would be a scandal if nonsensical red tape allowed local authorities to charge health trusts for such a facility. Have health trusts approached councils on that matter? Have the local authorities responded helpfully? Can the minister cut through the red tape and issue guidance and direction as required?
Car leasing arrangements are also in the gift of trusts. I understand that that provision varies greatly throughout the country. Those arrangements are interrelated with tax issues, but I think that there would be a strong argument for a Scotland-wide arrangement. The issue of the proportion of insurance and tax that is paid by the NHS needs to be considered, as do the implications of people going on sick leave while in possession of a leased car, and the setting of the mileage levels. Those and many more issues are involved, but surely the Common Services Agency or some similar body could examine a national scheme and consult with trusts. Such a body could also take account of the higher petrol prices in the north of Scotland; a subject that was touched upon in debate this afternoon.
Members will have received the RCN's briefing paper about the lack of progress that has been made with the oil companies on possible petrol card deals. Will the Executive help to bridge the gap that exists between the oil companies and the trusts, in order to produce a workable scheme? The details of the mileage allowance are complex, but they seem to compare unfavourably with MSPs' mileage allowance rates. Such things should not cause hassle in the working lives of our valued NHS staff and I hope that the minister can give us some hope and reassurance about those things.
Let us cut through the red tape and give NHS workers our backing with the words that are spoken in today's debate. It should be possible to sort out these matters reasonably easily, and we should certainly be able to sort out car parking charges and leasing arrangements. I hope that the minister will respond favourably on those points.
I thank Robert Brown for securing the debate. Because I am a member of the MSF, I am happy to take part.
Community nurses and health visitors play a key role in the NHS. They undertake valuable work that makes the NHS more accessible to a much wider range of people, in particular older people and people who have disabilities. They take health care to patients and they ensure that the service meets the needs of patients, rather than the other way round. That becomes particularly important in remote and rural areas. Community nurses and health visitors are a key element in social inclusion and are included in the document "Our National Health: A plan for action, a plan for change".
Car usage has become absolutely essential to community nurses and health visitors and although TV programmes give us an image from a long time ago when they walked about and cycled, such days are long gone. The car is vital in enabling them to carry out their work and their duties.
I am pleased that the MSF has campaigned hard on the issue, along with the deals on wheels campaign that has been run by the Community Practitioners and Health Visitors Association. That campaign has been very successful in bringing the issue to the attention of many different people, including the Scottish Parliament. As Robert Brown mentioned, the CPHVA successfully lobbied the Parliament at the beginning of March.
GPs have long had free car parking stickers to aid their work. The need for that has been recognised and we must consider extending that provision to community nurses and health visitors who, as congestion in our cities grows, are increasingly wasting time on looking for car parking spaces, which could be spent with patients. In addition, they have often to pay for parking or are given parking tickets when appointments with patients have overrun.
Members would probably agree that the time that community nurses and health visitors spend with patients is of paramount importance. Patients can suffer if their nurse or health visitor turns up late or stressed as a result of trying to find a parking space or change for parking. There was an incident in Aberdeen in which a community nurse had to cancel an appointment with a patient because she did not have enough change in her purse to pay the parking fee. As somebody who is always searching for change for parking, I have some sympathy with that nurse. If I miss an appointment, it is not the end of the world, but it is vital that health visitors and community nurses get to their patients.
As Robert Brown mentioned, car leasing arrangements vary considerably from trust to trust; workers in some areas get much better deals than others. It would be only fair to have a national arrangement and equity between trusts. Leasing agreements and low mileage allowances often result in people ending up effectively subsidising the NHS up to the tune of an estimated £700 a year.
I ask that we consider how valuable those workers are in delivering NHS services to Scotland's communities and that they are treated fairly. I urge that a uniform approach be adopted by trusts to ensure that we have equity. As I said, GPs have had free car parking stickers stickers for a long time. Now is the time to consider extending that provision to health visitors and community nurses. Local authorities could do that under existing legislation and it should be considered. I ask also that we consider a national review of mileage allowances.
I congratulate Robert Brown on securing the debate. While it raises an important issue, most people in Scotland would find it surprising that such an issue is a problem. Many people would assume that much of what Robert Brown is asking for exists already. As Elaine Thomson said, GPs already have free car parking stickers and most people would assume that that also applies to district nurses and community nurses. In many health trusts, senior health service managers have generous car leasing arrangements, which says something about the priorities of those who run our national health service. Again, that would surprise members of the public.
Health visitors and community nurses are central to the NHS in Scotland. They provide invaluable services to communities. As Elaine Thomson said, many of the Government's social inclusion initiatives are dependent on the community role of health visitors. For a group of people who require to travel as a matter of course in their daily employment, reliance on cars is inevitable, whether they live in rural areas, where long distances are involved, or in cities, where health visitors and nurses must be allowed to travel conveniently between patients.
When one adds the problem of car parking to the mileage problems that Robert Brown mentioned, one can see the problems that those workers face daily. That is something that Elaine Thomson outlined in very real terms. I have only to think of the congestion problems in cities such as Glasgow and Edinburgh to imagine how they affect the daily work of a health visitor who is travelling to visit new mothers, for example, because it is difficult to find somewhere to park. On top of that, the cost of parking must also be considered.
Those concerns have been expressed well in the debate. I want to mention another issue in closing. I know that there are a number of issues involved in hospital car parking charges and that it is not an entirely simple matter, but it gives me great cause for concern. The introduction of hospital car parking charges in Lothian and Fife, which are leading the way in that, adds a burden to those who work in the health service. It cannot be beyond the ability of those who manage the health service to find a way round that problem at least.
In conclusion, I am sure that there are many different ways in which the problems that Robert Brown mentioned can be tackled. As he rightly said, many of the problems have been created by bureaucracy, but none is insurmountable. As I said at the outset, most of them are very simple. I look forward to the minister's response. If we could find ways of getting round even some of the problems, we would make the daily life of people who provide vital services in our communities throughout Scotland that bit easier. It will be well worth doing that, if we can.
I start by declaring that I am a member of MSF. I support the motion and I congratulate the CPHVA and MSF on the deals on wheels campaign and on their success in getting the issue debated in Parliament. I also congratulate Robert Brown on securing this evening's debate.
Although there are areas in the motion that the Scottish Parliament cannot deal with, there are also areas that we need to highlight. As Nicola Sturgeon said, we need to find ways round problems and to consider how they can be dealt with. At a time when the health service depends greatly on what is happening at community level and on the services that are carried out by those who work at that level, it seems really weird that the workers themselves must subsidise the service. Health visitors and community nurses play a key role in delivering services locally.
When my mother was terminally ill, she chose to be nursed at home. She was an ex-nurse and she felt that she certainly did not want to die in hospital. We could never have survived as a family if the community nurses and health visitors had not been there to support us. They play a crucial role for families throughout the country. Community care depends on people working at local level. Many vulnerable members of our communities depend on their care. It is therefore absurd that health visitors are currently subsidising the NHS through their travel costs.
A mileage rate of 10p a mile seems to be crazy to me. The smallest voluntary organisation in this country would throw out the suggestion of 10p a mile. I have worked in a voluntary organisation, and we thought that we were hard done by to have a mileage rate of 25p a mile. Health visitors must work up and down the country, visiting elderly people and young mums. With a mileage rate of 10p a mile, they are subsidising their transport. It is crazy. That does not take account of the costs of tax, insurance or wear and tear on the vehicle, and it is important that those things are considered. There must be a realistic mileage rate that is worked out at national level and reviewed regularly.
Will the minister do something to encourage health boards to consider petrol cards? A petrol card scheme could be implemented nationally. If private companies, some of them quite small, can operate such schemes, why cannot the health service do it? Health boards could also consider ways of securing free parking for NHS staff, perhaps by working with local authorities. It cannot be impossible and it must be done.
The discussion must continue. As I said at the outset, there are things that the Parliament can do. Surely we can consider a realistic national car leasing scheme, which staff can use without having to subsidise it, and which recognises their crucial role in delivering health services. I hope that we can continue this debate and continue to support this very important campaign. Let us see whether we can resolve the issue.
I thank Robert Brown for securing the debate, because the issue needs to be brought to the fore. It has been recognised and various MSPs have done work on it; I count myself as one of many.
I asked parliamentary questions last year about the progress that was made by the joint review of section 24 of the "General Whitley Council Handbook", covering mileage and travel allowances for all NHS staff. I received a reply on 27 November. I asked what further progress had been made and the reply came in a written answer on 20 April:
"The Joint Review is still ongoing."—[Official Report, Written Answers, 20 April 2001, vol 11, p 507]
When I phoned the health department today, I asked when the joint review was going to conclude and make recommendations. Of course, I am not allowed to talk to officials and the person on the end of the line said that she could not say anything. I am pleased that, out of frustration at trying to do something, Robert Brown has secured today's debate.
According to the Royal College of Nursing, the General Whitley Council has been considering travel within the NHS since 1988. A debate in this Parliament may be what it takes to get the General Whitley Council to do something; 13 years is rather a long time. As Nicola Sturgeon said, this should not be dealt with within the Parliament simply because there is a bureaucratic problem somewhere else.
John McLaren, of the CPHVA states:
"We have had a very sympathetic hearing"
from MSPs,
"but we would like to see warm words translated into concrete action."
I say to John McLaren that I would like to see the General Whitley Council doing its job and the minister holding it to account for this unacceptable delay.
There is greater emphasis on care at home. Lee Whitehill, of the MSF, said in an e-mail that employees in trusts throughout Scotland are subject to widely varying terms and conditions. Dundee, Edinburgh and now Glasgow have parking permit schemes worked out with local authorities, but other trusts do not. Surely employees who are on the same grade and who do the same job within the NHS are entitled to the same terms and conditions.
As other members have said, why would somebody choose to work in a part of Scotland where it costs them an extra £700 to £1,000 to do their job? Should not we ask that all mileage rates in the public sector be re-examined to ensure greater fairness and equity throughout the system?
Several members have mentioned the agency card. If someone applies for an agency card—I know only about the Highlands, but I assume that the scheme is the same throughout Scotland— they can get one, as long as they have a business account and administration for it. It should not be an administrative problem for the NHS to endorse an agency card for community nurses.
Ministers—I mean of the clergy—in the Highlands can get an agency card to buy petrol and diesel at the UK average price. I see no problem in community nurses having such a card. If one can get a petrol card to heal the sinners, surely one can get a petrol card to heal the sick.
I congratulate Robert Brown on bringing this important issue to the Parliament's attention. I also welcome the opportunity to participate in the debate. As an MSF member, I am especially pleased that the campaign is gaining support throughout the Parliament. It is important because it aims to ensure that community nurses and health visitors get a fair deal. As many colleagues have said, they are a vital part of the NHS in Scotland. Without them, the NHS could not do its job as effectively as it does in communities throughout Scotland. I would also like to thank members of the CPHVA and the Community Psychiatric Nurses Association. Without their combined lobbying persistence, the matter would not be being considered today.
I want to concentrate on parking, which several members have already mentioned and which the Parliament itself is able to address. At the moment, community nurses must pay for parking and then claim back those expenses. As well as placing the initial payment on nurses instead of on the NHS, that presents them with the problem of finding suitable parking spaces. The time that they spend looking for such spaces—we all know how difficult that can be in a city centre—is wasted and would be far better spent caring for patients.
To all intents and purposes, an exemption from parking restrictions would be cost-free and would enable our community nurses and health visitors to spend their time where it is needed most—with patients.
The Scottish Executive is rightly attempting to bring health and care closer to our communities, which means that the use of the car by community nurses and health visitors is not a perk, but an operational tool. NHS trusts and local authorities must recognise that and provide consistent support to NHS staff members who need to use a car. Any such measures must include parking exemptions, consistent car leasing arrangements and a realistic mileage rate.
What practical steps is the Scottish Executive taking to ensure that local authorities and NHS trusts come to an arrangement whereby NHS staff are allowed certain dispensations if they are forced to contravene parking restrictions while delivering care? I am sure that the minister is aware that general practitioners occasionally have to park on double yellow lines; such might well be the case for community practitioners.
I urge the minister to do all that is in his power to ensure that our health visitors and community nurses are valued and that they are properly compensated for their efforts in delivering health care in the community.
Perhaps I, too, should declare an interest, which is included in the register of members' interests.
I congratulate Robert Brown on securing this member's business debate; I attended the Manufacturing, Science, Finance union lobby several weeks ago as well. I want to widen the focus of the debate slightly. The motion concentrates on health visitors and community nurses, who are often attached to primary care teams. Community health care has changed dramatically in the past couple of years with the extension of secondary care provision, particularly the introduction of multidisciplinary area rehabilitation teams. Although health visitors and community nurses play an important role in delivering health care, area rehabilitation teams include therapists such as physiotherapists, occupational therapists and psychologists, who are all affected by the same problems as community nurses and health visitors. If the minister makes a commitment to examine ways in which the system can be changed, I ask him to ensure that any review includes people who are members of professions allied to medicine or of multidisciplinary teams in the secondary care sector.
Although this point is slightly outwith the focus on the health service, I point out that social workers and community social care staff suffer similar problems because of a dislocation in the car leasing system operated by local authorities. I have suffered from the problem myself; when I left Highland Regional Council, I was offered the opportunity to buy my lease car at an extortionate price that was nowhere near its market value. I then had to buy myself out of the car leasing scheme so that I could go and do the same job in another local authority. In both posts, I was an essential car user; I was doing a job that the local authority was legally obliged to fulfil. As the same difficulties exist in the social care and health care sectors, any attempt to address the problem must be comprehensive.
In the course of the MSF lobby, I was extremely surprised to hear about the car leasing agreements that are provided to senior managers in the health service. Nicola Sturgeon has already touched on this point: senior managers in the health service who are not essential car users are offered extremely generous car leasing arrangements and loans way above the level for clinical staff who are essential car users. There is a need to examine that, to determine whether it is an appropriate use of public money. I was surprised to hear that consultants also receive a generous package involving either a car loan or a car leasing system. They may have to make occasional trips, but they do not strike me as being essential car users.
I recognise the need to ensure that appropriate packages are supplied to maintain the high quality of health care professionals, but I ask the minister to consider the anomalies in the system that have developed over the years because their presence has just been accepted. There is a need to examine the issue comprehensively, to ensure not only that the car leasing system for health visitors and community health nurses is revised, but that the situation for social care staff and other professionals in the health service who are affected is considered.
I, too, am a member of the Manufacturing, Science, Finance union—I am not sure whether that constitutes a declaration of interest.
All members have spoken with one voice in this short debate. That is perhaps not surprising and I hope that the minister will not buck the trend. There is not much to add to what has been said, as the important elements of the argument have been put across by all parties—that is significant—but there is one important piece of information that I have not heard mentioned. I may not make myself popular among members, but I shall put it on record anyway.
Earlier this month, we received from our allowances office an indication of the new car user rates that MSPs will receive from 1 April. Point 6 of the document states that motor mileage will be reimbursed at 49.3p a mile. Health visitors throughout Scotland receive, on average, between 9p and 13p a mile for using a lease car. If they are offered a lease car and turn it down, they are treated as a casual user and receive the public transport rate of some 23p a mile. I know that negotiations on standard user and regular user allowances have been on-going and have achieved some increases, but the figures are well short of what should be expected for people who, as all members have said, are essential to the delivery of community care. Without them, patients who were unable to travel for their care would be treated much less effectively.
The comparison with doctors has been well made. The amount of time community nurses must spend looking for a parking space, let alone the cost of paying for it, simply because they do not have the facility that doctors have concerns me. Mary Scanlon outlined the differences between the situations in Glasgow, Edinburgh, Dundee and Aberdeen. At the lobby to which many members have referred, it was pointed out that in the city of Aberdeen, community nurses are quite often obliged to travel by public transport. That seriously restricts their ability to visit patients and the amount of time that they can spend with them, which cannot be right.
Neither can it be right, as Michael Matheson said, that someone moving from one health board to another enters a completely different system. Leaving aside the differences between travelling in urban and rural areas, the job should be relatively uniform. Some sort of central scheme should be applied.
I may be wrong—I hope that I am—but it is likely that the minister will say that the Executive gives money to health boards and allows them to determine their priorities. That is all very well in some aspects of health care, but when it comes to the people who are required to deliver that health care, any impediment to their doing their job—any disincentive or anything that lowers their morale or the level of service that they feel able to provide—must be examined seriously. I hope that, as a first step, the minister will undertake to carry out a survey of the situation in Scotland and will then issue guidelines to health boards regarding minimum standards. I hope that he will go further than that, but that should be the absolute minimum.
The people whom we have been talking about are essential health service workers. They are not being treated with the respect they deserve. I hope that as a result of this debate and debates in the UK Parliament, the Welsh Assembly and so on, their situation will be improved.
Robert Brown and members who have spoken subsequently have covered the detailed, technical issues well. I shall draw out three more general issues that the debate highlights.
The people who voted for us expect us to put things right and, clearly, there are a lot of issues around this debate that are wrong. However, we have no power to put things right; we rely on Malcolm Chisholm to do that. He is an excellent guy and I am quite sure that he will put things right, but there should be a way in which the will of the Parliament can be brought to bear and by which the usual civil service attitude—which is that the matter is for the health board or the Whitley council or whatever—can be avoided. If there is a clear, democratic view, it should be expressed to the relevant people. It is true that health boards and councils are supposed to make their own decisions, but they must be clear about what the informed public, the people involved and their representatives want them to do. We must examine our system of bringing the democratic will to bear on recalcitrant public bodies who act in a foolish manner, as the health boards and the Whitley council are doing.
It is interesting that relatively minor issues often impinge on working people—including MSPs—far harder than the great world picture. We should listen more to employees at all levels. The lobby with which we are dealing today happens to be an extremely well-organised and articulate bunch of people. However, lots of people, particularly in the public sector, are not so well organised. We should listen to them carefully and try to put their minor niggles right—a stone in one's shoe often hurts more than a big event. We should listen more carefully to public sector employees, but not to the top brass, who are able to feather their nests efficiently, as we have heard.
The lesson is that, in all sorts of spheres, we get our public services on the back of sacrifices made by the employees and so we get them on the cheap. Often, that happens because we underpay public sector workers. However, in this case, people who work on a wage that is not huge subsidise the health service by paying more for their car. That is absolutely ridiculous. We should improve our philosophy to ensure that we pay adequately for our public services by paying the employees adequately and giving them proper conditions of service. We must not deliver services on the cheap on the backs of our employees.
I hope that the minister will reply in detail to the points that people have raised and will promise to put them right.
I congratulate Robert Brown on securing this debate and declare my membership of the Manufacturing, Science, Finance union.
As everyone has said, there is no doubt that the funding arrangements for health visitors and other community workers are inadequate and that the bureaucracy of the system is overly complex. It is difficult to overestimate the irritation that is caused to clinical staff by the system. MSPs will know how annoying it is to fill in forms on parking costs every month; it is even more annoying for clinicians who are under considerable pressure. Obviously, public funds have to be accounted for, but the system is incredibly bureaucratic.
As a general practitioner, I, too, was employed by two trusts at one point. Every year, I had to fill in two different forms for the two trusts. Do we have a corporate NHS or do we not? If we do, let us have a uniform system throughout the NHS.
Whether public servants of the type we are discussing should have access to some form of red diesel or red petrol is another matter.
There is a lack of uniformity on parking: in some towns, GPs get car permits; in others, they use various emergency doctor badges that do not have legal standing but which are accepted through custom as meaning that doctors can park illegally on double yellow lines and so on, but even they are sometimes subject to charge and cases have gone to court. There is a need for health professionals to have access to a scheme like the orange badge scheme. We should have a national green badge scheme with clear guidelines. People with the green badge should use it appropriately and they should get in trouble if they use it inappropriately.
We will not go into parking at hospitals again today, but the appropriateness of access is an important matter.
Michael Matheson rightly referred to other groups in the community, but let us first consider the model of primary care teams. When I started, there was one multipurpose community nurse/health visitor/midwife. When I retired to come here, there were 30 workers in the primary care team. Some of them came from the primary care trust, some came from the acute services trust and some came from the local authority. They all needed to have access to patients.
In addition, there were volunteers who transported patients. They, too, had difficulties with parking. We need a scheme whereby the service can work smoothly and efficiently. I hope that, as part of establishing a corporate national identity, we will get such a scheme.
Donald Gorrie was trying to draw out themes. Another one is bureaucracy. The abundance of paperwork that professionals must put up with now at all levels needs to be tackled. That is one small area where we could make a start.
I congratulate Robert Brown on securing the debate and on bringing these important matters to our attention.
The Scottish Executive recognises the extremely valuable work of health visitors and nurses in the community and the dedication they show in caring for their patients.
The most effective way of delivering services is often to do so in the patient's home or in the community. That is why we have targeted funding to increase the number of community nurses and have recently announced plans for new public health nurses to address Scotland's health challenges.
We are equally keen to do everything we can to support those key staff in their vital work and to ensure that they do not find themselves out of pocket as a result. We are already taking steps to address the concerns Robert Brown raised and to put in place measures to deal with the difficulties health visitors and nurses face, although I accept that there is still a long way to go to ensure all the progress that members seek.
Let me make it clear from the outset that, where parking charges are unavoidable, there is provision for NHS staff to claim reimbursement from their employers. I assume that that always takes place and would want to know if it did not. More generally, car parking arrangements are essentially a matter for individual local authorities in exercising their responsibilities under the Road Traffic Regulation Act 1984. That will be a disappointment to Donald Gorrie, who wants me to be able to do everything. The statutory power lies in that act. I will explain that in more detail, as Robert Brown asked me to elaborate on the point.
We are keen to encourage concessions for staff while they are carrying out NHS duties in the community, not least because of the problems Elaine Thomson described, including the time wasted looking for parking spaces. Local authorities already have powers to make traffic regulation orders for a variety of traffic management purposes. That could include the issuing of parking permits for use by community nurses and health visitors when making visits.
The City of Edinburgh Council, for example, issues about 350 such passes to NHS trusts for use by health visitors and community nurses. Those passes allow community nursing staff exemption from certain parking restrictions and enable them to stay for longer periods when certain time restrictions apply.
We want that example of good practice to be adopted throughout Scotland and will write to all local authorities, reminding them that they have the powers to implement similar schemes. In law, the decision rests with local authorities, but we hope that they will react positively and make parking permits available for use by health visitors and community nursing staff throughout the country. We will also ensure that trusts and health boards are advised of those provisions.
Elaine Thomson referred to what happens with general practitioners. I should clarify that point, because GPs do not in fact have any legal exemption from parking restriction, although the British Medical Association issues doctors with "Doctor on call" stickers so that they can be easily identified.
As Mary Scanlon reminded us, a review of car leasing and mileage arrangements is in progress—I am not sure that it has been going on since 1988, but I hear what she says about the time it is taking. A UK working group of Department of Health officials, NHS managers and staff representatives has been looking at how we can simplify and modernise the existing formula for mileage allowances to provide fair reimbursement of staff expenses that are necessarily incurred on NHS business and to reflect wider environmental policies. I cannot give a precise date for the conclusion of the review, but it will be this year.
The Scottish Executive will ensure that the review fully addresses the needs of the service in Scotland, for example in relation to services in rural and remote areas. I would be pleased to receive details of the figure of £700 that has been mentioned so that that information can be fed into the review at this late stage.
As an interim measure, mileage allowances for NHS staff were increased from July last year. Those interim increases are especially beneficial for staff working in the community who currently receive a regular user allowance.
Additionally, in more remote areas such as the Highlands and Islands, a number of trusts and boards operate petrol card schemes to ensure that they take advantage of average mainland petrol prices. A problem is that some trusts and boards do not take up such schemes; I encourage them to do so.
Those measures demonstrate that the Scottish Executive takes seriously the needs of NHS staff in relation to their working conditions as well as financial matters such as pay and reimbursement. We believe that an investment in staff is an investment in patient care.
We are developing new models of care in our communities and matching our ambitions with targeted additional funds to increase staff numbers in key areas. We recognise that the conditions and provisions for travel reimbursement, too, need to be changed and we have set action in train to ensure that they are. That is just one of the many aspects of pay and terms and conditions of service that need to be reviewed. We are considering all aspects of pay and conditions as part of the UK talks on pay modernisation that are in progress. We are demonstrating by our actions and our investment that we are committed to improving terms and conditions of service for all staff in NHS Scotland in the short and the long term.
I end by thanking members for drawing these matters to the attention of the Parliament. I will watch progress with keen interest and I will certainly intervene where I have the power to do so.
Meeting closed at 17:58.