Beatson Cancer Centre (Patient Safety)
To ask the Scottish Government what action it has taken to ensure that the concerns of 56 doctors at the Beatson cancer centre regarding patient safety are fully addressed. (S4T-01028)
Let me first be absolutely clear that patient safety is of paramount concern.
Although this is a very complex issue about a highly specialised unit and its support services, there is no question but that the views of clinicians, including those at the Beatson, are extremely important and need to be fully addressed. I have spoken to the chair of NHS Greater Glasgow and Clyde and have been assured that that will happen. The chief medical officer has had constructive discussions with the chair of the local consultants committee and the health board’s medical director about the need for all parties to commit to resolving these concerns. It is vital that the health board addresses the issues that have been raised so that the move can go ahead with the support of clinicians. A meeting is planned for tomorrow to continue to take that forward.
In the meantime, I have been assured by the health board that key support services, such as 24/7 anaesthetic cover, will be maintained until an agreed sustainable solution is in place.
I thank the cabinet secretary for that reply, and I particularly welcome the emphasis on patient safety.
The fact that the 56 consultants warned that services for seriously ill patients who required a high dependency unit were not going to be safe is surely worrying, and the fact that they felt the need to go public to fulfil their obligations, based on the General Medical Council guidance after what happened in Mid-Staffordshire, is surely an indictment of the board’s approach. How did we reach the point at which doctors—who do not go public lightly—felt the need to do so? Why is it the case that, despite having had four years to consult on the effect on services at hospitals such as the Beatson of the opening of the Southern general hospital, the board does not appear to have properly consulted the doctors in question beforehand?
There have, of course, been a number of discussions over a long period of time. The issue is that there was a failure to agree on some of the detailed changes.
Richard Simpson is right. I would have preferred all the issues to have been resolved in a different manner, but what is important is that they are resolved going forward.
The GMC’s role is in the regulation of doctors. Healthcare Improvement Scotland is the organisation that is tasked with looking into issues of patient safety. I understand that it is going to look into the concerns that have been raised and make an assessment. It is critical that, at tomorrow’s meeting, an interim set of arrangements is agreed, beyond the moves that have already been made on anaesthetic cover, that is to the satisfaction of the clinicians and the board, in order to create the space to agree some of the more difficult issues and ensure that there is a sustainable service in the future.
I am in exactly the same place as Richard Simpson. Those issues have to be resolved and the clinicians must be assured that patient safety is paramount.
In the response from Greater Glasgow and Clyde NHS Board, which is in the public domain and which the cabinet secretary has referred to, it has said that it will provide resident—and therefore, I presume, junior—anaesthetists on site overnight and a consultant on call during the 24-hour period. I have reservations about that, but my views are irrelevant. That is a matter for the consultants to agree on—they must assure themselves that the service will be adequately safe.
Speaking of adequacy, is the cabinet secretary comfortable with the reports in today’s press of mayhem at the Southern general hospital accident and emergency unit, with eight-hour waits, trolleys lining corridors, sick patients having to sit on the floor, diversion to the Glasgow royal infirmary and ambulances waiting two hours to discharge patients into A and E? What modelling was done for the transition? Even if those are teething problems, they affect real individuals. Will the cabinet secretary agree to look very closely at that, so that we do not end up in the same situation in future with the opening of other hospitals that involve a transfer of services?
The Western general’s accident and emergency department is due to close at the end of the month. Given that there is already chaos with the current transfer, I suggest to the cabinet secretary that the officials need to look very closely at postponing that transfer in order not to create more chaos.
Richard Simpson is in danger of conflating two very serious but different issues.
Let me first finish dealing with the issue of the Beatson. As I said, it is critical that clinicians are satisfied with matters going forward. That is why the proposal to continue 24/7 anaesthetic cover has been agreed with clinicians, but there are other remaining issues that need to be resolved. Tomorrow night’s meeting is an important part of that process. I expect everyone to arrive at an agreeable set of arrangements that will provide an interim solution while further discussions take place about a permanent sustainable solution for the Beatson.
Richard Simpson went on to talk about the new south Glasgow university hospital. Last week, there was a major transfer of patients and staff from the Victoria infirmary to the new hospital. Such transfers are complicated and difficult to make, and some challenging issues emerged to do with the availability of beds and staff. There were some pressure points at the end of last week. I can tell him, though, that as of yesterday the hospital was performing very well. A and E was performing very well, with—I think—around 91 per cent achievement of the four-hour target and patients flowing through the system.
Richard Simpson mentioned the Western, which will begin to move across this weekend. Staff are absolutely looking at the lessons learned from the transfer of the Victoria and making sure that the pressure that emerged are addressed in the way in which they move the Western. I do not think that there would be anything to be gained from not sticking to the timetable of transfer so that we can get all the services transferred across, staff can get working in their new environment and patients can be settled into their new environment.
I hope that, despite some of the challenges that have come with the transfer, Richard Simpson will recognise that what we have is a first-class, world-class hospital. I hope that he will visit it at some point and be as impressed as I was. I am, of course, being kept in touch on a daily basis with the detail of what is happening at the front door of the hospital to make sure not only that we are alerted to any emerging issues but, more important, that those are addressed. A big move such as this one brings with it some challenges, but I hope that we will have Richard Simpson’s support as we work through those challenges over the next few days and weeks.
Clearly, the concerns of the Beatson clinicians have to be taken very seriously. As Richard Simpson said, it takes a lot for clinicians to go public as they have done. I would be interested to know whether any of the concerns were raised via the NHS Scotland national confidential alert line. Also, given that that line has now been in place for two years, what assessment has been made of its effectiveness? I understand that a review of it is taking place. When will that be published?
I will get back to Nanette Milne on whether any issues have been raised. The information will not be as specific as saying that a particular clinician from a particular location raised a particular issue, but I will get back to her on the general point about the alert line.
On this issue, there has definitely been an on-going dialogue with clinicians and the board. It is not that the board was not speaking to clinicians; it is just that there was a failure to agree on certain aspects of the way forward. The clinicians have a strongly held view about certain aspects of the arrangements going and they did not agree with the board on that. Those issues must be resolved not just to the satisfaction of the clinicians but to the satisfaction of us all. Patient safety is paramount and we will take absolutely no risks.
I am confident that, through those on-going negotiations—the meeting tomorrow is an important part, as is the involvement of the chief medical officer—we will get to a place where the clinicians are satisfied and the board has a sustainable model to take forward the excellent, world-class service that we have at the Beatson, which is one that we should all be proud of.
High-speed Rail
To ask the Scottish Government what recent discussions it has had with the United Kingdom Government on the subject of HS2. (S4T-01033)
I discussed the weekend newspaper reports about the HS2 Ltd study with Sir David Higgins, the chair of HS2 Ltd, this morning. I have written to the Secretary of State for Transport, Patrick McLoughlin, on several occasions, including three times subsequent to his statement to the Conservative Party conference in favour of three-hour journey times between Scotland and London. I have made it clear to Mr McLoughlin that the Scottish Government’s position—indeed, the position of, I think, all the parties in the chamber—is that high-speed rail must come to Scotland.
Despite those challenges at ministerial level, my officials are in contact with their UK Government counterparts and with HS2 Ltd. Transport Scotland officials sat on the steering group for the HS2 Ltd study into broad options for extending HS2 to Scotland. The study’s advice has been with UK and Scottish ministers since December, but despite, as I said, several requests for a meeting with the Secretary of State for Transport, I have had no positive response; indeed, he has not managed to meet me since he was appointed in September 2012.
Does the minister agree that including Scotland in HS2 would deliver significant economic benefits by improving connectivity and removing barriers for everybody in Scotland, but particularly for businesses in the more remote parts of the country?
Yes, I agree with that, as does civic Scotland—in particular, the business community to which Mike MacKenzie referred, but also our councils, trade unions and many others. Significant economic benefits would accrue at both ends of high-speed rail and at all points in between. There would also be far greater environmental benefits from modal shift if we could achieve the journey times of two and a half hours to three hours between Scotland and London that HSR can bring. That would be in addition to the already required additional freight capacity, which would help in terms of the environment and productivity.
Given the minister’s answer to my initial question, does he agree that the UK Government has shown a lack of ambition and insufficient consideration for Scotland throughout development of the plans for HS2?
I agree. The UK Government has been unambitious and disrespectful in respect of there having been a complete lack of dialogue, and leaking of its reports—the confidentiality of which it asked us to respect—on high-speed rail coming to Scotland.
I encourage all parties and interest groups to join me in demanding that the Secretary of State for Transport start to discuss how he can bring HSR to Scotland as quickly as possible. It is, of course, also worth saying that if high-speed rail goes to the north of England but does not come to Scotland, that will be the worst of all worlds for Scotland because it will put us at a substantial disadvantage. There is substantial unity on the issue across Scotland in political parties and in civic society. The UK Government would be ill-advised to ignore that unity.
The minister will be aware that one of the dimensions of the development of high-speed rail in recent months has been the discussion that has been taking place between cities in the north of England on how they can steer the development. Has the Scottish Government had contact with the organisation that has been formed by those north of England cities and has he facilitated any contact between Scotland’s major cities and those north of England cities?
Yes—there has been such contact with cities in the north of England. I have spoken at conferences, the most recent of which was in Manchester, at which the leaders of various cities in the north of England gathered to talk about high-speed rail and its implications. My predecessor, Alex Neil, had particular discussions with some of the cities that will be affected. Of course, some of the high-speed rail proposals are not actually about high-speed rail services—for example, the proposals for services traversing the north of England are for higher-speed rail rather than high-speed rail.
However, we think, for the reasons that I have already outlined, that if we can get high-speed rail to Scotland—to both Edinburgh and Glasgow—all points between Manchester, Leeds and Scotland could benefit from it. We urge everybody in the chamber, including Conservative members who might hold some sway with the Conservative Government, to get behind high-speed rail and to get the transport secretary to come and speak to people in Scotland so that we can progress the issue.
Police Scotland (Use of Facial Recognition Technology)
To ask the Scottish Government what its response is to reports that Police Scotland has been using facial recognition technology on images stored on the police national database. (S4T-01034)
Police Scotland retains images in order to prevent and detect crime. It has provided assurance that photographs are taken only when a suspect is detained, arrested and/or charged. The service does not retain indefinitely images of people who were not subsequently charged with, or convicted of, an offence. The images are retained on the criminal history system and uploaded to the police national database, which was created and is administered by the Home Office. The facial recognition technology has been available to Police Scotland on the police national database since 2014 and it has been used on 440 occasions. The police national database is an extremely valuable resource that helps to prevent and detect crime in order to make communities safer across Scotland.
Of course facial recognition technology has the potential to help to detect crime, but like other biometric technologies, its use must be properly regulated. However, the technology has been put into operation without any public or parliamentary scrutiny. The Commissioner for the Retention and Use of Biometric Material has warned of the dangers in creating the facial recognition database because it is subject to none of the controls and protections that currently apply to DNA and fingerprint databases. Does the cabinet secretary share the concerns of the expert independent biometrics commissioner?
It is important that we take into account any concerns that are raised on such matters, but Alison McInnes will be aware that in Scotland we have the Criminal Justice and Licensing (Scotland) Act 2010, which includes provision on retention of information on the criminal history system that Police Scotland operates, and which feeds into the police national database.
It would be wrong to suggest that there is no provision for how records are held on individuals who are charged for or convicted of offences. As ever, we are prepared to look at areas in which improvements can be made, but I am not aware that any particular concerns have been identified about how Police Scotland operates the system that is presently administered by the Home Office.
It important not to be complacent; we do not have a clear regulatory framework or proper safeguards. What prevents the police from using the technology to go on fishing trips or to embark on mass surveillance? Could the police identify individuals at football games, for example? The technology has also not been rigorously tested. What safeguards, if any, are in place to prevent wrongful or mistaken identification?
In my earlier response, I described how Police Scotland operates the photographic facial recognition system. Photographs are taken only of individuals if they are arrested, detained and/or charged. Police Scotland does not retain indefinitely images of people who have not been charged for or convicted of a crime. If the person is not charged, is dealt with under a non-prosecution disposal, or is found not guilty, the criminal history system that Police Scotland operates is updated to recognise that. It then weeds out the files and updates the police national database, which means that any information that has been put on it is removed. The system’s weeding mechanism removes individuals who have not been charged for and/or convicted of offences, which ensures that the images are not retained on the police national database.
Does the cabinet secretary know whether the Scottish Police Authority agreed to Police Scotland uploading custody photographs to the police national database? Was the SPA aware, was its agreement sought, and if not, is this situation just like the deployment of armed police and stop and search? Is the SPA doing its job? If it is not, can the cabinet secretary have a word to get it to take some control of what Police Scotland is getting up to?
It is important to maintain perspective in such matters. Trying to wrap the issue up with armed police officers and stop and search is to blow it out of all proportion, to be perfectly frank.
There are areas in which the Scottish Police Authority can improve how it operates. Her Majesty’s inspectorate of constabulary has already looked at that and an action plan is in place. It is therefore important to recognise that although we will have to address issues in policing and how the SPA is operating, to try and roll everything up together and say that everything is just bad does not help anyone and does not help us to progress in a reasonable and considered way.
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