SCOTTISH EXECUTIVE
Health and Wellbeing
Parkinson's Disease
To ask the Scottish Executive how it supports people who have Parkinson's disease. (S3O-6756)
As with all long-term conditions, we want people with Parkinson's disease to get services that are personal to them, fully integrated and delivered as close to home as possible, but with ready access to specialist care when they need it. Implementing clinical guidelines and clinical standards, both of which are under development, is a key way of improving support and services to people with Parkinson's disease.
There is no hidden agenda behind the question. A local group in my region raised with me an issue in relation to Parkinson's disease, on which I seek clarification. The cabinet secretary will be aware of the difficulties in ensuring equity in access to specialist nurses. A number of Parkinson's groups in various locations have fundraised in order to facilitate that, realising the pressures that the national health service is under. However, there seems to be inconsistency in how health boards deal with such donations. Do guidelines allow the ring fencing of funds that are donated to underwrite the cost of a nurse or other facility? Alternatively, does the money just go into the general pot for the health board, and, if so, is there some way of remedying that apparent anomaly?
That is a good question. Hugh O'Donnell might be interested to know that I have recently asked the Health and Sport Committee to consider the draft guidance to health boards that I asked for following the case in which the Royal Bank of Scotland donated a scanner to the NHS. Margo MacDonald suggested that guidance might be helpful. I will consider the Health and Sport Committee's views on the draft guidance and determine the way forward. Although the guidance was initiated by the RBS situation, it would apply more generally.
Leisure and Health Facilities<br />(North of Scotland)
To ask the Scottish Executive what action it is taking to maximise the use of leisure and health facilities in the north of Scotland. (S3O-6763)
It is essential that we work together to change people's attitudes and behaviour towards physical activity and sport to help to achieve the outcome of people leading longer and healthier lives. As the Minister for Public Health and Sport said in a debate last week, the development of the common health legacy programme and community sports hubs will be key to our efforts in achieving that. We are committed to working with local authorities, health boards, community planning partnerships and others across the whole of Scotland to make greater use of existing facilities.
I thank the cabinet secretary for that informative answer. It is arguable that in my constituency some health and leisure facilities are not used as much as they could be, which is not the fault of the Government, and that there is an historical lack of facilities, which, again, is not the fault of the Government—it is probably due to the change in local government in the 1990s.
As I am sure Jamie Stone agrees, such work is best done locally. It is for local agencies to decide on the need for and the appropriateness of such work.
National Health Service Waiting Time Targets
To ask the Scottish Executive whether it plans to introduce new NHS waiting time targets. (S3O-6665)
The Government is committed to ensuring that patients have swift and safe access to the full range of services that they need from the NHS. In addition to our general 18-week referral-to-treatment target, we are working to establish by April next year a referral-to-treatment waiting time target for specialist child and adolescent mental health services. Access to psychological therapies will receive a similar focus, to inform consideration of establishing a waiting time target to access those services. This year, we also plan to set a clear target for reducing the time that drug users must wait to access treatment, with a view to introducing a formal measure in April 2010.
I thank the cabinet secretary for her comprehensive answer. She might know that a focus on targets is not always in patients' best interests. Did she read the article in The Herald on 13 April by Gavin Tait, a consultant orthopaedic surgeon from Kilmarnock? He said:
As far as I know, Gavin Tait is an excellent surgeon—he is certainly of high repute. I hope that he will not take what I say as a criticism, because it is not meant to be. He is entitled to his opinion and he vehemently opposed my decision to save the accident and emergency unit at Ayr hospital—he is based in Crosshouse hospital. That was a difference of opinion that we had.
Will progress on waiting times be affected by the planned cut of £129 million in the health board budget next year as a result of the chancellor's budget last week?
The chancellor's budget last week—the point is serious—places under threat public services and thousands of jobs in Scotland. That is why it is serious and potentially damaging. As well as the so-called efficiency savings that the chancellor talks about—in anybody else's language, they are cuts, because the money does not stay with front-line services—a baseline cut to the health capital budget in England means sustained year-on-year cuts to the health budget in Scotland. That is serious, and the Scottish Government must consider how to deal with it, but the Scottish Government will always work extremely hard to protect health services, as we have done throughout the past two years, and to ensure that patients continue to receive speedy access to good-quality treatment. That is my priority and the priority of all Scottish National Party members.
The cabinet secretary will be aware that 40 per cent of wheelchair users are using wheelchairs that belong to someone else and are not therefore fit for individual needs. In some instances, there can be a waiting time of more than two years before someone gets a wheelchair that fits them. Does she believe that wheelchair users should be included in the waiting time initiative? Does she believe, as I believe, that being confined to home because of an inappropriate wheelchair is just as much a mobility issue for someone as needing a new hip?
Trish Godman previously asked me a similar question. I commend the passion that she brings to the issue. I agree in general that for someone who needs a wheelchair, not having access to one damages their ability to be mobile and to live a normal and independent life. The issue should be seen in that context.
Care Homes
To ask the Scottish Executive what action it is taking to improve the quality and consistency of care that is provided by care homes. (S3O-6755)
The Scottish Government is committed to improving the quality of all care services, including care homes. That commitment is, of course, shared by the Convention of Scottish Local Authorities, the Scottish Commission for the Regulation of Care, Scottish Care and other key stakeholders. Together, I believe that we are making significant progress in advancing the quality of care in care homes in Scotland.
It is interesting to note that the care commission recently found that 43 per cent of care home providers and staff do not recognise that they should be delivering palliative and end-of-life care to residents who have a life-limiting illness. How will the cabinet secretary ensure that the palliative care needs of care home residents with a life-limiting illness are recognised and met at every stage, in addition to their end-of-life care?
The care commission report to which John Farquhar Munro refers is important. As he is aware, it contains a large number of recommendations, which I expect to be implemented. The importance of good-quality palliative care that respects individuals' choices, regardless of where they happen to be, is fundamental. I hope that we have reflected our commitment to improving the quality of palliative care services in "Living and Dying Well", our palliative care strategy, which covers many of the care commission's recommendations. I give the member this assurance: we are very focused on improving the quality of palliative care for people in care homes, their own homes and other settings.
The cabinet secretary will be aware of the concerns that care home directors have expressed about the implications of the European working time directive for the costs involved in employing live-in staff to provide care. How will the Government tackle those costs over the long term?
To my knowledge, I have had no specific representations from care home directors on that issue, although they may have provided them recently. I am more than happy to have a discussion with them, albeit that, as employers, care home directors hold the primary duty to ensure that they comply with the law.
The cabinet secretary mentioned people who are cared for in their own homes. She will be aware of the concerns that were raised in the recent "Panorama" programme. What action is the Scottish Government taking to ensure that people who receive care in their own homes receive proper care and are not simply warehoused in their own homes because that is a cheaper option than having them in proper residential care facilities?
I take the view that everybody takes: people should receive the care that is appropriate to them and their needs. People have an element of choice—some will prefer to be in an institutional setting as opposed to their own home—but people's care needs should be reflected in the type of care that they receive, and we must ensure that we properly regulate the quality of that care. Obviously, local authorities have a key role in ensuring that the services that are provided—and which, in the main, they fund—achieve the right quality and standards.
The care commission regularly makes recommendations about services that do not meet the national care standards. In some cases, little is done to check that service providers act on those recommendations, which results in many care homes continuing to operate well below the care standards that they and all of us should expect. Will the cabinet secretary outline the care commission's auditing and monitoring process and confirm whether she is satisfied with the current system?
It may be appropriate if I write to Mary Scanlon to give her a proper and detailed answer to that question and outline the audit arrangements. However, I make it clear that when the care commission considers complaints and finds failings on the part of care homes, it typically asks the provider to respond to the concerns. It has a range of powers and can take a range of actions, including, of course, deregistering a care home if it is not satisfied. Those possibilities exist. However, Mary Scanlon's question about the auditing process deserves the courtesy of a detailed response.
In-patient Telephone and Audiovisual Use (Charges)
To ask the Scottish Executive what discussions it has had with chief executives of national health service boards in respect of charges for in-patient telephone and audiovisual use. (S3O-6715)
A number of NHS boards in Scotland choose to offer Patientline bedside entertainment and telephone facilities. No further discussion has taken place about that, because the provision of such services for patients in hospitals is primarily a matter for NHS boards. A patient's access to those services is, of course, always voluntary.
I have investigated charges throughout the NHS in Scotland and will forward my findings to the cabinet secretary later today.
I know that Bill Butler has raised this issue before, and I look forward to seeing the information that he has gathered.
Authorisation to Lift Patients
To ask the Scottish Government whether it will review the bodies and emergency services authorised to lift and raise patients who have fallen at home but do not have an immediate life-threatening condition. (S3O-6758)
Various services are in place throughout Scotland to respond to people who suffer falls at home, including local authority and health board falls teams. The emergency services are also available to deal with falls victims. There are no plans at present to conduct a review of the arrangements, but cross-organisational working groups are in place to deliver enhanced systems of communication between the key stakeholders.
I am grateful for the cabinet secretary's reply, but I appeal to her to consider the issue again. In the past year, I have been approached by two families who have experience of falls at home. One gentleman who came to an advice surgery told me that, after his wife had fallen, it was eight hours before the police came to lift her because, after contacting NHS 24, they were informed that the council had no ability to lift her and that the fire or ambulance services would not do so unless there was a 999 call-out. That is clearly not acceptable. I understand that procedures are in place, but they are insufficient to provide the support that people need, particularly people with degenerative conditions such as multiple sclerosis. Will the cabinet secretary reconsider the issue?
I am more than happy to give Jeremy Purvis an assurance on that. I cannot comment on the detail of the cases that he cites but, if he writes to me giving more information about them, that might inform a further consideration of the issue. I agree with the general thrust of his question that it is important that people in such situations receive the right response. Preventing and dealing with falls is an important aspect of avoiding unnecessary admissions to hospital, for example. The issue is important, and I am more than happy to engage further with Jeremy Purvis on it, based on the experience of his constituents.
Short-term Lets (Antisocial Behaviour)
To ask the Scottish Executive whether it has considered the various options for regulation of houses in multiple occupation with particular reference to addressing the problem of antisocial behaviour in short-term lets. (S3O-6716)
Houses in multiple occupation are required to be licensed primarily to ensure that they meet standards that are designed to protect their residents from the risks of that type of accommodation. We have stated that we will discuss with stakeholders the possibility of including short-term lets in HMO licensing, to extend the protection. However, it would not be appropriate to extend HMO licensing to any category of accommodation solely to address antisocial behaviour.
As the minister will know, I wrote to him a few weeks ago asking him to consider various options for dealing with antisocial behaviour in short-term lets. Why will he not bring such lets into the HMO licensing regime so that action can be taken when there is a persistent problem, as with the stag and hen weekends at Western Harbour in my constituency? Over and above that, why will the Scottish Government not consider modifying by order part 7 of the Antisocial Behaviour etc (Scotland) Act 2004 to ensure that antisocial behaviour notices can be served on the landlords of such properties?
I have two points. First, we will discuss with stakeholders the possibility of extending HMO provision to short-term lets. Secondly, I want to make a clear distinction between short-term lets and holiday lets. Based on advice from the City of Edinburgh Council, we believe that the kind of incident to which Mr Chisholm refers is primarily related to people who are in holiday lets, not short-term lets.
I welcome the minister's statement that he will examine the matter and that all avenues will be explored. Is he aware of the potential negative impacts that some changes might make to the holiday and short-term lets sectors, which are important to tourism not just in Edinburgh and the Lothians but the rest of Scotland? Will he ensure that, while we deal with the antisocial behaviour that is undoubtedly happening in a small but significant number of cases in Edinburgh, we still protect our vital tourism market and the contribution that it makes to the economy?
Holiday lets are already covered by part 7 of the Antisocial Behaviour etc (Scotland) Act 2004, so legislation is in place to deal with the problem of antisocial behaviour in holiday lets. For us to extend licensing to holiday lets could do enormous damage to the tourism industry in Scotland, including to the Edinburgh festival, which accounts for a lot of holiday lets.
The minister has to listen to the residents of the city as well as to the tourism industry. He said that he is not prepared to act solely on grounds of antisocial behaviour, but I put it to him that my constituents have raised significant safety issues with me about the lack of appropriate regulation in the sector, which urgently needs to be addressed.
We are listening to what people say; we have had representation from three MSPs but none from anyone else. We have discussed the matter with the City of Edinburgh Council, which is strongly of the view that holiday lets should not fall under HMO licensing. Although we will deal with the problem of short-term lets, unless we see evidence to the contrary we will not include holiday lets within the ambit of licensing legislation.
If the minister is listening to all voices, he will listen to Sarah Boyack's in particular because she speaks for most of Edinburgh when she says that most people are absolutely fed up with the city centre being trashed. It contains high levels of rental and owner-occupied property. The minister has to tackle the problem one way or the other; we wait to find out which way he will choose.
I do not think that that was a question, but I am happy if the minister wants to comment.
I agree that the problem of antisocial behaviour in the centre of Edinburgh or anywhere else has to be tackled, but it is antisocial behaviour legislation that must be used to do so and not, in this case, any additional legislation that relates to holiday lets.
Children's Hospital (Project Team)
To ask the Scottish Executive when it last met the project team responsible for the new children's hospital at the Southern general hospital. (S3O-6738)
Officials have an appropriate level of contact on an on-going basis with those developing the new south Glasgow hospitals. That includes having representation on the executive board and the procurement and finance group for the project.
I know that the minister is aware of how hard Glasgow MSPs and campaigners fought to preserve the world-renowned integrated child and maternity services that are currently at Yorkhill hospital and the Queen Mother's hospital in my constituency. I asked in a written question on 10 March whether there would be a delay in the transfer of integrated services to the new gold-standard children's hospital, and I was concerned to learn that, rather than the one-year gap that everyone expected, it will now be four years—the transfer will happen in 2014 instead of 2011.
Pauline McNeill referred to the campaign that she and other Glasgow MSPs were part of some time ago; I was also part of that campaign. The plans that we are now implementing were signed off by the previous Administration, but she raises two points about the current state of those plans and it is appropriate to give her answers.
Health Services <br />(Young People with Disabilities)
To ask the Scottish Government what actions it is taking to support health services for young people with disabilities. (S3O-6700)
Children and young people with complex health needs were identified as a priority for investment in the "National Delivery Plan for Children and Young People's Specialist Services" that was launched in January this year. A national managed clinical network has been established and will inform and support future work to ensure that each child is fully and appropriately assessed and has access to a full range of specialist care, underpinned by agreed clinical pathways and protocols. Each child should receive equitable, quality care regardless of their location and tailored to their individual requirements.
I thank the cabinet secretary for her full answer. We know that many children with disabilities experience a negative impact from poor moving and handling. What steps have been taken to address that issue?
Gil Paterson will be aware that Scotland's Commissioner for Children and Young People has done work on moving and handling, and he is right to say that that is an extremely important issue for children with physical disabilities. The commissioner's work placed particular emphasis on the need to bring about greater clarity, inclusion and dignity in the moving and handling of children and young people. On the back of that, the Scottish Government is working to develop a cohesive approach to the issue, to deal with some of the particular issues that have been raised. We have kept in touch with the commissioner's office as our work progresses. We plan to engage the office and, using its expertise, to engage children, young people and families when finalising our approach. I am more than happy to keep Gil Paterson updated on the progress of that work.
Ageing Population (Highlands and Islands)
To ask the Scottish Executive what support it will give to NHS Highland and other key agencies in the Highlands and Islands to help them respond to the needs of a predicted increasingly ageing population. (S3O-6666)
Local health and social care partnerships throughout Scotland must review and redesign services to ensure provision of sustainable good-quality services to meet the needs of an ageing population. The joint improvement team offers practical help with capacity planning, investment strategies and service redesign.
Is the minister aware of the recent comments of the respected University of Stirling academic Professor David Bell about the difficulties that my region of the Highlands and Islands faces as a result of the increasing number of elderly people in the area? Does the minister agree with his statement that
Jamie McGrigor is right to say that our whole society faces challenges as a result of the ageing population. I recognise that those challenges are more acute in some parts of the country than they are in others. In rural areas, especially in the Highlands, the challenges are stiffer than they are elsewhere.
Dental Waiting Lists (Borders)
To ask the Scottish Executive how many patients will be removed from dental waiting lists following the opening of new dental facilities at Coldstream and Hawick. (S3O-6667)
NHS Borders expects that about 7,000 new national health service registrations will be achieved within 12 months of the opening of the new facilities, but that will be done in a phased way in order to manage the previously unmet treatment needs of patients.
I am sure that the cabinet secretary will agree that it is the massive underinvestment in dental services by the previous Liberal-Labour Administration that has resulted in this chronic shortage of NHS dentists in the Borders. I am sure that she will also agree that dental checks are an important part of general health checks. What action will the Scottish Government take beyond what has already been announced to address the fact that waiting lists in the Borders are still growing?
I will resist the temptation to get involved in party politicking, which is against my nature as John Lamont well knows.
“Better care every step of the way”
To ask the Scottish Executive how it plans to respond to the recent report by the Scottish Commission for the Regulation of Care, "Better care every step of the way". (S3O-6765)
"Living and Dying Well: A national action plan for palliative and end of life care in Scotland" aims to improve the quality of palliative and end-of-life care and to ensure that it is available for anyone who requires it, regardless of their diagnosis or location. The implementation of the plan includes work to support care homes in the delivery of effective palliative and end-of-life care.
There might be cost implications if 57 per cent of services have not trained their staff in palliative and end-of-life care. How will the cabinet secretary deal with homes that are supplying a much-needed service but find themselves unable to provide the quality and depth of training needed for such a wide range of people?
As I have learned over the past couple of years—albeit probably not as much as my colleague John Swinney, who has just joined us in the chamber—everything has cost implications, and these services are no different. However, it is an important question.