Chamber and committees

Will the member take an intervention?

To ask the Scottish Government what discussions the housing secretary has had with ministerial colleagues regarding what work can be done to repurpose empty commercial and other proprieties for affordable housing in Glasgow. (S6O-04440)

I am pleased to open for the Labour Party in this debate. In an age of technological marvels—from artificial intelligence to identifying cancers earlier and advanced robotics that can turn what were once impossible surgical procedures into routine day cases—it is clear that innovation is vital for the national health service and for our wider population’s long-term health and prosperity. However, when we look across the past decade or so at innovation and who is truly leading the field, I am afraid that the Scottish Government, given its leadership of the national health service, can be considered something of a laggard by international standards. For example, we are told that we can expect the full roll-out of the NHS digital front door over the next five years, yet Estonia—a European country with less than a third of Scotland’s population—has already pioneered digital healthcare, embracing digitisation of its healthcare system as early as 2008.

We are told that the Government is building partnerships between itself and healthcare professionals, universities and technologists in a so-called triple helix of innovation, which the health secretary referred to, but, to an extent, that has always existed in this country. It seems that the Government is only announcing something that is already long established from when this country pioneered diagnostic ultrasound, back in the 1950s, for example. The test, truly, is how we are delivering improved at-scale patient outcomes and how we are achieving productivity enhancements across the healthcare system. There is huge unmet potential across the national health service.

As the member knows, the healthcare system in England—which has been a separate entity from the one in Scotland since its foundation, in 1948—is broadly modelled on a trust system. Scotland experimented with the trust model in the 1990s and moved to health boards in the early 2000s. Therefore, it is not a fair comparator. Scottish Labour’s policy is to rationalise the 14 current territorial boards into three, which would largely mirror the cancer pathways that are currently in existence. We feel that that is a more optimised scaling for the NHS in Scotland. With a population of 5 million or so, that seems like a more optimised balance. A direct comparator is not necessarily clear.

My point is about productivity across the system. We are not fully utilising the benefits that the national health service provides to Scotland and the UK—such as purchasing power and scaling ability—to drive improvements in patient outcomes. At present, the accelerated national innovation adoption pathway talks mostly to Scottish Government bodies and NHS boards. That seems like a very insular ecosystem. We are in danger of creating another echo chamber—one in which the same people with the same vested interests say the same things to the same Government bodies while the nation continues to drift ever further behind.

It has been a really interesting and insightful debate. There has been a degree of unity across the Parliament this afternoon on the opportunity for Scotland to harness its great strengths in healthcare—not just to advance our country’s performance, but to make a global contribution to the condition of mankind. As a country, we can all aspire to achievement of that.

We have already achieved so much, but we could do so much more by harnessing the unique opportunity that the national health service gives us—internationally, it is a unique model—to rapidly achieve triple-helix effectiveness. Other countries have done so in the past, and we could learn from what other countries are achieving, particularly in creating national champions who can drive forward rapid advancement in healthcare technology.

Just last year, I was walking through Liverpool and saw the statue of Brian Epstein, the fifth Beatle, and I thought about what that represented. The Beatles were a great cultural achievement for the UK, but inadvertently, they gave birth to one of the greatest healthcare inventions of all time. What links the Beatles to the computed tomography scanner is EMI, which ran not only the EMI Records label but a massive medical technology research company as part of the industry that it developed.

Working in concert with the NHS through the 1970s, Godfrey Hounsfield, who ran EMI’s laboratories, used proceeds from the Beatles’ record sales, along with a Department of Health and Social Security grant, to develop what was then known as the EMI scanner. He went on to win a Nobel prize. Not many people realise that the Beatles are indirectly responsible for his winning a Nobel prize for a global medical innovation that has saved millions of lives.

The development of CT scanners for the world is a great medical achievement, but the catch is that, despite Britain and Scotland having such great technologies, inventors, universities and creative outpourings—often because working-class people have been able to access education and improvement in a way that has not been achieved in other countries—we seem not to have a knack for turning them into industrial benefit for our society and our country. To return to my point about EMI, I note that that company has since been broken up. It is now owned by American and German companies, and most of the CT scanners in the world are made by American and German companies, so Britain does not benefit from that technology.

Similarly, diagnostic ultrasound was developed in Glasgow. In 2014, I was at a dinner to celebrate the inductees to the Scottish Engineering hall of fame. The late Tom Brown was being inducted. He had been working in Glasgow for Kelvin and Hughes Ltd, mainly in industrial radiography, and had teamed up with colleagues who were clinicians to develop the first diagnostic ultrasound machine. In his acceptance speech, he made the point that, although

“It wasn’t an easy birth, nor one that was recognised at the time for the impact it would have on diagnostic medicine in general, and mothers and babies in particular ... it was the ‘little acorn’ out of which would grow the great oak”

of that global advancement. However, he said,

“it was the engineers who made it happen”,

and

“As usual the medics tried to claim more credit than their due share”

for the invention, and that,

“through our seeming national incompetence at exploiting our own inventions, we lost out to the Americans and”

Japanese,

“and ultrasound machines are now only made abroad and imported back”

into Scotland.

We see that happening with Optos, which was another fantastic innovation company, based in Dunfermline, that was sold to Nikon in 2015. Douglas Anderson—who started that amazing company, which produced ultra-wide-field retinal imaging systems—made a great invention, but why could we not scale it in Scotland? As many members mentioned in their speeches, we have a real problem with taking companies that have fantastic potential, and keeping them anchored and owned in Scotland, and achieving benefits in concert with the national health service. I earlier mentioned Touch Bionics, which was a spin-out from the NHS that was sold to an Icelandic company in 2016.

Many members have touched on the opportunities to harness technology across our national healthcare system, and not just in hospitals. On the critical point that time is the currency of healthcare, Mr FitzPatrick told a touching story about his father’s experience of having a stroke. I have heard from constituents about similar situations, in which not getting people to hospital in time and not getting rapid emergency treatment has often led to lifelong disabilities when conditions were not dealt with quickly.

Time is of the essence: ultimately, that is what we are talking about when it comes to technology. Equipping our clinicians—the people on the front line of our NHS—to act more rapidly, more accurately and more effectively to treat our population will, I hope, get better outcomes for everyone and add to our national prosperity.

That carries over from acute hospitals into the home setting. Hospital at home has been mentioned, as have housing associations. We need to ensure that such adaptations are carried through to the primary care system.

Many GPs say that they are overwhelmed. They would love to harness new technologies and to work with their community links workers. They would love to have a sophisticated interface for their patients, but they have queues out the door and are dealing with clinics every day—there is no head space to implement innovations. The cabinet secretary needs to think about how he can support our primary care practitioners to develop and deploy technologies that are industry standards elsewhere in the world. We have heard about other parts of the UK where use of those technologies can be achieved.

I thank the member for indulging me in a second intervention. He makes an interesting point about silos and about harnessing the technology that Scotland is good at. For example, we have one of the biggest fintech clusters in the world. We know how advanced financial services applications are and how easy it is to access banking services by phone, but there is no such development in the healthcare system. Could we tap into some of the existing centres of excellence that the member mentioned? There is work in Dundee on the gamification of technology as well as on fintech. Could we look at more and deeper collaboration on that?

Progress has certainly been good, but so much more could be done. Some recent changes might militate against effective reuse of listed buildings, such as those on empty property relief, administration of which was devolved to Glasgow City Council a couple of years ago. A charge is now being made, without any exemption, on vacant listed buildings. Because that process has been handled in a blanket way it is gumming up the market and preventing restoring purchasers from taking on listed buildings.

I also highlight the opportunity that Lar Housing Trust has identified through its project to restore the Inn on the Green, which is a grade B listed property in Bridgeton. The trust says that it could have the building ready in time for the Commonwealth games next summer, so that it could house 150 athletes before it is first let on the market. It has just been told that the Scottish Government has knocked back its application for further funding. Perhaps the minister could consider that opportunity to be a demonstrator of sustainable reuse of Glasgow’s buildings, as part of the Commonwealth games project.

It is perfectly fair that the health secretary highlighted those examples. The question is how quickly we can disseminate, integrate and rapidly roll those things out into operational improvements. That is where we could see significant improvement on a number of fronts.

One example in the NHS that is very promising but still tantalisingly underutilised is robot-assisted surgery. We have already achieved the breakthrough milestone of 10,000 robot-assisted procedures in Scotland, and, in the NHS Ayrshire and Arran health board area, more than 250 women have benefited from minimally invasive robotic surgery in the past year alone. That has transformed outcomes. They walk out the door within hours of the surgery, whereas previously it required convalescence for weeks.

That is testament to the skill of the NHS staff—the surgeons and clinicians—who are supporting those roll-outs and improvements. However, there is still underutilisation, because the bureaucratic inertia of the NHS means that it is not fully geared up to deal with such innovation and roll it out to its full potential. That is where the Government needs to push it further. Before we congratulate ourselves, we need to recognise that Scotland could be much better at that, and we should hold everyone to account for that improvement.

We need to look at international standards. It is not good enough just to meet the global standards of a decade ago and think that that is sufficient. That is why Labour’s amendment recognises that, for the past 18 years—nearly two decades—Scotland has been stuck following a technological innovation pathway rather than leading that pathway. Despite our world-leading research hospitals and universities, we often fail to turn research that is developed in Scotland into action. We must follow the lead of other nations and companies that are developed in other countries.

Even when we show promise, such as in the development of Touch Bionics, which was one of the first spin-outs of the NHS in 2002 and was sold off in 2016 to an Icelandic company, we do not build it into a unicorn—a major international technology company that could be headquartered and led from Scotland rather than from Iceland. We should do more to harness the Techscaler programme and make strategic investments that benefit the nation and its prosperity.

We are exasperated to hear NHS staff talk about computer update timescales in terms of decades, not years. Even basic things such as wi-fi and mobile signals in hospitals are so bad that modern smartphones cannot be used. The Scottish National Party came to power before the iPhone was invented, and it seems that, as far as the NHS goes, it has still not been invented. That is why staff in the NHS still rely on pagers—technology that has been scrapped, with the vendors keeping it in service purely because the NHS still needs it. The NHS would fall over otherwise. The default mode of communication is paper-based prescribing, and the goal of e-prescriptions is seemingly unachievable for a Government characterised by its satisfaction with analogue processes.

There needs to be much more improvement. We know that delays in the sharing of data between health providers are slowing down patients’ diagnoses. Those delays are also leading to duplication of work and are wasting NHS staff time and slowing patients’ treatment plans. The lack of an NHS app means that patients are often unaware of their own medical records. The lack of interconnectedness across the healthcare system in Scotland is not just hypothetical; it directly worsens the healthcare outcomes of many thousands of NHS patients and is acting as a drag on national productivity. We know that the equivalent of one in eight people in Scotland is on a waiting list for some sort of procedure. That is a huge national lag. The NHS workforce is equivalent to the population of one of Scotland’s biggest cities, Dundee. If that workforce is not efficiently harnessed, it affects national productivity. We already know about the pressures on our social security system as a result of chronic illness and that, if people are unable to access the workplace, it affects our national finances.

We could have a virtuous circle rather than a vicious cycle. The pandemic shows that, when Scotland is serious about its national mission to adapt and innovate in healthcare, it can bring everyone with it and mobilise the country to achieve public health objectives. Now is the time to show that Scotland—the birthplace of the enlightenment and the pioneer of so many technologies, such as diagnostic ultrasound, which has transformed the world—can, once again, lead the world in healthcare innovation.

I hope that Parliament will support the amendment in my name.

I move amendment S6M-16777.2, to insert at end:

“; regrets that the Scottish National Party administration has, after almost 18 years in office, allowed Scotland’s NHS to lag behind in adopting innovation, with end-to-end paperless and e-prescribing policies undelivered and dated medical diagnostics equipment still in use, and calls on the Scottish Government to move Scotland’s NHS and social care sector from analogue working to the digital age, starting by creating a shared care record system and empowering patients through an NHS app.”

The cabinet secretary knows that there are a number of important capital projects across NHS Greater Glasgow and Clyde that are beset by serious delays, including the new radionuclide dispensary and the institute of neurological sciences. The Government says that it is committed to publishing a new infrastructure investment plan later in the year. Will that include details of timescales for delivery of those critical projects, which must progress so that patients can be assured that they will happen without further delay?

Will the member take an intervention?