Chamber and committees

Under our second agenda item, we will continue our scrutiny of front-line national health service boards. I welcome to the meeting Jim Miller, who is the chief executive of NHS 24.

We will move straight to questions. What efficiencies do you envisage will provide the £2.9 million of savings that are required by the board?

That is helpful. How will you monitor your invest-to-save proposals? You have touched on them a little bit, and what you submitted to the committee in advance of today’s meeting included some detail in that regard. You described them as “digital and workforce improvements”. How will you ensure that they deliver the expected savings, and over what timeframe do you expect to see a return on that investment?

That is helpful. How does the organisation balance the rising costs and vacancies with the plans for future expansion to meet the growing demand that we anticipate? There has certainly been growing demand for NHS 24 services over recent years, and projections suggest that demand will increase.

What steps are being taken to ensure local accountability in implementing the MAT standards with a view to driving improvements across Scotland?

It is clear that Scotland will not find either of those things as part of the Westminster system of Government. The route to both is Scotland becoming an independent country.

Challenges remain, and there are still unacceptable waits in some specialties, but the Scottish Government remains committed to delivering sustained improvement and year-on-year reductions in waiting times, through maximising capacity across Scotland, enhancing regional and national working, and redesigning care services.

As the cabinet secretary has referenced, the BMA today wrote to Rishi Sunak, asking to meet him urgently to find a resolution to the on-going dispute in England.

Thank you.

In the remainder of my speech, I will focus specifically on alcohol misuse and its contributory impact on liver disease. Alcohol harm is on the rise, with a 22 per cent increase in alcohol-specific deaths in the past two years. Nearly one in 15 of all deaths in Scotland is caused by alcohol, mainly due to cancer, stroke and heart disease. An estimated 16 per cent of ambulance call-outs in Scotland are alcohol related, and one person is admitted to hospital as a result of alcohol every 15 minutes.

In 2021, NHS Lanarkshire, which is the health board that covers my Rutherglen constituency, reported the second-highest mortality rate as a result of chronic liver disease of all health boards in Scotland. Earlier this month, I had the opportunity to meet Alcohol Focus Scotland and clinicians who specialise in the harm that is caused by alcohol misuse. One of the main issues that they raised with me was how normalised drinking alcohol is in the UK and how readily available alcohol is to buy. According to the Scottish liquor licensing statistics for 2021-22, there are 710 places from which to buy alcohol in South Lanarkshire, around 460 of which are in pubs and restaurants, with the remainder in shops.

During my discussion with Alcohol Focus Scotland and the clinicians, they spoke of the beneficial effects of minimum unit pricing, without which the impact of alcohol-related harm or liver disease would likely be even greater. The recent Public Health Scotland and University of Glasgow study “Evaluating the impact of alcohol minimum unit pricing (MUP) on alcohol-attributable deaths and hospital admissions in Scotland” indicates that a 13.4 per cent reduction in deaths and a 4.1 per cent reduction in hospital admissions were wholly attributable to alcohol consumption in the first two and a half years after minimum unit pricing was introduced.

I know that the Scottish Government is currently reviewing the 50p minimum unit pricing rate, with calls from Alcohol Focus Scotland for an increase to the level. As convener of the Parliament’s Health, Social Care and Sport Committee, I look forward to seeing more details of the Government’s plans regarding that in due course.

Alcohol-related harm is one of the most pressing public health challenges that we face in Scotland. There were 2,340 alcohol-related hospital admissions in South Lanarkshire in 2021-22. Over the same period, 77 people died in South Lanarkshire from conditions solely caused by alcohol. Every year, alcohol costs South Lanarkshire an estimated £301 per person.

In truth, however, the cost is not just financial. The impact of a loved one being hospitalised or dying due to alcohol can be devastating not just for the person involved but for their friends and family and for the wider community. The Scottish Government has taken action to prevent and reduce that through the introduction of the minimum unit pricing policy, the reduction in the drink-driving limit and the multibuy discount ban. However, we should not be complacent. We should recommit to doing all that we can to tackle the challenges of liver disease and liver cancer in order to save lives.

Can the cabinet secretary outline what engagement the Scottish Government has had with the BMA to address these concerns while the UK Government continues to fail to listen to junior doctors?

I congratulate my colleague Stuart McMillan on bringing this important debate to the chamber.

We know that 90 per cent of liver disease is preventable but, sadly, it is one of the leading causes of premature death in Scotland. In addition, liver cancer has seen the largest increase in mortality rates of all cancer types over the past decade, and it is now the fastest-rising cause of cancer deaths in the UK.

It is vitally important that we focus on the prevention of liver disease and liver cancer, and step up efforts to detect them earlier. For that reason, I welcome the news that NHS Lanarkshire has partnered with the British Liver Trust to launch a series of love your liver roadshows across Lanarkshire this summer.

The love your liver mobile unit will stop at 10 locations in Lanarkshire over the next three months to find people who have been exposed to the hepatitis C virus, which is a silent disease that can lead to severe liver complications if it is left undetected. Visitors to the unit will have the opportunity to gain information about hepatitis C and receive a non-invasive liver scan, and a swab test if they are identified as being at high risk of hepatitis C and liver disease. The roadshow will be in my Rutherglen constituency, at Morrisons in Cambuslang, on Wednesday 26 July. I greatly encourage constituents to attend it.

The Scottish Government is determined to reduce waiting times across all health specialties. Within the past seven days alone, the health secretary has announced funding for a new national digital dermatology programme, which could reduce demand for out-patient appointments in dermatology—one of the biggest out-patient specialties in Scotland—by up to 50 per cent.

In addition to that, on Monday in Inverness the First Minister opened Scotland’s third national treatment centre. The extra capacity that it has created will help to reduce NHS waiting lists that have built up during the pandemic, and the two further NTCs that are set to open this year will help to further that aim.

Although there is still more to do, since targets were announced last July such actions have resulted in a continued reduction in long waits of over 18 months, as well as a significant reduction in long waits of over two years.

The Labour motion shows us that that party has its head in the sand and demonstrates how little it understands the challenges that are faced by our NHS—not only in Scotland but across all the UK nations. There is no recognition or acknowledgement in it of the biggest challenge that the NHS has faced in its almost 75 years of existence: that is, the Covid-19 pandemic. Scottish Labour might not wish to accept that fact coming from SNP members, but it should listen to Welsh Labour’s First Minister, who recently said:

“The health services are trying to cope with the impact of the coronavirus, and they are also trying to re-establish everything else that is important in those services.”

Quite evidently, health services across the four nations and, indeed, internationally, are dealing with the effects of the pandemic on waiting times.

I also find it telling that, in its motion, Labour refers to use of private healthcare, which—although Labour would have us believe otherwise—is not unique to Scotland but affects health services across the UK. The rate of people who are self-funding for private in-patient day-case care in England is 19.9 per cent higher than it is in Scotland. In Wales, where Labour has been in charge of the health service for about 25 years, the rate is an eye-watering 120 percent higher than it is in Scotland. Labour’s UK shadow health secretary, Wes Streeting, recently said that

“Labour would use the spare capacity in the private sector to get patients seen faster”.

Another area in which some self-reflection from Labour would not go amiss is Brexit, which it now fully supports despite the impact that it is having on recruiting and retaining NHS staff. Although NHS staffing is up to historically high levels under this Scottish Government, we know that workers from overseas have long been an important part of our health and care workforce, and that international recruitment is vital to addressing staffing shortages in the NHS. Since Brexit, the number of new international nurse registrants from inside the European Union has fallen dramatically. Friends and colleagues have returned to their EU home countries, and other people who might have considered a new life here have decided not to come to the UK. That is evidenced in Nursing and Midwifery Council registration data from the past few years, so it is fact, rather than opinion.

As a country, we need to find a way of ensuring that we have an immigration system that is not just humane but meets our social and economic needs.