Meeting of the Parliament

Meeting date: Thursday, November 10, 2016

Official Report 984KB pdf

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Accessible Hospital Transport

The next item of business is a members’ business debate on motion S5M-01935, in the name of Liz Smith, on accessible hospital transport in Scotland. The debate will be concluded without any question being put. [Interruption.] I remind people in the public gallery that the Parliament is still in session.

I ask members who wish to speak to press their request-to-speak buttons now. [Interruption.] I repeat my request to people in the gallery to leave quietly out of respect to members who are taking part in the debate.

Motion debated,

That the Parliament acknowledges the use of bus services by the public to travel to and from hospital appointments; notes that these services are often used by older, infirm and disabled passengers and that journeys often take place at times of anxiety, bereavement or distress; understands that a number of services, such as the X7 between Perth Royal Infirmary and Ninewells Hospital, the G1 and G2 routes that serve the Queen Elizabeth Hospital in Glasgow, and the X40 in Aberdeen, have been cut, are under threat or do not provide suitable access for disabled travellers; believes that all hospital patients should be able to travel to and from appointments in comfort, and notes the calls for the Scottish Government to work with its partners and the private bus operators to address what it considers an important issue.

12:46  

As we have seen with projects such as the new Forth bridge and the Edinburgh to Glasgow improvement programme, securing Scotland’s transport infrastructure is essential for our country’s future. However, for many Scots, what is important is not just the big projects but their local bus routes—especially those that provide vital links to hospitals and medical clinics. Those bus services are essential to the quality of life and the physical and mental health of patients and their families. Without those services, many Scottish communities would struggle, especially in an age when there is so much pressure to merge acute services.

The situation was made plain in a letter from one of my constituents. Because of complications from recent surgery, this lady is required to travel regularly from Perth royal infirmary to Ninewells hospital in Dundee. In the past, she used the 333 service but, since that route was withdrawn in November 2014, Stagecoach East Scotland has extended an existing coach route—the X7 service, which runs from Aberdeen to Dundee—to Ninewells hospital and now on to PRI. Although Stagecoach is offering a new coach, which in some respects provides a higher quality of service, it is leaving behind many people with mobility issues, such as my constituent. For example, the coach has only two seats downstairs, which are both often in use by other passengers. As my constituent suffers from chronic arthritis, she struggles to climb the stairs, and she claims that drivers are not in a position to help her when boarding the bus. [Interruption.]

I am going to say this again: I cannot hear the member speaking because of the noise from the public gallery. I am sorry, Ms Smith—please go ahead.

That is okay.

My colleague Alexander Stewart will say more, as he has been on the case for some time, as have councillors from across the political spectrum. There is an issue for people who have visual impairment, those who are recovering from orthopaedic injuries, those with heart conditions and people who find it difficult to negotiate the stairs on a moving bus.

There is a genuine concern that the buses are badly designed for the hospital link route. On top of that, the new £750,000 coaches cannot turn properly at Perth royal infirmary, as the turning circle was designed for the buses that were used on the old 333 service. Stagecoach offers a low-floor alternative—the 16—but that takes one hour and 13 minutes, compared with the 45-minute journey that the X7 provides. For someone such as my constituent, who has been on a difficult road with her treatment, the situation is very difficult indeed.

That constituent’s story is not the only case—there are dozens of similar stories from across Scotland. In August, there were problems for Fife passengers after changes to the 77 service between Gauldry and Ninewells hospital. The alternative service, which terminates at Dundee bus station rather than Ninewells, forces passengers to change buses and has been branded awful by local councillors. It has prompted a raft of complaints from constituents and many who are in the medical profession.

The X42 route, which connects Cupar and Ninewells, is also under threat, with a proposed alternative service also terminating at Dundee bus station. In Glasgow, the G1 and G2 bus services from Maryhill to Queen Elizabeth university hospital have been closed. In Falkirk, the First Bus services X86 and 24, which provide residents with vital access to Forth Valley royal hospital, have also been cut, which led community council members to label the cuts as unacceptable because they directly affect

“the elderly, infirm and those who do not have a car.”

In the Borders, the council-funded 71 route from Hawick to Borders general hospital was cut in July 2014, which left Hawick residents without a direct bus to their nearest major hospital. In Aberdeen, First Group has threatened to end the X40 and 11 services from Kingswells to Aberdeen royal infirmary, which is a move that local people claim will leave residents of the suburb without access to their hospital and will cause them to miss important medical appointments.

When those cases are put alongside each other, they give us a worrying picture of a Scotland where communities and, in particular, older people feel abandoned by transport providers and cut off from essential services. Although it is heartening that Transport Scotland is now offering subsidised bus services for older and infirm residents in some areas—an excellent example comes from the Strathclyde partnership for transport area—many of our elderly and infirm who face routine visits to their GPs are experiencing daunting and exhausting trips on buses. A weekly check-up can become a four-hour odyssey that requires multiple changes at different bus stations. For older residents, that can often prove to be too much, particularly at times of distress or bereavement and in poor weather.

The issue is not limited to the elderly. Non-drivers face equally challenging experiences to get to and from hospital. Centralisation has meant that many hospital appointments no longer take place in local hospitals, which results in longer and more costly journeys being required. It is often difficult for people to get a bus from outlying places to a hospital and, in many cases, it is impossible to visit in-patients in the evenings. That means that bus companies are in a difficult position—for example, the first bus to Livingston from Dunfermline leaves at 9 am and the last one back is at 5.40 in the evening.

Buses are a lifeline for rural communities and it is commonly agreed across the Parliament that support for community schemes needs to be increased by extending the free bus pass scheme to community transport. Otherwise, far too many people will become victims of a patchy national strategy that means that access to local hospitals is even more difficult for those who are most in need. This is not a party-political issue, and I hope that Scottish ministers will give it a lot of consideration.

Well done for persisting. We will deal on another occasion with the issue of noise, which is not fair to members.

12:52  

I thank Liz Smith for bringing this important subject to a members’ business debate. I agree with the first part of the motion. Bus services to and from hospitals are used by a variety of people and, as Liz Smith said, they are used by the most vulnerable in our society.

My area of Lanarkshire has three major hospitals and on occasion members of the public need to be taken to one that is not their local hospital in order to receive the most appropriate expert care. I had a query recently from an elderly gentleman who was taken for emergency treatment to Hairmyres hospital. He reported being taken to the hospital promptly and treated well by staff. However, when he recovered and was discharged, he found it extremely difficult to get public transport back to his home in Coatbridge. There were no available family members to collect him and he eventually resigned himself to getting a taxi. He was satisfied with the national health service care that he received, but he was worried about what someone who could not afford a taxi would do in his position.

Members will note that my use of that example indicates that I agree that there is a transport issue that can affect constituents from time to time. However, I do not agree with the second part of the motion, which suggests that the Scottish Government has not taken appropriate steps to address the issue or that it is somehow solely responsible—although I do not think that Liz Smith said that entirely.

It is fair to say that the Scottish Government has not acted appropriately. There has been no new bus legislation since 2007 and we are in danger of having the weakest bus laws in the whole of Britain once the Bus Services Bill is passed at Westminster.

I thank the member for interjecting but, if he lets me continue, I will go on to describe how a local issue in Lanarkshire has been dealt with by a number of stakeholders. I am sure that the Minister for Transport and the Islands will summarise a lot of the stuff that the Scottish Government has been doing.

During the recent NHS Lanarkshire health care strategy consultation, transport between hospitals for visitors and patients was raised on many occasions. In fact, it was one of the most widely raised issues. For instance, in relation to the recent temporary move of orthopaedics from Monklands hospital, it has generally been agreed by all stakeholders—including NHS Lanarkshire, the council and local representatives—that public transport services could be better and more responsive for individuals.

If the Presiding Officer will allow me to digress for a second, I will say that I hope that the NHS board will soon decide on orthopaedics being permanently at Monklands hospital. Many people have engaged with the consultation to outline the reasons why the service should be located at the new-build hospital, funding for which has been given by the Scottish Government.

I am in a good mood, so I am allowing that rather wild diversion.

Thank you for that wee detour, Presiding Officer.

Bearing it in mind that many stakeholders are involved in providing transport to and from hospital facilities, I contacted NHS Lanarkshire yesterday, which told me that it is committed to continuing to work with Strathclyde partnership for transport, as Liz Smith mentioned, to ensure that each of its sites is supported by appropriate public transport links and that transport and travel information is available quickly and easily through the creation of a transport hub.

The board is committed to working with the Scottish Ambulance Service to support its patients and services with the provision of routine, as well as emergency, transport. NHS Lanarkshire will also work with the community transport sector to identify how its services can help to support patients who cannot access public transport and do not meet the Scottish Ambulance Service’s eligibility criteria for patient transport.

I have spent most of my time talking about a local issue in Lanarkshire and describing what is proposed to address transport to hospitals. It is clear that there is still work to be done and that it is incumbent on local members of all parties to help to resolve the issues in their areas and come up with ideas and suggestions for all the stakeholders.

I firmly believe that the Scottish Government has demonstrated commitment to improving transport links and enhancing partnership working between operators and transport authorities. It will continue to invest nearly £250 million a year in the network and to improve services by, for example, investing in increasing passenger numbers and providing more environmentally friendly buses. There is also a desire to consider whether local transport authority powers can be further improved and what additional support and guidance might be helpful to authorities.

To conclude, there is no doubt that bus services to hospital facilities can be difficult for our most vulnerable people, including those who are elderly or disabled. I commend the launch of Scotland’s first accessible travel framework by the transport minister, Humza Yousaf, on 29 September. Through the framework, we will improve accessibility for all members of the public and strive to give everyone in our society equal opportunity.

You could see that I was thinking that that was a long conclusion.

12:58  

I thank Liz Smith for bringing the motion to the chamber, as it gives me the opportunity to speak on behalf of my constituents in the South Scotland region, which has a large rural population.

I am sure that all members agree that a decent, affordable public transport service that is accessible to all is mandatory. Certainly, regular bus services to and from hospital should be a given. However, that is not always the experience that users of public transport highlight.

For example, in May, First proposed pulling the majority of its bus services in the Borders. In July, Scottish Borders Council approved plans to halve the number of buses running between Galashiels and Edinburgh. In April, south west of Scotland transport partnership abandoned plans to halt several Sunday and weekday evening services in Dumfries and Galloway. However, other services were still cut and campaigners said that they

“heard stories of … people wanting to go to hospital on the bus but were struggling”.

In 2015, the only bus linking Ayrshire’s two acute hospitals was withdrawn by Stagecoach. A doctor criticised the move, saying:

“I have a morning clinic at Ayr and an afternoon one at Crosshouse and I don’t drive. This bus is the only way I can carry out my work.”

When the bus service was launched, it received a £20,000-a-year subsidy from NHS Ayrshire and Arran. Stagecoach blamed the

“decreasing patronage and a further cut to the reimbursement paid to bus operators under the Scottish Government’s free concession travel scheme”.

However, it is not all doom and gloom. Last month, a new bus service was launched in East Lothian to provide access for local shopping and hospital and doctors appointments in the area of Haddington. Lothian Country bus 113, which connects East Lothian with Edinburgh and the Western general hospital, won best bus service in Scotland at the Scottish transport awards. Although it appears that Lothian Buses has managed to be successful in that area, in May First proposed withdrawing from East Lothian; in doing so, it blamed an “increasingly competitive market”. That highlights the patchiness of the approach to public bus transport coverage in the rural communities, which require the same access to services, and have the same right of access to services, as everyone else.

Liz Smith and Fulton MacGregor aptly highlighted the difficulties that the elderly, the frail and the sick face when bus services are withdrawn, but I would like to draw members’ attention to another hidden problem and cost arising from the travel difficulties that are caused by a reduction in public transport accessibility: missed treatments and screenings, which lead to missed opportunities to diagnose conditions and deliver preventative treatment before those conditions escalate and more serious, traumatic and costlier treatment is required. For example, higher levels of breast cancer in rural and the most deprived areas have been attributed directly to non-attendance at routine breast cancer screening. There are other similar examples. The issue is exacerbated when public bus transport links are withdrawn, which makes attendance at such appointments that much more difficult.

We appreciate that there is a balance to be struck between cost effectiveness and service delivery, but there are cases in which the face-value cost does not paint the full picture. It is paramount that people have rights of access to medical services regardless of their personal circumstances, and it is incumbent on the Scottish Government and the Parliament to ensure that everyone has decent public bus transport that is accessible and affordable to all. Therefore, I am delighted to support the motion.

I see that members are threading in other issues that are tenuously connected with the motion—that is all right. Mr Whittle managed to do that.

13:01  

I congratulate Liz Smith on securing the debate and giving us the opportunity to discuss bus services to and from our hospitals.

I know from the views that I have received from community representatives in Clydebank just how strongly people feel about the importance of having good public transport links to the new Queen Elizabeth university hospital. Without a direct service, many people in Clydebank now find that they have to take three buses to get there.

As the motion rightly points out, passengers who travel to hospitals can often be anxious, bereaved or distressed. Bus services are not a luxury that the private sector might choose to provide but essential public services and assets of real value to the community that the travelling public cannot do without. That is why it has been so disappointing to see the scale of the decline in bus services in Scotland over the past few years.

The total number of journeys on Scotland’s bus services has fallen to a record low. The rate of decline is 10 times higher in Scotland than it is across Britain as a whole. Transport Scotland’s figures show that the number of bus journeys has fallen by 74 million since 2007, and 66 million vehicle kilometres have been stripped out of the bus network over the same period. The number of buses in operators’ fleets has dropped by 14 per cent over the most recent five years for which figures are available, and there has been a 5 per cent contraction in the size of the workforce in the bus industry.

Instead of achieving a modal shift towards public transport, the Scottish National Party Government has presided over a decade of decline in bus services. The bus market is broken and the SNP Government has shunned every opportunity that it has been given to fix it. That is why the cuts that are referred to in Liz Smith’s motion come as no surprise.

If we want to protect vital services to hospitals—or anywhere else, for that matter—we must consider more democratic alternatives to the deregulated market. To its credit, the United Kingdom Government is doing that at the moment in its Bus Services Bill. I make it clear that that bill is by no means perfect, but it is interesting that, while Labour, the Liberal Democrats and the Conservatives now all support the extension of London-style bus franchising powers in England, Scotland continues to lag behind the regulatory curve. We could change that if there was the will to do so across the Parliament. I hope that Liz Smith and the Scottish Conservatives will seriously consider the case for extending those powers to Scotland. We could give transport authorities the power to protect services to the hospitals and decide the best way of delivering bus services in their communities.

We will hear from the transport minister shortly but, when he was confronted about bus cuts in his own city, including services that bring people closer to connections with the new Queen Elizabeth university hospital, he was keen to shift the blame for a commercial operator’s service cuts on to Strathclyde partnership for transport. Of course, there are times when transport authorities need to step in, but with bus cuts from one end of Glasgow to the other, the minister’s response to what is happening in the bus industry so far has been wholly inadequate. There is no recognition of the financial pressures that the Government have put on SPT’s member authorities and on local government across Scotland; there is no comprehension of the limitations that are placed on public transport authorities when they decide to tender for a route; and there is no comprehension of the scale of the cuts that operators have made to bus services across Scotland.

Remember that the 66 million vehicle kilometres that have been stripped out of the bus network come from across both commercial and subsidised routes. The public sector simply cannot afford to replace services at the rate at which they are being axed. The position of the transport minister and the Scottish Government is untenable. The old ways will not work any more. Something has got to change. If the main parties at Westminster can agree that it is time to roll back or even replace the deregulated market, why cannot we? The time has come for action to protect vital bus services. It is time to look at alternatives to the current system, which is letting passengers down. It is time for London-style bus franchising powers to come to Scotland and it is time to put passengers and communities first.

13:07  

I note my registered interest as a serving councillor and as the chairman of Perth Access Cars, a patient group that is based at Perth royal infirmary.

I pay tribute to my colleague Liz Smith for securing a debate on this most important issue. Access to transportation to hospital and medical clinics is vitally important in our communities. I have had a particular interest in such services for many years, in my role as a councillor on Perth and Kinross Council.

Many of those who work at the Perth royal infirmary in my council ward of Perth City South regularly have to go to Ninewells hospital in Dundee as part of their work, and patients have to go for consultations, clinics and treatment. There was no regular transport link between the two establishments before the introduction of the 333 bus service, so from time to time we had ludicrous situations in which medical staff, patients and even records were taxied between Perth royal infirmary and Ninewells hospital. Moreover, time and again, my council constituents told me that getting to an appointment from Perth could mean having to take up to three buses each way. For an elderly or disabled person, that meant that a half-hour consultation could consume their whole day. The reality is that non-driving patients face an equally challenging experience to get to and from hospital, as do younger, non-disabled patients and patients who do not receive benefits, who usually have to fund such trips themselves.

It is not just out-patient appointments that cause a problem. If someone has been admitted to hospital, it may well be impossible for individuals to visit them in the evenings or weekends because the bus service is so erratic, meaning that there is no opportunity for a visit. For example, when a constituent and her husband, who are both non-drivers, wanted to visit their son, they had to rely on family members taking them on the 80-mile round trip each day; otherwise, they would have had to stay in a local hotel, which could have cost up to £100.

Over many years, I regularly fought to ensure some kind of transportation between the Perth and Ninewells facilities. However, it took eight years for that to become a reality. I could not believe that I had to keep going back year after year with the same questions about funding. It was obvious that there was an opportunity for funding to be given, but that did not happen. It took eight years of fighting by me and others in the council before we finally got the bus service. I pay tribute to a fellow councillor, Councillor Willie Wilson, who worked with me to achieve the introduction of the dedicated bus service.

We had support for the campaign from across the political spectrum, and from the Stagecoach Group and NHS Tayside. The bus service materialised in the form of the 333 route. The service was a considerable achievement and became an astounding success, so I was extremely disappointed when the decision was taken to replace that dedicated hospital shuttle with the new X7 service between Perth and Aberdeen. Stagecoach has reported an increase in the uptake of the new service, but it neglects to point out that that is because of the different demographics of those who use the service, which sometimes means that there is a conflict with those who are going to hospital. As Liz Smith pointed out, there are myriad problems with the new service. For example, the bus cannot have an accessible location, the double-decker coaches have little seating on the lower deck, and there is no dedicated access ramp for individuals journeying to hospital. The bus service is not really suitable for individuals who have ailments and want to go to hospital.

All those factors again highlight the need for dedicated bus services between the two hospitals. If we have such services, they are used. We have difficulties with parking around hospitals, but a dedicated bus service relieves the pressure on parking. That is not rocket science; it is just reality. The situation should be managed properly across the hospital sector.

It is clear from members’ contributions to the debate that communities across Scotland face the same problems with hospital transport, and that has to be recognised. I am pleased that there is consensus in the chamber on the issue. It is clear that there is a general desire for hospital bus services to continue, which Transform Scotland supports. We need to look at transforming transport schemes across Scotland. If we can get better hospital bus services, that will go some way towards achieving the wider aim. I hope that the Scottish Government takes that issue on board.

I am delighted to have taken part in the debate and I pay tribute again to Liz Smith for bringing the debate to the chamber today.

Thank you, Mr Stewart. I was nodding in agreement when you referred to the difficulties with parking at hospitals. I think that we all know about that.

I call the Minister for Transport and the Islands, Humza Yousaf, to wind up for the Government—you have seven minutes, minister.

13:12  

I thank Liz Smith for securing the debate and I thank members for what I thought were good contributions to the debate, by and large. I also thank Liz Smith for the tone of her remarks.

All members who have spoken in the debate highlighted local problems and issues that go to the very heart of their communities. I have been in post for about six months and at any time of the day—morning, afternoon or evening—all that I have to do is look at my Twitter feed to see how emotional people get about transport. I do not say that in a negative way. Transport is an emotive issue because it connects us with our families and communities, it connects businesses with other businesses, and it helps to get staff into work and deliveries made. It can also make the difference in getting people to their hospital or GP surgery appointment—or not. Brian Whittle said rightly that those with long-term health conditions can be affected if they are prevented from getting to appointments because of poor public transport. All the points in that regard were well made. As transport minister, I do not take lightly my responsibility for hospital transport, which is a huge issue for me.

I put on record the Scottish Government’s support for the bus industry. Members referred to the £58 million bus service operators grant. We are coming into the spending review period, and I have felt the strength of feeling among bus operators and MSPs about the importance of that subsidy. We also provide funding of £212 million for free bus travel for disabled and older people. I hope that members across the chamber recognise that that funding promotes social inclusion and, over the years, has had substantial health benefits by helping people get to hospital and GP appointments.

I will address some of the issues that members raised, and raised well, particularly in relation to the bus services that are mentioned in the motion. Liz Smith made an important point about the X7 service and accessibility. After I launched Scotland’s accessible travel framework, which Fulton MacGregor and other members mentioned, I was genuinely astounded by some of the stories that I heard from people who use public transport. I have no doubt that we have come a long way—for example, there is legislation on low-floor single-decker and double-decker buses—but some of the challenges that people with disabilities face in using public transport are simply unacceptable in 2016. The first accessible travel framework, which was developed and will be monitored throughout its 10-year lifetime by people with disabilities, is a huge step forward.

Stagecoach is aware of the issue with the X7 that Liz Smith raised and is working with the Mobility and Access Committee for Scotland and with passengers with disabilities to see how it can retrofit some of its fleet of buses and coaches to make improvements.

I accept what the minister is saying. He made an important point.

Another issue, which I know is not the Government’s direct responsibility, although I think that Government influence would be helpful, is the practicality of getting much larger buses into hospitals. Alexander Stewart talked about the parking issue. If a bus cannot physically get into the hospital area, that is a serious issue for many people. Will the minister encourage bus service providers to think about that when he talks to them?

I will certainly endeavour to do that. Liz Smith touched on an important point about the need for transport and planning to work closely together. She will be aware that the Government is preparing a consultation paper on the planning review, into which everyone across Government will look to have an input. As transport minister, I should feed her point into that discussion.

On services that affect people in Aberdeen, I spoke to a number of councillors yesterday and met Councillor Willie Young, from Aberdeen City Council, to discuss the matter. On services in Glasgow, I am well aware of the services to the Queen Elizabeth university hospital that Neil Bibby mentioned. I have made representations to First, in particular, about services. The hospital is well served by bus routes. Some 60 buses an hour come in and out of the hospital, but I am more than happy to have conversations with bus companies about whether they can go further.

I want to talk about wider issues and challenges that we face in relation to buses. There has been a decline in patronage on the buses. From some of Neil Bibby’s remarks, we might think that that started with the Scottish National Party Government. Let me give members some context: it absolutely did not start with the SNP Government.

Will the minister take an intervention?

In a second.

The decline started in 1960, and the steepest decline was in the period from 1960, when there were 1,664 million passengers, to 1970, when there were 860 million passengers. At the time, of course, the buses were regulated. The decline in patronage is not simply an issue of bus ownership.

The decline in bus patronage has been steepest in Glasgow and the west. That is not to shift the blame to SPT—I hope that I have not given that impression—or to Glasgow City Council, North Lanarkshire Council or South Lanarkshire Council. It is an issue that we all—national Government, councils and regional transport partnerships—have to deal with. Regulation of the buses is not a silver bullet.

Let me try to reassure Neil Bibby if I can. In our manifesto we committed to introducing a transport bill. As I think that I have said, both to him and on the public record, there will be a bus element to the bill, and I look forward to receiving his submissions on that.

The bus operators tell me that the biggest issue is not ownership—although I will happily explore Neil Bibby’s idea of local franchising and other models—but congestion. If it takes 50 per cent longer for a bus to go through Glasgow than it took many years ago, there is an issue to do with buses becoming less reliable and therefore less popular.

There are issues there for all of us to tackle. I am more than willing to tackle the issue of reliability and declining patronage—I am committed to doing so. I want an upward trend in bus patronage, so I will do everything that I can do in that regard.

Members mentioned community transport. Although I see the real value of community transport, there are real difficulties with extending the concessionary travel scheme to it. The majority of community transport is provided by private cars, and there are also the obvious budgetary pressures. However, I am willing to look at how I can support community transport. For example, one of the most prohibitive costs for community transport initiatives that rely on minibuses is that of getting a minibus licence. Therefore, I recently announced that we have committed to putting some money into a fund that will help community transport projects get those licences.

I commend Liz Smith for bringing the motion to Parliament. I will certainly work with members from all parties to see how we can ensure that our public transport—buses and so on—works for the people of Scotland, particularly for those who are vulnerable and simply want to get to the doctor’s surgery, clinic or hospital. We all have a duty to ensure that all the people of Scotland can access public transport, regardless of ability or postcode.

13:20 Meeting suspended.  

14:30 On resuming—