Meeting date: Thursday, May 12, 2022
Meeting of the Parliament (Hybrid) 12 May 2022 [Draft]
Agenda: General Question Time, First Minister’s Question Time, Striking University Staff, Portfolio Question Time, Cladding Remediation, Coronavirus (Recovery and Reform) (Scotland) Bill: Stage 1, Coronavirus (Recovery and Reform) (Scotland) Bill: Financial Resolution, Appointments to Scottish Fiscal Commission, Business Motion, Decision Time, International Nurses Day
- General Question Time
- First Minister’s Question Time
- Striking University Staff
- Portfolio Question Time
- Cladding Remediation
- Coronavirus (Recovery and Reform) (Scotland) Bill: Stage 1
- Coronavirus (Recovery and Reform) (Scotland) Bill: Financial Resolution
- Appointments to Scottish Fiscal Commission
- Business Motion
- Decision Time
- International Nurses Day
International Nurses Day
The final item of business is a members’ business debate on motion S6M-04202, in the name of Jackie Baillie, on celebrating nurses on international nurses day. The debate will be concluded without any questions being put.
That the Parliament recognises that 12 May 2022 is International Nurses Day; understands that International Nurses Day is celebrated across the world every year on the anniversary of Florence Nightingale’s birth; believes that this day is an opportunity to celebrate the contribution nursing staff make to people’s lives and thank those working in health and social care across the country for all that they do; understands that the Royal College of Nursing is marking the day by asking staff and members of the public to share stories that demonstrate the best of nursing and, in Scotland, will launch the inaugural RCN Scotland Nurse of the Year Awards; acknowledges what it sees as the challenges and pressures nursing staff continue to be under as the country emerges from the COVID-19 pandemic; believes that nursing staff will play a critical role in the recovery from the pandemic, and notes the calls to urgently address the reported high levels of nursing vacancies in the Dumbarton constituency, and across the country, including by the implementation of the Health and Care (Staffing) (Scotland) Act 2019.17:17
I am grateful for the opportunity to bring forward this debate on international nurses day. The importance of our hard-working nursing staff, particularly in the past two years, cannot be overstated. They have been at the front line of the global pandemic, acting selflessly to provide essential healthcare in the most difficult of circumstances. It is fitting that this day is celebrated on the birthday of Florence Nightingale, a nurse who showed similar strength, compassion and commitment. To our nurses, from the retired to the newly qualified, from palliative care to paediatrics, we take this opportunity to say thank you.
However, it is not enough to stand here today to thank nurses or, indeed, to clap on our doorsteps each week. Nurses are experiencing unprecedented levels of burnout and there are record numbers leaving the profession. Vacancies are also skyrocketing. Nursing staff are reporting increasing concerns around a lack of flexible working and a lack of effective workforce planning and are expressing disappointment that the Health and Care (Staffing) (Scotland) Act 2019 has not yet been implemented.
I recently attended a Royal College of Nursing round table at which I met nurses from across Scotland to hear some of their concerns; the cabinet secretary was there too. Hilary Nelson, an NHS Forth Valley intensive care unit nurse, explained how difficult it is for staff to come to work every day knowing already that their wards are understaffed. Nursing and midwifery vacancies in NHS Scotland reached a record high of 9.3 per cent, according to the latest workforce statistics, which were published on 1 March 2022. That is 6,674 vacant posts.
We know that the work that nurses do is not easy, but it is made yet more difficult by staffing shortages that force one nurse to do the work of many. This is unfair and unsafe for staff and patients alike. The Royal College of Nursing has repeatedly called for the Scottish Government to increase investment in the workforce and respond to the record high vacancy rates at the same time as implementing its own safe staffing legislation. The Health and Care (Staffing) (Scotland) Act was passed by the Parliament in 2019, but we are still no closer to seeing it being implemented. While the Scottish Government delays any meaningful action, nurses such as Hilary remain overburdened due to understaffing.
The Government says that it values nurses, and I believe that it does, but national health service staff—nurses—deserve action, not just words. With more and more people leaving the profession, not enough work is being done to replace the ageing workforce. The RCN has identified high levels of forced retirement of nurses in their 50s, causing already overstretched staff to take on extra workloads. Many of those nurses, such as Joanna Maloney, who was a senior nurse in mental health, would have stayed in their jobs if offered flexible working, but no one was interested in retaining her skills and experience—a loss to the profession.
Therefore, we need to tackle both recruitment and retention. I know that the Government talks about having more nurses than ever before, and that is probably true, but there is no mention of the fact that there are more patients being treated, there is more pressure on the system and capacity is truly stretched. We need to see a commitment to increasing the number of nursing student places in line with workforce modelling rather than simply affordability, as well as the urgent implementation of the 2019 act, to allow our NHS to function well.
Let me give you an example. In Scotland, the ratio of whole-time equivalent specialist cancer nurses to cancer incidence is lower than in England for most tumour types. It is crucial that the current Scottish Government consultation on workforce ensures that the cancer nurse workforce is fit for purpose for the constantly rising cancer incidence in Scotland that comes with an ageing population. Further, the overall number of stoma nurse specialists across Scotland has declined by a staggering 50 per cent over the past 10 years, despite the number of patients with a stoma increasing by 1 to 2 per cent per annum. Patients with a stoma rely heavily on the in-depth knowledge of those specialist nurses, and health boards should be providing the resources that are needed to support that vulnerable group of patients and support nurse specialists.
It is hard to recruit new nurses when the level of pay on offer does not reflect the demands of the job. In fact, there has been a real-terms pay cut over several years. Shirley Robertson, a school nurse, spoke passionately to us about the effects of low pay when we met earlier this year, along with the cabinet secretary. We all know that the cost of living crisis is here now, but this year’s NHS pay award is five weeks, six days and 17 hours overdue, and we are still counting. Nursing staff are waiting for the Scottish Government to act. Those delays come after years of underinvestment from the Scottish Government. To continue to withhold fair pay, particularly after the events of the pandemic, is frankly insulting.
In response to that, I am sure that the Scottish Government will argue that on average nurses in Scotland are slightly better paid than staff elsewhere in the United Kingdom. Let me tell you the reality of that. The reality is that the difference is meagre. It is about £8.60 a week for a newly qualified registered nurse. That is then offset by higher taxes paid by those working in Scotland, and in recent years pay for nurses has simply failed to rise in line with inflation.
It is, therefore, no surprise that, of the six in 10 nursing staff thinking of leaving their jobs, 54 per cent cite low pay as one of the main reasons for wanting to leave. Our nurses love their jobs, but they are being asked to work long hours for low pay, often doing the job of two people for the price of one. Nurses and NHS staff were there for all of us over the past two years. Now is the time to acknowledge that work.
In the meantime, we must continue to support and boost our nursing staff in any way that we can. I am delighted that today the RCN has launched the inaugural RCN Scotland nurse of the year awards, which will take place on St Andrew’s night later this year. The awards will shine a spotlight on the best of nursing and will highlight and celebrate the dedication and outstanding professional care of nursing staff across Scotland. MSPs can nominate constituents, and I encourage all of my colleagues to do so.
Let me finish by once again thanking nurses for the work that they have done and continue to do. I certainly will—and I know my party will—continue to fight for better pay and working conditions alongside the RCN, Unison and all health service trade unions. I understand that kind words and tokens of gratitude do not pay the bills. On this international nurses day, I am reminded of a trade union rallying cry: “What do we want? Fair pay! When do we want it? Now!”17:25
Thanks to Jackie Baillie for securing the debate and for her contribution this evening. I remind the chamber that I am a registered nurse and I was able to practise as a Covid vaccinator over the past two years. I thank the RCN for its two very helpful briefings ahead of the debate, one for the Scottish National Party and one for the Opposition.
The theme today for international nurses day 2022 from the International Council of Nurses is “Nurses: A Voice to Lead—Invest in nursing and respect rights to secure global health”. My contribution will focus on my amendment, and I thank colleagues who have supported it. My amendment intends to celebrate the immense contribution of nurses, to value nursing as a highly skilled, highly varied profession and to note the progress that has been made to support the nursing workforce in Scotland, especially in the past two years, during the global Covid-19 pandemic. The pandemic has definitely had an impact on the mental health of all in our healthcare workforce, including nurses, and I welcome the Scottish Government’s action to address that.
Nurses work in a variety of areas, including adults, children, learning disability, mental health, maternity, perioperative—that was my job when I worked as a nurse—resuscitation, diabetes and cardiac as well as expert cancer care, as the Macmillan briefing that we received noted. Nurses make up the largest single profession in our NHS and are at the heart of the health service. The diversity of jobs in nursing is demonstrated through their work in our hospitals, general practitioner practices, homes and care homes, as well in schools and communities across the country.
Nurses in Scotland have some of the most advanced clinical skills of nurses anywhere in the world and we are leading the way. I cannae go through the whole of the ICN report, but, according to the ICN, there are huge benefits in investing in nurse education. The ICN states that that is needed to meet the
“changing health needs and rising expectations of individuals and communities”.
For example, in Scotland nurse-led education for patients on the management of conditions such as diabetes, medications and the prevention of ill health plays a hugely important role in promoting the positive health and well-being of the nation.
However, nursing skills in Scotland are not replicated across the globe. We should, therefore, be celebrating the competence of our nursing workforce in Scotland and use that competence as evidence to improve healthcare systems internationally. As co-convener of the lung health cross-party group, I joined the recently created International Coalition of Respiratory Nurses, which was initiated by Andreja Šajnic, who is a specialist respiratory nurse from Croatia. The ICRN has political support from Željana Zovko MEP, who is the co-convener of the lung health cross-party group in the European Parliament. We are proposing to work together to look at lung health across Europe and across the globe. ICRN is a global coalition aiming to promote best practice for respiratory education for nurses.
As we celebrate IND, I recognise the workforce challenges. I welcome the steps the Scottish Government is taking to address workforce recruitment and retention challenges. Scotland has a £10,000 per year bursary for nursing students. We are ensuring that nurses receive the best and fairest pay deal, with nurses in Scotland being on average the highest paid in the UK. The Scottish Government’s nursing vision to 2030 is welcome and shares many of the points from the World Health Organization’s global strategic directions for nursing and midwifery. The WHO strategy aims to ensure that nursing is better understood by the public, to increase nursing’s appeal as a career option, to retain a focus on supporting people experiencing periods of acute ill health, to promote prevention and to tackle inequalities. I ask the cabinet secretary for a commitment that those will be built on.
This is a day to celebrate. It is a day to be cheerleaders for our nurses. It is a day to thank nurses across the globe for all that they do on this day, international nurses day.17:30
It would be an understatement to say that the topic of the NHS has been somewhat of a current theme in the chamber of late. The pandemic has thrown into sharp focus the way that people in Scotland and, indeed, in all of the United Kingdom rely on our health service for our ways of life. On today’s international nurses day, we pay tribute to a vital section of the health service without which the entire operation would come to a grinding halt. The army of nurses in the NHS work tirelessly, day and night, to ensure that the patients in their charge are given the care that they need.
On a personal note, I have many experiences of years in hospitals, for both myself and loved ones. In every case, the nurses have not only provided top-class care but have been a calming bedside presence, but in reality they are under vast amounts of pressure. On Monday night, my father was taken into hospital in the early hours of the morning. The nurses and doctors looked after him in a superb way, but there were too few of them and they were under too much pressure. We need to address the shortages of nurses quickly and efficiently. I want to add my personal thanks, as well as those of the chamber, to all our nurses and to thank them for their work.
Looking forward, the main issue for me is, as I said, the number of nurses that we have. There can be no doubt, when we look at the staffing numbers in nursing, that Scotland is going through a difficult period. As Jackie Baillie said, the Scottish Government will say that there are more nurses, but there are also more patients and people requiring healthcare. However, I did find some encouraging news when I visited Edinburgh Napier University just a few weeks ago. I understand that it is hoping to take in 2,000 first-year students to study nursing in September. The facilities and training that they will get at the university are excellent. If anyone wants a good trip, I recommend going to the university to see how the nurses are taught and learn on amazing equipment.
We can be proud of those who will qualify in the next few years, but the question is whether they will stay in Scotland or go and work in other parts of the United Kingdom and other parts of the world. We need not only to train nurses but to ensure that they stay in NHS Scotland.
Finally, I want to make special mention of cancer nurses. We all know that cancer numbers in Scotland are going up, with Macmillan estimating that 110 people will be diagnosed per day by 2027. Macmillan’s recommendations say that the Government’s upcoming cancer strategy must ensure that a specialist cancer nurse is made available to every cancer patient who needs one, making sure that people are receiving the care that is needed. That is a big ask but one that I hope the Government will continue to support; I hope that the cabinet secretary will confirm that tonight. We need our universities such as Napier bringing forward, recruiting and training, but we also need the Government to make the future brighter for those who have cancer. We need to make sure that it continues to be an amazing field of nursing across the whole of our country.
In conclusion, I say “Thank you” to our nurses. Thank you for what you do, often unseen, day in, day out. We appreciate it, we respect you and we thank you for what you do.17:34
I thank Jackie Baillie and Emma Harper for their opening contributions. The nursing experience that Emma Harper brings to the debate is extremely welcome, and it was underlined in her contribution and in the amendment in her name. That has helped to ensure that the full objective that has been set out for international nurses day is achieved and supported by the Parliament.
International nurses day is overseen by the International Council of Nurses, and 12 May is the chosen date because it is Florence Nightingale’s birthday. The lady of the lamp is possibly one of the most famous nurses in the world and, although her best known achievements are associated with her work with soldiers in the aftermath of the Crimean war, she was also a pioneering medical educator. As Emma Harper pointed out, we also take inspiration from Louisa Jordan, a Scottish nurse who showed compassion and bravery while caring for soldiers during the first world war, and who lost her life while doing so at only 36 years of age.
International nurses day is a chance to celebrate the best of nursing and to thank staff who work in health and social care for all that they do. This year’s theme is “Nurses: A Voice to Lead—Invest in nursing and respect rights to secure global health”. That could not be more pertinent, in the face of the on-going global pandemic of Covid-19. Nurses have been at the front line across the world, fighting against a relentless, invisible foe that has tragically killed more than 6 million people. Nurses are the backbone of the NHS and social care. We know how dedicated, caring and compassionate the profession was when we especially needed them. In some cases, they were the only human contact available to people who tragically lost their lives to the pandemic.
The pandemic must have been, among many other things, an emotionally draining time for nurses. I can relate to that enormously difficult situation from my time as part of the nursing team at the St Margaret of Scotland Hospice in Clydebank. To nurse someone at the end of their life is a privilege, but it is also challenging and can impact on a nurse’s health and wellbeing. On international nurses day, as well as celebrating the work of nurses across Scotland on behalf of those whom I represent, I pay tribute to every single one of the nursing team at the St Margaret of Scotland Hospice, in the heart of my constituency. I know how much love, support and care those nurses have given to my constituents and families. I have experienced it myself with the death of my mother at the hospice. It is a time of greatest need. I am proud to have worked there and proud to have such a centre of excellence and compassion in my constituency.
I also thank the Royal College of Nursing Scotland for its briefings. I agree with it that the debate is a chance to celebrate the best of nursing and show our appreciation. I also agree that saying thanks is not enough. We must continue to work hard to provide the best possible terms and conditions for our nurses. We must also support efforts to ensure that more progress is made on nurse vacancies. I am pleased that the Royal College of Nursing is using international nurses day to launch its nurse of the year awards, which is an excellent way to recognise and celebrate the dedication and outstanding professional care of nurses across Scotland.
The debate is a very welcome one that allows the Parliament to further acknowledge the importance of our nurses and to highlight their sacrifices when working through such a turbulent time in modern medicine. We must also rejoice in the dedication of our nurses, who have been so determined to play their part in administering more than 12 million Covid-19 vaccines across Scotland. I thank all the nurses in my constituency and across the world for everything that they have done and continue to do—we owe them so much.17:38
I thank my colleague Jackie Baillie for bringing this important debate to the chamber and I, too, welcome international nurses day, which, as has been mentioned, is marked on the anniversary of the birthday of Florence Nightingale. The debate offers us the opportunity to commend the work of our nurses, highlight the impact that they have on our society and pay tribute to them for the work that they carried out throughout the pandemic.
Our nurses are the best of our country—I will touch more on that later in my speech. However, in Scotland we have a situation in which nurses feel undervalued, overworked and underpaid. They feel as though the pressures of the workplace have become too much during the pandemic, with vacancies not being filled, agency staff being used more often than normal and staff shortages meaning that others have to double—or sometimes treble—their workload. It would therefore simply be wrong of us to debate the motion without highlighting the clear and fundamental challenges that face nurses and nursing more widely.
As on many issues, the Scottish Government certainly talks a good game, but, when it comes to action, it falls short. I have spoken to many constituents in my South Scotland region who tell me, time and again, that the challenges facing our hospitals and care settings are like none that they have ever seen before.
The issues that Carol Mochan is highlighting are really important, and it is important that we debate them. However, it is kind of difficult to do that when we are allotted four minutes in which to speak. Is it worth reflecting on that?
Of course, it is difficult to do that in four minutes, but it is important that we address the issue and at least acknowledge to the nurses that we see it as important. I hope that the cabinet secretary will address some of that in his remarks.
The pandemic has exacerbated many problems, but it did not create them. They were created due to consistent mismanagement of our health service by consecutive health secretaries in the Scottish Government. However, all is not lost. With the right investment in nursing, including increasing pay and conducting public awareness schemes to encourage people to join the profession as part of the implementation of the Health and Care (Staffing) (Scotland) Act 2019, as we have heard, we could relieve some of the stress and pressure on the current workforce and show people in it the value that they truly deserve. I say to the cabinet secretary that Scottish Labour stands ready to support positive change from the Scottish Government if it shows the political will to introduce that.
Our nurses deserve to be celebrated. They work day in, day out to provide the highest standard of care to patients in different settings up and down the country, and it is right that they are recognised with accolades and awards. Indeed, each and every one of them deserves an accolade and award for their work in the past two years, but they need more—they need action from the Government. I look to the nurses in Ayrshire and across the South Scotland region and consider the tremendous efforts that they have put in to provide for those most in need in very difficult times. I think of the mental health nurses across the country, who are also under significant workplace pressures and who are working to reduce lengthy waiting lists but still providing high-quality services.
Before I conclude, as suggested in the motion, I want to share my personal story. It is of a dear lifelong friend who has worked tirelessly in my local community since training in a small local hospital—I am sure that she would not wish me to remind her how long ago it was. That local hospital, Ballochmyle, is now closed, but the bulk of her career has involved working in the community. My friend, Hilary Sharp, has demonstrated the best of nursing and the best of the profession. Despite pressures at work, she is always kind, caring and committed to her patients. It is a great tribute to her that her daughter, Jennifer Sharp, has now started a nursing degree at the University of Aberdeen. I cannot tell members how proud the family are of that, and rightly so. The dedication of our country to the NHS is often shown in generations of family members who are committed to a lifelong career in caring for others.
Without doubt, nurses in Scotland face pressure, but we must celebrate them tonight.17:43
I congratulate Jackie Baillie on securing the debate. I am glad to speak in it, because it is great to have the chance to reflect on and celebrate the contribution that nursing staff make to people’s lives. I thank those who work in health and social care in my constituency of East Kilbride and across the country for all that they do, and particularly for what they have done during the pandemic. Nurses have been working together to deliver care under the most extreme and challenging circumstances, setting up new ways of working in response to changing demands and maintaining staffing and equipment levels to deliver on-going and essential services.
It is always interesting to hear about members’ backgrounds that we would not hear about other than in members’ business debates. I commend Emma Harper for being a community champion and delivering the vaccination roll-out. Every single one of the people involved in that were true heroes.
The date of 12 May was chosen as the day on which to celebrate international nurses day because it is the birthday of Florence Nightingale. Florence is undoubtedly one of the most famous nurses and has earned her place in the history books. She modernised the approach to care during the Victorian age and was instrumental in improving care with mathematical science and statistical analysis. She noted, too, the importance of hygiene, diet and ventilation, all of which are very much relevant today.
As my colleague Emma Harper’s amendment to the motion rightly recognises, Scotland takes inspiration from Louisa Jordan, a Scottish nurse who had a prominent role during the first world war. Interestingly, in the previous members’ business debate on the subject in 2017, there was no mention at all of Louisa Jordan.
Each year, the International Council of Nurses celebrates nurses day by focusing on a specific theme. As we have heard, this year the theme is “Nurses: A Voice to Lead—Invest in nursing and respect rights to secure global health”. The focus is on the need to protect, support and invest in the nursing profession to strengthen health systems around the world. The pandemic has laid bare and drawn our attention to the vulnerabilities of our health systems. Being recognised, appreciated and valued is important for nurses around the world.
NHS Lanarkshire has recently put together short videos highlighting the hostility that staff have unfortunately faced in recent months. The videos draw attention to wider reports that staff and partners continue to experience violence and aggression from a minority, with the short clips ending with the phrase, “Please be kind”. Hospital staff are still under a great deal of pressure and should not face any abuse or threats. That should go without saying.
Without the nursing profession, the NHS would be unable to offer the high-quality healthcare that it provides day in, day out. We owe nurses our thanks for all that they do—their dedication and professionalism are inspiring.
Before I call the next speaker, I advise members that, due to the number of members who wish to speak, I am minded to accept a motion without notice under rule 8.14.3 of standing orders to extend the debate by up to 30 minutes. I invite Jackie Baillie to move such a motion.
That, under rule 8.14.3 of Standing Orders, the debate be extended by up to 30 minutes.—[Jackie Baillie]
Motion agreed to.17:47
I, too, thank Jackie Baillie for securing this important debate.
It has become almost clichéd to acknowledge the impact that the pandemic has had on our public services and the country more widely, but nowhere are the impacts of Covid-19 more evident than in the toll that it has taken on our health and care system over the past few years. When the pandemic was at its most precarious and most of us were asked to stay at home to protect ourselves, our loved ones and the NHS, and no vaccines or recognised therapeutics had yet been developed, our nurses and healthcare workers were on the front line, risking their health and wellbeing to ensure that the many thousands of those who were hospitalised with Covid and, indeed, with other illnesses, were treated in the most challenging of circumstances.
I thank nurses at Forth Valley royal hospital for the support that my loved ones received over the pandemic. Without the nurses in the stroke ward, mum would not have been able to have those few phone calls with us, and without the phenomenal district nurses in Grangemouth, grandpa probably would have ended up in hospital far earlier than he did. Nursing staff allowed us to stay with mum for as long as we needed, making sure that we had what we needed. Our story is not unique; people’s experiences of those who went above and beyond—from school nurses to intensive care unit nurses—are repeated across the country.
Although it is only fair to recognise nurses for all the great work that they do, we must also recognise the circumstances in which nurses find themselves now. NHS workforce vacancy statistics that were published in March show the continued trend of rising vacancies, emphasising the need to refocus on retaining and recruiting staff.
NHS Lanarkshire alone is experiencing a high vacancy rate of 10 per cent of available posts. The Royal College of Nursing Scotland has also relayed that, according to its workforce survey, 61 per cent of nursing staff are thinking about leaving their current posts. Those numerical factors alone underline the need for support to ensure that those within the profession are supported to continue in their roles.
The NHS in Scotland continues to be under significant strain as we begin to emerge from the worst of the pandemic, and it is necessary to ensure that existing staff are retained and that recruitment is significantly stepped up to fill vacancies.
Workforce planning remains central to providing long-term, effective healthcare, and the Scottish Government must consider its approach in the light of those recent publications. After all the NHS has done for us over the past two years of the pandemic, it is vital that we build back a system in which nurses feel valued and in which their safety and wellbeing are a priority.
Although I am proud of some of the measures that my party has helped to deliver over the past few years, such as creating a legal duty on the Scottish Government to ensure that there are appropriate NHS staffing levels, I join the RCN’s calls on the Government to implement the Health and Care (Staffing) (Scotland) Act 2019. I hope that the cabinet secretary might be able to lay out a timetable for that.
The Scottish Greens have also helped to ensure that all nurses have the legal right to funded continuous professional development. We still have great strides to make to ensure that nursing is a long-term occupation for those who enter the profession. Those are tangible steps towards progress.
It also merits mention that nursing is not a singular block of professionals—they are people who are split across various and specialised areas. Mental health needs across Scotland and the historical lack of recognition of them have become much more focused in the public eye as a result of the pandemic. Successive lockdowns, although necessary for public health, exacerbated existing mental health conditions, and continuity for those receiving treatment is essential. A recovery response to the growth and acknowledgement of mental health conditions caused by Covid-19 needs to take a holistic approach that addresses the wider social, systemic and structural inequalities of health and wider society, rather than placing the onus entirely on the individual.
In closing, I point out that international nurses day is about celebrating all that nurses do and thanking them for everything that they do. I thank nurses for all that they have done for my family—and, I am sure, for the families of countless others in this chamber—and for going above and beyond to deliver for constituents in my Central Scotland region. I thank them for all the enduring support that they provide.17:52
I thank my friend Jackie Baillie for securing the debate, and I thank the Royal College of Nursing for its tireless work in representing its profession.
As Jackie Baillie said at the top of the debate, we celebrate international nurses day on the anniversary of Florence Nightingale’s birth. She was a truly remarkable pioneer. However, her contemporary and fellow nurse Mary Seacole is not often talked about enough. She was born to a Jamaican mother and a Scottish father. She often talked affectionately about her Scottish heritage. Like Nightingale, she nursed her way throughout the Crimean war. However, unlike the lady of the lamp, she was shunned by the British Army. She instead established her own hospital, where she provided help to countless British soldiers. She was the only person to do so right on the front line. Determined to care for those who needed it, she said,
“I ask no greater or higher privilege than to minister to it.”
That sentiment encapsulates the heart and the character of nurses everywhere.
Seacole spoke openly about the racial discrimination that she faced, and, indeed, it is widely believed that such prejudice means that, even today, she does not get the recognition that she deserves. In a parallel sense, I want to note that it was disconcerting to read in the RCN workforce report the variation in the treatment and experiences of nurses depending on their ethnicity.
As has been made blisteringly clear time and time again, and as has been stated eloquently many times in this debate, we owe an enormous debt to our nurses, so why is it that that debt remains so poorly serviced? A record 9 per cent of registered nursing posts are still unfilled. That is having a devastating impact on workload and wellbeing. An astonishing 70 per cent of nurses feel undervalued and almost half feel unable to give patients the right level of care. One nurse practitioner admitted that they always enjoyed the job and found it rewarding but said that it now feels like
“we are sinking in quicksand with no way out.”
When Jackie Baillie and I attended a round-table event with nurses that was hosted by the RCN, we heard many such stories. It is appalling that that is the experience of a single nurse in this country, yet, as the report suggests, it is a commonplace one.
Despite that, nurses continue to go above and beyond in the face of the inordinate pressure that they come under. I was particularly struck by that given what nurses in my constituency experienced in January. Due to mismanagement—we have talked about this several times in this place—numerous nurses were unable to park at the Royal infirmary of Edinburgh. Nurses told me that they were sacrificing the little sleep that they get to wake up hours earlier than they usually do just to make it on time for their shift. That is one of countless stories that demonstrates the difficulties that nurses face being compounded by decisions made by management.
This Government is presiding over what will soon be, if we do not act fast, the disintegration of one of the most important workforces in our health service. There is so much more that the Government can do and should be doing. For example, it needs to set out a clear and urgent timetable for the safe staffing aspect of the Health and Care (Staffing) (Scotland) Act 2019 to be activated. The legislation has existed for three years, but it has still not been utilised properly. All the while, staff and patients are left unsafe on the shifts that they are asked to deliver.
Although the Government has pledged £12 million for staff wellbeing, we are yet to see a viable plan as to how such investment is being implemented into tangible and accessible support for staff. Instead, our proposal for a burnout prevention strategy has been routinely dismissed by the Cabinet. Meanwhile, more nurses are being pushed away from the job that they love and more patients risk losing out.
I will end on a quote from the ineffable Maya Angelou, who said:
“If you find it in your heart to care for somebody else, you will have succeeded.”
If that is the metric of success, nurses succeed tenfold every day and it is about time that we politicians started recognising that success with more than just words.17:56
I, too, thank Jackie Baillie for lodging her motion. This is a day for celebration. It is a day to celebrate the dedication, kindness and passion of nurses in Scotland and beyond. Nurses are people who keep the health service going, no matter what happens. They deserve our recognition and thanks, and they need our commitment to their future because that safeguards our futures, too.
My colleagues have spoken about the important challenges and pressures that nursing staff in the NHS face, and I will not repeat a lot of those points. Suffice it to say that the pandemic has been extremely hard on nurses and other health professionals in carrying out their role. Those roles will be vital as we recover from the pandemic, especially with Brexit making it harder to attract overseas passion. This is a profession that is constantly evolving and needs to attract more talent.
However, today should not be about political disagreement, because our nurses deserve to be celebrated. Instead, I want to talk about what makes a great nurse and why it is such a brilliant profession to join.
Earlier today I spoke to Roz Kerr, a Hamilton lass who is filled with kindness and compassion. Roz and her sisters, Arlene and Jean, have dedicated their careers to the NHS and have recently celebrated a combined 100 years of service. That is an inspiration. [Applause.] For Roz, being a nurse means being an advocate for her patients, constantly treating people as she would wish to be treated and would wish her family members to be treated. As a member of a surgical team, Roz helps to create a sense of comfort and normality when patients have butterflies before theatre.
This morning, I asked Roz what makes a great nurse. One of the first things that she said is that nurses need to be really hard workers, that they need to be strong mentally and physically, and that they need to be unselfish and willing to put their patient first. I do not think anyone will be surprised that Roz said that nurses need to have great communication skills and that they need empathy. However, she also said that it is important that a nurse has great attention to detail, that they are a people person and that they are someone who really cares. We should note that those qualities make not only a great nurse but a great person.
Nurses deliver exceptional care to patients, bringing comfort to many. They are rewarded with a sense of achievement and joy—the feeling that they have made a real difference to someone’s life. Roz says that that feeling is absolutely priceless. She described the joy when a patient who has been suffering from chronic pain, often for quite a long time, has a hip or knee replaced, and they say, “Wow—this I can live with.”
I could tell from speaking with Roz just how much she loves her profession. She really wants to encourage others to follow in her and her sisters’ footsteps. She says that people should not be put off by Brexit. If someone is thinking about being a nurse, they should start on that incredible journey.
I also have a personal story of my own. In January 2020, my partner, the father of our three young children, had a massive heart attack. It runs in his family. Had he not been really fit and healthy, who knows what would have happened? Probably the worst, I imagine.
Any heart attack can be fatal, but one kind has earned notoriety and a scary sounding nickname because it is especially dangerous: the widow maker. Such heart attacks occur when the left anterior descending artery—LAD—which supplies blood to the larger front part of the heart, is completely blocked. My husband was rushed to University hospital Hairmyres and had a stent fitted. The care that he received from specialist nurses and other care professionals was nothing short of outstanding.
In another country, we would have been bankrupted by medical bills, but not in Scotland. It has been a really hard road at times, but, after two long years, he reckons that his health is nine out of 10 compared with how he was before. I think that that is amazing. My children still have their father because of those nurses and doctors.
To me, our NHS is beyond precious and our nurses are one of the jewels in that crown. I end with a thank you to Roz, Jean and Arlene, and to every single nurse in Scotland and beyond.18:01
I am tempted to say, “Follow that” after Stephanie Callaghan’s excellent speech, which was very powerful. I do not think that I can follow it, but I will give it my best shot.
I congratulate Jackie Baillie on lodging an incredibly important motion and bringing it to the chamber for debate. I thank members from right across the chamber for their very thoughtful and, sometimes, very personal speeches. Members have not just—rightly—extolled the virtues of our fantastic nurses up and down the country but challenged the Government on some of the significant pressures that our nursing cohort faces. I will do my best to address some of the points that have been made.
As many members have said, nurses make up the largest single profession in our NHS. They are crucial to the care of each and every one of us. We will all, no doubt, need the attention of a nurse at some point in our lives—for all of us, I hope that that will not be too many times. I reflect that, at any time that I have interacted with a nurse—in my younger days or, more recently, my not-so-young days—they have provided the greatest care and compassion, and I am most grateful for that. Many members have spoken about their personal stories, which I might touch on in just a second.
I agree with Jackie Baillie that warm words are not enough. Warm words are, of course, important—that is no doubt the reason, or part of the reason, why she brought the debate to the chamber. Warm words are important, but they are not the most important factor. She is absolutely right that it is important that we demonstrate that we are focused not merely on words but on actions.
I am proud of our record on how we treat our staff. Members would expect me, as the Cabinet Secretary for Health and Social Care, to say that. I certainly do not argue that there are no improvements to be made, but we have had an increase in staffing since 2006 in nursing, as well as more widely in the NHS. In fact, the number of qualified nursing and midwifery staff has gone up by almost 15 per cent since 2006.
Our nurses and midwives are also the best-paid staff. Jackie Baillie seemed to suggest that they were paid a meagre—I think that was her word—£8 more than those in England. However, for band 5, which is an important and significant banding in our agenda for change, the difference in the maximum pay between England and Scotland is more than £1,000—there is a £1,381 difference. That is not “meagre”; it is quite substantial, particularly given the cost of living crisis.
The cabinet secretary will accept that taxation in Scotland is higher than it is in the rest of the UK, so our band 5 nurses pay more than they would in the rest of the UK.
However, let us look to the future, because we are in a cost of living crisis now, and we know that inflation is heading into double digits and we are heading for a very deep recession. Do not make nurses pay the price, cabinet secretary. Will the Scottish Government provide decent pay to our nurses?
Yes, of course we will. We are in the middle of a pay negotiation. I note that the pay deal that we provided in the previous financial year was the best and highest single-year settlement in the history of devolution. We have a good record when it comes to pay negotiations. I completely understand that, on behalf of their members, the trade unions want us to go faster in the pay negotiation. I accept that. I also accept the point that we are well past 1 April without a concluded pay negotiation, so I give the absolute promise and commitment, without prejudicing the negotiation, that we will backdate pay to at least 1 April.
There are other benefits of being a nurse in Scotland. I thank our student nurses, who have done an incredible job throughout the pandemic. They do not pay tuition fees, which they would do in other parts of the UK.
I want to touch on challenges, but, before I do that, I thank members for their exceptionally powerful testimonies. We heard from Mairi McNair about her mother. We heard from Jeremy Balfour about the care and attention that he has received and that his father is receiving. We heard from Gillian Mackay about the attention that her mother and grandpa have received. We heard about Carol Mochan’s friend—forgive me, I should have taken a note of their name—who has worked tirelessly for our NHS. Most recently, we heard from Stephanie Callaghan about Roz, Jean and Arlene.
I pay tribute to every single nurse in our country for the incredible work that they have done. I am the first to recognise that all our nurses, whether they work in community or acute sites, are facing probably the most difficult period of their professional and personal lives. I know that nurses take their work home, perhaps not quite literally, but those pressures do not just go away the moment that they walk out of a hospital or away from the community site in which they work. Nurses who have worked in the NHS for 30 or 40 years have told me that the past two years have been the most difficult in their entire career.
I mention that point because, although we have a good record on recruitment—I have given some statistics on that—and we will continue to recruit, Jackie Baillie and other members who made the point are absolutely right that retention is key.
Gillian Mackay, Alex Cole-Hamilton and Jackie Baillie were at the round table that I attended; Craig Hoy, who is not in the chamber, was also there. We heard very clearly that there needs to be better flexibility in the NHS, particularly for staff who might want to reduce their hours but are not given the choice to do so and then decide to work through an agency. When that happens, we have to pay them higher rates to come back in to do shifts. On the back of that round table, I give a commitment that we will look at greater flexibility.
Taking care of the wellbeing of our nurses is essential. We have a record £12 million investment in wellbeing, but I have heard recently from nurses who, rightly and fairly, have said, “That is great but, if we don’t have time to access the wellbeing services, what good is it for us?”.
To members who are rightly raising concerns about the challenges that nurses are facing, I note that the reason why I mentioned the past two years is that, notwithstanding the fact that there were challenges before, the pandemic has severely exacerbated those challenges. That is why nurses tell us that the past two years have been the most difficult—not the past five or 10 years, although I accept that there were challenges before. In the past two years, nurses have been put under pressure that goes beyond any challenge that any of us could have envisaged before.
The number 1 thing that we can do to alleviate the pressure in the immediate term is to keep Covid under control. If we do that, it will begin to alleviate some of the pressure, although it will not happen overnight. As I have said, it will take not weeks or months but years to recover our NHS, but there are actions that we can take immediately, and we are working right now on pay, terms and conditions, recruitment and retention.
I thank Alex Cole-Hamilton for mentioning Mary Seacole, who I was going to mention—it is very important that we do so. Understandably, we give a lot of focus to Florence Nightingale and Louisa Jordan. As many members will know, Mary Seacole was a nurse and a woman of colour who did an outstanding job, particularly in the Crimean war. However, I will not say any more about her, because Alex Cole-Hamilton spoke very well about the incredible contribution that she made to nursing.
Quite rightly, I have been asked about the implementation of the Health and Care (Staffing) (Scotland) Act 2019, which was referenced in the round table that many members attended. Honestly and truthfully, we are not in the position right now to implement the act, because of the challenges that that would have for our recovery and remobilisation. However, on the back of the round table, I have promised to produce an implementation plan, which I will publish in relatively short order.
Let me finish where I started by thanking Jackie Baillie for lodging an incredible motion. I give even more thanks to our nurses up and down the country for their phenomenal effort. Let me give them a promise. I hear their message. They require deeds, not words, and I promise them, as we have promised in previous years, that we will honour the debt that we owe them, and we will ensure that we value them and recognise the incredible contribution that they have made.Meeting closed at 18:10.