Meeting of the Parliament

Meeting date: Tuesday, November 6, 2018

Official Report 1245KB pdf

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Topical Question Time

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NHS Tayside (Staff Numbers and Workforce Planning)

To ask the Scottish Government what discussions it has had with NHS Tayside regarding staff numbers and future workforce planning. (S5T-01299)

As all national health service boards do, NHS Tayside works to plan effectively to ensure patient safety by having the right staff with the right skills where they are needed. I have made it clear to all boards that I will not accept changes that impact negatively on patient access to care. Yesterday, I spoke to the chair of NHS Tayside, who reiterated his concern about how work to develop long-term plans has been portrayed. He has made it clear that, as the board plans improvements to accessibility, quality and delivery across all its services to meet current and future demand, it will not reduce capacity.

I am sure that the cabinet secretary will appreciate the public concern that has been expressed in response to reports that NHS Tayside is looking to shed 1,300 jobs, or 10 per cent of the workforce. There have already been temporary closures in the minor injuries units in Pitlochry and Crieff because of nurse shortages. This morning, the Royal College of Nursing contacted my office to express concern about the reduction in the nursing and midwifery staff head count in NHS Tayside over the past four years.

I hear what the cabinet secretary said about protecting front-line services, but with that level of a reduction in staff, surely it is inevitable that there will be some impact on already stretched front-facing services.

There is no agreed level of reduction in staff; there is no agreed level of any reduction in staff. What we are dealing with is a sub-committee minute, which the board simply noted. No decisions have been taken. NHS Tayside is doing precisely what we want it, along with other boards, to do—plan its use of resource and its service delivery with its health and social care partners, its unions and its clinicians. That is exactly the right approach, contrary to what Mr Fraser’s colleagues have said. They have accused us of not planning for the future, but that is what NHS Tayside is doing. In doing that, it is looking at all options within the overall context of improving the accessibility, quality and delivery of care, as I have made clear.

I understand the public concern, but I understand that that public concern has been fuelled by reporting based on false assertions. If the people who had made those assertions had taken the trouble to know our health service as well as they think they do and to check the facts, they might not have made such irresponsible assertions in the first place.

The cabinet secretary talks about false assertions, but the figure that was put out—1,300 jobs, or 10 per cent of the workforce—was derived from minutes that were produced by NHS Tayside. There has been nothing in any public statement issued by the health board since the story appeared in the public domain on Sunday denying that level of reduction. If the figure is not 1,300 jobs, or 10 per cent of the workforce, what is it?

Mr Fraser knows better than that. He knows as well as I do that, when a board looks at how it will configure its services across the area, it looks at all the options that are available. In doing that, it gathers data on how it stands compared with what other boards are doing. That is what the sub-committee minute reflects. I am not going to confirm the 1,300 figure, but I will certainly confirm that we will not have compulsory redundancies or changes in our health service that remove capacity.

As far as not removing capacity is concerned, it is necessary to have staff to deliver capacity; I would have thought that that was self-evident. Capacity is not about buildings—it is about the people who deliver the service.

If you want to plan and look ahead properly, you do it in the following way. You gather the data. You look at what your demand is—what your patient cohort needs now and in the future as best as you project it. You look at where your services are. You map one over the other and you look at how you need to make changes to redeploy the use of those services. That is precisely what NHS Tayside is doing, and it is not assisted by assertions that are factually incorrect. There is no agreement to cut any staff in Tayside. The NHS chair and I could not be clearer than that.

What we need to do is understand how these matters happen. If we have concerns, we should absolutely raise them, but on the basis of understanding how our health service works and not on the basis of looking for cheap headlines and scoring political points. That does no one any service whatsoever.

For information, six members would like to get in. I am not sure that I will be able to get through them all.

I remind the chamber of my interest as a former front-line staff nurse.

I welcome NHS Tayside’s commitment to review how to make use of taxpayers’ funding most efficiently. However, I can understand that the press coverage of the report may make some NHS Tayside staff feel uneasy. For the elimination of doubt, will the cabinet secretary confirm again that the Scottish Government’s policy of no compulsory redundancies remains firmly in place?

Yes, it absolutely does. Both I and the chair of NHS Tayside have confirmed that. What we are looking at here is how best to deploy the staff resource that we have in NHS Tayside and elsewhere in order to meet current and future demand across the whole system, which includes health and social care as well as acute and secondary care in our health service.

When I read the report in The Herald on Sunday, it was clear to me that NHS Tayside was confirming the nature of the story. The cabinet secretary’s remarks will have caused further distress to hard-working staff in NHS Tayside. She may be aware that, last year, there were 35,000 stress-related sick days in Tayside. Notwithstanding this very serious report in The Herald on Sunday, what discussion has she had with NHS staff unions about the working conditions in NHS Tayside and about these very worrying plans?

Can we just be clear that the worrying report in the Sunday papers probably came from the news release from Scottish Labour, which talks about

“a recipe for disaster that could risk patient safety”.

What sloganising nonsense, based on little except a sub-committee minute about looking at options, precisely as I described to Mr Fraser. I will get to the point of the question, but let us be clear—let us not blame our press for how it covers news releases that come out in that language and in those terms.

I take stress-related absence very seriously. That was part of the discussion that I had with Mr Brown yesterday, and it will continue to be part of the discussion that I have with all the health board chairs and which we pick up with our chief executives. It is also something that I raise when I do ministerial reviews and talk in some detail with the partnership forums in each of our boards. I talk to them about the issues that concern them but also about the issues that I want to raise with them, which include staff absence and what more we can do to assist them in the work that they do as members of unions and as employee directors. I take it very seriously and we continue those discussions and look to see what more we might do to assist our staff.

Members will have received a statement from the chairman of NHS Tayside, in which he said:

“I want the public to know that any changes to our services and staffing will only be made if they ... enhance our capacity to improve the quality of health ... care.

Is the cabinet secretary aware of any comparable health board that has made a similar level of workforce reduction but still managed to support and protect its capacity and the quality of its services? If it has managed to do that, how did it do it?

Let me say again that NHS Tayside has not made any level of staff reduction. What it has done—I, too, will quote from Mr Brown’s statement—is this:

“At this early stage of the”

transforming Tayside

“programme it is important, as well as looking at how and where health and care services are delivered, we start to consider where staff are best placed to respond to the needs of all our patients and service users.”

That is precisely what he is doing, and we will support him and his board and other boards in doing that because we need them to look at not only what they are delivering now but how sustainable and appropriate the services are across the whole system for the future.

The cabinet secretary describes the committee as a sub-committee. I have no doubt that there are some very important and informed people on that sub-committee. The fact that they are discussing the level of reduction that has been mentioned reveals the real problems that exist in the NHS—and certainly in Tayside.

There is something that I would like to understand. The cabinet secretary says that no decisions have been made, but what is the process? When will conclusions be reached? The Parliament has a right to know that.

Mr Rennie is absolutely correct to say that the sub-committee has informed members. The transforming Tayside programme, which Mr Brown referred to, directly involves work with trade union colleagues, managers and lead doctors and nurses. Very well-informed and experienced individuals are involved in that programme, which, as I have said before, is at an early stage.

If the conclusions that the board reaches involve major changes, or I consider them to be major changes, they will be referred to me for decision. At this point, it is not yet clear from the board exactly how long it thinks it will take before it reaches final conclusions, because it began the work before I published the medium-term financial framework, which gives boards relief from paying back brokerage and a three-year financial planning cycle, and the waiting times improvement plan, which, as members will recall, produces significant additional investment. The board will need to recast some of its work in light of those significant enhancements to the context in which it works and consider how it will go forward from there.

I am sure that the board will provide me with a timetable of what it expects to do over the coming months. I would be happy to share that timetable with Mr Rennie and other members.

I apologise to Fulton MacGregor and Jenny Marra. We do not have enough time for any further supplementary questions.

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Firework Season (Protection of Emergency Workers)

To ask the Scottish Government what action it is taking to protect emergency workers during the firework season, in light of the reported increase in levels of violence and intimidation that they face at this time of year. (S5T-01303)

The Scottish Government will not tolerate any attacks on our emergency services. A number of legal protections are in place, including the Emergency Workers (Scotland) Act 2005. Powers that are available through antisocial behaviour legislation have been used effectively as part of the multi-agency approach to planning and to prevention.

I am aware of some reports of antisocial behaviour and attacks on emergency services this year, and I recognise the impact that they have on not only emergency service personnel but the communities that are affected. However, we are awaiting a full response from Police Scotland.

I am sure that members will join me in extending my formal thanks and recognition to our emergency services following their busiest night of the year.

I, too, thank the emergency services for the work that they do. Rather than running from danger, firefighters run to it, and the fact is that people use fireworks night to draw them in. Other members will be as concerned as I was to read reports over the weekend of watch managers having described war zone-type situations in which projectiles and fireworks were thrown at firefighters, and they will have found them deeply disturbing.

I am alarmed that there is a need for a campaign at all. Will the minister join me in welcoming the Scottish Fire and Rescue Service’s do not attack me campaign? What steps is the Scottish Government taking to follow up that campaign? I had hoped that the minister would be able to share initial reports from last night about the level of violence and intimidation that the service faced with last night’s festivities.

I am aware of the do not attack me campaign, as a result of which very good work has been done.

Unfortunately, we do not have the full data from last night. It is too early for that; the agencies are still putting together the numbers. The number of incidents last night has still to be confirmed, but there is no suggestion at this stage of a significant increase. I hope that that reassures Daniel Johnson on that point.

Antisocial behaviour, unfortunately, occurs all year round, and the police and local agencies have a range of powers and measures available to them to direct and disperse. This year, there has been a lot of multi-agency work on planning and prevention. I have seen the work that has been undertaken in Edinburgh this year, and I was very impressed by the amount of working together, the range of measures that were used and the different levels of planning that were involved. The work has been good, and I commend everyone who has been involved in it.

We will work with the Scottish Fire and Rescue Service and Police Scotland to review last night’s events and consider any lessons to be learned.

I hope that those early reports are correct and that there was a reduced level of violence.

I am pleased that the minister raised the Emergency Workers (Scotland) Act 2005, which was passed under the previous Labour Administration. It has led to more than 8,000 convictions, with about 800 convictions a year. Individuals who are found guilty receive up to 12 months in prison, a £10,000 fine, or both. I was pleased that the Scottish Government extended protection to general practitioners and community midwives. Does the minister agree that the legislation is useful? More important, does she agree that those who protect us and those who we ask to uphold the law should enjoy the protection of the law and that offences such as those in the act are a vital tool in extending that protection?

Yes, I agree. Specific laws are in place to protect emergency workers through, as the member mentioned, the 2005 act. In 2008, this Administration extended the act to cover GPs, other doctors, nurses and midwives when they are working in the community. Penalties are available to the courts, all the way up to life imprisonment and unlimited fines, to deal with the most serious assaults. That gives the police, prosecutors and courts the tools to ensure that those who attack public-facing workers are dealt with appropriately and effectively.

Thank you. I apologise, again—this time to Liam Kerr and George Adam. I remind all members and ministers to be concise. We will then have more room to fit in other members.