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Chamber and committees

Meeting date: Tuesday, April 25, 2017

Meeting of the Parliament 25 April 2017

Agenda: Time for Reflection, Topical Question Time, Child Tax Credit Cuts, Air Departure Tax (Scotland) Bill: Stage 1, Air Departure Tax (Scotland) Bill: Financial Resolution, Criminal Finances Bill, Decision Time, Earth Hour 2017


Topical Question Time

Queen Elizabeth University Hospital (Staff)

1. Alex Cole-Hamilton (Edinburgh Western) (LD)

To ask the Scottish Government what its response is to claims that staff at the Queen Elizabeth university hospital are “incredibly stressed” and that the hospital is “very short staffed”. (S5T-00525)

The Cabinet Secretary for Health and Sport (Shona Robison)

First, I pay tribute to the unstinting professionalism and dedication exhibited by the staff at the Queen Elizabeth university hospital in Glasgow, as seen in last night’s BBC documentary. All national health service boards, including NHS Greater Glasgow and Clyde, have a statutory responsibility to carry out and actively monitor workforce planning. That ensures that high-quality services continue to be delivered safely while boards remain responsive to the needs of staff, not least through effective partnerships with their professional and union representatives.

Under the current Government, the number of staff in NHS Greater Glasgow and Clyde is up by 3.7 per cent to 34,385 whole-time equivalent staff, with the number of consultants up by 38.4 per cent and the number of qualified nurses and midwives up by 5.5 per cent.

Although the numbers of doctors and nurses are up, I recognise that there is increasing demand on services, which has an impact on staff. That is why it is so important for health boards to continuously improve their workforce planning. The Government is providing them with the tools to do so.

Alex Cole-Hamilton

I absolutely share the cabinet secretary’s sentiment about the staff. I watched the BBC documentary last night, in which the dedication of the staff shone through. We could not fail to be impressed by their expertise and the care that they provide, and the facilities are evidently first class. However, the Royal College of Nursing has said that the pressure that staff are under because there are too few of them makes it

“really hard to deliver care”.

It added that there is

“real strain on the services”.

Can the cabinet secretary tell the staff and patients at the Queen Elizabeth university hospital when they will see a material improvement and what plans there are to increase the number of staff at that hospital?

Shona Robison

Of course I saw the RCN’s comments. We engage closely with the RCN at the national level, and we expect NHS Greater Glasgow and Clyde to engage with it at a local level, too.

To ensure that staffing levels are appropriate, staffing levels are reviewed at the hospital’s daily safety huddle. When staff are absent or posts are vacant, additional staff are sought, and it is important that that happens. The board has also assured me that it holds regular meetings with the staff-side partners to ensure that any concerns that have been raised with them are addressed.

As I said in my initial answer, we have seen an increase in staff across the NHS in Scotland, which includes a 5.5 per cent increase in qualified nurses and midwives in NHS Greater Glasgow and Clyde. We have the workforce planning tools, which are very good—in fact, they have been replicated by other health systems—but we want to go further than that, which is why we have committed to enshrining safe staffing in law and placing the nursing and midwifery workforce planning tools on a statutory footing. Alex Cole-Hamilton might be aware that a consultation on the legislative proposals was launched on 12 April and that it will run until 5 July to ensure that we gather the views of staff, including those who are represented by the RCN.

Alex Cole-Hamilton

It is not just the Queen Elizabeth university hospital that is under pressure. The Royal infirmary of Edinburgh serves thousands of my constituents and today, The Scotsman reported that a memo to ERI staff that was sent last week described the ERI as being “in extremis”. It stated that 36 patients waited up to 17 hours in accident and emergency for admission to a bed and that the potential safety implications for patients, their families and scheduled surgery are serious. How often do such warnings and requests to repatriate patients to other health boards occur?

Shona Robison

Occasionally, particular A and E departments experience a surge in demand. That happens for a variety of reasons. The issue at the royal infirmary was a post-Easter surge in demand, with high levels of attendances on Thursday 20 April. In such circumstances, it did what any emergency department would do—it asked for beds to be released as quickly as possible. That is because it is for the whole hospital to address any issues in A and E departments; it is not just for the staff who work in A and E departments to manage those issues themselves. There is nothing unusual about taking a whole-hospital approach.

NHS Lothian’s performance returned to normal within a few hours of that surge. In fact, performance against the four-hour target at the infirmary in the preceding day was 96.7 per cent. The hospital’s performance in a steady state has been very good, but it experienced a surge in demand, which was managed appropriately, and it returned to a steady state quickly after that.

Sandra White (Glasgow Kelvin) (SNP)

The cabinet secretary mentioned workforce planning in reply to Alex Cole-Hamilton. What steps is the Scottish Government taking to support nursing and midwifery workforce planning?

Shona Robison

Our workforce planning tools are very good. I recently visited Forth Valley hospital, where I saw the deployment of the tools. In that hospital—it is not dissimilar to the Queen Elizabeth university hospital—a number of facilities came into one site, and there have been challenges associated with that.

The good thing about the workforce planning tools—as has been recognised elsewhere—is that they take into account not just the numbers of patients and staff but the acuity of patients’ illness, which enables us to bring in additional staff if they are required because of heightened levels of acuity of illness.

As I said in my initial answer, we want to go further than that. Our proposals to enshrine safe staffing in law have been widely welcomed by the RCN and others. I encourage people to put as many views as possible into the consultation, which runs until 5 July. There will be a number of regional events across Scotland during the consultation period to enable people to share their views.

Donald Cameron (Highlands and Islands) (Con)

The cabinet secretary will be aware that GMB Scotland recently commented that,

“Due to staff shortages and extra demands that are being placed on them, many hard working hospital staff are struggling to cope and sadly for many of them they need to take time off to recover.”

Given the level of vacancies among consultants, nursing and midwifery services, what action will the Government take to ensure not only that such gaps are filled but that current staff receive the support that is required to carry out their jobs without undue stress?

Shona Robison

It is important that staff are supported in the workplace. As I said in my initial answer, we have seen record levels of posts across Scotland—there have been increases in consulting posts and nursing and midwifery posts. Sometimes vacancies are harder to fill, particularly if they are in certain specialties. That is the case not just here in Scotland but elsewhere. It is important that boards manage that issue and that they do everything possible to fill those vacancies and support staff in the meantime.

We are also looking at doing things differently. For example, the east of Scotland boards are working together to address radiology shortages by bringing together such staff in a network to provide support. That shows a positive and imaginative way to address shortages in that specialty.

Anas Sarwar (Glasgow) (Lab)

For almost a year, the cabinet secretary has come to the chamber and said that she is addressing workforce issues, but in that time vacancies and private agency spend have gone up. The reality is that our NHS staff are overworked, undervalued and underresourced by the Scottish National Party Government. The result is that, yet again, the Queen Elizabeth university hospital has the poorest-performing A and E in the whole of Scotland. Is it not true that such mismanagement is having a direct impact on our staff, services and patient care?

Shona Robison

Is it not a shame that Anas Sarwar could not find it in him to welcome the positive documentary that was shown on the BBC last night about the hardworking staff in the Queen Elizabeth university hospital? If, as I do, he looks at social media—I am sure that he does—he will be interested to see how many staff have said how nice it was to have a positive portrayal of their efforts at the hospital, instead of the eternal talking down of their efforts that we hear emanating from some quarters of the Scottish Parliament.

Anas Sarwar will be well aware of the efforts that are going on in the Queen Elizabeth university hospital. Tim Parke, who is an A and E consultant at the hospital, reported that, despite some of the difficulties, the service at the new hospital is better than before and work is continuing to make more service improvements.

I tell the staff of the Queen Elizabeth university hospital that we absolutely value the efforts of every single one of them and that we will work with the board to make further improvements, as we have done over the past year.

Poverty Alliance Survey

2. George Adam (Paisley) (SNP)

To ask the Scottish Government what its response is to a Poverty Alliance survey that suggests that one in three people in Scotland on a low income are struggling to afford food. (S5T-00524)

The Cabinet Secretary for Communities, Social Security and Equalities (Angela Constance)

It is depressing to read that people in a country as rich as Scotland are struggling to afford to feed themselves. Sadly, the figures do not come as a surprise, considering the United Kingdom Government’s failed austerity and continuing barrage of welfare cuts.

We will continue to do all that we can to support people on low incomes and to tackle the underlying causes of poverty. Our fairer Scotland action plan sets out 50 concrete actions to tackle poverty and inequality in Scotland, and is backed by a £29 million fund for local communities. That is alongside the more than £100 million a year that we spend on welfare mitigation measures. Resources that could have been invested in lifting people out of poverty are instead having to be invested in offsetting the very worst of Tory welfare cuts.

In addition, we believe that access to sufficient nutritious food is a basic human right, which is why our £1 million a year fair food fund supports approaches that help, in a dignified way, people who are affected by food poverty.

George Adam

Does the cabinet secretary agree that the Scottish Government’s promotion of the Poverty Alliance accredited living wage, which includes ensuring that it is paid to all national health service staff and adult social care workers, is another clear action that has protected Scotland’s people from Tory austerity? Can she outline further plans to increase payment of the living wage in Scotland?

Angela Constance

We have allocated a further £250 million from the NHS to integration authorities to protect and grow our social care services and deliver our shared priorities, which include paying the living wage to care workers who support vulnerable adults. That will give up to 40,000 people—mainly women—who do some of the most valuable work in Scotland, a pay rise.

We will also provide up to £50 million of additional revenue to extend, by the end of this parliamentary session, payment of the living wage to all childcare staff who are delivering the funded element in private and third sector nurseries.

We continue to support the living wage accreditation scheme. As a result, in 2016, Scotland remained the best performing of all four United Kingdom countries, with the highest proportion of employees being paid the living wage, or more.

George Adam

As the right-wing Tory Government in Westminster continues its attack on the poorest people in our society, is the cabinet secretary—as I am—appalled, but not surprised, by Trussell Trust research that was published this morning, which shows that food bank use is at an all-time high? What advice will she give the good people of Paisley and of all Scotland who seek to avoid that continued attack and the risk of Tory austerity?

Angela Constance

The Tories are turning their backs on the poorest people in this country. I think that, in return, the people will turn their backs on the Tories. As many members of this Parliament are, I am appalled, but not surprised, that there has been a 9 per cent increase in people accessing three-day emergency food parcels. According to the Trussell Trust, a quarter of referrals are driven by low income and almost half are driven by the UK Government’s benefits regime. The Trussell Trust and the Poverty Alliance provide strong evidence that more and more people in this country are going hungry and are having to make impossible decisions. That is a shocking trend, which will have to stop.

Adam Tomkins (Glasgow) (Con)

The Trussell Trust and others have shown that the overwhelming majority of people who use food banks do so because of an acute shortage of money rather than any more sustained cause. Indeed, the Trussell Trust told me that 80 per cent of Scots who use one of its food banks do so only once. [Interruption.]

The Presiding Officer (Ken Macintosh)

Order, please. We have heard everyone else in silence. Please hear Mr Tomkins in silence, too.

Adam Tomkins

Thank you, Presiding Officer.

There is an issue to be debated about the extent to which we want food banks to become more closely allied with our taxpayer-funded welfare system. I have talked privately with the cabinet secretary about that. What steps—if any—has the Scottish Government taken to ensure that people who use food banks in Scotland are at least aware of the support that might be available to them from the Scottish welfare fund and other devolved sources?

Angela Constance

The real question is about why people are on low incomes in the first place. It can be because they are in work and on poor pay, which is why this Government is committed to doing everything that it can to promote and support the living wage—unlike the UK Government south of the border, which, of course, holds the powers in relation to minimum wage legislation.

As more and more people in this country go hungry and struggle to feed their kids, it is somewhat ironic that Mr Tomkins comes to this Parliament and points to the Scottish welfare fund. The Scottish welfare fund has assisted 241,000 households that have been forced to access the fund as a result of Tory cuts, Tory austerity and draconian welfare cuts.

The Presiding Officer

I apologise to the members who could not get in to ask a question.