Meeting date: Tuesday, June 26, 2018
Meeting of the Parliament 26 June 2018
Agenda: Time for Reflection, Business Motion, Topical Question Time, Education Reforms, Scottish Parliament (Powers), Decision Time, National Health Service 70th Birthday
- Time for Reflection
- Business Motion
- Topical Question Time
- Education Reforms
- Scottish Parliament (Powers)
- Decision Time
- National Health Service 70th Birthday
National Health Service 70th Birthday
The final item of business today is a members’ business debate on motion S5M-12842, in the name of Richard Leonard, on the NHS’s 70th birthday. The debate will be concluded without any question being put.
That the Parliament celebrates 5 July 2018 as the 70th anniversary of the founding of the NHS; agrees with the words of its founder, Aneurin Bevan, that it is “a triumphant example of the superiority of collective action and public initiative”; believes that, each and every day, both in Central Scotland and throughout the country, there are countless examples of the importance and success of the NHS; thanks all health service staff, past and present, for their compassion and dedication in delivering care to people in need, and wishes the NHS a happy 70th birthday.17:01
As we celebrate and reflect on 70 years of the national health service in this debate, let us remind ourselves of the vision for a healthy nation that was first outlined in Labour’s 1945 manifesto. It read:
“By good food and good homes, much avoidable ill-health can be prevented. In addition the best health services should be available free for all. Money must no longer be the passport to the best treatment. In the new National Health Service there should be health centres where the people may get the best that modern science can offer, more and better hospitals, and proper conditions for our doctors and nurses.”
Yet today, as in 1945, health inequalities—that glaring flaw in our society—persist. That is precisely why tackling poverty and inequality in Scotland, and the health inequalities that result from them, should be the first priority of this Parliament.
Poverty is a moral issue. Not only does it diminish the lives of the people who are caught up in it, it diminishes us all. It holds us back as a country, weakens our society and hinders our economy. It is the cause of much preventable ill health. That is why we cannot carry on as we are, with poverty deepening and inequality widening.
I pay tribute to all the staff who work so hard to keep our NHS going, day in and day out, night in and night out, caring for and curing our sick. They deserve better support than they are getting from this Government.
It is not just NHS staff who are being let down, but NHS patients, too. Patients, many of them elderly, and often with underlying health conditions, are waiting for hours for an ambulance, despite repeated 999 calls, and then waiting for hours on trolleys in hospital corridors.
We have been able—at long last—to secure an independent inquiry into mental health services in Tayside, but it should not take questions to the First Minister and families marching into this Parliament demanding justice for action to be taken.
The Labour Party founded the national health service, and something that is often overlooked is that Labour’s Tom Johnston, when he was appointed Secretary of State for Scotland in the wartime Cabinet in 1941, began an experiment in the Clyde basin, in which civil defence hospitals that had been set up to treat civilian war casualties, were used to treat war workers who could not afford specialist diagnosis and treatment. He rolled out the approach across Scotland and, in so doing, drove down hospital waiting lists by 34,000, helped form the basis of the 1944 white paper and blazed a trail for the national health service of the post-war years.
Down the years, it has been always been Labour Governments that have invested in our NHS. When Labour was last in power, spending on the national health service in Scotland doubled—not merely in cash terms but in real terms. We scrapped the internal market and we took the Health Care International private hospital in Clydebank, which the Tories had used public money to establish, and put it into the NHS. In the future, we will put before the people a clear choice: a decade of austerity and public expenditure cuts with the SNP and the Tories, or a decade of real and sustainable investment with Labour.
As we celebrate 70 years of the national health service, we recall its pioneers in the Labour Party, reflect on its transformative achievements and, once again, renew our commitment to an NHS that is free at the point of use; an NHS that is fully funded and resourced; an NHS that values its staff and serves its patients; and an NHS that works for the many, not the few. The NHS is practical socialism in action—“pure Socialism”, as Bevan described it. That, in the end, is the Labour Party’s defining idea.
The heralding of the NHS 70 years ago meant the end of insurance stamps, the means test and endless queues. Medical care was no longer connected to ability to pay. General practitioners stopped having to compete for business and joined forces as part of a medical team. It became a single service and a national service. Commercial principles were replaced with collective action and public initiative. That is a powerful and enduring idea, which we will defend with every sinew in our bodies, but it should not be limited in its application to our national health service. It would be well applied in responding to growing demands to provide care for the elderly, which is an area in which we are seeing commercial principles and a market-based approach pulling us into a crisis; to social care, so that we can support the human rights of disabled people, remove the profit motive and pay carers a proper rate of pay; and also in the field of public transport, and the provision of energy supply and distribution in housing. The possibilities are limitless.
In 2018, it is time that we started to learn the lessons of 1948. The national health service was created when the country was almost bankrupt. It is time that we started to think big and act radically. It is time that we recaptured the spirit of that 1945 Government and it is time that we once again applied those enduring and timeless principles to our times.17:08
I start by paying tribute to things that the Labour Party has done, which is not a natural thing that members would expect me to do. However, in the past hundred years, the legislation that it has introduced to establish the national health service is a most significant and enduring achievement that we should all commend. In this Parliament, I have commended Jack McConnell in the past—and I do so again today—for his political courage in introducing legislation on smoking. The Labour Party is capable of getting things right. However, I have to draw one or two different conclusions from those that we have just heard in the contribution that has been made so far in this debate.
First, I remind members on the Labour benches that, in fact, the story of the national health service really started with the Highland and Islands medical service, which was established in 1913 and covered half of Scotland’s land mass. It was not free at the point of supply, but it set the limit on what people paid at a very low level so that, for the first time, ordinary working men and women had access to a health service.
In rolling out the service in the 1940s, Beveridge was drawing on that model, so the routes that have got us to where we are are more diverse than the simple idea that it was Beveridge. It is none the worse for any of that, I have to say, and I do say. Indeed, the quotation from Nye Bevan in the motion is one that I agree with.
I will do what I did in the previous health debate. I went again to the Care Opinion website and found the following entries, all from the past week, and it is not all doom and gloom. A patient treated at Aberdeen royal infirmary said:
“I was diagnosed with Type I diabetes in September 2017 ... the support of the whole diabetic team at Davidson Anderson Building, ARI has been incredible.”
A comment on the play service at Aberdeen children’s hospital states:
“I think the play service is a really valuable service that helps children make the hospital seem less scary.”
Commenting on their son’s three-and-a-half-week stay at the Royal Aberdeen children’s hospital, a parent said:
“My boy broke his femur at 2.5 years old and was in traction for 3.5 weeks ... My son really enjoyed his time with the play staff who made his stay very enjoyable”.
Listen to that. They are talking about someone in traction with a broken femur. That is how good the hospital was. Another comment, on Dr Gray’s maternity hospital, states:
“When my grandchild was born in August 2017 he had to stay in SCBU for 10 days ... The care that was given to both my daughter and grandchild was exceptional.”
That tells us a lot about the staff in the health service, because that is front-line experience. It also tells us about the system that supports the staff.
I will conclude with a comparison with the world before then, because I was born before the health service. I have here a copy of a medical bill that my mother had to pay, because the year before I was born she had an ectopic pregnancy—a pregnancy in the fallopian tube—and had to go to hospital and have that fallopian tube removed. It was a very serious operation, but fortunately it was done with such skill that she was then able to give birth to me, her first live birth, and to two subsequent children.
The point is that the amount of money on the bill is three-and-a-half weeks of the average working man or woman’s wage at that time. My mother was fortunate to come from a family who could afford that. The health service made it possible for the quality of service that my mother was able, fortunately, to pay for, to be available to all. I congratulate the health service on its upcoming 70th birthday. We are all grateful for its enduring contribution to our society.17:12
I start by paying tribute to the Cabinet Secretary for Health and Sport, as she has announced her intention to leave the Scottish Government. We have had many disagreements across the chamber on health policy, but I have never doubted Shona Robison’s commitment to improving the health and wellbeing of our nation. All of us have seen how former cabinet secretaries for health and sport, once they have left the Government, acquire a new independent lease of life, so I hope that she, too, will experience that in the coming weeks, and will hold the Government to account from the back benches.
I congratulate Richard Leonard on securing today’s important debate, and am pleased to take part in it.
I record my sincere thanks to all those who currently work or have worked in our NHS—from GPs, surgeons and consultants, to the nurses, midwives, health visitors, hospital porters, ambulance drivers, paramedics, hospital cleaners, auxiliary staff and many more.
Each and every day, thousands of NHS workers in Lothian and across Scotland go above and beyond the call of duty to provide our constituents with some of the very best healthcare in the world. We owe them a huge debt of gratitude. As we celebrate the 70th birthday of our NHS, it is right that we thank NHS staff: that is a key part of the celebration.
Any organisation is, at its heart, its people. The NHS is no different. I am lucky enough in my job as shadow cabinet secretary for health to meet NHS professionals daily. Many of my meetings focus on the challenges that face our NHS and the increasing demands that are being placed on Scotland’s health and social care services. However, more often than not the focus is on people and on lives that have been saved. The conversations are about the people who work in our NHS going the extra mile every day to deliver patient care. There are stories of hope, of love and, often, of recovery against the odds. Thanks to the efforts of our NHS staff at all levels, who use the medicines and technological advances that we are lucky enough to access, our people’s health has been completely transformed since 1948.
A child who was born in Scotland in 1948 could expect to face a raft of illnesses including polio, measles, whooping cough and diphtheria. Vaccination programmes have now virtually wiped out those diseases. Child and infant mortality rates are a fraction of what they were, and people are receiving cancer treatment and surviving cancer in ways that could only be imagined by clinicians in the 1940s.
I hope that the debate will celebrate our NHS, its achievements and its outstanding workforce. However, our NHS’s 70th birthday should also be a time for us to look to the future and to help to put in place the long-term policies and plans that will ensure that our NHS is free at the point of delivery for every constituent in the decades ahead.
Building a sustainable NHS needs to be a priority for everyone in Parliament, because our NHS faces constantly evolving, new and complex challenges—from obesity-related conditions to an ever-increasing demand for mental health services, to antibiotic resistance, to the costs of new drugs and technology, and to provision of social care for an ageing population as life expectancy continues to increase—although we should celebrate that increase as the major achievement of our NHS. Those are all massive challenges, but all of them can be addressed if we develop the long-term strategic thinking and policies that are required to meet them, and if we do that by working alongside our NHS staff, who are at the front line and who know better than any politician does how to respond to patients’ needs and to cope with the demands that are placed on our health service.
Great countries come together to turn challenges into opportunities, and I know that our NHS staff are ready to do that to help to transform our nation’s health and wellbeing. In the coming months, Conservative members will put forward our plans and vision to take forward our Scottish NHS. I believe that Parliament and every party that is represented in it need to come together to deliver a sustainable future for our Scottish NHS.
For the time being, let us celebrate the fact that our Scottish NHS is 70 years young, and let us look to the future. If we do that, and if we work positively and co-operatively across Parliament, we can be confident that the best days for our NHS lie ahead of it.17:17
I thank Shona Robison for her service as our Cabinet Secretary for Health and Sport. It is no secret that she and I have had our disagreements—we were not exactly best friends—but I genuinely wish her the best for the future.
I congratulate my leader, Richard Leonard, on securing this important debate to celebrate the 70th birthday of our NHS. It is 70 years since—for the first time—hospitals, doctors, nurses, pharmacists, opticians and dentists were brought together under one umbrella to provide, for everyone, services that are free at the point of delivery.
It is only right that a Labour member has led the celebration of the NHS. Our NHS—Labour’s NHS—is Labour’s greatest-ever achievement and our country’s most cherished public service.
It is thanks to our NHS that we have all but eradicated diseases including polio, and have pioneered new treatments including the world’s first liver, heart and lung transplant. Every day, the NHS treats, supports, cares for and cures tens of thousands of our fellow citizens through services that are free at the point of need, and which are paid for through our collective contribution, with no questions asked about how much money is in a patient’s pocket.
Every day, our amazing NHS staff go above and beyond the call of duty in order to care for others. To all the staff across the NHS, I say, “Thank you.” We all have our personal stories and connections. I thank midwives such as June, who cared for my family. I thank the doctors such as Dr Rajan, who aided my father’s recovery from his heart attack. To the dentists including my wife Furheen—I have to say this or I will not be allowed back in the house tonight—I say, “Thank you.” I thank all our NHS and social care staff, no matter their role.
However, we must be honest that the workforce is overworked, undervalued, underresourced and—after almost a decade of pay restraint—underpaid. We say thanks, but that is not enough: we need to support the staff.
We have debated many times in the past few months many of the challenges that are facing the NHS: the 3,000 nurse and midwife vacancies; the 1 million bed days that are lost to delayed discharge; the 1,200 children who are not receiving the mental health support that they need; and the fact that the treatment waiting time law has been broken more than 100,000 times.
In the run-up to its 70th birthday, we need not just to recognise the successes, but to demonstrate how we will fix some of the challenges in our NHS because, as Bevan said,
“The NHS will last as long as there’s folk with faith left to fight for it”.
Labour members have the faith to fight for it and the political will to deliver the investment that is needed to save it. Over the course of the celebration week, we will be making the case for what we would do differently, if Labour was in Government. We would be using our tax system to fund the NHS properly. We would have a credible and deliverable workforce plan that would reverse the cuts to nursing and training places that have been made by Nicola Sturgeon. We would have a mental health counsellor in every school, crisis mental health services, protection of local services, cancer diagnoses being done within two weeks, access to vital lifesaving medicines, an end to cuts to social care budgets, an end to the 15-minute care visit, access to free sport, a meaningful pay increase for NHS staff, and a return to an NHS that is true to the vision of Nye Bevan—an NHS that, once again, supports us from the cradle to the grave.
In closing, Presiding Officer, if anyone ever asks why we need a Labour Party, tell them this: the NHS. If anyone ever asks what a Labour Party ever did for us, tell them this: the NHS; and, if anyone ever asks what the Labour Party will ever do again, tell them this: the NHS.17:21
I begin, as others have, by paying tribute to Shona Robison, who is stepping down as health secretary, and I wish her well for the future.
I congratulate Richard Leonard on bringing the motion to the chamber for debate. I do not think that there is any great downside to having two motions on the same topic in the one week; it is perhaps a small pity, however, that there is not an opportunity to reconcile the motions and unite behind a single motion—[Interruption.] That it would have felt a little more unified is the only point that I was trying to make. Nevertheless, I express my support for both motions.
Several other members have also opened their remarks by commending and thanking the very many people who work in our NHS: the dedicated—and often tireless, because they have to be—professionals who deliver its services. I have to offer the same thanks and echo Anas Sarwar’s reference to midwives in particular, because my mother was a midwife. I grew up with a mum who very often worked night shifts in the NHS, so the NHS is a natural and instinctive part of my understanding of what healthcare is about.
I would have found it peculiar, bizarre and incomprehensible at that young age to think that in such recent times—just one generation previously—there was no such thing as the NHS. It is very easy to think of history just a few decades before one’s own youth as though it is ancient history, but it is such a recent change. Just a generation before mine, there was no NHS.
My experience of the NHS was not just through seeing my mum going out to work there and coming back early in the morning, as we were getting ready for school. I was also a bit of a sickly child and was often in and out of hospitals with infections, and had long-term kidney damage as a result of those infections. I became a bit of a human pincushion and, at times, I may even have resented having to go through so many treatments in the NHS. However, now, standing here, I can reflect on the fact that I and so many other people do not even know whether we would be able to stand here and contribute to such a debate if we had not had access to those health services.
We all need to convey deep and profound gratitude. Richard Leonard made a profound point in saying that something of the spirit of the post-war generation needs to be recaptured. That was a generation of people who were brutalised and traumatised by their wartime experience, and who were not in a strong place economically—but invest, they did. They had fought together and survived together, and they said that together they were going to rebuild a society that would make them better off together, not only through the national health service but through the welfare state.
I wish to goodness that we could see something of the spirit of that post-war generation in today’s political climate, instead of an exercise in disaster capitalism, which I fear may be the legacy of our political generation. However, if we were able to recapture that spirit, it would mean not only that we would pay more collectively for high-quality services that make us better off collectively and remunerate fairly the people who deliver the service, but that we would take collective social responsibility for the determinants of ill-health. One of those determinants is poverty, and Richard Leonard mentioned the inequality in health outcomes.
There are also the facts that our food chain has been handed over to commercial interests and that recreational drugs have been handed over to gangsters without the state having any ability to regulate them effectively. There is a huge need for us to take collective social responsibility for the things that create and worsen ill health in our society, because we cannot rely on science alone to create the conditions for health. If we run an unhealthy society, we will have unhealthy outcomes, and the NHS alone will not be, even with the greatest support that we could provide for it, in a strong position to do the work that we need it to do.
Because of to the number of members who still wish to speak in the debate, I am minded to accept a motion without notice, under rule 8.14.3, to extend the debate by up to 30 minutes. I ask Richard Leonard to move such a motion.
That, under Rule 8.14.3, the debate be extended by up to 30 minutes.—[Richard Leonard]
Motion agreed to.17:27
I echo the thanks of other members to Richard Leonard and the Labour Party for bringing this important motion to Parliament. I will address the cabinet secretary’s departure later in my remarks. I also echo the thanks of other members to our hard-working NHS staff.
In 1961, a prominent United States actor walked into a recording studio and cut a record. I am sure that many other members will have on their iPod that hot-button favourite and spoken-word classic “Ronald Reagan speaks out against Socialised Medicine”, which contains 11 minutes of vignettes such as:
“soon your son won’t decide what he will do for a living. He will wait for the government to tell him”,
“One of the traditional methods of imposing ... socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project, most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it.”
To Ronald Reagan and the American right wing, who still support that view, I say, “Nonsense.” In 2016, 29 million people in the United States were still without medical insurance. Had I been one of them, an operation that I had 20 years ago to fix the rotator cuff muscles in my shoulder, which had resulted in repeated dislocation, would have cost me $30,000. Theatre delivery of my son when my wife had complications during our first pregnancy would have cost $50,000, plus the fee for the resuscitation that he needed. All told, my lifetime involvement with the NHS would have cost me hundreds of thousands of dollars, but I have never left hospital with anything other than a dodgy shoulder fixed and three beautiful children—so, to the NHS, I say, “Thank you.”
Members from across the chamber are right to remember some part that their party played in the creation of the NHS, because it was a cross-party creation. Good things happen when we put aside our differences and work together. It was absolutely a Labour Government that brought it in, but that was off the back of a Conservative member of Parliament’s proposal for legislation, and in its infancy it stemmed from Beveridge, that great giant of liberalism, and his report in which he talked about the five giant evils of ignorance, idleness, squalor, want and disease. It was for that last giant evil that he envisaged the formation of a universal healthcare system or, as he described it,
“comprehensive health and rehabilitation services for prevention and cure of disease”.
How prescient is that? More than 70 years ago, people were talking about prevention, and we are still working towards that goal.
We are bolstered by an amazing staffing complement in our health service—people who work all hours of the day and days of the year to bring comfort, safety, security and treatment to our most vulnerable people. The model of treatment and care in this country is sound; the direction of travel is off.
My call for the cabinet secretary’s resignation is a matter of public record but I do not revel in it today. She was always kind to me, was always generous with her time and displayed a compassion that is uncommon in Scottish politics. I wish her well.
However, the Government has certainly presided over a panoply of error and misjudgment in the discharge of its responsibilities to our health service, such as in delayed discharge, which the former cabinet secretary pledged to eradicate. There is still an interruption in flow that means that, after being declared fit to go home, people are waiting in our hospitals for as many as 600 nights to get back into their communities. There is also service redesign without communities’ involvement. The worst example is in mental health services, with 1,000 adults having waited for more than a year for first-line psychiatric or psychological therapies and children in some parts of Scotland waiting for two more years.
Let us celebrate today the creation of our much-loved NHS. Let us try to strip out the party politics behind it. That means the new cabinet secretary listening to the helpful criticism of Opposition members in the discharge of her responsibilities.17:31
Like others, I welcome the debate as a chance to speak positively and constructively about the huge achievements of our NHS on this important anniversary. As the motion says,
“each and every day, … there are countless examples of the importance and success of the NHS”,
and the Parliament
“thanks all health service staff, past and present, for their compassion and dedication in delivering care to people in need, and wishes the NHS a happy 70th birthday.”
That is the sentiment that I want us to focus on in the debate. I say that not just because of the countless examples that I see in my constituency, which has a large population, and the different challenges that we have in such a dense urban area, but because of my family connection to the NHS. I wondered whether to touch on that but Patrick Harvie has opened the door and given me encouragement to mention it.
My mother worked for more than 30 years as a geriatric physician at the forefront of the NHS in Lothian until she retired. That is one of the most challenging areas of our NHS at present. As Patrick Harvie said of his mother, seeing that commitment as I grew up meant that, in my childhood and beyond, I recognised the sheer dedication that our public servants in the NHS give daily to make a difference to others and to try to tackle the changing scenarios, factors, pressures and areas of need that we have to deal with in our society and which bear down on our health system.
It is important for us not to take the NHS for granted, as its egalitarian and inclusive nature and history are unique in the world. It is important to recognise that.
It is good that other speakers talked about the new and complex challenges, needs and demands that our NHS faces. Miles Briggs said that we need to look to the future. In his motion, and in his speech, Richard Leonard talked about the need for collective responsibility. That call to action is about how we preserve and enhance the NHS over the next 70 years so that we do not take it for granted but build on it, improve it and facilitate it in a way that deals with the needs that are coming at us.
In the time that I have left, I would like to focus on MSPs and other politicians. We all have case work to do that involves the health service and we all recognise the importance of the NHS. Given what Shona Robison said about her resignation today, perhaps we should use this debate as an opportunity to think harder about what more we can do to collaborate.
There has been quite a lot of grace with regard to the topic today but I have seen some quite ungracious behaviour, to be frank, in previous discussions in the chamber. There is a lot of opportunism when it comes to talking about our NHS. We should all be more solution focused. Before we press the button on the tweet or sign off the press release, we should think, “Will this help?” We want to ensure that our NHS survives for the next 70 years, and the challenges that it will face during that time are profound. We could achieve so much more if we worked together to take forward what is, in the words that are quoted in the motion,
“a triumphant example of the superiority of collective action and public initiative”.
Let us show public initiative and commit to collective and collaborative action.17:36
I am pleased that Richard Leonard has brought forward this motion for debate, in part because the NHS is Labour’s greatest achievement—Labour is at its best when it makes change that is so profound that it cannot be undone, and the NHS is one such achievement. However, the main reason why I am pleased that we are debating the motion is that it allows us to do something that is important to me, which is to say thank you, on a personal basis.
My eldest daughter was born in 2012 and spent the first four months of her life in the Royal hospital for sick children. She was born with an intestinal atresia, which is a blockage that is created in the gut through an interruption in the blood supply. Within 12 hours of her birth, she was in an operating theatre being operated on. I will never forget the experiences of those first few hours, days and months, such as the midwives talking us through the way in which they counted the baby’s movements in the womb when we were worried that she was not moving enough. I will never forget holding my wife’s hand in the operating theatre as she went through an emergency caesarean section—and I will never forget some of the smallest details. I remember silly things from when I was talking to the surgeons before and after the operation, such as the details of the room and what they were wearing, but I cannot remember what they said, because the detail was so overwhelming that I could not take it in.
However, I will be forever thankful—thankful because I now have a happy six-year-old child who is just finishing primary 1 and who, despite the fact that she has only half the length of small intestine that she is supposed to have, is in the 90th centile for height for her age. I will always be thankful that we knew from an early stage in the process that it was only a matter of time before she would get out of hospital, and thankful for the care that would have cost hundreds of thousands of pounds if we had had to pay for it ourselves. I am thankful to the surgeons, the medical teams and the nurses, especially Mr Munro and a nurse called Anna, whose surname I do not know but who looked after my daughter when she first got out of the operating theatre.
Above all else, I say thank you to the NHS for getting us through that time and for providing us with the care that my family needed, and I say thank you to the sick kids hospital, which was wonderful. Despite how traumatic and difficult that experience was, I would not change a thing. The sick kids hospital and the NHS more broadly took a stressful situation and made it one that was extremely rewarding. I am thankful for certain small things that I have mentioned before in the chamber, such as the fact that there were nurses on hand to tell me how to bathe my child for the first time, which would otherwise have been an incredibly nerve-wracking experience. I have to say that I finished up thinking that, if I ever got ill, I would want to go to the sick kids hospital, because it was such a fantastic place.
However, there are some realities that lie behind that. This year marks the 70th anniversary of the NHS. In 1948, 80 per cent of children who were born with the condition that my daughter had would have died. By the 1970s, 80 per cent of those children would have survived, because of the advances in enteral feeding, which is intravenous feeding. Now only a small percentage of such children do not survive. The NHS has allowed us not just to progress in medicine but, as Richard Leonard pointed out, to ensure that we all benefit from those advances.
The other key issue, and why my experience was so positive, is the number of staff. The nurse to patient ratio in the sick kids is 1:6, which is about twice the number of nurses that we would expect to see in an adult hospital.
We face a number of challenges. The NHS is under huge pressure because of the ageing population and because we are ever more capable of doing new things, introducing new technologies and making new medical advances.
In some ways, though, we face the same old issues. It is not magic—there is not some complicated science behind this. It boils down to resource and numbers. If we want the NHS to provide the level of care that we want, we need to resource it. Ben Macpherson is right. It is easy, with the NHS, to get trapped in the small politics, but there is also the big politics. Yes, the NHS is underresourced, but the Government needs to step up, acknowledge the challenges and accept that we need more than just a strategy, a new bill or a consultation to fix it. If we are going to tackle the big challenges, we need a step change such as the one that saw with the creation of the NHS—a step change such as the one that we saw when Labour was last in power, when we doubled the resource going into the NHS. If we want the NHS to continue for another 70 years and to continue to do the amazing things that it has done for my family and for families throughout Scotland, we have to face up to those big challenges and put in the resource. We need to put in the investment to ensure that we live up to the enduring principles on which the NHS was founded.17:41
I am delighted to take part in the debate, and I congratulate Richard Leonard and thank him for securing it.
On 5 July 1948, the national health service was launched by the then health secretary, Nye Bevan, at Park hospital in Manchester. For the first time, hospitals, doctors, nurses, dentists, opticians, pharmacists and all kinds of specialists became part of one service, to be provided free of charge from birth to death. That is what we still have, 70 years on.
The NHS has transformed the health and wellbeing of people throughout the United Kingdom and is envied across the world. It has delivered huge medical advances and improvements to public health. There are experts in their fields across the service.
Why do we have the NHS? After the second world war, we needed to look at health and poverty and at housing for individuals who had come back from serving. The NHS was an opportunity for celebration. I pay tribute to all the politicians who saw the NHS as the way forward and thank everyone who has played their part, and continues to play their part, in providing services throughout the country, every day, 24 hours a day.
The NHS has eradicated many diseases—for example, polio and diphtheria. There have been transformations in lung and heart health and new techniques that improve the situation in the case of strokes. Individuals have had their sight restored with bionic eyes, and there are now transplants on the NHS. In the past, some techniques would have been seen as science fiction, but now they are in everyday use.
Since its inception, 70 years ago, the NHS has been at the forefront of innovation. In the early 1950s, vaccinations were not common. The NHS introduced vaccinations for polio and diphtheria. Until then, there were 8,000 cases of polio and 70,000 cases of diphtheria across the UK every year.
The NHS launched the idea of the modern hospital, and a hospital plan was put in place to ensure that every population of 125,000 had a district general hospital. In the late 1960s, heart transplants took place. Moving into the 1970s, there were computed tomography scans and, in 1978, a “test-tube baby” was born. Then there is the whole idea of organ donation. All of those technologies and innovations have given opportunities to individuals.
I pay tribute to everyone who has participated. I have something in common with a number of members, as my mother trained as a nurse and then became a midwife, a district nurse and a health visitor. I grew up in an environment in which the phone would ring in the middle of the night and our mother would go out and deliver a child or deal with someone who needed support. For 40 years, she gave of her time and talent to the NHS. She knew the value and the opportunity that that created. I pay tribute to all the individuals who have done that.
The service does a fantastic job every single day, but that comes at a cost. Looking back, how many billions of pounds were spent 70 years ago to start the NHS? We are now dealing with tens or hundreds of billions of pounds being spent around the United Kingdom. We all need to pay our fair share so that the NHS is retained, maintained and sustained for generations to come.17:45
I am delighted to have the opportunity to speak in the debate, and I thank Richard Leonard for securing it. It is fantastic that we have two debates this week in which to express our feelings and views on the NHS, which are universally positive, notwithstanding the challenges that the service faces.
I pay tribute to Shona Robison, Maureen Watt and Aileen Campbell, who leave the health portfolio today. I had the privilege, briefly, to be the parliamentary liaison officer to the Cabinet Secretary for Health and Sport at the beginning of this parliamentary session, and I saw at first hand the dedication, commitment and passion that all three of those individuals brought to their respective portfolios. I wish them all well. I congratulate Aileen Campbell on her elevation to the Cabinet and I wish her well in her new portfolio.
I join colleagues from across the chamber in thanking our dedicated NHS staff. I come from an NHS house, as both my parents worked in the health service for more than 30 years. My mother started off as a theatre and district nurse before retraining as a mental health nurse and working for more than 20 years at Gartnavel royal hospital. She did a difficult and demanding job during a period of significant change in public attitudes to mental health and in how we, as a country, sought to treat and support people with mental health conditions.
My father worked in a different side of the NHS. He worked in estates, a department that is often overlooked. He started off as an electrician in the health service and worked his way up—during an era when there was perhaps far more social mobility—to become an electrical engineer and, before retiring, an estates manager. That gave me a different perspective, and I pay tribute to all those who work in the health service whom we do not talk about every day. I remember family events being cancelled when I was growing up because my father was on call and a security system went off, a boiler failed or a door would not open. We do not discuss enough the tremendous work that is done by those who work in estates in our health service.
It is fitting to mention my dad, as he was born in 1951, the year in which the great Labour Government of Attlee demitted office. In 1951, the average life expectancy in the UK was 72 for women and 66 for men. Last year, life expectancy in the UK stood at 86.2 for women and 83.4 for men. There has been a transformation in the demands that our health service faces and, to some extent, it is a victim of its own success. The occurrence of infectious diseases has been massively reduced, notwithstanding the challenges that we still face with, for example, hepatitis C.
The real challenges that we face are with non-communicable diseases and the ageing population. Some important speeches in the debate, particularly Patrick Harvie’s, have highlighted our need to think more broadly about the social determinants of ill health. Although we rightly focus on the services that people use, whether accident and emergency services or child and adolescent mental health services, we cannot allow ourselves to forget the bigger picture of those social determinants of ill health. We cannot think about health services as being in a silo; we must always think about how housing, education and social security can be used collectively and holistically to make sure that we have a healthier population.
I welcome the broad measures that this Government is taking in areas such as the national clinical strategy and the 2020 vision, setting out our ambition in relation to acute and primary services. I also welcome the Government’s vision of achieving a fairer, more equal society by having a social security system that is based on fairness, dignity and respect and by taking necessary measures through the minimum unit pricing of alcohol and the obesity strategy, which is to be launched shortly.
There is much work still to be done, but I will close as I began, by thanking everyone who works in our NHS for the outstanding work that they do. They really are the best examples of people in this country.17:50
I congratulate Richard Leonard on securing the debate. I also pay tribute to Shona Robison, who gave her best to our health service during her time in office, and I thank her for the personal help that she gave me on behalf of my constituents. I welcome Jeane Freeman to her new role as the Cabinet Secretary for Health and Sport.
As others have done, I congratulate our NHS in Scotland on reaching its 70th birthday and on having evolved into the remarkable institution that it has become. That everyone in the chamber is bursting with pride and wants to say good things about our NHS is beyond doubt, and with good reason. That many of us have a personal story to tell, too, is touching, and it reflects the gratitude and commitment that we all feel towards our health service on the occasion of its 70th birthday.
Given my age, I feel as though I have grown up alongside the health service, and I have many reasons to be grateful for its existence, not least for the GP part of the service, which has probably saved my life on more than one occasion. My first encounter with our GP service was when, at the age of nine months, I needed five stitches in my forehead, as the result of being kicked by a cow while I was crawling around in the byre, but my real gratitude is for the life-saving penicillin that I was given to treat secondary infections that were caused by ringworm, which was a cattle-borne problem for me as a four-year-old. Like others, I have much to be grateful to the NHS for, then and since.
The NHS in Scotland started with a budget of £42 million in 1948, which has grown to around £12 billion—almost a third of Scotland’s total budget. Along the way, we have seen dramatic advances in so many areas of medicine. In 1954, Sir Richard Doll and Austin Bradford Hill identified the causal link between smoking and cancer that has led to improved cancer treatments and the pioneering anti-smoking legislation here in Scotland. In 1960, the Edinburgh royal infirmary pioneered kidney transplants under the guidance of Sir Michael Woodruff, while in 1972, 15 health boards were created in Scotland under the National Health Service (Scotland) Act 1972. In 1988, breast cancer screening was introduced in the United Kingdom following a report by Sir Patrick Forrest of the University of Edinburgh, and in 1989, keyhole surgery was introduced at Ninewells hospital by Sir Alfred Cuschieri.
Fast forwarding through 2014 and the groundbreaking development of health and social care partnerships takes us up to today, and my local health board. We in Ayrshire have a diligent and hard-working service in the shape of NHS Ayrshire and Arran, where, in almost every case, all the staff combine and go beyond the call of duty to deliver a constantly expanding and daily more sophisticated service. It is good to be able to take the opportunity to say a big thank you to our doctors and nurses and all the other staff in NHS Ayrshire and Arran and across Scotland.
Regrettably, the nature of being an MSP—in my case, I led the campaign to keep the two accident and emergency units in Ayrshire open 12 years ago—is such that we are like lightning conductors, because we often hear only about the problems and difficulties that are faced by patients and staff in the NHS, when most of the time they are delighted by and proud of the outcomes that are achieved by our doctors and nurses. Indeed, it is easy to lose sight of the positives in much of the constant debate about the efficiency and future of the NHS, but my only ambition for our NHS in Ayrshire and Arran is for it to be the very best provider in Scotland among all the different health boards.
What is important is what has been achieved and what is still likely to be achieved, and there is a bright future for our NHS in Scotland. Given that additional funding has been promised by the Scottish and UK Governments, it is possible to see how the growing future needs of our ageing population, whose life expectancy is growing, will be met. Today, we celebrate 70 years of better health and look forward with confidence to continuing improvement in healthcare in Scotland in the next 70 years.17:55
I thank Richard Leonard for securing the debate, because we should take every opportunity to celebrate our NHS and, especially, to say thank you on its 70th anniversary. Although 11 men have spoken so far and just one woman, we should remember that more than three quarters of NHS staff are women. I say an extra special thank you to the sisters in the NHS.
Most of us hope that we will never need it, but when we do the NHS is always there. When I told a constituent about the debate, without prompting she sent me a message yesterday about what the NHS means to her. With her permission, I will share it with you.
“I have squamous cell cancer in my colon. It is an unusual cancer in that area. It does not present itself with a lot of symptoms for most people. More often it is only detected in later stages. However my GP listened to me when I told her I had some rare occasions of slight bleeding which worried me.
That examination was done on the Wednesday and the diagnosis was confirmed the following Monday by a colonoscopy. I then had various tests, CT scans, MRI scans, PET scans, chemotherapy and radiotherapy at the Beatson. I was very well looked after by all involved in my treatment, despite the slight complication of a heart attack in the middle of it all. The very last step is to reverse my stoma. Although the NHS have missed the anticipated date for this procedure, they have sent me a letter hoping to increase capacity in general surgery so that I may have a date for my operation soon.
I owe my life to the NHS. The hardworking doctors, nurses, radiologists, oncologists, surgeon, colorectal nurses, cardiologists, anaesthetists, paramedics and auxiliary staff who looked after me are true heroes in my eyes. I fully support the NHS and hope we never take it for granted. I am grateful to Lanarkshire Cancer Care Trust for their services in taking me to and from my many medical appointments during my treatment.
I have had a very positive experience of our NHS, but I know that there is always room for improvements. Long live the NHS and may Scottish Labour”
—that is us, guys—
“always fight to keep it as it is one of our country’s finest institutions. Happy 70th birthday NHS; because of you I will see many more birthdays with my family, and continue to work and contribute to society and our nation.”
It is signed with a kiss, from “Mum”.
That is the story of my mum, Helen, who was diagnosed with and treated for bowel cancer, and who suffered a heart attack in the middle of it all last year. Both she and I, and all our family, are so grateful for the amazing care that she has received over the past year from the amazing healthcare staff in our NHS, including Dr Mary Jo Sommerville from Calderside medical practice in Blantyre, who was on the telephone several times a week, Mr Arijit Mukherjee, the surgeon at Hairmyres hospital, Dr Tareq Abdullah, my mum’s oncologist at the Beatson, Dr Grainne Dunn, the medical colorectal oncologist at Hairmyres hospital, and numerous nurses at the Beatson.
My mum has had a phenomenal experience with the NHS, but resourcing problems in the NHS can affect us all. It is true that my mum is still waiting to have her final operation to reverse her stoma. At the end of May, she received an apology letter from NHS Lanarkshire to say that her 12-week treatment time guarantee had not been met due to capacity issues in general surgery. Even the best of cases are not immune from the challenges and pressures facing our NHS.
There is no doubt that our NHS faces serious pressures, but in my mum’s case I will be forever grateful to the incredible men and women who have treated her over the past few months. As the motion says, it is right that we celebrate our NHS; we should be celebrating, and it is the incredible stories of success that we should always be mindful of when we talk about why ensuring that our NHS is properly cared for is so important.
Thank you, NHS, and happy 70th birthday.18:00
Presiding Officer, I am sure that members will be surprised to see me closing tonight’s debate. I know that I am. [Laughter.] However, as I am sure every MSP does, I recognise the precious value of our NHS and the skill, dedication and compassion of its staff. I know that I speak for everyone when I offer my thanks to all the staff, past and present, of NHS Scotland, who have delivered medical advances and improvements to health and social care, which means that more people can expect to live longer and healthier lives. Although there has, of course, been a good smattering of politics in tonight’s debate, there has also been a common thread of gratitude to all NHS staff, which has crossed and transcended the party lines.
I am sure that you will understand, Presiding Officer, when I offer my thanks for the service of my friend Shona Robison to our NHS and care services. Over almost four years as health secretary, she fought for our health services, and I know just how happy she was when, this week, she was able to offer our NHS agenda for change staff a pay rise of at least 9 per cent over the next three years. I thank Miles Briggs, Anas Sarwar, Patrick Harvie, Tom Arthur, John Scott and Ben Macpherson for their good wishes and warm words to her.
Scotland has made an immense contribution to the development of the NHS. Indeed, before there was an NHS, the Highlands and Islands medical service was established in 1913 as a state-funded health service. It proved to be highly successful, and by 1929 there were 175 nurses and 160 doctors working in 150 practices. By 1935, an air ambulance service was available to transport patients to specialist mainland hospitals. The Highlands and Islands medical service was a remarkable achievement for its time. It is seen by professionals as having an important influence on the development of the national health service. It was a model of state-funded care that clearly delivered improved health in the communities that it served.
After the establishment of the NHS, Scotland continued to pioneer medical treatment that has saved countless lives. In 1958, Glasgow produced the first practical ultrasound scanner, and in modern forms such devices continue to save lives around the world. In 1960, the first successful kidney transplant in the UK was performed by a team at the Royal infirmary of Edinburgh, and in 1980 the world’s first clinical magnetic resonance imaging service was introduced at Aberdeen royal infirmary. In 1989, the UK’s first use of keyhole surgery to remove a patient’s gall bladder was undertaken at Ninewells hospital in Dundee, in my constituency.
That work in the Highlands and Islands, Glasgow, Edinburgh, Aberdeen and Dundee are only some examples. Health and care staff throughout Scotland have led innovations and treatments that have made our NHS admired and emulated around the world, which is still the case today. The SNP Government is working with NHS staff and many other partners to introduce world-leading solutions in order to improve health and social care.
We have launched the Scottish patient safety programme, which is the first national approach to improving patient safety. Professor Donald Berwick, who is a former adviser to President Obama, has been quoted as saying:
“The reality is that Scotland is the internationally leading success story of healthcare safety improvement. Other nations have made progress, but not to the degree of comprehensiveness—and, I think, scientific discipline—that Scotland has.”
We are the first country in the world to implement minimum unit pricing for alcohol. We took that bold decision and stuck to it despite the many obstacles that were placed in our way, because we are determined to tackle Scotland’s unhealthy relationship with alcohol.
The minister has moved on to a public health issue. Does he agree that if we are going to have a successful health service and a healthy population in the long term, we need to face up to the reality that most developed societies have been more successful at extending lifespans than we have been at extending the healthy and active part of life? Does he agree that not just ministers who have direct responsibility for the NHS but ministers across the spectrum of Government need to take responsibility for transforming public health, if we are going to achieve the outcomes that we all want?
That is a very good point. In dealing with just about any aspect of government, we need to look across the whole of Government and consider how we can make differences to outcomes. The approach of considering how we can join things up and make a difference to outcomes in people’s lives is very much the one that has been embedded in our national performance framework.
Patrick Harvie was also right to say that it is not just about the extension of life; the quality of life is important, too. We need to be careful that we measure the correct outcomes that will make a difference. He has made a very good point on a subject to which I was coming, so I will skip over that part of my speech.
In continuing to move our public health priorities forward, we have jointly published with the Convention of Scottish Local Authorities our “Scotland’s Public Health Priorities”. I will touch on points that Patrick Harvie made. Our new priorities focus on place and community, the early years, mental wellbeing, reducing the harms that are associated with alcohol, tobacco and other drugs, reducing poverty and inequality, and healthy weight and physical activity. The priorities have been developed in collaboration with, and broadly endorsed by, a wide range of organisations and professional groups. It is not just across the Government that we need to work together; we need also to work together across society.
I am reassured that our message about the collective effort of society as a whole, and about the importance of empowering communities, is being heard and is resonating with people. We have already made progress with the publication of an action plan on tobacco. That will, in the coming weeks and months, be followed by strategies and plans on physical activity, mental health, diet and healthy weight, and substance use.
Collective action and public initiative are the driving forces that enable our NHS to care for us all—to care for the mother who is delivering her first baby, to care for those who are suffering from illness and accidents in communities across Scotland, and to care for and ensure that our elderly people live healthy and fulfilling lives for as long as possible.
The NHS has cared for us for 70 years, and will do so long into the future. Again, I thank all our health and care, staff past and present, for their work. They can take pride in their achievements, past and present, and have given us a tremendous gift for the future.Meeting closed at 18:07.