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Chamber and committees

Meeting date: Wednesday, June 27, 2018

Meeting of the Parliament 27 June 2018

Agenda: Agriculture (Culture and Heritage Value), Portfolio Question Time, Homelessness, Prescription (Scotland) Bill: Stage 1, Complaint Against Mark McDonald MSP, Scottish Parliamentary Corporate Body Motion, Business Motions, Parliamentary Bureau Motions, Point of Order, Decision Time, National Health Service at 70


National Health Service at 70

The Deputy Presiding Officer (Christine Grahame)

The final item of business today is a members’ business debate on motion S5M-11441, in the name of Ash Denham, on the NHS at 70. The debate will be concluded without any question being put. I call Ruth Maguire to open the debate.

Motion debated,

That the Parliament celebrates that 5 July 2018 will mark 70 years since the launch of the NHS; notes what it sees as the continuing importance of having a publicly-owned, funded and operated health service, which is universally available and free at the point of need; acknowledges the reports of gross inequalities in healthcare for the general population prior to its foundation, which was spearheaded by Aneurin Bevan; salutes the continuous hard work and contributions of NHS staff throughout the years; believes that this has made it possible for the NHS to provide an invaluable and life-changing service through care and treatment that has saved and improved the lives of millions of people across Scotland; notes the view that the public, NHS boards, partners in health and social care and the voluntary sector, professional bodies and unions should take the opportunity to look back and celebrate 70 years of achievement of the NHS in Edinburgh and across Scotland and welcome the difference that it has made to people’s lives, and appreciates what it believes is the ongoing commitment to the founding principles of the NHS.


Ruth Maguire (Cunninghame South) (SNP)

It is a pleasure to introduce this debate to celebrate the 70th birthday of the NHS in Scotland, and I look forward to hearing members’ speeches from across the chamber.

There is no one in Scotland who has not benefited from the NHS in some way or another—either by being treated themselves or through the care provided for a loved one. It has become an integral part of Scottish society. On this anniversary, it is appropriate for us to reflect on the transformative effect that the NHS has had in Scotland, none of which would be possible without those who make the NHS the incredible service that it is today: the porters, the surgeons, the nurses, the catering staff, the cleaners, the ambulance drivers, the paramedics and so many more. We owe a great debt of gratitude to current and past NHS staff, and I thank them all.

In celebrating 70 years of incredible service, we must also remember the circumstances that led to its creation. In the early 20th century, there was no centralised health service, treatment was expensive and health provision was inconsistent; investigations into public health exposed high levels of poverty and low levels of public health across Scotland; and a doctor’s visit could cost as much as 10 per cent of an annual income. It is right that we acknowledge the commitment of the Labour Government and particularly Aneurin Bevan in establishing the nationwide NHS to end those conditions. Their commitment to creating a collective health service, free at the point of need and paid for through taxation, was revolutionary.

The Beveridge report was a main driver of the changes, but we can also look to highly influential reports undertaken in Scotland. The Dewar committee report led to the establishment in 1912 of the Highlands and Islands medical service, which provided state-funded medical care for those who were unable to afford it a full three decades before the establishment of the NHS, and the Cathcart report advocated radical reform of healthcare provision in Scotland, putting general practitioners at the heart of medical care.

David Stewart (Highlands and Islands) (Lab)

Does the member share my view that, where the Highlands and Islands lead, the rest of Scotland follows?

The Deputy Presiding Officer

You had better say yes, Ms Maguire. [Laughter.]

Ruth Maguire

I am a Highland girl, so I would say that—yes.

Those reports created a consensus that action had to be taken to improve the state of Scotland’s health well before the introduction of the NHS in 1948.

Bevan was right when he described putting the welfare of the sick before every other consideration as

“the most civilised thing in the world”,

but I do not think that the impact that the NHS has had on Scotland, nor its impact on world medicine, could have been imagined. In its 70 years, the Scottish NHS has achieved some remarkable accomplishments. Over these past decades, Scottish medical academics and practitioners have been at the forefront of medical discoveries and the development of new treatments that have been truly world class and world changing.

Glasgow developed the first practical ultrasound and the Glasgow coma scale, both of which were exported to the world. Edinburgh was the home of the United Kingdom’s first successful kidney transplant and is where the dangers of thalidomide were exposed. Aberdeen was the home of the first MRI scan, and the first keyhole surgery took place in Dundee. NHS practitioners in Dumfries, Aberdeen and Dundee were early pioneers of screening for cervical cancer, and Edinburgh established a UK first in screening for breast cancer. Scotland was the home of Sir James Black, who won the 1988 Nobel prize for medicine for his drug discoveries relating to heart disease and stomach ulcers.

Staying true to the vision of improved public health, Scotland has twice acted as a world leader, being the first UK nation to introduce a smoking ban and the first country in the world to introduce minimum unit pricing for alcohol. Under this Scottish National Party Government, the Scottish patient safety programme has been internationally recognised as the first national system to systematically improve the safety and reliability of hospital care, while the diet and obesity strategy continues in that vein of progressive action.

As we look back, we can see just what a transformative impact the NHS in Scotland has had on the lives of those living here, but also on the lives of millions of people around the world. The Government is entrusted by the electorate to look after NHS Scotland and guarantee it for the next generation, and it is a responsibility that must not be taken lightly. I am proud that this SNP Government has delivered on that promise to the electorate, overseeing major improvements in the NHS and in public health.

The Scottish Government has prioritised health throughout its time in office, successfully protecting the front-line health budget, keeping the NHS publicly owned and free at the point of need, scrapping prescription charges, protecting free eye tests and ensuring continued free personal care for the elderly. Recognising that the NHS cannot provide a world-class service with an imaginary Brexit dividend, we have invested a record amount in the NHS. Scotland now has the highest number of NHS workers on record so that people can see a doctor to get the medical treatment that they require and so that their loved ones are cared for properly by nurses and midwives. We have delivered the highest GP to patient ratio in the UK so that people can get access to a GP when they need it. We have rewarded our NHS workers, making them the best paid in the UK.

The NHS has undergone many changes as it has faced challenges over the years. We must always seek ways to improve the NHS and must never shy away from our responsibilities. The SNP is committed to meeting those challenges to retain our NHS’s reputation as one of the world’s leading health services.

As we reflect on 70 successful years, we can see why the NHS is held in such high regard in Scotland. It has delivered a revolutionary service that is free of charge at the point of need, creating a healthier and fairer Scotland, and it is a source of great pride as an innovative, world-class service. It is right that we celebrate it now and take this time to imagine how much further we can go in the next 70 years.


Brian Whittle (South Scotland) (Con)

I draw members’ attention to my entry in the register of members’ interests. I have a close family member who is a healthcare professional with the Scottish NHS.

I congratulate Ash Denham on securing time in the chamber to celebrate the 70 years of our most treasured institution.

I take this opportunity to welcome the new front-bench members, led by Jeane Freeman, the new Cabinet Secretary for Health and Sport, and to wish them well in their new appointments. I also take the opportunity to thank Shona Robison for her time as cabinet secretary. I know that we did not always agree on everything, but no one could deny her commitment to the post. On a personal level, I thank her specifically for all her help with constituency cases, some of which were delicate and complicated. That is an element of the job that is not often mentioned or seen by the public, but she was always willing to help finding solutions. I wanted to put that on the record today.

This is the second debate on the NHS in as many days in the chamber, such is the positive strength of feeling and support for our NHS and its staff, who deliver what is—and this is sometimes forgotten in the heat of debate—a world-renowned service. It is without doubt held up as a shining light in health delivery by countries around the world, and we are, quite rightly, recognising the incredible work that our NHS staff do on a daily basis, both in yesterday’s debate and again in this one.

I have looked back to 1948, when the NHS came into being. At that time, Oor Wullie was on his upturned bucket, offering weekly cheer, along with the Broons. In sport—I have to mention sport—Hibs won the league, Rangers won the cup, East Fife won the league cup, Henry Cotton had just won his third British open at Muirfield, and Cathie Gibson from Motherwell was about to head off to the London Olympics, where she became the only British swimming medallist. It made me think that the more things change, the more they seem to stay the same. In 1948, there was a recognition that major change was needed to look after the health of the nation and to tackle health inequalities. Here we are, 70 years later, with all the incredible developments in treatments and procedures, still debating the self-same issues.

This morning, Lewis Macdonald and I chaired a conference entitled “Next steps for integrated health and social care in Scotland—governance, workforce planning and improving delivery of care”. That is a wonderful title, I have to say, but maybe we needed to shorten it a bit. What came out loud and clear is that major change is under way and that further change is required. People are wrestling with the implementation of the integration joint board policy. It is also clear that prevention must move further up the agenda if current health inequalities are to be tackled.

This morning, I raised the point that the first step in developing a preventable agenda is looking after the health of our healthcare professionals. The Convention of Scottish Local Authorities has said that healthcare professionals will forgo their own health to deliver care to others—that is the nature of those who decide to go into the care of others in our NHS. However, if we are to strive for a healthier nation, we require those whom we charge with delivering that policy to themselves have the opportunity to have an active, healthy lifestyle. Currently, nurses, midwives and other healthcare workers are, on average, unhealthier than the rest of the population as a result of the workload that they willingly accept to ensure the good health of others.

In celebrating 70 years of the NHS, we should be looking ahead to the next 70 years, to ensure that sustainability and the very basis of the NHS, which is free healthcare at the point of need. We will have to accept change; in fact, we will have to drive the change that the healthcare profession itself is asking for. I look forward to continuing the debate with the Scottish Government’s new health team.


David Stewart (Highlands and Islands) (Lab)

I congratulate Ash Denham on securing the debate, and on her elevation to the ministerial ranks, and I say well done to Ruth Maguire for stepping up to the plate—I presume at the last moment. I also welcome Jeane Freeman, Clare Haughey and Joe FitzPatrick to their new roles and I wish them every success. White smoke has been much in evidence in the past few days.

I also want to place on record my thanks to Shona Robison, particularly for the help that she and Maureen Watt have given me in the work that I have carried out on diabetes.

My colleague Anas Sarwar has asked me to pass on his apologies. He is speaking in London this evening to a Westminster all-party parliamentary group on Islamophobia.

Nye Bevan launched the NHS at the Park hospital in Manchester, where the first ever patient was 13-year-old Sylvia Beckingham, who was treated for a liver condition. It was a big event in her life but an even bigger event in British history. It was the birth of a national icon and institution. No one could have predicted how Nye Bevan’s infant would grow, whether it would survive its early days and develop into adulthood, or whether it would mature into old age.

However, the NHS—our NHS—is turning 70 years old, and its story is impressive. The uniting of all the hospitals and doctors’ surgeries into a state-run service was ground breaking in the western world. In the 1960s, the first heart and liver transplants took place, and the first kidney transplant took place in Edinburgh royal infirmary. In the 1970s, there was the first test-tube baby, and computerised tomography scans revolutionised the way that doctors examined patients. Breast cancer screening was introduced in the 1980s. In the 2000s, there was a new emphasis on public health, with measures such as the smoking ban.

Nye Bevan and the Labour Party successfully founded the NHS in the teeth of strong opposition. Three score and 10 years later, the Labour Party is still defending it. I am proud to belong to a party with that 70-year-old pedigree, but I am prouder still of the NHS’s hard-working front-line staff—the junior doctors, nurses, midwives, consultants, GPs, allied health professionals, porters and receptionists.

Despite the hard work and commitment of those front-line staff, we face a number of challenges: our ageing population, the pressure on social care, the need for robust workforce planning now and post-Brexit, and a growing mental health crisis. Those public health challenges may look modern but, under the surface, the root causes are the same. Poverty, social deprivation and inequality are significant contributors to poor health expectations, and the least well-off are most at risk.

Inequality in health was a serious issue at the birth of the NHS, and it remains a serious issue today. Life expectancy in the UK has stalled and, in the past 50 years, the chasm between the health outcomes of the rich and the poor has widened. Is it not an outrage that, in our 21st century society, individuals’ health expectations are intrinsically linked to their postcode?

In reality, innovation will be the key to the future of the NHS, so we must ensure that good ideas are embraced with open arms. For example, flash glucose monitoring with FreeStyle Libre monitors has revolutionised the management of glucose for individuals with diabetes. I have supported Diabetes Scotland’s campaign for monitors to be available across all Scotland’s health boards and to fight the postcode lottery.

In England, five NHS trusts are trialling a step into health programme, which utilises the transferable skills of armed forces veterans and encourages them into the NHS workforce.

There are also exciting developments in the fight against superbugs, with the use of ultraviolet C light to sanitise surgical tools in 60 seconds using the nanoclave cabinet that was designed by the tech firm Finsen Technologies. Such pioneering initiatives and technological research must be encouraged if we are going to steward the NHS through the next 70 years in the 21st century.

Nye Bevan’s words from the start of the NHS are as applicable today as they were then. He said:

“The NHS will last as long as there’s folk left with faith to fight for it.”


Emma Harper (South Scotland) (SNP)

I congratulate my colleague Ash Denham on securing this historic, significant and celebratory debate, and Ruth Maguire on eloquently outlining historical information on the formation of the NHS.

This is a personally significant debate for me. I proudly direct members to my entry in the register of interests. I started my nurse training in 1984 and am very proud to be a nurse. In fact, I have three sisters who are also nurses. Between us, the Harper sisters have almost 140 years of NHS nursing experience.

Ash Denham’s motion

“salutes the continuous hard work and contributions of NHS staff throughout the years”.

I am keen to focus on celebrating the staff who have cared, contributed and collaborated for 70 years, from the phlebotomist who often has sick, tired and peripherally shut-down patients and yet still manages to find a vein to take blood, to the radiographers who show empathy and care and are discreet in obtaining mammograms. That is our NHS.

On my first Saturday in the operating room at Dumfries and Galloway royal infirmary as a new staff nurse, I had a patient with a ruptured aortic aneurysm. I was brand new, but Christina Marshall and John Carnochan kept me right, and the whole team was fantastic. The patient survived through having lots of fresh frozen plasma and lots of red blood cells. I accompanied the patient to the intensive care unit. A surgeon, assistant surgeons, an anaesthetist, lab technicians, blood donors, phlebotomists, floor nurses, scrub nurses, anaesthetic nurses, ICU and radiology technicians were all involved in that one case. There were 13 experts. That is our NHS. There is comfort, care, collaboration and experts.

I have worked in NHS Scotland and NHS England and I spent 14 years as an economic migrant working at the Cedars-Sinai Medical Center in Los Angeles as a transplant nurse and nurse educator. That experience of working in private healthcare in the USA truly showed me how essential and amazing our NHS is. I know from first-hand experience what an awful and frustrating conundrum it is for people who cannot afford to get sick, cannot afford to be injured or cannot afford their medication. When I was in the USA, health insurance cost me $800 every month—600 quid. However, that did not cover my type 1 diabetes, so I had to pay for my insulin, my syringes, my test strips and my blood-testing machine.

David Stewart pointed out that we now have more blood testing and development technology in our NHS, which is fantastic. We are so lucky to have our NHS.

We need to protect not just the health service, but our free prescriptions and every single person who works in our NHS. People who work in our NHS experience trauma, tragedy and triumph every day. It is important to remember that although the NHS has been in existence for 70 years, it is not a collector’s item; it is not old and it is not a thing of the past. Our NHS has never rested on its laurels but is an ever-changing, ever-improving and ever-growing dynamic health service. That is the triumph of our NHS. It often seems that change comes as slowly as a turning big oil tanker, but the people in the NHS know that performance improvement and best practice are constantly evolving.

Our NHS is a national treasure that is constantly improving and adapting, and I want to ensure that we continue to support it. I thank Shona Robison for her contribution, hard work and excellence as Cabinet Secretary for Health and Sport. We have a new team, whom I welcome to the front bench, and I look forward to working with Jeane Freeman, Clare Haughey and Joe FitzPatrick in the future. [Applause.]

The Deputy Presiding Officer

I am not allowed to applaud. It is a great shame, because I sometimes want to applaud.


Alison Johnstone (Lothian) (Green)

I, too, begin by congratulating the new health front-bench team, and I look forward to working with them to improve Scotland’s health. I thank Shona Robison for her clear commitment to improving our national health. Her door was always open: I am sure that the new cabinet secretary’s will be, too.

There is so much to be proud of in our NHS and I am delighted that we are marking its 70th year by paying tribute to all the staff who make it the incredible service that it is, and who make it such an important part of our national life. The roots of the NHS in Scotland go even further back: to the Dewar committee of 1912, which helped to establish the highlands and islands medical service in 1913. Dr Annie Tindley’s research has helped us to discover the importance of the Dewar report, and when we celebrated the Dewar centenary with a debate in Parliament, it led us to question how care and treatment in rural areas could be better supported today.

There is much that we can learn from the history of our health service. Although it is vital that we support innovation in our healthcare and treatment, we must never stop looking back at the collective endeavour and values that were the health service’s foundation. Members have rightly highlighted the incredible advances that we have seen in medical treatment since the NHS began. If we want to build on those and ensure that every generation looks forward to better health than the last, we have to renew that sense of collective care and ambition in other aspects of our public life.

In recent years, we have seen, for the first time in a long time, life expectancy in the UK begin to fall. It is not a coincidence that it has happened in an age of austerity. Professor Danny Dorling is clear that “the politics of austerity” are the most plausible reason for that troubling trend. Professor Michael Marmot links it to the UK Government’s spending record and states that its

“social expenditure is among the most miserly of Western European countries”.

The impact seems to be most severe in areas of high deprivation, which have suffered deindustrialisation and are now being hit by another round of welfare reform.

I am sure that we are united in believing that our life expectancy should not depend on where we are born. However, our health is still being damaged by economic inequality and many other forms of discrimination and prejudice. Martin Luther King said:

“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman.”

However, we still see severe health inequalities in Scotland, but not only between the richest and poorest parts of the country.

The links between poverty and mental health are so clear. The impact of damp and cold housing and poor diet on our health are so obvious. If we do not fix those problems, our NHS takes the strain. Above all, as others have said, we can never give up the principle that healthcare must be free at the point of need. In Scotland, we have made the decision that vital social care should also be free at the point of need. On ending charges for personal social care, Shona Robison listened and she should be applauded for making that position a reality.

I believe that we could still go further by ending charges for other care, but I have no doubt that the changes that this Parliament has pushed for will have long-term benefits for our collective health and our NHS. Let us not forget that minimum unit pricing for alcohol has now been introduced, too.

It is right that, at times, we call for change within the NHS itself. I reflect on the Nuffield Foundation’s view that while the NHS in England has been hampered by multiple reforms, marketisation and competing priorities, the NHS here has benefited in some ways from a consistent approach to improvement and from openness to collaboration. I heard with alarm the news that the private healthcare firm Virgin Care won £2 million of public money by suing NHS England. We have to make sure that our NHS and the public are protected from corporate interests.

The prospect of leaving the European Union raises real concerns, too. The new cabinet secretary must be absolutely resolute in defending the NHS in Scotland.

I am glad to celebrate the achievements and ambitions of the NHS today. Our society does not always feel like a caring place, but every day there are patients in our waiting rooms and hospital beds who know that they can trust the nurse or doctor whom they will see, wherever they are and whatever treatment they need. The efforts of thousands of healthcare professionals, researchers, administrators and support staff make that treatment possible: we must never underestimate how much we all rely on them.


Annie Wells (Glasgow) (Con)

I welcome the front-bench health team to the chamber and I thank Ash Denham for securing the debate. It is absolutely fantastic to have the opportunity to contribute to a debate that celebrates a national service that is renowned across the world. I, too, give my heartfelt thanks to every member of the NHS’s hard-working staff, who work tirelessly under extremely pressing conditions.

We all have personal experience of the NHS. One that will always stick in my mind was when, eight years ago, we got the call that we would never have expected, to say, “I think it’s time to come up and say goodbye to your dad.” We went up to the hospital and the staff who were looking after my dad said that they were not giving up, but they wanted to give us the opportunity to say our final farewells. It was only through their expertise, their determination and their extremely hard work that we managed to keep my dad and have an extra three years to spend with him, for which I will always be truly grateful.

I am also extremely grateful to have a debate that allows us time to reflect on what the NHS represents to us as a nation and to celebrate all that it has to offer. Over the past 70 years the NHS has transformed the health and wellbeing of our nation, delivering huge medical advances and allowing people to live longer lives.

Officially formed in 1948 and pioneered by the Labour MP and then health secretary Nye Bevan, the NHS brought hospitals, doctors, nurses, pharmacists, opticians and dentists together for the first time under one umbrella to provide services for free at the point of delivery.

In Scotland, the service was set up by a separate act passed a year earlier to reflect the country’s established medical traditions as well as its links to esteemed medical schools and ancient universities. Since then, we have seen many milestones in Scotland. I, too, wish to highlight those great successes, as many others have done. In 1960, the UK’s first successful kidney transplant took place right here in Edinburgh at the royal infirmary. In 1980, the world’s first clinical service for MRIs was launched at Aberdeen royal infirmary. In 1989, keyhole surgery was used for the first time in the UK at Ninewells hospital in Dundee.

Fast forward 70 years from its inception and we can see how much things have changed and the positive impact that the NHS has had on our population’s health. Some 140,000 staff are now employed by NHS Scotland. In 2016-17 alone, it performed 1.5 million hospital procedures and conducted around 17 million GP consultations.

There are growing demands, and it is important to reflect on those, too. In the years since the NHS was set up, demographic and health trends have changed significantly. On top of increasing costs, there is a growing demand for the NHS’s services, meaning that more people wait longer to be seen. The pressure on staff is a huge concern and it is thanks to the huge passion of those who work in the NHS that the quality of care has remained at its current level. I again stress the importance of supporting our hard-working NHS staff.

As it celebrates its 70th birthday, the NHS faces many challenges around Scotland. Today is not the day to discuss those challenges, but I make the very important point that, for our society to flourish as a whole, building a sustainable NHS that is fit for the future must be a top priority. The correct resources and a fresh vision for the future must be outlined. At some point in their lives, everyone in Scotland will use a service that is provided or funded by the NHS, and we owe it to all our citizens to ensure that the NHS that they experience is of the highest standard at all times.


Jackie Baillie (Dumbarton) (Lab)

I join other members in congratulating Ash Denham on securing debating time and on her promotion, which explains her absence from the chamber this afternoon. I thank Ruth Maguire for standing in at incredibly short notice and for the content of her speech.

I join other members in welcoming to their new positions the new Cabinet Secretary for Health and Sport, Jeane Freeman, and her team, Clare Haughey and Joe FitzPatrick. They can be sure that I will beat a path to their doors about, among other things, the Vale of Leven hospital, which, incidentally, was the first hospital to be built after the creation of the NHS.

I thank Shona Robison and Maureen Watt for their contributions to the NHS and to the Scottish Government.

The NHS is, arguably, Labour’s greatest achievement and probably the greatest achievement of any Government. The 1945 Labour Government had a radical vision and it acted quickly to deliver it. The creation of the welfare state and of the NHS was delivered at a time of severe post-war austerity, and it signalled the kind of country that we wanted to be. As Aneurin Bevan said,

“no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”

On 5 July 1948, our NHS was born. People did not need to pay for their healthcare if they were ill and they were not penalised as a result of ill health; instead, the cost was shared by all. Equality and social justice were the founding bases of the NHS and there were three core principles at its heart: that it met the needs of everyone, that it was free at the point of delivery and that it was based on clinical need, not the ability to pay.

Although those principles hold good today, there have been some challenges. Medicine has changed dramatically over the years, which is a positive thing. We are all living longer and some diseases have been completely eradicated, which is great. However, we are not necessarily healthier and more of us present at our hospitals. Although there might be more money and staff, we treat many more people than ever before. That causes considerable strain, which we see in the unfilled vacancies that exist because we do not have enough doctors and nurses, and in the increasingly long waiting times. In my area, people wait in pain for orthopaedics and ophthalmology services for more than 52 weeks. We also see that strain in the longer cancer waiting times. Hundreds of patients are let down by the system; we know that the longer they wait, the bigger the impact on their mortality.

Across a range of areas, there are huge challenges, and I will not point to them all. I recognise that our NHS staff do a tremendous job for which we cannot begin to thank them enough, but they are overworked and understaffed. We cannot expect them to do ever more with declining resources, which is a concern that is shared by members across the chamber.

Despite the challenges and the changes in medicine, Bevan’s vision has stood the test of time. At the centre of his vision was the NHS and, 70 years on, it remains at the centre of the life of our nation. It is a unique institution not just in Scotland but in the UK, and it is still a uniquely powerful engine of social justice that we all value and will continue to value in the years to come.


Sandra White (Glasgow Kelvin) (SNP)

I thank Ash Denham for securing the debate and congratulate Ruth Maguire on stepping in with a well-delivered speech.

I want to take this opportunity to thank Shona Robison for all the work that she did in her time as cabinet secretary. It has already been said that her door was always open and I am sure that that will also be true with the new team. I wish Shona Robison well in her future role and I welcome Jeane Freeman to her new role. It will be a challenge but I am sure that she and her team—Joe FitzPatrick and the others—will rise to it. I look forward to working with them.

I found Emma Harper’s contribution to be very moving. It rang true with me. My contribution might not be the same because I do not have the same experience as Emma Harper, but it will be slightly similar. I am not as old as the NHS, but I remember my grandmother and mother talking about the time when they could not afford medical care. They could not afford a doctor because people had to pay for it. Sometimes whole closes or whole streets chipped in with money to pay for a doctor. I am sure that the same thing happened in villages. The community would pull together, and that was never more true than for maternity care.

We think of the number of women who died during childbirth because they could not afford a doctor or midwife, so it was very important that community-spirited people gave money to get doctors to come so that other people did not have to go to moneylenders. That seems to be pretty unbelievable now, especially when we look at what we have got, so that is why it is important that we celebrate the NHS and make sure that privatisation does not creep in. Emma Harper talked about her first-hand experience in her emotional contribution and I think that there is nobody who would not have been moved by it.

We must ensure that healthcare remains free at the point of delivery, and that it is available to all. We must ensure that privatisation is never achieved and is never an option, and that people never have to scrape and borrow money so that they receive healthcare. That is a very important message.

We have certainly moved on since 1947, when the NHS started in Scotland, albeit in smaller way, and 1948 when it started in the rest of UK. The improvements that have been made to public health through the NHS are fantastic. I am sure that people of 70 years ago would not have believed how it would move on during those years. There is no comparison between what went on then and what is going on now.

We have many other public health strategies for tobacco, obesity, alcohol, diets and so on, and they all improve our health further, and that is fantastic.

I know that I am running out of time. However, on a personal note, I have nothing but praise for the NHS. The treatment that a member of my family received when they were taken very ill was second to none. The intensive care staff were fantastic; nothing was too much trouble for them. They provided a one-to-one service. I also never heard the NHS staff complain once, even when we were asking questions like, “What is that machine for? What is that other machine for?” They would just tell us. They were absolutely fantastic and I have nothing but praise for them.

The other point that I want to make is about aftercare, which we do not talk enough about. The aftercare that we received was unbelievable, and it is still going on now. We have phone calls, appointments and people coming to the house. It is fantastic.

It should go without saying that I and many of us here are indebted to the many people who work in the health service, and I thank them very much.

The Deputy Presiding Officer

I have to say to Ms White that I have just realised that I am older than the NHS, so there we go.

Members: Never!

The Deputy Presiding Officer

I am afraid so, guys.


Jeremy Balfour (Lothian) (Con)

In the short time that I have, I would like to talk about three words that I think define the NHS, and give three personal examples of the role they have played in my life.

The first word is innovation. As we have heard from other speakers, things such as kidney transplants and cutting-edge technology have been developed through our NHS here in Scotland and in the UK.

Fifty-one years ago, I was born with just one finger. When I was six months old, Douglas Lamb, a consultant at the Princess Margaret Rose hospital in Edinburgh, decided to innovate by cutting that finger to give me two fingers. That procedure had never been done before, but that innovation allowed me to be able to do much more than I could have with just one finger. Beyond Mr Lamb, who is, sadly, no longer with us, there were occupational therapists, physiotherapists, auxiliaries and nurses who were so beneficial to my life that I am able to stand here today. To people such as Mr Lamb and those who are willing to take a risk to help someone, we say thank you.

The second word is caring. The NHS is caring and compassionate. I have experienced that on numerous occasions in my life. As a 13-year-old, I had to go through a scoliosis operation, and, even after all this time, I remember the time that the nurses spent with me the night before.

Presiding Officer, let me take you to a Saturday afternoon eight years ago, when my little girl was born asleep. It was the worst moment in my life. However, I remember not only the pain of her loss but the care and love that was given by the midwives, nurses and auxiliaries to me and my wife. That care and compassion defines our NHS, and we should say thank you for it.

The third word is dedication. Doctors in the NHS go the extra mile. Presiding Officer, let me take you forward from that dark period of our lives to a different time, seven years ago. My wife had been through a difficult pregnancy. We were expecting twin girls, who would have to be taken into special care at the Simpson’s maternity unit here in Edinburgh, and we had to wait until two spaces were available there. On the morning that it was announced that those spaces were available, our consultant, Shona Cowan, had just worked a 24-hour shift. She went home for a short sleep and came back on her day off to deliver my two girls. That is going the extra mile, and that is what doctors, nurses, auxiliaries, physiotherapists and everyone in the NHS do on a daily basis.

Across the chamber, although we have political differences and divides, all of us can unite in saying, “Happy birthday, NHS.”

The Deputy Presiding Officer

Thank you, Mr Balfour. That was difficult for you, but it was an extraordinary speech. The experiences that members have shared today must mean a lot to people in the NHS. I know that I should not say these things, but I am all upset.

I call Jeane Freeman to close for the Government. I have to call you minister just now, Ms Freeman, as you have not yet been voted into your new post by the Parliament.


The Minister for Social Security (Jeane Freeman)

I thank all the members who have spoken for the spirit in which they have done so. In particular, I thank Emma Harper, Sandra White and Jeremy Balfour for being willing to share with us such deeply personal but very important experiences and stories that encapsulate what the NHS means to so many people across Scotland.

I am absolutely delighted that my first words in this chamber as cabinet secretary-designate for health and sport are to pay tribute to the work of NHS staff, past and present, on the occasion of the NHS’s 70th birthday. Subject to parliamentary approval of my appointment, I would like to say on my own behalf and on behalf of my colleagues in the health team how much we look forward to continuing the work of those who have gone before us and working to secure the precious NHS that we have in Scotland.

Jackie Baillie was right to remind us of the importance of the Labour Government acting on the founding vision of an NHS. However, it was not an easy birth. We must remember that it was, in many ways, resisted by those who feared that it would work against their personal interests and by those who did not see the value of the collective investment that we have made together over the generations in something as vital to our daily life as our health.

Sandra White talked about life before the NHS, and I well remember my mother and father describing the situation before there was a national health service. My grandfather was a herbalist, which was one of the ways in which he would provide some degree of healthcare and support in his village. The introduction of the NHS had a huge impact on all their lives but, as Sandra White said, it had an impact particularly on the lives of women.

The NHS is an essential part of all our lives. That is true for members of this Parliament and for every person in the country, and it has been true for 70 years. The NHS has provided world-class medical care to successive generations. It has adapted and evolved during that time, but it has always remained true to its founding principle of being free at the point of delivery.

Members have mentioned many of the achievements of our health service in Scotland, and I will add one of my own. The Caledonian pain control technique, which was developed at the Golden Jubilee national hospital, has been effective across the country in reducing pain for many people who have gone through elective orthopaedic surgery, and it has made a significant difference to their hospital stay. I was reminded only the other day that not more than a few years ago, part of our debate on health would always have focused on infection. So much work across our health service has been done to challenge and eradicate—or minimise, where it is not possible to eradicate—hospital-acquired infection.

The NHS has always faced challenges, from its earliest days until the present. David Stewart, Emma Harper, Alison Johnstone and others were right to talk about its history of innovation. I am proud that the Scottish Government invests in the innovation centre at Clydebank, specifically to encourage and turn into practice innovative ideas that will make a practical difference to patients and to those who work in our health service.

Demand on services continues to rise, and so—rightly—do expectations. There is no doubt that the ways in which we deliver health and social care in Scotland must continue to evolve and improve in order to deliver safe, affordable and sustainable services in the future. Our services must continue to meet those expectations.

Our health and social care delivery plan sets out our shared framework for delivering on the challenges that face us, and work is well under way at national and regional levels. Health boards and their partners across health and social care are coming together to develop and implement proposals that will increase the pace of improvement and focus our efforts on what is needed for better care, better health and better value.

A cornerstone of that plan is the “what matters to you?” programme, in which we focus on what matters to patients. Between the publication of the delivery plan and the end of 2018-19, we expect there to be a 7 per cent reduction in acute unscheduled bed days across Scotland—that is about 280,000 bed days. That will be a huge step in the right direction for patients and staff. Only this morning, I witnessed and learned something about the initiative that is being taken in Edinburgh—at the Edinburgh royal infirmary and at GP practices across the city—to focus on the “what matters to you?” programme. In doing so, the speed of healthcare will be improved and the number of unscheduled and other visits to accident and emergency will be reduced.

The latest published data from February shows that, since August 2016, across Scotland, the number of days spent in hospital by people whose discharge was delayed has reduced by over 15 per cent.

I am in absolutely no doubt that there is scope for further improvements. Our focus on prevention, integration and closer collaboration in order to deliver improved population health is one of the central themes of the delivery plan. I recognise all the challenges that members have so thoughtfully and, if I may say so, maturely described.

It is my firm belief that, as one member said, if we can work collaboratively across parties and this chamber, where it is possible to do so, there are many problems and issues that we can collectively solve. We will, of course, continue to disagree politically on some matters, and that is fine.

Maurice Corry (West Scotland) (Con)

Does the cabinet secretary-designate agree that the NHS staff in Scotland who serve as reservists in the armed forces have provided the most magnificent support to our armed forces, in many conflict zones throughout the world, since the NHS in Scotland was born?

Jeane Freeman

I certainly do. Indeed, our NHS staff provide significant and important services in many different settings, not least in our Scottish Prison Service and elsewhere.

Over the past 70 years, we have made huge strides in public health. I am very proud of the fact that we are leading the way on minimum unit pricing of alcohol. It is a bold policy that shows our commitment to public health, and it is a policy that we stuck with through many difficult trials and tribulations.

Looking ahead, the development of an agreed set of public health priorities is now complete, producing priorities for the whole public sector. Work is well under way with the Convention of Scottish Local Authorities and the Society of Local Authority Chief Executives and Senior Managers to develop the new public health body that will direct public health improvement across the country.

Alongside our constant quest for improved services, we know that we can only make a difference to people’s lives as a result of the dedicated, skilled and talented staff who work in our health service. Every achievement and success over the past 70 years would not have happened without their hard work and commitment. That is why we announced on Monday that agenda for change staff who work in the health service in Scotland will be offered at least a 9 per cent pay rise over the next three years, which is the highest pay uplift across these islands. That will cover around 170,000 staff, including nurses, midwives, allied health professionals, paramedics, porters and others. It is a recognition of the value that we place on their work and I hope that it will see an increase in our ability to recruit and retain the staff that we need in order to continue to provide not only innovation but high-quality, compassionate services.

As a Government and—I am certain—as a Parliament, our task as we go forward is to ensure that, when we pass on this vital, compassionate service to future generations, it has a clear direction and a solid foundation, grounded in a workforce that is valued and gives value back to the service throughout the working lives of each person in it.

Let me conclude by paying tribute to Shona Robison and Maureen Watt and to their predecessors, but in particular to Ms Robison and Ms Watt for their work for our health service and as fine public servants. Lastly, I say a very sincere, deep and well-meant thank you, from across this chamber and from this team, to all our health and social care staff and volunteers across Scotland for their hard work, their dedication and above all the care and the compassion that they deliver every single day. We owe them a huge debt of gratitude and we will not forget that.

The Deputy Presiding Officer

I thank all members for their contributions.

Meeting closed at 17:29.