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Meeting of the Parliament 22 September 2010

22 Sep 2010 · S3 · Meeting of the Parliament

Item of business

E-health

Matheson, Michael SNP Falkirk West Watch on SPTV

I will not offer another definition of “clinical portal”. Members have provided several definitions and I suspect that the members who still do not understand what a clinical portal is probably never will.

It is fair to say that clinical portals, e-health and telehealth make for a dry topic. I confess that I have never had a constituent come to my surgery to complain about problems with the clinical portal or e-health. However, constituents have expressed concern about the loss of medical records and their difficulties in accessing records. I have little doubt that an appropriate, effective clinical portal offers a key way to address issues that my constituents have experienced over the years.

When the public sector talks about being innovative and finding IT solutions to such problems, I am conscious that it does not have a great track record in the area. However, it is fair to say that the NHS has gradually introduced more and more IT into its processes during the past 25 years, which has revolutionised how many patients are treated. The challenge is to ensure that we continue to find innovative and effective IT measures that will improve patients’ treatment in the NHS.

The key test of such innovation must be whether it improves patient experience. That is the principle. The committee heard that, rather than patients’ interests being central to the matter, innovations have been stifled over the years by what appears to be professional self-interest. That is sad. I will return to the issue, which relates to telehealth more than it relates to the clinical portal.

Significant progress has been made in the development of an effective clinical portal, as members said. The main objective, however, is to improve patient experience and during the committee’s evidence gathering I was concerned about the lack of patient engagement in that development process. I accept that the clinical portal programme board is trying to shape things and take the initiative forward at national level, but I am concerned that there is no permanent patient representative on that key body, which is largely made up of clinicians and IT experts. That in itself represents a failure on the part of some of the people who are leading the approach in the NHS to recognise that the clinical portal is about making life easier and better not just for clinicians, but patients. I hope that there will be greater engagement with patients in future, to ensure that the portal is designed to reflect their views.

We should not overplay the extent to which professional self-interest is stifling developments in telehealth, but nor should we underestimate the impact of such self-interest. When the committee started its inquiry, I was under the impression that telehealth had made significant progress over the years. I was disappointed to find that little progress has been made and that the progress that has been made has been relatively slow.

I acknowledge that progress is starting to be made in some areas, but there seems to be a pattern with telehealth. People will say, “Let’s try a pilot in this particular field and see how it runs for a few years.” If an initiative proves to be quite effective, we will hear no more about it. Ian McKee highlighted what happened with the telehealth programme that his practice developed some 35 years ago. I hope that one of the key objectives of the Scottish centre for telehealth with its move into NHS 24 will be ensuring that pilots and programmes that are developed are rolled out throughout the country so that good practice is spread across different health boards. We need to ensure that we capture the benefits that come from those pilots and do not lose them time and again. That appears to have been the pattern over the past two or three decades.

Professional self-interest, particularly in relation to dermatology, was highlighted to the committee. Greater use of telehealth in dermatology could probably be well developed, but it was suggested to the committee that the real inhibitor to that is that fewer dermatologists would be required to do the work that is currently done. It is not exactly in the dermatologists’ interests to be too enthusiastic about the introduction of greater use of telehealth in that field and I have no doubt that elements of professional self-interest will creep in to undermine telehealth developments in other areas of health care.

To conclude, it is extremely important that we try to make greater progress in the use of telehealth, but we must also be prepared to confront professional self-interest when it arises. The key way to achieve that is through strong leadership in driving forward telehealth measures in the NHS. It is probably better to do that in the current economic climate than it has ever been.

15:52

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Meeting of the Parliament 22 September 2010

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