Chamber
Meeting of the Parliament 22 September 2010
22 Sep 2010 · S3 · Meeting of the Parliament
Item of business
E-health
As I represent Scotland’s largest parliamentary region, which contains hundreds of large and small communities in remote glens, peninsulas and islands, I am very much aware of the challenge that our health professionals face in delivering the care and support that our constituents need. In the past, that health care was delivered by innumerable village doctors and community nurses who were scattered throughout the Highlands and Islands, who made themselves available to their patients whenever the need arose.
Times have changed and individual doctors are no longer available to serve their patients 24 hours a day, so we must consider new ways of delivering the ever-more complex benefits of medicine and nursing care to patients throughout our rural and island communities.
In that context, modern information and communications technology comes into its own. It allows medical staff to spread their expertise over a far greater area than used to be possible by jumping into a car to pay a personal visit to a patient’s home or requiring a sick highlander to make their way to Inverness, Broadford or Fort William for what was often an urgent medical appointment.
In recent years, improvements in communications technology have allowed some of our more experienced doctors—in Inverness, for example—to use telemedicine to have consultations with patients in Caithness, Skye or the Western Isles by using a videoconferencing link and to make an informed diagnosis of a patient’s condition and create an individual treatment plan.
However, not all remote health care needs to involve consultants. At another level, it can involve an elderly or infirm patient wearing a sensor to alert staff in a sometimes distant care centre of any change in their condition. Sometimes that is as simple as a button on a box hanging around the patient’s neck that can be pressed in an emergency, but advances in such telecare technology have allowed that simple alarm button to be supplemented with a range of sensors to monitor breathing, blood pressure or heart rate.
Between those two extremes is telehealth. Increasingly, it allows health professionals to access a growing range of vital details about the changing condition of patients who have long-term conditions, such as diabetes, or a history of heart failure without the need for patients to leave their homes and be brought into often distant hospitals that are many miles from their local support network of family and friends.
Health care managers and enterprise chiefs in the Highlands and Islands have adopted e-health enthusiastically, and not just for its benefits in spreading care to remote and isolated communities. A cluster of related businesses has been built to help progress and test e-health developments in exactly the type of environment in which they are most needed.
Capitalising on this new sector of health care was a key driver in Highlands and Islands Enterprise’s decision to invest £24 million in the creation of the new centre for health science beside Raigmore hospital in Inverness. E-health companies are being encouraged to congregate at the centre to allow cross-fertilisation of ideas and knowledge in a manner that is similar to that used in silicon valley in California, where great advances in computing have been seen in recent decades. The cluster of cutting-edge researchers who operate from the centre for health science has helped to establish the region as an internationally recognised centre of excellence in this pioneering area. Indeed, the strategy is already bearing fruit. So far this year, some of the world’s leading communications and telehealth experts have gathered twice in Inverness for major e-health conferences.
Although current developments in telehealth require only a relatively conventional mobile phone or traditional land-line telephone connection to operate, there is growing concern that the patchy provision of broadband in rural areas will have a limiting effect on the next generation of e-health developments in the areas where those developments are needed most. Other members have mentioned that, and the committee touches on the issue in paragraphs 78 and 79 of its report:
“A key piece of infrastructural development necessary to support such telehealth services is the availability of high-speed broadband internet access. As with many other aspects of the public services, broadband access is especially important in remote and rural areas.
In our view, the forthcoming telehealth strategy must clearly set out how such services will be delivered and how this links with the Scottish Government’s broadband development policy.”
Unfortunately, responsibility for Scotland’s broadband infrastructure is reserved to Westminster, although the Scottish Government has done what it can to support the roll-out of vital new communications technology into communities where it is needed desperately.
Westminster’s approach to broadband roll-out often appears to be that it should be driven purely by commercial considerations. Regrettably, the businesses with a role in delivering the telecommunications infrastructure that is needed for modern broadband access will always concentrate on areas of high population, not scattered communities in large regions. Government intervention is needed to help with that. We must do all that we can to encourage Westminster to ensure that Scotland’s rural and island communities catch up with the provision that is taken for granted in the rest of the UK—provision that allows people to benefit fully from the important developments that are taking place in e-health. Jamie Stone and Liam McArthur touched on the problem, but we do not need yet another Liberal Democrat campaign and petition. I say to them, “You are in government now, gentlemen.” Jeremy Hunt must deliver broadband for the Highlands and Islands, too. We need no more petitions, political games and spin from Jeremy Hunt and the Lib Dems in London; we need real progress.
Times have changed and individual doctors are no longer available to serve their patients 24 hours a day, so we must consider new ways of delivering the ever-more complex benefits of medicine and nursing care to patients throughout our rural and island communities.
In that context, modern information and communications technology comes into its own. It allows medical staff to spread their expertise over a far greater area than used to be possible by jumping into a car to pay a personal visit to a patient’s home or requiring a sick highlander to make their way to Inverness, Broadford or Fort William for what was often an urgent medical appointment.
In recent years, improvements in communications technology have allowed some of our more experienced doctors—in Inverness, for example—to use telemedicine to have consultations with patients in Caithness, Skye or the Western Isles by using a videoconferencing link and to make an informed diagnosis of a patient’s condition and create an individual treatment plan.
However, not all remote health care needs to involve consultants. At another level, it can involve an elderly or infirm patient wearing a sensor to alert staff in a sometimes distant care centre of any change in their condition. Sometimes that is as simple as a button on a box hanging around the patient’s neck that can be pressed in an emergency, but advances in such telecare technology have allowed that simple alarm button to be supplemented with a range of sensors to monitor breathing, blood pressure or heart rate.
Between those two extremes is telehealth. Increasingly, it allows health professionals to access a growing range of vital details about the changing condition of patients who have long-term conditions, such as diabetes, or a history of heart failure without the need for patients to leave their homes and be brought into often distant hospitals that are many miles from their local support network of family and friends.
Health care managers and enterprise chiefs in the Highlands and Islands have adopted e-health enthusiastically, and not just for its benefits in spreading care to remote and isolated communities. A cluster of related businesses has been built to help progress and test e-health developments in exactly the type of environment in which they are most needed.
Capitalising on this new sector of health care was a key driver in Highlands and Islands Enterprise’s decision to invest £24 million in the creation of the new centre for health science beside Raigmore hospital in Inverness. E-health companies are being encouraged to congregate at the centre to allow cross-fertilisation of ideas and knowledge in a manner that is similar to that used in silicon valley in California, where great advances in computing have been seen in recent decades. The cluster of cutting-edge researchers who operate from the centre for health science has helped to establish the region as an internationally recognised centre of excellence in this pioneering area. Indeed, the strategy is already bearing fruit. So far this year, some of the world’s leading communications and telehealth experts have gathered twice in Inverness for major e-health conferences.
Although current developments in telehealth require only a relatively conventional mobile phone or traditional land-line telephone connection to operate, there is growing concern that the patchy provision of broadband in rural areas will have a limiting effect on the next generation of e-health developments in the areas where those developments are needed most. Other members have mentioned that, and the committee touches on the issue in paragraphs 78 and 79 of its report:
“A key piece of infrastructural development necessary to support such telehealth services is the availability of high-speed broadband internet access. As with many other aspects of the public services, broadband access is especially important in remote and rural areas.
In our view, the forthcoming telehealth strategy must clearly set out how such services will be delivered and how this links with the Scottish Government’s broadband development policy.”
Unfortunately, responsibility for Scotland’s broadband infrastructure is reserved to Westminster, although the Scottish Government has done what it can to support the roll-out of vital new communications technology into communities where it is needed desperately.
Westminster’s approach to broadband roll-out often appears to be that it should be driven purely by commercial considerations. Regrettably, the businesses with a role in delivering the telecommunications infrastructure that is needed for modern broadband access will always concentrate on areas of high population, not scattered communities in large regions. Government intervention is needed to help with that. We must do all that we can to encourage Westminster to ensure that Scotland’s rural and island communities catch up with the provision that is taken for granted in the rest of the UK—provision that allows people to benefit fully from the important developments that are taking place in e-health. Jamie Stone and Liam McArthur touched on the problem, but we do not need yet another Liberal Democrat campaign and petition. I say to them, “You are in government now, gentlemen.” Jeremy Hunt must deliver broadband for the Highlands and Islands, too. We need no more petitions, political games and spin from Jeremy Hunt and the Lib Dems in London; we need real progress.
In the same item of business
The Presiding Officer (Alex Fergusson)
NPA
The next item of business is a debate on motion S3M-7015, in the name of Christine Grahame, on the Health and Sport Committee’s report, “Clinical portal and ...
Christine Grahame (South of Scotland) (SNP)
SNP
Going by my helpful note from the clerks, I fear that I have 13 minutes for this speech. A pattern appears to be emerging of my having extensive time to spea...
The Presiding Officer
NPA
I ask members not to follow the convener’s example by not using up their allocated time, because we have a little time available.I call Shona Robison, who ha...
The Minister for Public Health and Sport (Shona Robison)
SNP
I welcome this debate on the important role of information technology in improving the safety, effectiveness and efficiency of care. I hope that I will be ab...
Jeremy Purvis (Tweeddale, Ettrick and Lauderdale) (LD)
LD
Will the 111 telephone number be utilisable in Scotland?
Shona Robison
SNP
We have said that we will look at the evidence on how the number rolls out, what it looks like and some of the learning from that before giving further consi...
Mary Scanlon (Highlands and Islands) (Con)
Con
Why did the minister decide not to set a health improvement, efficiency, access and treatment target for telehealth, as recommended in paragraph 87 of the co...
Shona Robison
SNP
As I am beginning to outline, we have decided to move forward on a phased basis, focusing on the areas that I have identified. Rather than ask boards to do e...
Dr Richard Simpson (Mid Scotland and Fife) (Lab)
Lab
I welcome the debate. As the Health and Sport Committee’s convener suggested, it might appear to be a dry subject, but it is also a very important debate. I ...
The Presiding Officer
NPA
You have a minute and a half more.
Dr Simpson
Lab
Telehealth is moving forward, but rather slowly. We have four systems—telestroke, telepaediatrics, mental health and long-term condition management—but, as M...
Mary Scanlon (Highlands and Islands) (Con)
Con
Much is said about consensus in the Parliament, although it tends to be lacking in many debates. However, the considerable consensus in committees—particular...
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
LD
The motion asks us to note the contents of the Health and Sport Committee’s report, which I do with great interest. I, too, thank the members of the committe...
The Deputy Presiding Officer (Alasdair Morgan)
SNP
We now move to the open debate. I can allow members up to seven minutes each.15:23
Ian McKee (Lothians) (SNP)
SNP
As a member of the Health and Sport Committee, I am pleased to speak about our report. I begin by thanking our committee support team for their hard work in ...
The Deputy Presiding Officer
SNP
Wind up, please.
Ian McKee
SNP
In summary, we could be on the brink of huge and game-changing developments in patient care, but only if we prepare carefully and fund sensibly. I commend th...
Helen Eadie (Dunfermline East) (Lab)
Lab
I am pleased to take part in what I consider to be an important debate that could help to unlock exciting developments throughout Scotland. I echo Christine ...
Mary Scanlon
Con
Does the member agree that the public-private partnership between optometrists and the NHS is one of the best in Scotland and puts patients at the heart of t...
Helen Eadie
Lab
I am not in a position to evaluate that, but if Mary Scanlon says that it is, she must be right.Mr Taylor’s digital images clearly showed terrible wet macula...
The Deputy Presiding Officer
SNP
Wind up, please.
Helen Eadie
Lab
I make no apologies to anyone in the chamber for providing an intense case study, as it illustrates very well how telehealth can magically make a difference ...
Nanette Milne (North East Scotland) (Con)
Con
I join others in acknowledging the painstaking work of the Health and Sport Committee and its clerks that has led to the comprehensive report that we are dis...
Michael Matheson (Falkirk West) (SNP)
SNP
I will not offer another definition of “clinical portal”. Members have provided several definitions and I suspect that the members who still do not understan...
Rhoda Grant (Highlands and Islands) (Lab)
Lab
The subject matter of this debate is the use of technology, but the committee’s report is really in two distinct parts. The first part considers a single pat...
Liam McArthur (Orkney) (LD)
LD
I, too, am pleased to participate in this afternoon’s debate. I congratulate the members of the Health and Sport Committee on what their convener celebrated ...
Dave Thompson (Highlands and Islands) (SNP)
SNP
As I represent Scotland’s largest parliamentary region, which contains hundreds of large and small communities in remote glens, peninsulas and islands, I am ...
Jeremy Purvis
LD
I am sure that the member is aware of the pathfinder north project under which schools got broadband connections. The project was fully delivered by the prev...
The Deputy Presiding Officer (Trish Godman)
Lab
You are in your last minute, Mr Thompson.
Dave Thompson
SNP
Okay. Thank you, Presiding Officer. Mr Purvis will find that the Scottish Government has done many things with its limited powers, but that does not change t...