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Meeting of the Parliament 09 November 2011

09 Nov 2011 · S4 · Meeting of the Parliament

Item of business

Rehabilitation and Enablement

Milne, Nanette Con North East Scotland Watch on SPTV

The change fund arrangements are welcome, but they will need to be closely monitored to ensure their effectiveness. As Jackie Baillie has said, there are already problems with how change fund money is being spent.

At their core, rehabilitation and enablement are known to be effective not only in improving the independence of individuals but in reducing the cost to the taxpayer of care services. The 2007 framework expands the style of healthcare delivery outlined in the earlier document, “Delivering for Health”, which I believe was the first real attempt to define rehabilitation. Similarly, its sister manifesto, “Changing Lives”, highlighted the need for a greater emphasis on cross-agency co-operation, with a particular focus on delivering services close to where people live, offering services on a suitable and reasonable timescale and promoting a greater stress on anticipatory care as well as supporting individuals and carers in the self-management of long-term conditions. That is key to a successful future for the wellbeing of people in this country.

That revolutionary shift in how the NHS works, which has taken it from a hospital-driven service to one that is embedded in the community, is important as it represents a significant attempt to make services more patient focused. The framework was also the first to instruct NHS boards to appoint rehabilitation co-ordinators to measure existing services, implement the recommendations of the national implementation group, redesign services, where appropriate, and promote new treatment styles. As the minister has said, we are some way along the road to success in that regard, but there are many challenges ahead that must still be met.

Another extremely significant point is the emphasis on the greater use of e-health to increase service provision, for example when local authorities work to develop local transport for rehabilitation purposes. There is enormous untapped potential for telehealth in many spheres, including rehabilitation and enablement. My colleague, Mary Scanlon, will touch on that point in her speech.

There are areas of concern that were highlighted by the Parliament’s Health and Sport Committee when it conducted an investigation into the rehabilitation framework three years ago. Among its findings was a call for better information and data on what services are available, greater multi-agency working through joint management structures, better workforce planning and training, and greater co-operation between health and social care services.

As Jackie Baillie said—I totally agree—there is a key concern about allied health professionals. I totally agree with the minister that AHPs are vital to patients in their health journey, and he outlined the many areas where they play a leadership role in patient care. That is clearly very important. However, AHPs such as physiotherapists find that once they are qualified they are unable to get positions. Indeed, in 2007, unemployment among physios stood at 71 per cent, with the Chartered Society of Physiotherapy predicting a crisis in recruitment.

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Meeting of the Parliament 09 November 2011

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