Hansard

I welcome the opportunity to debate Scotland’s health service. We are all—rightly—proud of the national health service and we are all grateful to the dedicated staff who work in it to make our experience of the NHS the best it can possibly be. However, let us be clear: they do not want just our thanks; they want and need our support and, above all, they want us to be honest about what is going on in hospitals and health centres across the country.

We in this chamber trade figures about staffing numbers and budgets. I know that there are 2,500 fewer nurses in the NHS, which has brought the nursing workforce to a level that is lower than it was when the Scottish National Party took power. I also know that the health budget has declined by £189 million in real terms and that the cost pressures on health boards are enormous. A cursory glance at any set of health board papers will tell anyone the truth of that. However, the SNP simply denies the truth. The level of complacency that it has displayed—and that its amendment shows that it continues to display—is frankly breathtaking. However, it will not be able to deny the reality as health service workers themselves report how they struggle to cope with increasing demands and even less resource.

Audit Scotland has put the NHS on an amber warning. Nine health boards had underlying deficits, and three health boards had to borrow money to break even. Health budgets have decreased in real terms from 2009-10 and are set to continue decreasing over the next three years. Savings have been deemed to be at significant risk of not being delivered, and there is a £1 billion backlog of repairs, more than half of which has a direct impact on patient care.

The SNP’s amendment might as well have come from a parallel universe. Is it really questioning what the Auditor General had to say? It was a damning report card by anybody’s definition, but what we got from the SNP at the time was a blizzard of statistics and assertion from the cabinet secretary about how everything is wonderful.

I have to say that I feel a degree of sympathy for Alex Neil. Most of the mess is not of his making. He has inherited this situation from the former Cabinet Secretary for Health, Wellbeing and Cities Strategy, Nicola Sturgeon, and he has been left holding her poisoned chalice.

Let us consider some of the challenges that Alex Neil has inherited, starting with waiting times. Others will talk more about NHS Lothian, but what is now becoming clear is that the manipulation of waiting time figures was going on well beyond NHS Lothian. It was going on in NHS Tayside and NHS Grampian, and allegations have been made about none other than NHS Greater Glasgow and Clyde.

Labour members said months ago that the practice was widespread. We even gave examples, but the former cabinet secretary was in denial and said that it was just a local problem. I even recall Mark McDonald—who is in the chamber—and Joe FitzPatrick accusing me of innuendo and of casting aspersions about NHS Tayside. That would, of course, be the same NHS Tayside that last week suspended two members of staff due to suspected manipulation of waiting times. I look forward to receiving Mark McDonald’s apology, but I will not hold my breath.

In NHS Grampian, patients get a letter saying that they should call to set up an appointment, but there are time restrictions on when they can call and the line is constantly engaged. Also in NHS Grampian, a pensioner who was approaching the 12-week time limit was offered, at short notice, treatment in Glasgow or Tayside, when there was no space available at either of those two locations. His wife kept on the case and, when she threatened publicity, she got a cancellation the next day. She tells me that she reported this matter to the former cabinet secretary’s constituency office and to her civil servants, but that she was, essentially, ignored. Did the former cabinet secretary know that the problem was widespread? Did she know about that experience in NHS Grampian? The real scandal will be if she knew and simply did nothing.

When we last debated waiting lists, we pointed out the warning signs to the then cabinet secretary. Social unavailability underwent a dramatic and unexplained rise from 4,967 in 2008 to 20,662 in June 2011, which is a fivefold increase in a few years, as people had their waiting time suspended so that the figures would look good. That was the SNP’s hidden waiting list.

In 2010, Audit Scotland produced a report that highlighted concerns about how waiting times were recorded. It said:

“The report also finds that the NHS is not accurately recording all relevant information on patient waits which makes it difficult to demonstrate that it is managing all patients correctly in line with the new guidance.”

The Government’s Information Services Division says:

“several health boards have been warned about the high levels of social unavailability”.

What did the cabinet secretary do to address those concerns? Did she even monitor what was going on? Did anything change as the result of Audit Scotland’s report in 2010 and its clear warning? I suspect not, which is why we are in the mess that we are in today.

Let us not forget that behind each and every one of those statistics of a waiting time breached is a patient—a patient with a need for treatment who might be suffering unnecessarily as health boards fiddle their figures to satisfy the SNP.

Waiting time targets are challenging—there is no doubt about that—but they are not delivered by creating a culture of fear and intimidation so that staff are forced into the position of hiding the truth. In one of the largest health boards in the country, staff are off work as long-term sick as a result of stress because of what they have been asked to do to manipulate waiting times.

A woman in my own constituency with suspected breast cancer was told that she would not be seen until the new year, breaching the waiting time target, because clinics were being cancelled for the whole of the holiday period. What happens when those targets on waiting times are missed? As we understand the system, the breach needs to be reported to the Scottish Government, but is there any monitoring of what then happens to patients who have breached the target? Are they left to languish, waiting for treatment, as the attention turns to those who are not yet in breach?

I will explain that point to the cabinet secretary. In Forth Valley, a patient waited 337 days over the 62-day target to be treated for upper gastrointestinal cancer. The overall wait was therefore more than a year. In Grampian, a patient with colorectal cancer waited 133 days over the 62-day target. In Lothian, a patient has been waiting for lung cancer treatment for 67 days over and above the 62-day target. It just seems that those who have breached the target are not treated quite so urgently. I hope that the cabinet secretary can reassure me that that is not the case and that he will investigate and monitor the situation.

Reports in The Herald identify hundreds of Scottish patients who wait too long for cancer treatment, with more than 1,000 breaches in the past two and a half years. To be clear, that was due to a shortage of staff and equipment, not because of the complexity of the cancer or the need for more diagnostic tests. The Government response is that that number of breaches is within the 5 per cent tolerance level. Can we really tolerate delays to cancer treatment of such extraordinary length when we know that early diagnosis and early treatment can save lives?

Only yesterday, damning evidence was given at the Health and Sport Committee by Scotland’s leading cancer specialists, who described the lack of access to up-to-date cancer treatment and training and the current difficulty in recruiting to specialist cancer centres. That is because Scotland’s NHS is now looked on as being “quite inferior”. The specialists’ frustration is over their inability to prescribe courses of treatment that they know will prolong life and that are routinely available in England. Their clear view that the individual patient treatment request is inadequate and simply leads to a postcode lottery must be acted on. I welcome the review that the cabinet secretary has announced, but we must ensure that any replacement system is fair and not dependent on where someone lives.

Members may also recall similar comments that one of our leading cardiologists made recently in respect of cardiac treatment about Scotland falling behind in the use of new technology and innovative treatments such as transcatheter aortic valve implantation.

I confess that I find the SNP amendment a little embarrassing. We only need to look at NHS Lothian to know that financial targets are indeed at risk. The most recent set of NHS Lothian board papers report a projected deficit of £12 million. Of course, the SNP amendment removes the line in our motion that calls on the Scottish Government

“to provide guarantees that waiting times manipulation has not spread beyond NHS Lothian”.

Now we know the truth—that manipulation has indeed been wider than NHS Lothian.

The NHS in Scotland is in danger of becoming second rate on the SNP’s watch. I implore it, genuinely, to stop and listen, to set aside the spin, and to pay heed to the chorus of voices, not from within this chamber but from health professionals and patients who are telling it that all is not well with our NHS. The more the SNP hides the truth, the more it buries its head in the sand, and the more it comes up with delusional amendments, then the more people will decide that they cannot trust the SNP with the NHS.

I move,

That the Parliament recognises that the NHS has been put on an amber warning by the Auditor General and calls on the Scottish Government to urgently act on the concerns raised; believes that reductions in staffing levels as well as financial pressures are having a negative impact on patient care and that further inaction is not an option; is concerned at reports that raise further questions about the integrity of waiting times data, and calls on the Scottish Government to provide guarantees that waiting times manipulation has not spread beyond NHS Lothian.