Chamber
Meeting of the Parliament 05 November 2013
05 Nov 2013 · S4 · Meeting of the Parliament
Item of business
Person-centred Healthcare
We are already looking into it, and a number of pilot schemes have been carried out in Midlothian. In one GP surgery, the patients preferred not to have an appointments system at all but to go back to days gone by, when they could just turn up and take the risk of having to wait half an hour or even an hour. My view is that we should look at what works best but leave it more up to local decision making and not have it centrally imposed through targets or otherwise by the Cabinet Secretary for Health and Wellbeing.
In primary care modernisation, throughout our health and social care system there are many great examples of innovation and improvement that are delivering for their local area. I have heard of examples from inner city Glasgow to rural Aberdeenshire and from the Isle of Arran to suburban Edinburgh, all of which suggest new ways of working and new models of care. For instance, the deep-end practices, ably led by Professor Graham Watt, are 100 practices that work in Scotland’s poorest communities and take a genuinely bottom-up approach. They demonstrate some of the very real health inequality challenges that are faced by our most deprived populations and suggest how we must begin to address them.
I have also heard about an initiative in Buckhaven that is based on the Alaskan nuka model of care, which puts the needs of the community at the heart of the healthcare system and assists both in finding solutions to seemingly intractable healthcare challenges. A number of initiatives like the Alaskan model, such as patient access, productive general practice and managing patient flow, show that the solution lies in primary and social care teams focusing on the needs of the people whom they support. That is challenging for us, but it is at the heart of our moves towards the integration of health and social care and the legislation that we are introducing to make that happen.
To make that a reality, we must understand what works, why it works and how it works. We must invest in developing new models of care and ensure that we spread the learning from the approach far and wide. That is why I am today announcing a modernisation programme to support innovation and best practice in primary care. I am also delighted to announce that, in year 1, there will be pump priming of £1 million to pilot the new developments and move the agenda forward, along with the massive resources that we already have in primary care.
The first stage of that modernisation will be in commissioning strategic assessments of primary care from each of our health boards as part of their normal planning process. It will be a modernisation programme that truly delivers change. The transformation of primary care needs to be delivered in partnership across health and social care, and the mutual NHS model that we have in Scotland is the right one for delivering safe, effective and person-centred care.
There is a sharp contrast between our approach, which is based on the founding principle of services being free at the point of care, and that in England, where privatisation is growing ever more pronounced and damaging. Although we have abolished prescription charges, in England they remain, with the result that some people on low incomes are forced to choose which of their prescribed medicines they can afford. We have legislated to ensure that there is no privatisation of GP services in Scotland, and we have banned the privatisation of cleaning contracts, which we have supported by providing more than £23 million of additional resources since 2009 to pay for the hundreds of additional cleaning staff who keep our hospitals safe. Free personal and nursing care, to which patients in England are not entitled, currently improves the lives of more than 77,000 older vulnerable people in Scotland. Those are achievements that not just the Government but the Parliament can be proud of.
I have set out our ambitious approach to person-centred, safe and effective care and have announced a clear direction for the transformation of primary care to match our 2020 vision. Given the increasing divergence between what happens north of the border and what happens south of it, I hope that every member will agree that ours is the right way forward. I began by outlining the serious strategic challenges that health and social care services in Scotland face. We need to create a health and social care system that is fit for purpose in the 21st century. That is why we are taking forward our 2020 vision. My ambition is not just to have the safest health service in the world—which, according to the world’s leading expert on the issue, we already have; it is that the Scottish people will have the best health service in the world by 2020.
I move,
That the Parliament recognises the importance of person-centred healthcare in delivering the best health outcomes possible; supports measures to ensure that individuals are supported to be active partners in their own care; agrees that all parts of the healthcare system should be focused on the patient, and that should include both community and hospital care, and further supports Scotland’s modernisation programme to test measures to make GP services more accessible for patients, while reducing bureaucracy for GPs and freeing their time to focus on patients.
14:26
In primary care modernisation, throughout our health and social care system there are many great examples of innovation and improvement that are delivering for their local area. I have heard of examples from inner city Glasgow to rural Aberdeenshire and from the Isle of Arran to suburban Edinburgh, all of which suggest new ways of working and new models of care. For instance, the deep-end practices, ably led by Professor Graham Watt, are 100 practices that work in Scotland’s poorest communities and take a genuinely bottom-up approach. They demonstrate some of the very real health inequality challenges that are faced by our most deprived populations and suggest how we must begin to address them.
I have also heard about an initiative in Buckhaven that is based on the Alaskan nuka model of care, which puts the needs of the community at the heart of the healthcare system and assists both in finding solutions to seemingly intractable healthcare challenges. A number of initiatives like the Alaskan model, such as patient access, productive general practice and managing patient flow, show that the solution lies in primary and social care teams focusing on the needs of the people whom they support. That is challenging for us, but it is at the heart of our moves towards the integration of health and social care and the legislation that we are introducing to make that happen.
To make that a reality, we must understand what works, why it works and how it works. We must invest in developing new models of care and ensure that we spread the learning from the approach far and wide. That is why I am today announcing a modernisation programme to support innovation and best practice in primary care. I am also delighted to announce that, in year 1, there will be pump priming of £1 million to pilot the new developments and move the agenda forward, along with the massive resources that we already have in primary care.
The first stage of that modernisation will be in commissioning strategic assessments of primary care from each of our health boards as part of their normal planning process. It will be a modernisation programme that truly delivers change. The transformation of primary care needs to be delivered in partnership across health and social care, and the mutual NHS model that we have in Scotland is the right one for delivering safe, effective and person-centred care.
There is a sharp contrast between our approach, which is based on the founding principle of services being free at the point of care, and that in England, where privatisation is growing ever more pronounced and damaging. Although we have abolished prescription charges, in England they remain, with the result that some people on low incomes are forced to choose which of their prescribed medicines they can afford. We have legislated to ensure that there is no privatisation of GP services in Scotland, and we have banned the privatisation of cleaning contracts, which we have supported by providing more than £23 million of additional resources since 2009 to pay for the hundreds of additional cleaning staff who keep our hospitals safe. Free personal and nursing care, to which patients in England are not entitled, currently improves the lives of more than 77,000 older vulnerable people in Scotland. Those are achievements that not just the Government but the Parliament can be proud of.
I have set out our ambitious approach to person-centred, safe and effective care and have announced a clear direction for the transformation of primary care to match our 2020 vision. Given the increasing divergence between what happens north of the border and what happens south of it, I hope that every member will agree that ours is the right way forward. I began by outlining the serious strategic challenges that health and social care services in Scotland face. We need to create a health and social care system that is fit for purpose in the 21st century. That is why we are taking forward our 2020 vision. My ambition is not just to have the safest health service in the world—which, according to the world’s leading expert on the issue, we already have; it is that the Scottish people will have the best health service in the world by 2020.
I move,
That the Parliament recognises the importance of person-centred healthcare in delivering the best health outcomes possible; supports measures to ensure that individuals are supported to be active partners in their own care; agrees that all parts of the healthcare system should be focused on the patient, and that should include both community and hospital care, and further supports Scotland’s modernisation programme to test measures to make GP services more accessible for patients, while reducing bureaucracy for GPs and freeing their time to focus on patients.
14:26
In the same item of business
The Deputy Presiding Officer (Elaine Smith)
Lab
The next item of business is a debate on motion S4M-08155, in the name of Alex Neil, on person-centred healthcare.14:12
The Cabinet Secretary for Health and Wellbeing (Alex Neil)
SNP
I thought that it would be useful for us to have a fairly wide-ranging debate on health and social care in Scotland, given where we are—particularly as we ar...
Neil Findlay
Lab
Before the cabinet secretary moves off the subject of GPs, will he address the system of GP appointments? In some practices, people have to take a ticket as ...
Alex Neil
SNP
We are already looking into it, and a number of pilot schemes have been carried out in Midlothian. In one GP surgery, the patients preferred not to have an a...
Neil Findlay (Lothian) (Lab)
Lab
I begin by declaring an interest, in that my wife and daughter work in the NHS.I say at the outset that Scottish Labour shares and supports the good intentio...
Mark McDonald (Aberdeen Donside) (SNP)
SNP
I take on board what the member is saying, but as he will know there have always been and will always be individual examples of people whose care does not me...
Neil Findlay
Lab
That might be the case from a survey, but I tend rather to speak to people on a daily basis who come to my surgery, email me and talk to me. I am sure that m...
The Deputy Presiding Officer
Lab
I ask you to move your amendment, Mr Findlay.
Neil Findlay
Lab
I move amendment S4M-08155.1, to insert at end:“; commends the hard work and dedication of those working in Scotland’s health and care services, and calls on...
Jim Hume (South Scotland) (LD)
LD
I, too, welcome the opportunity to participate in this afternoon’s wide-ranging debate.In 2010, when the Deputy First Minister introduced the Patient Rights ...
Alex Neil
SNP
I explain to the member that one reason why there are so many more vacancies is that there are many more jobs because we have doubled the number of consultan...
Jim Hume
LD
I am grateful for that, but the situation is worse with nurses and midwives. In June, there were 1,672.9 whole-time equivalent vacancies. The number of vacan...
Nanette Milne (North East Scotland) (Con)
Con
Despite certain parts of the previous two speeches, I think—and hope—that the debate is likely to be another fairly consensual one on health. None of us can ...
Dr Richard Simpson (Mid Scotland and Fife) (Lab)
Lab
Is the member aware of the fact that the guidance that was issued on the quality outcomes framework in May this year, one month after it came in, ran to 224 ...
Nanette Milne
Con
I confess that I was not aware of that, but it is interesting information—I thank Dr Simpson.When my husband did GP locums after retiring from full-time prac...
The Deputy Presiding Officer
Lab
Before we move to the open debate, I remind members that those who participate in the debate must be in the chamber for closing speeches at the end of the de...
Bob Doris (Glasgow) (SNP)
SNP
I am delighted to speak in today’s debate on person-centred care. As deputy convener of the Health and Sport Committee, I often meet stakeholder groups in he...
Siobhan McMahon (Central Scotland) (Lab)
Lab
Last week, I and a number of colleagues from Lanarkshire met Healthcare Improvement Scotland’s review team. During what I thought was a productive meeting, t...
Aileen McLeod (South Scotland) (SNP)
SNP
I welcome the opportunity to speak in this debate on a fundamental principle in the delivery of safe, effective and world-class care for the people of Scotla...
George Adam (Paisley) (SNP)
SNP
The Scottish Government’s ambitious plans for person-centred healthcare are to be welcomed. The Scottish Government introduced its healthcare quality strateg...
Neil Findlay
Lab
Maybe I could mention the other side of self-directed support. People come to us from third sector organisations that provide person-centred support and they...
George Adam
SNP
If I was Mr Findlay, I would make sure that I was speaking in the right debate when I said things. What he raises is more a procurement issue than an issue a...
Margaret McCulloch (Central Scotland) (Lab)
Lab
The Royal College of Nursing tells us that person-centred care is one of its eight principles of nursing practice. It is a holistic approach based on mutual ...
Alex Neil
SNP
Our capital budget has been cut by 26 per cent this year alone. That cut originated from Alistair Darling. It is impossible to meet all the original commitme...
Margaret McCulloch
Lab
We support the protection of front-line services; that is not happening under the SNP’s watch.Meanwhile, plans for minor injuries units in places such as Cum...
Fiona McLeod (Strathkelvin and Bearsden) (SNP)
SNP
The ambition to have person-centred healthcare is not new, as I know from my many years as a health service librarian. More than 20 years ago, I worked in pa...
Mark McDonald (Aberdeen Donside) (SNP)
SNP
We have heard much about what person-centred healthcare and support are. A 2011 Joseph Rowntree Foundation report entitled “Transforming social care: sustain...
Neil Findlay
Lab
I am sure that the member will be gracious enough to acknowledge that, because the Government could not meet the targets, the cabinet secretary had to change...
Mark McDonald
SNP
It is good to see that Mr Findlay does not accept the progress that the Government has been making on accident and emergency waiting times.During Mr Findlay’...
Dr Simpson
Lab
We passed an excellent Patient Rights (Scotland) Act 2011 with a new complaints system that includes the four Cs: compliments, comments, concerns and complai...