Hansard

The two-week target comes in from April. However, two weeks is too long for most patients and therefore the integrated partnerships will have an ambition to work towards the 72-hour discharge standard, because we know that, clinically, that is what is required for most patients. We want the partnerships to make progress towards that as speedily as they can.

Our current work with integrated partnerships shows a strong commitment to the shared agenda and I plan to provide another early opportunity over the next few weeks for Parliament to be updated in more detail on the progress that is being made by partnerships in advance of them hitting the ground running on 1 April.

With the NHS budget next year increasing by £380 million to reach more than £12 billion for the first time, perhaps we should focus more on what we spend the money on, rather than having bidding wars about delivering 1,000 more nurses or spending £100 million more than the Scottish National Party. That approach is not the best way to plan for what our NHS needs.

We have an NHS that works hard to meet the challenges of today. It puts patients and their families first and delivers amazing outcomes for most patients. However, we cannot rest on our laurels. To do so would be to betray the values of the NHS and we know that we have much to do to make our health and care services meet our goal for the provision of safe, person-centred and effective care. We need an approach to health in Scotland that fits the 21st century.

We have the 2020 vision. That vision, with its emphasis on new models of care, healthcare delivered closer to home, and prevention, remains the right one. However, it is clear to me that, as a nation, we are not making sufficient progress quickly enough towards that vision. We need to be clearer on how we are going to deliver that vision and the step changes that are required to get us there. We also need to raise our eyes beyond that horizon and see what success would look like over a 10 to 15-year timeframe.

We need to move more quickly to a system that has a greater focus on prevention and which supports people with long-term conditions better, given that there will be 779,000 people over 75 by 2037, which is a rise of 83 per cent. They will need to be supported in their homes and communities to live productive fulfilling lives. We need a system that has more of a focus on tackling the legacy of health inequalities. We must do all of this in a very challenging financial environment, which will require a cross-Government approach.

To achieve those goals, we need to do things differently. We need an NHS that improves and evolves to meet those needs and which is bolder on the need to have more care delivered locally, with more services organised around primary care practices where patients have those continuing relationships. That will mean enhancing primary and community care, including more resources and teams of health professionals working together in communities. It will mean ensuring that health services work effectively with third sector and community organisations to engage with people who are least likely to access healthcare and consequently are most at risk of poor health outcomes.

Health professionals will need to be able to support patients facing wider social issues that are having an impact on their health and wellbeing. Specialist doctors and nurses will be needed to support people in their own homes, care home or hospice, as well as in hospitals. We must be clearer about what care should be delivered locally, regionally and nationally. I am hugely ambitious, through the use of technology and by deploying the talents of our NHS staff appropriately, about how much more care we can deliver locally, in homes and in communities.

Without a doubt, the service that we will provide in the next 10 to 15 years will have to be different from the service that we have provided in the past 10 years. We need to work with communities to improve their health and wellbeing by harnessing their existing assets and enabling them to develop those into meaningful changes.

Good relationships are vital to achieving the best possible outcomes. We want people to be at the heart of every decision, and we want an NHS that cares and is compassionate. We have the stronger voice project, which was announced by Alex Neil last summer, but I want to go further than that. Today, I announce my intention to develop a longer-term 10 to 15-year plan for the NHS that builds on but takes us beyond the 2020 vision.

In doing so, I want to work with stakeholders, including patients and families, professionals and clinicians of all stripes, the Parliament’s Health and Sport Committee and indeed even Opposition parties. I want to reach as much consensus as possible around what we want our health and social care systems to look like over those longer timeframes and the steps that we need to take to get there. As that will include planning what capacity is required where and what the workforce will need to look like to deliver these new services in a different way, the role of the professional bodies and the royal colleges will be key to informing that work.

That engagement will be on-going, but I would like, if possible, to reach broad agreement on this plan by the autumn. I do not think that we will agree on every detail, but I hope that we will be able to agree the key planks of what success will look like if we get everything that we are doing now and will do in the future right. On that note, I hope to hear some ideas about that in the chamber this afternoon.

I move,

That the Parliament is committed to ensuring that Scotland’s NHS remains in public hands and free at the point of need; recognises that Scotland’s caring services face challenges common across the developed world, including those derived from an ageing population, changing demands of service provision and increased costs associated with new medicines and technologies; supports the achievements that quality improvement programmes have made, such as the Scottish Patient Safety Programme and the Early Years Collaborative, and the importance of sustaining and spreading these achievements; agrees that the 2020 vision’s strategy for integrated health and social care is key to ensuring sustainable caring services long into the future; commends the contribution of NHS and social care staff in caring for Scotland and in seeking to achieve the aims of the 2020 vision; believes that the contribution of staff, stakeholders and users of the country’s caring services will be vital to the development and implementation of delivery plans for the short and long term that meet the aims of the 2020 vision, and welcomes the recent additional investments in Scotland’s NHS, including a further £100 million over three years to address delays in discharge and support people to remain at home or in a homely setting for as long as possible.