Hansard

We very much welcome this debate. Like everyone here, Scottish Conservatives greatly value the work and dedication of the staff in NHS Scotland and Scotland’s care services. At all grades and in all professions, they perform a tremendous role and are rightly regarded as among our most respected and valued citizens. All those people and the patients whose health and wellbeing are their overriding concern are tired of hearing politicians scoring party political points whenever the NHS comes up for discussion and of the scare stories that we see so often in the media.

We all value our NHS, and most patients have a good experience when in its hands. Almost all the letters that I see in the local press from patients are full of praise for the care and attention that they have received, for which they are grateful. Of course, there are exceptions, and they tend to be the cases that come to our notice as politicians. We would fail in our duty if we did not take them seriously and work towards ensuring that such failures of the system are not repeated.

We are all increasingly aware of the pressures under which the NHS is operating and of the need to take action to ensure its sustainability as the population ages and expensive medical technologies and pioneering medicines continue to become available for clinical use in a publicly funded system in which money will always be tight and every last penny should be used to give best value to service users. The acceptance that we need to look beyond short-term demands is welcome, and the new joint report from the medical and nursing royal colleges on building a more sustainable NHS in Scotland, together with the cabinet secretary’s stated desire to foster a consensus to find a way of ensuring that the service can meet the very significant challenges ahead, are like music to my ears.

For many months, if not years, Jackson Carlaw and I have been pleading in the chamber for some political consensus around the health service in Scotland. We had some very fruitful discussions with the previous health secretary about various health matters, not least the need for more health visitors. That resulted in the announcement of an extra 500 of that grade of professional. I am very pleased that the current cabinet secretary is keen to follow that pattern. I listened with interest to her suggestions for future planning.

Of course, we will not always agree about the means to an end, but if we can find a consensus on the way forward for the NHS in conjunction with all stakeholders—including, of course, patients—then I think that we can succeed. Only by having a common goal that can be worked towards whatever the political colour of the Government of the day will we overcome the short-term planning that is currently a feature of political life.

The Scottish Conservatives have been championing a long-term plan for a very long time, and a long-term economic plan under a Conservative Government has meant that the Scottish NHS will benefit from an additional £800 million in the next five years. However, that money must be used wisely, and we have to take notice of Audit Scotland’s warning that, if we do not restructure the current running of the NHS, it will struggle to cope with future demands, particularly those of our ageing population. Audit Scotland tells us that the proposed integrated health and social care system is in jeopardy because the Government has so far failed to focus on long-term planning.

Scotland needs a process that involves all political parties and gets beyond the silo mentality that hitherto has hindered co-operation between different professional groups. That is why we are very supportive of the Public Bodies (Joint Working) (Scotland) Bill, which provided a legal framework for the integration of health and social care, on which the future success of the NHS will depend.

We should listen to the advice of the medical and nursing royal colleges and take serious steps to move away from the traditional model of hospitals as the mainstay of the health service. It has been recognised for a long time that care in the home or as close to the home as possible for as long as possible is in the best interests of the health and wellbeing of our population, many of whom are now living into advanced old age with multiple and complex health problems. That point has been backed up by the Marie Curie charity’s recent report that indicates that the majority of those who die in Scottish hospitals would wish to die at home or in a homely setting.

Marie Curie also found that 11,000 people living with a terminal illness in Scotland who need palliative care do not have access to it at the present time. Moreover, from a financial point of view, it has been shown that to provide palliative care when needed would generate net savings of more than £4 million annually in Scotland, hence the charity’s plea for a clear commitment in the Government’s forthcoming strategic framework for action on palliative and end-of-life care to ensure that everyone with a palliative care need has access to it by 2020. I noted from a previous debate that the cabinet secretary is receptive to that.

We increasingly hear of staff shortages in both primary and secondary care due to an ageing workforce and recruitment and retention problems, and at all levels we hear of the need to pull together and work co-operatively along with patients to develop a sustainable service that will adapt to change and cope with the ever-increasing demands that are placed upon it.

Given the high numbers of GPs and nurses who are set to retire in the near future and the fact that not enough young blood is coming in to meet the demand, together with serious problems with the recruitment of carers within many of our communities, the pressures on the NHS and care services will continue to grow unless we introduce new initiatives to sustain them. All parties agree that we need more nurses and midwives, for instance, although we differ on how to pay for them. It is well known in the Parliament that we would pay for 1,000 more nurses by abolishing free prescriptions for people who can afford to contribute to their cost.

We absolutely agree that there has to be new thinking on how to overcome existing problems and deliver a sustainable NHS into the future, and that that will be achieved only if we put the outcomes for patients at the core of our planning and all interested parties work together in an integrated way to make the best use of the available resources to secure a viable future for a service that is treasured by every one of us.

I close by restating how grateful we are to NHS and care services staff and emphasising our commitment to protect the NHS. I quote the medical and nursing royal colleges:

“The time for talking and political point scoring has passed. We need to take practical action, together, now.”

I look forward to that. We will support the motion and the Government’s amendment.