Meeting of the Parliament 25 June 2015
I thank Jim Eadie for securing a debate on this important subject. The topic is highly important in its own right but, in many ways, it is symbolic of the whole area of preventative spend, which I will concentrate on.
I must say that, as a Glasgow MSP, I do not always support motions that start with the words:
“That the Parliament congratulates Edinburgh”.
However, I will make an exception today.
We can come at the subject from different angles and take, say, a health or Edinburgh focus on it. I will take a finance angle, not least because the Finance Committee, of which I am a member, has spent a considerable amount of time thinking about preventative spending. Whenever we discuss the subject, we find that family nurse partnerships are one of the most common examples that are given. Indeed, this was the major topic at a recent round-table event at the University of Edinburgh in which the committee took part.
If we as a Parliament and as a country are serious about spending money in the earlier years to save it later, family nurse partnerships are exactly the kind of thing that we need to be doing. As the preceding two speakers made clear, if a child gets a better start in life, they will not be so far behind when they start school, they are less likely to be in trouble in their teenage years and they are more likely to do well in later life. I think that we are all signed up to the concept; I certainly sense a lot of agreement on the issue when we MSPs are in smaller groups at committee meetings and are, perhaps, behaving more sensibly.
As I understand it, the FNP programme has tightly defined rules—albeit that, as we have heard, it has a certain flexibility. It deals with a specific group of young mothers and has been well analysed, especially in the United States.
One of the challenges that we face is whether we can move more resources into the early years—whether that means FNPs or other programmes—because that means moving resources away from more reactive forms of expenditure. For example, in the health field, we might think of moving resources away from hospitals and into community and preventative programmes. That is where it becomes more difficult to gain consensus, especially when we get together in the combative atmosphere of the chamber. Are we really happy for some hospitals to be closed to free up resources for young families in the community? Are we happy to let accident and emergency waiting times rise to let general practitioners spend more time with their patients?
I thank the Royal College of Nursing for its briefing for today’s debate, in which it, too, highlights the tension on where resources should go and refers in particular to resources, staffing and the professional back-up that is required for the FNP programme. The RCN is particularly concerned that the wider health visiting service is stretched and competing for the same resources. The question that it raises is valid. In the final paragraph of its briefing, it says:
“So that no children fall through the gaps, the RCN believes that the Scottish Government should ensure Scotland has adequate health visitors, in addition to FNP nurses.”
As a result, we should be putting more emphasis on FNP nurses and health visitors, given that both are based very much in the community.
As for where the resources would come from, I presume that they would come from reducing resources for hospitals. I note that in the statement entitled “Building a more sustainable NHS in Scotland: Health professions lead the call for action”, which has already been debated in the chamber, the RCN said:
“the focus has remained firmly on the traditional model of hospitals as the mainstay of the health service. This needs to change.”
As the motion says, we congratulate Edinburgh and commend the valuable work undertaken by family nurse partnerships in Lothian and across Scotland, and I very much hope that we can continue building on this example by disinvesting from our more reactive services and investing more at the preventative end.