Meeting of the Parliament 28 September 2016
Of course we should put more money into preventative spend, but John Mason’s intervention is interesting. He had an opportunity to intervene to say that he believes that we should protect the hospital that protects his constituents, but instead he chose to make a different point. It is important to stand up and represent the individuals, families and communities who sent us to this place to represent them.
I want to talk briefly about what constitutes a major service change, because it is certainly not clear or consistent. Given that, rightly, the removal of a children’s ward is deemed to be a major service change, how can the closure of a whole hospital be deemed minor?
The Scottish Government’s amendment references the role of the Scottish Health Council in what constitutes a major service change, but its guidance is clear. It states:
“The decision on whether a service change should be regarded as major ultimately rests with Scottish Ministers.”
Furthermore, the Scottish Government’s own guidance states that health boards should
“seek advice from the Scottish Government Health Directorate ... on whether a service change is considered to be major”.
It continues:
“for those that are, Ministerial approval on the Board’s decision will be required.”
That is an important point. In our system, the Cabinet Secretary for Health and Sport is responsible for the health service. The buck stops with Shona Robison, and she is accountable to this Parliament. That is why it is vital that the cabinet secretary calls in the proposals, so that all members of this Parliament, representing their different communities and constituencies, can ensure that all the various voices are heard.
That is what was reflected in the proposed Liberal Democrat amendment, which was not selected. I support its sentiment. It set out the importance of democratic accountability and responsibility in our health service, which the Government seeks to avoid in its amendment. Indeed, I would go further and say that it would be a democratic outrage if we allowed health boards to proceed with these decisions without individual members, this Parliament or indeed the cabinet secretary having a say.
Ministers should be free to say whether they do or do not support the proposed changes. What is particularly frustrating for campaigners is that the cabinet secretary is saying nothing at all. Her position is spectacularly unclear. If the cabinet secretary opposes any of the proposed changes, she should say so and thereby remove the concerns of local families and campaigners.