Meeting of the Parliament 19 November 2025
I thank my friend and colleague Finlay Carson for securing the debate, which I have been listening to intently. I did not map out a speech—I thought that I would just listen to what everybody had to say—but I will draw members’ attention to an issue that happened with one of my constituents, which I think highlights exactly what we are talking about today.
An elderly constituent approached me after a change in policy in rural Lanarkshire. He must get a vitamin B injection every 12 weeks. Previously, that was done at his local GP surgery, which was a 10-minute walk from his home. Following the changes, my constituent—who is on the NHS waiting list for a double knee replacement, which affects his mobility—must now make an appointment with a GP to get his prescription, take the prescription to the pharmacy, then phone his closest community treatment and care service, which is in Larkhall, to make an appointment for the injection, and then take a three-hour round-trip journey on a bus that he reports does not run according to the timetable. What used to take a single appointment at his GP now takes him days.
When we asked NHS Lanarkshire what could be done to reduce the journey that my constituent must undertake in order to get a simple, routine injection, the advice was that he could join a self-administration pilot or select a closer treatment service. Neither option is patient centred or able to produce a good patient outcome in this case. The fact is that there are no closer treatment services that do injections, and he does not feel confident enough to self-administer.
I have listened to colleagues across the chamber, and particularly note what Douglas Ross said about the trauma that his constituent suffered. It strikes me that this issue is not just about poor patient outcomes, which is the most important thing, but is also about waste. What a waste all of this is in a system that is crying out for investment. When we talk about the need to clear out the waste and redistribute resources to the front line, the issues that have been raised today are exactly what we are talking about.
On the issues of health and how healthcare is delivered, I think that we should be looking at how we deliver the basic services to people across Scotland, no matter whether they live in rural or urban areas or on the islands, or what the demographics of that area are. People should be able to readily access their GPs, dentists, A and E departments, pharmacy services and—certainly—maternity services. However, the reality is that delivery in urban areas will be different from delivery in rural areas and on our islands. We have to take cognisance of that, because the reality is that that basic level of service has to apply across all our communities. Most people who live in a rural area will accept that they will have to travel for specialist treatment such as a knee or hip replacement. However, they should not have to accept that we do not get the very basics of healthcare right.
I am a big advocate of the adoption and development of technology, including artificial intelligence. That approach would positively affect rural areas and islands to a greater extent than urban areas. That is one of the major solutions.
We cannot just talk about health in isolation; we need to look at other services. Education is part of health, as is access to leisure services and the community participation that is associated with those facilities, which Craig Hoy talked about. Of course, in many ways, the problems that we face in relation to health are the same as those that we face in relation to those issues.
When I think of the south of Scotland, I can see that transport by rail and road are also part of the solution, because we are talking about creating communities that are sustainable and that offer good local services and give people opportunities to be part of those communities. Trying to apply urban solutions to rural areas and islands just will not work.
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