Chamber
Plenary, 28 Nov 2001
28 Nov 2001 · S1 · Plenary
Item of business
Community Care and Health (Scotland) Bill: Stage 1
My quote came from the Official Report.
Page 67 of the Sutherland report states that personal care
"falls within the internationally recognised definition of nursing, but may be delivered by many people who are not nurses, in particular by care assistants employed by social services departments or agencies."
Therefore, if personal care is nursing care and Westminster has decided to pay for nursing care with no argument over attendance allowances, we have to ask whether older people in Scotland are getting a raw deal or a different deal from older people in England. I ask the minister to address and clarify that point when he is summing up.
My next point highlights the most recent figure of 2,954 people who remain in hospital beds despite being assessed as requiring care in the community, at home, in a residential home or in supported accommodation. In February 1999, three months before the start of Parliament, the bed-blocking or delayed discharge figure was 1,724. Despite various initiatives and commitments, as well as a few million pounds here and there, the latest figure of almost 3,000 people highlights that major issue.
This week, I was at a meeting at NHS Highland with my colleagues Rhoda Grant and John Farquhar Munro. We were told that children were writing to the hospital to ask why their grandparents were being kept in hospital when they were being told that they should be cared for at home.
We welcome the emphasis on outcomes rather than budgets. However, point 66 of the policy memorandum refers to cases of failure in joint working and states:
"where the expected service outcomes are not being delivered … Ministers will be able to use this power to require that local authorities and NHS bodies adopt certain key principles, such as a single management structure, with a single budget".
Why should we wait for failure when we already have well-documented failure? The case for a single budget is well made—it was recommended in the Health and Community Care Committee report. That issue must be addressed now.
More worrying statistics were published recently in "Scottish Community Care Statistics 2000" and in the Accounts Commission's review of home care services for older people, which was published last Friday. Between 1997 and 2000, the number of people seen by health visitors fell by 49,800. Between 1998 and 2000, the number of people who received home care fell by more than 9,000. Between 1999 and 2000, the number of people seen by a district nurse fell by 13,300. The number of people attending day centres and the number of people in residential homes were also down.
In a written response to those figures, the minister stated:
"recent changes in practice include increased activity in clinic-based settings".
In fact, the Accounts Commission's report states that
"with national policy focusing on care at home rather than institutional settings",
the facts and the figures prove that the opposite is true. The national review revealed a different picture to Government policy.
We know the problems and we have the time, so we should address them and get the matter right.
Page 67 of the Sutherland report states that personal care
"falls within the internationally recognised definition of nursing, but may be delivered by many people who are not nurses, in particular by care assistants employed by social services departments or agencies."
Therefore, if personal care is nursing care and Westminster has decided to pay for nursing care with no argument over attendance allowances, we have to ask whether older people in Scotland are getting a raw deal or a different deal from older people in England. I ask the minister to address and clarify that point when he is summing up.
My next point highlights the most recent figure of 2,954 people who remain in hospital beds despite being assessed as requiring care in the community, at home, in a residential home or in supported accommodation. In February 1999, three months before the start of Parliament, the bed-blocking or delayed discharge figure was 1,724. Despite various initiatives and commitments, as well as a few million pounds here and there, the latest figure of almost 3,000 people highlights that major issue.
This week, I was at a meeting at NHS Highland with my colleagues Rhoda Grant and John Farquhar Munro. We were told that children were writing to the hospital to ask why their grandparents were being kept in hospital when they were being told that they should be cared for at home.
We welcome the emphasis on outcomes rather than budgets. However, point 66 of the policy memorandum refers to cases of failure in joint working and states:
"where the expected service outcomes are not being delivered … Ministers will be able to use this power to require that local authorities and NHS bodies adopt certain key principles, such as a single management structure, with a single budget".
Why should we wait for failure when we already have well-documented failure? The case for a single budget is well made—it was recommended in the Health and Community Care Committee report. That issue must be addressed now.
More worrying statistics were published recently in "Scottish Community Care Statistics 2000" and in the Accounts Commission's review of home care services for older people, which was published last Friday. Between 1997 and 2000, the number of people seen by health visitors fell by 49,800. Between 1998 and 2000, the number of people who received home care fell by more than 9,000. Between 1999 and 2000, the number of people seen by a district nurse fell by 13,300. The number of people attending day centres and the number of people in residential homes were also down.
In a written response to those figures, the minister stated:
"recent changes in practice include increased activity in clinic-based settings".
In fact, the Accounts Commission's report states that
"with national policy focusing on care at home rather than institutional settings",
the facts and the figures prove that the opposite is true. The national review revealed a different picture to Government policy.
We know the problems and we have the time, so we should address them and get the matter right.
In the same item of business
The Presiding Officer (Sir David Steel):
NPA
Our next item of business is a debate on motion S1M-2247, in the name of Susan Deacon, on the general principles of the Community Care and Health (Scotland) ...
The Minister for Health and Community Care (Malcolm Chisholm):
Lab
There have been many significant developments in community care in this Parliament's lifetime, and the Community Care and Health (Scotland) Bill marks a furt...
Nicola Sturgeon (Glasgow) (SNP):
SNP
I welcome the new minister to his post and wish him well in the job. I congratulate the two new deputy health ministers, although it is perhaps appropriate t...
Mary Scanlon (Highlands and Islands) (Con):
Con
Does the member recognise that all 19 Conservatives voted in favour of free personal care? Will she endorse that fact?
Nicola Sturgeon:
SNP
I accept that, but it was the 19 years that preceded those 19 votes that led to me to make that judgment about the Conservative party. The real threat to fre...
Mary Scanlon (Highlands and Islands) (Con):
Con
I congratulate the new minister. That he has gone from being a member of the Health and Community Care Committee and back-bench rebel to Minister for Health ...
Malcolm Chisholm:
Lab
I want to point out that that was not correctly transcribed because, if members think about it, what I said was that free personal care could be regarded as ...
Mary Scanlon:
Con
My quote came from the Official Report.Page 67 of the Sutherland report states that personal care"falls within the internationally recognised definition of n...
Malcolm Chisholm:
Lab
I am sure that the member will accept that clinics are hardly an institutional setting. Does she accept that not only the number of visits but their length a...
Mary Scanlon:
Con
I welcome the minister's point about increases in funding, but as I think all members of the Health and Community Care Committee have said, we are looking fo...
Mrs Margaret Smith (Edinburgh West) (LD):
LD
I welcome Malcolm Chisholm to his new job as Minister for Health and Community Care. As Nicola Sturgeon said, that is one of the most difficult jobs in Gover...
The Deputy Presiding Officer (Mr George Reid):
SNP
We move now to open debate. Sir David announced that time would be tight, but some speakers have dropped out since then, so I shall allow up to five minutes ...
Margaret Jamieson (Kilmarnock and Loudoun) (Lab):
Lab
I record my congratulations to Malcolm Chisholm, Mary Mulligan and Hugh Henry on their appointments, and I look forward to working with them in the coming mo...
Tricia Marwick (Mid Scotland and Fife) (SNP):
SNP
I congratulate Malcolm Chisholm on his appointment. We have known each other for a long time in different roles and I am sure that he will bring to the job h...
Janis Hughes (Glasgow Rutherglen) (Lab):
Lab
I echo the comments that have been made elsewhere in the chamber and offer my congratulations to Malcolm Chisholm and to the two new Deputy Ministers for Hea...
Bill Aitken (Glasgow) (Con):
Con
When this matter was first debated, there was a consensus that the bill was an important piece of legislation. It is a sad fact that none of us is getting an...
Dorothy-Grace Elder (Glasgow) (SNP):
SNP
I do not know why Bill Aitken is so worried about blank cheques. He knows perfectly well that one has been issued to pay for the new Parliament. Anything tha...
Nora Radcliffe (Gordon) (LD):
LD
I congratulate the new health team, wish them well in their work and pay tribute to Susan Deacon for her contribution as our first Minister for Health and Co...
Irene Oldfather (Cunninghame South) (Lab):
Lab
I offer my congratulations to the new minister and his two deputies. I also extend my good wishes to Susan Deacon. As Margaret Smith said, two of the three m...
Alex Fergusson (South of Scotland) (Con):
Con
I take part in the debate with great personal pleasure. That is partly because, as I am now on the wrong side of 50, I am keen to ensure that as much as poss...
Colin Campbell (West of Scotland) (SNP):
SNP
I want to reiterate the point made anent the £20 million attendance allowances that are being held back by the UK Exchequer, to which the people of Scotland ...
Ben Wallace (North-East Scotland) (Con):
Con
If Scotland was independent, will Mr Campbell tell us where he would find the £20 million? Whom would he tax to get the £20 million to provide free personal ...
Colin Campbell:
SNP
We have already paid the money in tax to the United Kingdom Exchequer; it is sitting there as part of the totals that we have already paid in. Good try, Mr W...
The Deputy Presiding Officer:
SNP
If members want their time to be extended, permission will gladly be given on this occasion.
Karen Whitefield (Airdrie and Shotts) (Lab):
Lab
I add my congratulations to Malcolm Chisholm and his two new deputies. I wish them well in their new role. I pay tribute to the work of Susan Deacon, our for...
Mr Keith Raffan (Mid Scotland and Fife) (LD):
LD
I welcome the minister to his new post. When I first became a spokesman on health, there seemed to be at least two health debates a week. I was thrown in at ...
Members:
Go on.
The Deputy Presiding Officer:
SNP
Order. Carry on, Mr Raffan.
Mr Raffan:
LD
A lot has happened since then, not least in the past few days—so that period is almost pre-history. We have come a long way since the Minister for Parliament...
Nicola Sturgeon:
SNP
Will the member give way?