Official Report search · Parliament Workbench

Chamber

Plenary, 25 Apr 2002

25 Apr 2002 · S1 · Plenary

Item of business

Primary Health Care

Scanlon, Mary Con Highlands and Islands Watch on SPTV

I am pleased that the minister agrees with some of what I said.

The minister said that he is passionately committed to primary care. GPs in the Highlands are so passionate about his commitment to primary care that 10 per cent of them have walked out in recent years. None of them says that they need a golden hello payment or an extra few quid a year. Those have never been reasons for leaving. I value the primary care modernisation group report and the fact that the minister intends to listen to GPs, but if he thinks the matter is simply about golden hello payments, he has missed the mark.

I welcome the minister's endorsement of best practice becoming common practice and of the excellent work that is done in Dumfries and Galloway's managed clinical network for heart disease. My colleague David Mundell lodged a motion on that topic. He visited GPs and others who are involved and brought the matter to my attention. Many Conservative and SNP members have signed the motion, but not one member of the Labour party has done so. When we find excellent practice, which is endorsed in the modernisation group report, the minister should be big enough to ask his party members to support it.

One aspect that was missing from the minister's comments on one-stop shops in primary care was the voluntary sector, which has an enormous role. This week, I spoke to a representative of the Church of Scotland. Its work on drug problems and alcoholism—from detoxification and rehabilitation through to rehousing and support accommodation—should be welcomed. I hope that the minister will find a place in the new structure for the excellent work of the voluntary sector.

Before I begin the main part of my speech, I will deal with the joint future group. At yesterday's meeting of the Health and Community Care Committee, we were told that Edinburgh alone has 527 blocked beds, which has an obvious impact on the acute sector, patients and the primary sector. Although the minister talks about joint futures, joint working and partnership, we must consider the reality that, of Scotland's 3,000 blocked beds, 527 are in this city.

I am pleased that we are debating primary care. As a member for the Highlands, I can certainly confirm that primary care is in crisis. The Executive's reforms of the past five years have created the crisis. Dr Murray of Lochcarron described the provision of health care in rural areas as being in a state of near collapse. It is now impossible to register as an NHS patient with a dentist in Inverness and in most parts of the Highlands but, on the east coast of Caithness and Sutherland, it is becoming almost as difficult to access a local doctor. With 139 vacancies for dentists in Scotland and more than one third of GPs in their 50s, manpower planning is in serious crisis.

Like the SNP, we would support more nurse-led care, but those nurses must be appropriately trained for the responsibilities that they undertake. According to the National Asthma Campaign, 20 per cent of nurses who currently run asthma clinics do not have the appropriate qualifications. At yesterday's RCN conference, we heard via videolink that many nurses have difficulties in accessing training funds. If we expect nurses to do more, we must give them the support and training.

In the Highlands, many people with epilepsy have never seen a specialist and have never been given an accurate diagnosis. Many of them have been on the same medication for years, despite the new and more effective drugs that are now available. I agree that we should bring primary care into the health care team because it has an enormous role to play, but we need to ensure that budgets are available for training. We must also ensure that accurate diagnoses are carried out, in particular for neurological problems, before embarking on continuing care.

We support the placing of chronic disease management of diabetes, asthma, epilepsy and mental health within primary care, but we do so only with the proviso that there must be proper support. According to the RCN, fewer than four in 10 nurses feel that their employer enables them to keep pace with developments related to their job. Physicians and consultants have in many cases accessed the training fund, but I hope that equal access to training will be allowed to nurses.

On the radio this morning, the health minister said that things that could be done in primary care should be done in primary care, but the minister should acknowledge the truth that, under GP fundholding, things were increasingly being done in primary care. I hope that the devolution of budgets to the LHCCs will enable and empower them to utilise the skills and experience of the primary care teams.

The minister also mentioned that no new money would be made available for primary care this year and that he has set out the direction. By the time the minister decides to allocate extra funds to GPs in primary care, it might just be too late.

Search Hansard contributions

Plenary, 25 Apr 2002

In the same item of business