Chamber
Plenary, 09 May 2002
09 May 2002 · S1 · Plenary
Item of business
Nurses
Another week, another health debate, and this week another health minister, too. I welcome this debate on recruiting, retaining and valuing nurses, given that nurses provide 80 per cent of direct patient care. I must apologise, Presiding Officer, because I have to leave early to catch a train for the three-and-a-half-hour journey to Inverness, so I am afraid that I shall have to leave after my speech.
In speaking to my amendment, I note that the information and statistics division figures for 2000 show that nursing and midwifery staff numbers have fallen by 244 since Labour came to power and that hospital nurse numbers are down by 740. It is interesting to note that the new nurse numbers are due out tomorrow, as the minister said, and it would have been more appropriate to have this debate next week in the light of the latest figures.
Understaffing and sickness levels lead to even more pressure for existing staff, which affects nurse retention and morale. That problem is exacerbated by the fact that half of school nurses, practice nurses and health visitors are eligible to retire within the next decade. That is serious in itself, but it is even more serious given the predicted demographic patterns for elderly people and the need for more care at home.
Too often we hear, as we heard from the SNP today, that the NHS is too rigid in employing staff, and nurses are no exception. However, I give credit to Highland NHS Board, which seems at least to be facing up to the issue. In last week's Inverness Courier, I noticed an advertisement for a research nurse at grade E for 15 hours a week, staff nurses at grade D for 15 hours and 20 hours a week, and a nursing auxiliary for 15 hours a week. That is the kind of flexibility and family-friendly policy that we have all been asking for to bring back the many trained and experienced nurses who are not currently working in the NHS.
I also noted the pay scales for a nurse at grade E—from £17,000 to £20,000—and I could not help noticing the post that was advertised at the bottom of the group, for an audio typist
"providing secretarial cover throughout the Directorate, moving between the General Office, Medical Secretaries Office, Clinical Genetics Department and Nursing Administration."
The salary for that full-time post was £9,000 to £11,000. Although I fully support the emphasis on recruiting, retaining and valuing nurses, let us not forget the whole NHS team, including essential administration, secretarial and laboratory staff. Let us bear it in mind that one of the Beatson consultants cited the fact that he had to do his own typing as one of the reasons for walking out. Nurses are at the forefront of breaking down restrictive practices and old-style professional boundaries. They are prepared to take on more responsibilities and are capable of doing so, but we should not take advantage of their good will and commitment to care.
Recently, more emphasis has been placed on specialist nurses for multiple sclerosis, epilepsy, asthma and diabetes. At a recent Health and Community Care Committee meeting, Dr Roberts, a neurologist from Ninewells hospital, stressed the need for more specialist epilepsy nurses for counselling and support. That would also help to free up consultant time for crucial diagnosis and assessment of new patients. However, it is a matter of concern that 20 per cent of specialist asthma nurses do not hold the appropriate qualification. I welcome the additional money that has been allocated today for training, because we cannot expect nurses to take on more responsibilities without giving them the training and support that they need to carry them out.
Last week, nurse shortages in Orkney led to the proposal to close Macmillan House, which caters for terminally ill cancer patients, and St Magnus day hospital, which offers rehabilitation for patients such as stroke victims. In a large city, there is a larger pool of qualified staff for bank and agency nursing. In Orkney and other remote areas and islands, the flexibility simply does not exist.
The proposed closure has been averted temporarily, but the decision arose following staff resignations and retirements that coincided with training sessions for five nurses on family health nursing. I have spoken to the local member, who has stated his concerns and, I understand, has spoken to the Minister for Health and Community Care. I quote from The Orcadian on 25 April, when the Stromness doctors said:
"The staff retention, recruitment, job security, educational needs and working conditions have been consistently ignored by senior management of NHS Orkney with the inevitable results that we now see."
Ironically, there was no shortage of Macmillan nurses, but they were moved to acute wards.
The Orkney crisis could be replicated elsewhere in Scotland if we do not tackle nursing shortages. All parts of the NHS team need to be valued, not only nurses.
I move amendment S1M-3078.2, to leave out from "and supports" to end and insert:
"notes with concern, however, the recent decrease in nurse numbers; acknowledges that better staffing levels and conditions will lead to better morale and therefore higher levels of nurse retention, and therefore urges the Scottish Executive to promote a more flexible system that would recruit and retain appropriate numbers of nurses and midwives to serve Scotland's needs."
In speaking to my amendment, I note that the information and statistics division figures for 2000 show that nursing and midwifery staff numbers have fallen by 244 since Labour came to power and that hospital nurse numbers are down by 740. It is interesting to note that the new nurse numbers are due out tomorrow, as the minister said, and it would have been more appropriate to have this debate next week in the light of the latest figures.
Understaffing and sickness levels lead to even more pressure for existing staff, which affects nurse retention and morale. That problem is exacerbated by the fact that half of school nurses, practice nurses and health visitors are eligible to retire within the next decade. That is serious in itself, but it is even more serious given the predicted demographic patterns for elderly people and the need for more care at home.
Too often we hear, as we heard from the SNP today, that the NHS is too rigid in employing staff, and nurses are no exception. However, I give credit to Highland NHS Board, which seems at least to be facing up to the issue. In last week's Inverness Courier, I noticed an advertisement for a research nurse at grade E for 15 hours a week, staff nurses at grade D for 15 hours and 20 hours a week, and a nursing auxiliary for 15 hours a week. That is the kind of flexibility and family-friendly policy that we have all been asking for to bring back the many trained and experienced nurses who are not currently working in the NHS.
I also noted the pay scales for a nurse at grade E—from £17,000 to £20,000—and I could not help noticing the post that was advertised at the bottom of the group, for an audio typist
"providing secretarial cover throughout the Directorate, moving between the General Office, Medical Secretaries Office, Clinical Genetics Department and Nursing Administration."
The salary for that full-time post was £9,000 to £11,000. Although I fully support the emphasis on recruiting, retaining and valuing nurses, let us not forget the whole NHS team, including essential administration, secretarial and laboratory staff. Let us bear it in mind that one of the Beatson consultants cited the fact that he had to do his own typing as one of the reasons for walking out. Nurses are at the forefront of breaking down restrictive practices and old-style professional boundaries. They are prepared to take on more responsibilities and are capable of doing so, but we should not take advantage of their good will and commitment to care.
Recently, more emphasis has been placed on specialist nurses for multiple sclerosis, epilepsy, asthma and diabetes. At a recent Health and Community Care Committee meeting, Dr Roberts, a neurologist from Ninewells hospital, stressed the need for more specialist epilepsy nurses for counselling and support. That would also help to free up consultant time for crucial diagnosis and assessment of new patients. However, it is a matter of concern that 20 per cent of specialist asthma nurses do not hold the appropriate qualification. I welcome the additional money that has been allocated today for training, because we cannot expect nurses to take on more responsibilities without giving them the training and support that they need to carry them out.
Last week, nurse shortages in Orkney led to the proposal to close Macmillan House, which caters for terminally ill cancer patients, and St Magnus day hospital, which offers rehabilitation for patients such as stroke victims. In a large city, there is a larger pool of qualified staff for bank and agency nursing. In Orkney and other remote areas and islands, the flexibility simply does not exist.
The proposed closure has been averted temporarily, but the decision arose following staff resignations and retirements that coincided with training sessions for five nurses on family health nursing. I have spoken to the local member, who has stated his concerns and, I understand, has spoken to the Minister for Health and Community Care. I quote from The Orcadian on 25 April, when the Stromness doctors said:
"The staff retention, recruitment, job security, educational needs and working conditions have been consistently ignored by senior management of NHS Orkney with the inevitable results that we now see."
Ironically, there was no shortage of Macmillan nurses, but they were moved to acute wards.
The Orkney crisis could be replicated elsewhere in Scotland if we do not tackle nursing shortages. All parts of the NHS team need to be valued, not only nurses.
I move amendment S1M-3078.2, to leave out from "and supports" to end and insert:
"notes with concern, however, the recent decrease in nurse numbers; acknowledges that better staffing levels and conditions will lead to better morale and therefore higher levels of nurse retention, and therefore urges the Scottish Executive to promote a more flexible system that would recruit and retain appropriate numbers of nurses and midwives to serve Scotland's needs."
In the same item of business
The Presiding Officer (Sir David Steel):
NPA
The next item of business is a debate on motion S1M-3078, in the name of Malcolm Chisholm, on action to recruit, retain and value nurses, and two amendments ...
The Minister for Health and Community Care (Malcolm Chisholm):
Lab
The delivery of health services for patients requires a combination of sustained investment and reform—investment in staff, equipment, facilities and new tre...
Tommy Sheridan (Glasgow) (SSP):
SSP
Will Malcolm Chisholm give way?
Malcolm Chisholm:
Lab
In a moment. I need to make more progress first.We want all those who qualify to secure employment within NHS Scotland, if they wish to do so. We have theref...
Tommy Sheridan:
SSP
My question relates specifically to nurses' bursaries. Given his experience of speaking at various conferences, the minister will surely accept that the bigg...
Malcolm Chisholm:
Lab
There will be a further increase in bursaries this year. I am aware of the issue that Tommy Sheridan raises, and I am sure that it will come up at the specia...
Brian Adam (North-East Scotland) (SNP):
SNP
Will the minister give way?
Malcolm Chisholm:
Lab
Time will not allow me to take an intervention. I have only one and a half minutes left.Flexibility is another key issue that has been raised at nursing conv...
Nicola Sturgeon (Glasgow) (SNP):
SNP
I thank nurses, midwives and health visitors for the enormous contribution that they make to patient care and the national health service. I also pay tribute...
Mary Scanlon (Highlands and Islands) (Con):
Con
Another week, another health debate, and this week another health minister, too. I welcome this debate on recruiting, retaining and valuing nurses, given tha...
Mrs Margaret Smith (Edinburgh West) (LD):
LD
I am pleased to speak in the debate to acknowledge the work that Scotland's nurses do in international nurses week and throughout the year, and to highlight ...
Brian Adam:
SNP
Will Margaret Smith give way?
Mrs Smith:
LD
I will not give way. I have no time. I have only five minutes.
Brian Adam:
SNP
There will be no debate if she does not give way.
The Deputy Presiding Officer (Mr George Reid):
SNP
Order.
Mrs Smith:
LD
In areas in which the Scottish Executive has the power to make a positive difference to conditions, it has been listening to the RCN's campaign and has made ...
The Deputy Presiding Officer:
SNP
We now come to the open debate. We are obviously tight for time, but I will allow speeches of four minutes with some extra time for interventions.
Sarah Boyack (Edinburgh Central) (Lab):
Lab
I agree with other members that it is highly appropriate for us to hold this debate during international nurses week. Since 1997, Labour has delivered 20,000...
Nicola Sturgeon:
SNP
Will Sarah Boyack give way?
Sarah Boyack:
Lab
No, thank you, Ms Sturgeon. Those concerns are a legacy of what the Tories did to the health service. The recent pronouncements of Liam Fox show the Tories' ...
Ben Wallace (North-East Scotland) (Con):
Con
Will the member take an intervention?
Sarah Boyack:
Lab
I will take a brief intervention.
Ben Wallace:
Con
How does Ms Boyack reconcile her fine words and the fine words of the Scottish Executive with the fact that the chancellor will take £5.8 million out of the ...
Sarah Boyack:
Lab
I have not met any nurse who is unhappy about the massive increase that everyone recognises is going into the NHS. We need to talk up the fact that the money...
Mr Kenneth Gibson (Glasgow) (SNP):
SNP
Nurses now take on greater roles and greater responsibilities than ever before, but the average age of nurses is increasing. The average age in Scotland is n...
Mr Jamie McGrigor (Highlands and Islands) (Con):
Con
The contribution that our nurses make to our health care system is phenomenal. They are the backbone of the NHS and without them the NHS would crumble. There...
Brian Fitzpatrick (Strathkelvin and Bearsden) (Lab):
Lab
Jamie McGrigor's contribution—or perhaps what was omitted from it—speaks volumes about the lack of consensus in Scotland on sustained and rising investment i...
Alex Neil (Central Scotland) (SNP):
SNP
Members of all parties have produced statistics on a variety of issues, such as the number of nurses who leave the profession, the number of nursing students...
Donald Gorrie (Central Scotland) (LD):
LD
I will concentrate on two points—job satisfaction and prisons. Three things make a job worth having and attract people to it: pay and conditions; the public ...
Janis Hughes (Glasgow Rutherglen) (Lab):
Lab
I declare an interest as a member of Unison. As a nurse, I am delighted to speak in today's debate. During my years in the health service, I considered mysel...