Chamber
Plenary, 26 May 2005
26 May 2005 · S2 · Plenary
Item of business
National Health Service<br />(Age Discrimination)
Today's debate comes at an appropriate time in the wake of yesterday's publication of the Kerr report, which indicates a way forward for the NHS for the next 20 years. The NHS of the future is going to have to cope with a greatly increased number of elderly people, many of whom will be very elderly and frail. From 17.9 per cent in 1998, the elderly are expected to make up 24 per cent of the population by 2036. Several of us here, myself included, will be in that group. People are now living longer than at any other time in history. Many are healthy and active well into their eighth or ninth decade and many more are looked after with varying amounts of support in their local communities. By the time that they reach hospital, they tend to be very frail, with the complications of longevity, such as thin bones and dementia.
The people in that section of society, more than in any other, rely on appropriate and accessible health care. However, we know that older people have encountered significant problems with hospital care that range from delays in admission, poorly planned discharge and poor nutrition and hygiene care to the negative attitudes of or poor communication from hospital staff. We have also heard of incidents of abuse of the elderly, which can be physical or verbal or simply a case of failing to treat older people with the dignity and respect that they deserve.
Although the situation in some hospital wards is excellent, that is unfortunately not always the case. Various recent press stories have highlighted examples of the bad situations. I realise that the quality of care for older people in hospital is variable and that problems can occur in almost every aspect of a hospital stay, but patients and their relatives have highlighted several problems again and again. There is often a lack of assistance with eating and drinking. Young and even older members of staff can be abrupt or rude and, in the worst cases, patients' needs are ignored. Particularly vulnerable people such as those with dementia or those from ethnic minorities sometimes receive scant understanding of their needs. Older people often feel that, when decisions are taken about their care or treatment, their opinions are ignored or are not sought. It is all too easy for busy hospital staff to talk over or talk down to a frail elderly patient who might be visually impaired or hard of hearing.
Indeed, I have personal family experience of those problems. My elderly uncle was admitted to hospital for the flimsiest of reasons and was then moved from ward to ward as his bed was required for other patients. He became immobile and picked up MRSA and his discharge was delayed for more than a year. During that time, his wife, who fell and broke her hip when she was visiting the hospital, also had a prolonged hospital stay and, sadly, died very suddenly of an unrelated problem on the day that she was due to be discharged. My uncle eventually settled into a nursing home for a short time; however, he fell there and broke his hip. Because of a delay in treating the fracture, he died of pneumonia. It is a fairly classic tale of inappropriate admission, hospital-acquired infection, bed blocking and postponement of treatment for a hip fracture.
There is no excuse for the incidents of neglect by hospital staff of basic care needs such as eating and bathing that were reported recently in the Edinburgh Evening News. However, as long as we have a situation in which inadequate numbers of hard-pressed staff are being rushed off their feet to chase targets that have been set by central Government, I cannot see how matters can be resolved easily. That said, the hospitals and health boards that are involved should investigate such cases very carefully and take what steps they can to protect patients in future. We welcome the review in Lothian and hope that any lessons that are learned from it will be rolled out across Scotland.
We need to examine the issue of abuse of the elderly, which my colleague David Davidson has suggested to the Health Committee should be considered as part of the forthcoming post-legislative scrutiny of the Community Care and Health (Scotland) Act 2002.
At any one time, two thirds of hospital beds are occupied by patients over the age of 65. A number of them do not need to be there and would be far more appropriately treated in the community. However, wherever they are, they should be treated with respect and dignity at all times. There is no excuse for doing otherwise.
I move amendment S2M-2861.1, to leave out from "and believes" to end and insert:
"believes that the Health Committee should consider the issue of elderly abuse in its post-legislative scrutiny of community care legislation; further believes that any neglect of the elderly reflects the current problems and workforce pressures that the NHS suffers from, and recognises that the NHS needs real reform to alleviate these fundamental problems."
The people in that section of society, more than in any other, rely on appropriate and accessible health care. However, we know that older people have encountered significant problems with hospital care that range from delays in admission, poorly planned discharge and poor nutrition and hygiene care to the negative attitudes of or poor communication from hospital staff. We have also heard of incidents of abuse of the elderly, which can be physical or verbal or simply a case of failing to treat older people with the dignity and respect that they deserve.
Although the situation in some hospital wards is excellent, that is unfortunately not always the case. Various recent press stories have highlighted examples of the bad situations. I realise that the quality of care for older people in hospital is variable and that problems can occur in almost every aspect of a hospital stay, but patients and their relatives have highlighted several problems again and again. There is often a lack of assistance with eating and drinking. Young and even older members of staff can be abrupt or rude and, in the worst cases, patients' needs are ignored. Particularly vulnerable people such as those with dementia or those from ethnic minorities sometimes receive scant understanding of their needs. Older people often feel that, when decisions are taken about their care or treatment, their opinions are ignored or are not sought. It is all too easy for busy hospital staff to talk over or talk down to a frail elderly patient who might be visually impaired or hard of hearing.
Indeed, I have personal family experience of those problems. My elderly uncle was admitted to hospital for the flimsiest of reasons and was then moved from ward to ward as his bed was required for other patients. He became immobile and picked up MRSA and his discharge was delayed for more than a year. During that time, his wife, who fell and broke her hip when she was visiting the hospital, also had a prolonged hospital stay and, sadly, died very suddenly of an unrelated problem on the day that she was due to be discharged. My uncle eventually settled into a nursing home for a short time; however, he fell there and broke his hip. Because of a delay in treating the fracture, he died of pneumonia. It is a fairly classic tale of inappropriate admission, hospital-acquired infection, bed blocking and postponement of treatment for a hip fracture.
There is no excuse for the incidents of neglect by hospital staff of basic care needs such as eating and bathing that were reported recently in the Edinburgh Evening News. However, as long as we have a situation in which inadequate numbers of hard-pressed staff are being rushed off their feet to chase targets that have been set by central Government, I cannot see how matters can be resolved easily. That said, the hospitals and health boards that are involved should investigate such cases very carefully and take what steps they can to protect patients in future. We welcome the review in Lothian and hope that any lessons that are learned from it will be rolled out across Scotland.
We need to examine the issue of abuse of the elderly, which my colleague David Davidson has suggested to the Health Committee should be considered as part of the forthcoming post-legislative scrutiny of the Community Care and Health (Scotland) Act 2002.
At any one time, two thirds of hospital beds are occupied by patients over the age of 65. A number of them do not need to be there and would be far more appropriately treated in the community. However, wherever they are, they should be treated with respect and dignity at all times. There is no excuse for doing otherwise.
I move amendment S2M-2861.1, to leave out from "and believes" to end and insert:
"believes that the Health Committee should consider the issue of elderly abuse in its post-legislative scrutiny of community care legislation; further believes that any neglect of the elderly reflects the current problems and workforce pressures that the NHS suffers from, and recognises that the NHS needs real reform to alleviate these fundamental problems."
In the same item of business
The Deputy Presiding Officer (Murray Tosh):
Con
We move, rather behind the clock, to the next item of business, which is a debate on motion S2M-2861, in the name of Shona Robison, on age discrimination in ...
Shona Robison (Dundee East) (SNP):
SNP
I thank the many families throughout Scotland that have written to me about the experience of their elderly relatives. It is because of their concerns that t...
The Deputy Minister for Health and Community Care (Rhona Brankin):
Lab
I welcome today's debate on the standards of care for older people in the NHS. We have published standards that are both high and equitable and we all expect...
Shona Robison:
SNP
I accept, as I am sure the minister does, that there are lots of documents that say what should be done. However, does she agree that the problem is that wha...
Rhona Brankin:
Lab
Clearly, there is no point in having standards if we do not ensure that those standards are met. That is the challenge that we face. NHS QIS was established ...
Mrs Nanette Milne (North East Scotland) (Con):
Con
Today's debate comes at an appropriate time in the wake of yesterday's publication of the Kerr report, which indicates a way forward for the NHS for the next...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
Coming a day after the publication of Professor David Kerr's report, this debate is opportune. After all, Professor Kerr's very first proposal is for"All NHS...
The Deputy Presiding Officer:
Con
We now come to the open debate. Time is very tight indeed and I ask members to make speeches of strictly four minutes.
Mr Stewart Maxwell (West of Scotland) (SNP):
SNP
It is a sad day when, despite the hard work of many decent and caring staff in the service, we have to debate the indignity and lack of care that some older ...
Carolyn Leckie (Central Scotland) (SSP):
SSP
It is absolutely right that we should have a debate about age discrimination in the NHS. It is well known that the NHS is plagued with inequalities and has b...
Richard Baker (North East Scotland) (Lab):
Lab
The provision of a high standard of health care is important to everyone in Scotland but particularly to our older people. The starting point for this debate...
Christine Grahame (South of Scotland) (SNP):
SNP
Will the member take an intervention?
Richard Baker:
Lab
I am sorry, but I have only four minutes.Older people are the most frequent users of NHS services. Day in and day out, hundreds of thousands of older people ...
John Swinburne (Central Scotland) (SSCUP):
SSCUP
I welcome the debate on Shona Robison's motion. Sadly, it reflects the lack of basic respect for the elderly that exists in our society and which manifests i...
Stewart Stevenson (Banff and Buchan) (SNP):
SNP
When we see discrimination against older citizens in the NHS, we often see a reflection of broader, societal discrimination against older people. I make no p...
Jackie Baillie (Dumbarton) (Lab):
Lab
In 25 years' time, there will be more people of retirement age in Scotland than there will be children. The biggest growth will be in the number of people wh...
Eleanor Scott (Highlands and Islands) (Green):
Green
Two separate and yet connected issues have been referred to in the debate: age discrimination and neglect of the elderly. As various members have pointed out...
The Deputy Presiding Officer (Trish Godman):
Lab
We move to winding-up speeches. I call Donald Gorrie and advise him that he has a tight four minutes.
Donald Gorrie (Central Scotland) (LD):
LD
I apologise for missing the first part of the debate. The pressure on members in trying to get agreement on amendments to legislation is unrelenting. There a...
The Deputy Presiding Officer:
Lab
You must finish now, Mr Gorrie.
Donald Gorrie:
LD
That would help to reduce the problem and change people's attitude. They would see how much older people can contribute.
Mary Scanlon (Highlands and Islands) (Con):
Con
It is sad indeed that we are discussing problems relating to the elderly, given the number of debates that we have held in the Parliament and the amount of l...
Rhona Brankin:
Lab
We have all listened carefully to the debate. The issue is emotive and hugely important and, as I said in my opening speech, there is absolutely no room for ...
Mary Scanlon:
Con
Will the minister give way?
Rhona Brankin:
Lab
I am sorry, but I do not have time.Let me respond to some specific points that were raised in the debate. Shona Robison referred to "Frontline Scotland" and ...
Christine Grahame (South of Scotland) (SNP):
SNP
First, I make it clear that Ms Robison has given her excuses to the Presiding Officer for not being here for the conclusion of the debate.I preface my main r...
Stewart Stevenson:
SNP
Surely not.
Christine Grahame:
SNP
They are as quirky as Andy Kerr and they are as different as Stewart Stevenson. By the way, he has now delivered his 200th speech. I do not know whether to w...