Chamber
Plenary, 26 May 2005
26 May 2005 · S2 · Plenary
Item of business
National Health Service<br />(Age Discrimination)
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 been for a very long time.
Like me, other members will have received a briefing paper from Help the Aged. It would be better if this debate and subsequent debates could be held in the context of a well-documented problem, rather than in the context of specific allegations. That does not allow due process and it pre-empts the outcome of any internal investigation. People have the right to natural justice before they are judged in this Parliament. I will therefore concentrate my remarks on the general and well-documented problems.
NHS staff provide excellent care despite the system and despite staff shortages. My amendment—which was not selected for debate—calls for urgent action to respond to the well-documented problems that we are all aware of. That urgent action means increasing staff numbers; it means providing better food; it means allowing more time for people to spend with patients; it means moving and handling equipment properly; it means continuing training; and it means back-filling to allow people to be released for training. Trade unions have been talking about all those problems for years and years.
David Kerr's report proposes a further massive shift to community care. However, we have to consider the proposal in the context of today's reality. People wait far too long for adaptations to their homes, for funding packages and for care home placements. I see that everywhere I go. The Kerr report documents the fact that the proportion of people who are elderly is increasing, yet it claims that it is cost neutral. I do not see how we can plan for more care in the community on the basis of the report.
The problem with nutrition in hospitals is also well documented. The problem is directly related to costs, to the privatisation of catering and to the well-documented lack of dieticians. There are not enough staff on the wards to ensure that meals are taken. Because of the systems used—particularly the privatisation of catering—meals are often too hot, and therefore unpalatable to frail and elderly people, or they are too cold. Frail and elderly people often require special diets, but those meals can be simply unpalatable.
Age discrimination spans several spheres. In my final minute, I want to concentrate on the structural and systemic discrimination that exists. For example, guidelines from the National Institute for Clinical Excellence allow certain medicines to be withdrawn from elderly patients specifically on the basis of age. NHS QIS has, I believe, recommended that that particular guideline be removed, and I want to know whether the Executive will enforce that recommendation.
As we know, knee and other orthopaedic operations are rationed in the NHS on the basis of age. What will the Executive do to stop that practice as soon as possible?
It is right that we are discussing such issues, but I would prefer action to be taken and not to hold more inquiries and more discussions. We do not need any more inquiries, because the problems are well documented. I would like action, and I ask the Executive to respond to the points that I have made.
Like me, other members will have received a briefing paper from Help the Aged. It would be better if this debate and subsequent debates could be held in the context of a well-documented problem, rather than in the context of specific allegations. That does not allow due process and it pre-empts the outcome of any internal investigation. People have the right to natural justice before they are judged in this Parliament. I will therefore concentrate my remarks on the general and well-documented problems.
NHS staff provide excellent care despite the system and despite staff shortages. My amendment—which was not selected for debate—calls for urgent action to respond to the well-documented problems that we are all aware of. That urgent action means increasing staff numbers; it means providing better food; it means allowing more time for people to spend with patients; it means moving and handling equipment properly; it means continuing training; and it means back-filling to allow people to be released for training. Trade unions have been talking about all those problems for years and years.
David Kerr's report proposes a further massive shift to community care. However, we have to consider the proposal in the context of today's reality. People wait far too long for adaptations to their homes, for funding packages and for care home placements. I see that everywhere I go. The Kerr report documents the fact that the proportion of people who are elderly is increasing, yet it claims that it is cost neutral. I do not see how we can plan for more care in the community on the basis of the report.
The problem with nutrition in hospitals is also well documented. The problem is directly related to costs, to the privatisation of catering and to the well-documented lack of dieticians. There are not enough staff on the wards to ensure that meals are taken. Because of the systems used—particularly the privatisation of catering—meals are often too hot, and therefore unpalatable to frail and elderly people, or they are too cold. Frail and elderly people often require special diets, but those meals can be simply unpalatable.
Age discrimination spans several spheres. In my final minute, I want to concentrate on the structural and systemic discrimination that exists. For example, guidelines from the National Institute for Clinical Excellence allow certain medicines to be withdrawn from elderly patients specifically on the basis of age. NHS QIS has, I believe, recommended that that particular guideline be removed, and I want to know whether the Executive will enforce that recommendation.
As we know, knee and other orthopaedic operations are rationed in the NHS on the basis of age. What will the Executive do to stop that practice as soon as possible?
It is right that we are discussing such issues, but I would prefer action to be taken and not to hold more inquiries and more discussions. We do not need any more inquiries, because the problems are well documented. I would like action, and I ask the Executive to respond to the points that I have made.
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...