Chamber
Plenary, 26 May 2005
26 May 2005 · S2 · Plenary
Item of business
National Health Service<br />(Age Discrimination)
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 who are over 80, who I am sure will be assisted by the prescription of a glass of whisky every evening.
I begin with that fact because we know that, generally speaking, the older someone is, the more likely they are to suffer from ill health and to end up in hospital. To allow an elderly person to end up in hospital is often the default response; it is not what older people want, it should not be what we want and it is perhaps not what they need. Whenever they are asked, older people tell us that they want to remain in their own homes and be cared for in their own homes for as long as possible. The challenge for us in this chamber is to find alternatives to unnecessary hospital admissions, so that older people can be cared for in or at least much nearer to their own home.
I turn to the issue of care in hospital. Members—not only on the Labour benches but across the chamber—have long believed that older people should be treated with dignity and respect. We should never condone negative age discrimination—direct or indirect—in the NHS.
I want to sound a note of caution, however, and agree with comments that Richard Baker made. We need to set the debate in the context of all the positive work that goes on in the NHS. We must be careful not to convey the impression that the NHS is somehow rife with negative age discrimination. I am sure that the SNP would not want to do that—it is simply not true. As the minister said, there is no systemic failure in the NHS. There are many people in our health service who care—daily and well—for our older people.
That said, we must always respond, and respond robustly, to the genuine concerns of relatives and friends. Those concerns point to a need to raise standards of care, particularly standards that focus on nutrition and personal hygiene. I agree with many in the chamber that those care needs are essential to recovery; they are not an add-on luxury.
It is for that reason that the Executive has moved to put in place a number of different measures. I refer to the clinical standards for our older people in acute care, which have at their core the dignity and rights of older people. I refer also to the NHS QIS 2004 review of older people in acute care and to wider national care standards. Through those measures, we will ensure that the very highest standards of care are delivered to our older people. We need to ensure that the rigorous and professional service standards that are set for our hospitals and care homes are met. I acknowledge that they are being exceeded in many places across Scotland.
I turn to the wider question of care for older people. As the minister said, in 2002, an expert group on health care for older people set out to ensure that they have the health and care services that they need. The group looked beyond hospital care to a much wider set of health care policies that support active aging.
Professor Kerr's report, which was published yesterday, specifically looks at older people and how we can tailor health services in Scotland better to meet their needs. His key conclusion is that the more local the provision, the better it is. Ideally, supporting patients at home will prevent avoidable hospital admissions. In his initial response, the Minister for Health and Community Care committed the Executive to providing just such a service: personal, proactive and co-ordinated care in local communities.
Labour is committed to a better life for older people in Scotland, both now and in the future. We are committed to supporting older people to live healthy, independent lives. A key part of all of that is a recognition that age discrimination is a problem not just in the health service but for wider society. We need to send out a signal that all of us should value older people and that all of us want to support them in continuing to make the substantial contribution to Scottish society that they have made for many years.
I begin with that fact because we know that, generally speaking, the older someone is, the more likely they are to suffer from ill health and to end up in hospital. To allow an elderly person to end up in hospital is often the default response; it is not what older people want, it should not be what we want and it is perhaps not what they need. Whenever they are asked, older people tell us that they want to remain in their own homes and be cared for in their own homes for as long as possible. The challenge for us in this chamber is to find alternatives to unnecessary hospital admissions, so that older people can be cared for in or at least much nearer to their own home.
I turn to the issue of care in hospital. Members—not only on the Labour benches but across the chamber—have long believed that older people should be treated with dignity and respect. We should never condone negative age discrimination—direct or indirect—in the NHS.
I want to sound a note of caution, however, and agree with comments that Richard Baker made. We need to set the debate in the context of all the positive work that goes on in the NHS. We must be careful not to convey the impression that the NHS is somehow rife with negative age discrimination. I am sure that the SNP would not want to do that—it is simply not true. As the minister said, there is no systemic failure in the NHS. There are many people in our health service who care—daily and well—for our older people.
That said, we must always respond, and respond robustly, to the genuine concerns of relatives and friends. Those concerns point to a need to raise standards of care, particularly standards that focus on nutrition and personal hygiene. I agree with many in the chamber that those care needs are essential to recovery; they are not an add-on luxury.
It is for that reason that the Executive has moved to put in place a number of different measures. I refer to the clinical standards for our older people in acute care, which have at their core the dignity and rights of older people. I refer also to the NHS QIS 2004 review of older people in acute care and to wider national care standards. Through those measures, we will ensure that the very highest standards of care are delivered to our older people. We need to ensure that the rigorous and professional service standards that are set for our hospitals and care homes are met. I acknowledge that they are being exceeded in many places across Scotland.
I turn to the wider question of care for older people. As the minister said, in 2002, an expert group on health care for older people set out to ensure that they have the health and care services that they need. The group looked beyond hospital care to a much wider set of health care policies that support active aging.
Professor Kerr's report, which was published yesterday, specifically looks at older people and how we can tailor health services in Scotland better to meet their needs. His key conclusion is that the more local the provision, the better it is. Ideally, supporting patients at home will prevent avoidable hospital admissions. In his initial response, the Minister for Health and Community Care committed the Executive to providing just such a service: personal, proactive and co-ordinated care in local communities.
Labour is committed to a better life for older people in Scotland, both now and in the future. We are committed to supporting older people to live healthy, independent lives. A key part of all of that is a recognition that age discrimination is a problem not just in the health service but for wider society. We need to send out a signal that all of us should value older people and that all of us want to support them in continuing to make the substantial contribution to Scottish society that they have made for many years.
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...