Chamber
Plenary, 05 Jun 2008
05 Jun 2008 · S3 · Plenary
Item of business
Remote and Rural Health Care
No—I will press on, because I want to make a point about the purpose of our amendment that I hope will be helpful to Mary Scanlon and other Conservative members.
We want the report to be effective, but it could—I stress that word—be undermined if the funding of health boards is either unfair or seen to be unfair. I want to be clear, as the point may be important. The Liberal Democrats supported the establishment of the Arbuthnott committee and, when in government, we supported its replacement with the NHS Scotland resource allocation committee, or NRAC. We believe that it is right to establish a means of allocation that is based on objective criteria and we continue to support that principle and approach, not just using the current criteria but criteria as they are developed and refined to reflect poverty and health inequalities. However, we have grave reservations about the fact that, having studied the NRAC report in depth, health boards in remote and rural areas have serious questions about the basis on which some of the criteria were developed and may be applied.
My colleague Jeremy Purvis will develop that point in more detail by reference to the findings of NHS Borders. The problem is not simply that concerns have come to light; just as important is the fact that because NRAC is not currently operating—it has not been stood down—and no standing committee has been established, there is no forum for NHS boards in remote and rural areas to raise their concerns, seek satisfactory explanations or have their concerns resolved. In that vacuum, the NRAC-based allocations are perceived to be unfair and the system might be undermined. Hence, our amendment calls for the immediate establishment of a standing committee, as called for in the NRAC report. I am grateful to the cabinet secretary for expressing her willingness to accept that suggestion, and I hope that the explanation that I have given helps to persuade the Conservatives to stick by such principles. We think that genuine issues exist that could affect the delivery of services in rural areas and that addressing them requires the amendment to be agreed to.
I move amendment S3M-2056.3, to insert at end:
"and in line with recommendation 10.12 of the NHS Scotland Resource Allocation Committee's (NRAC) report calls on the Scottish Government to establish without delay a standing committee to lead work on the future development of the NHS board funding formula and to come forward with details on the precise membership, format and remit of the committee, and further calls on the Scottish Government to review the impact of the NRAC report on NHS boards' ability to maintain and develop remote and rural services."
We want the report to be effective, but it could—I stress that word—be undermined if the funding of health boards is either unfair or seen to be unfair. I want to be clear, as the point may be important. The Liberal Democrats supported the establishment of the Arbuthnott committee and, when in government, we supported its replacement with the NHS Scotland resource allocation committee, or NRAC. We believe that it is right to establish a means of allocation that is based on objective criteria and we continue to support that principle and approach, not just using the current criteria but criteria as they are developed and refined to reflect poverty and health inequalities. However, we have grave reservations about the fact that, having studied the NRAC report in depth, health boards in remote and rural areas have serious questions about the basis on which some of the criteria were developed and may be applied.
My colleague Jeremy Purvis will develop that point in more detail by reference to the findings of NHS Borders. The problem is not simply that concerns have come to light; just as important is the fact that because NRAC is not currently operating—it has not been stood down—and no standing committee has been established, there is no forum for NHS boards in remote and rural areas to raise their concerns, seek satisfactory explanations or have their concerns resolved. In that vacuum, the NRAC-based allocations are perceived to be unfair and the system might be undermined. Hence, our amendment calls for the immediate establishment of a standing committee, as called for in the NRAC report. I am grateful to the cabinet secretary for expressing her willingness to accept that suggestion, and I hope that the explanation that I have given helps to persuade the Conservatives to stick by such principles. We think that genuine issues exist that could affect the delivery of services in rural areas and that addressing them requires the amendment to be agreed to.
I move amendment S3M-2056.3, to insert at end:
"and in line with recommendation 10.12 of the NHS Scotland Resource Allocation Committee's (NRAC) report calls on the Scottish Government to establish without delay a standing committee to lead work on the future development of the NHS board funding formula and to come forward with details on the precise membership, format and remit of the committee, and further calls on the Scottish Government to review the impact of the NRAC report on NHS boards' ability to maintain and develop remote and rural services."
In the same item of business
The Presiding Officer (Alex Fergusson):
NPA
Good morning. The first item of business is a debate on motion S3M-2056, in the name of Nicola Sturgeon, on remote and rural health care. I remind members th...
The Deputy First Minister and Cabinet Secretary for Health and Wellbeing (Nicola Sturgeon):
SNP
I am happy to open yet another health debate. I suspect that there are members here this morning who have not been home since last night's member's business ...
Jeremy Purvis (Tweeddale, Ettrick and Lauderdale) (LD):
LD
I have heard that mantra on many occasions. It is, however, disingenuous. Although the baseline grant has not been affected for this year, boards such as Bor...
Nicola Sturgeon:
SNP
Jeremy Purvis came in right on cue when I was talking about irresponsible members. What I said is not a mantra; it happens to be the truth. No health board w...
Rhoda Grant (Highlands and Islands) (Lab):
Lab
Will the cabinet secretary take an intervention?
Nicola Sturgeon:
SNP
No—I have to move on and discuss the Liberal Democrat amendment. The amendment is sensible, because a funding formula should not be static. It should be kept...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
On what I hope is a consensual note, I begin by saying that Labour feels that this is certainly a welcome debate on an important issue. Health care in remote...
Nicola Sturgeon:
SNP
I am more than happy to engage in debate, but debate usually involves suggesting solutions as well as making criticisms. Does Margaret Curran agree that she ...
Margaret Curran:
Lab
I think you should pay attention to the exact details of what I said. My argument is not about the amount but about the share, and you know that full well, c...
The Minister for Public Health (Shona Robison):
SNP
Will the member take an intervention?
Margaret Curran:
Lab
No. I did Nicola Sturgeon the courtesy of taking an intervention, but she did not do me the same courtesy. I would prefer it if you would allow me to pursue ...
Shona Robison:
SNP
Will the member take an intervention?
Margaret Curran:
Lab
No, thank you.We are talking about the range of resources from funding for ambulance services to funding to ensure equal access to major Government commitmen...
Nicola Sturgeon:
SNP
Margaret Curran makes an important point, but will she acknowledge that the appointments in NHS Western Isles that have attracted much criticism were made un...
Margaret Curran:
Lab
I say with the greatest respect that the cabinet secretary has missed the point. The point is not party political. Laughter.
The Presiding Officer:
NPA
Order.
Margaret Curran:
Lab
The point is not political. It is about the NHS's management. The NHS's appointments procedures are governed not by politicians, but by its administration. W...
Mary Scanlon (Highlands and Islands) (Con):
Con
Margaret Curran talked about Western Isles NHS Board. On behalf of all of us and for the sake of NHS staff and patients in the Western Isles, I hope that peo...
Ross Finnie (West of Scotland) (LD):
LD
I am delighted that we are having a debate on rural health care, as this is the first occasion since the new Government was formed on which I have been able ...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
Will the member give way?
Ross Finnie:
LD
No—I will press on, because I want to make a point about the purpose of our amendment that I hope will be helpful to Mary Scanlon and other Conservative memb...
The Presiding Officer:
NPA
We move to the open debate. Speeches should be around six minutes, please.
Christine Grahame (South of Scotland) (SNP):
SNP
I welcome the temperate and considered speech that my colleague on the Health and Sport Committee, Ross Finnie, has just made.The foreword to "Delivering for...
Margaret Curran rose—
Lab
Christine Grahame:
SNP
I want to move on. I have only six minutes in total.On staff issues, we should consider the delays in implementing the agenda for change. That is not a Scott...
Rhoda Grant (Highlands and Islands) (Lab):
Lab
I am pleased to take part in this debate on remote and rural health care and I welcome the report. The cabinet secretary is pleased to endorse its recommenda...
Shona Robison:
SNP
The member has just said that the report referred to the minimum level of service that we would expect. Where there are more comprehensive services, we would...
Rhoda Grant:
Lab
I am grateful to the minister for that reassurance. I am sure that the people of Caithness will be grateful for it, too.The report states that there has been...
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD):
LD
The Howard Doris centre is funded jointly by NHS Highland and Highland Council. Does Rhoda Grant agree that there is a question mark over Highland Council's ...
Rhoda Grant:
Lab
Indeed. However, my point is that if the community had not brought forward that initiative, there would be no joint funding. It was the community that raised...