Hansard

I join others in acknowledging the painstaking work of the Health and Sport Committee and its clerks that has led to the comprehensive report that we are discussing. I also share the concerns that are expressed in the report about the slow and inconsistent provision of electronic technology in Scotland over the past decade or so. Like Christine Grahame, I am a bit of a technophobe—I hope that I have understood correctly the report on clinical portals, especially as I am not a member of the committee that took evidence during the inquiry.

Given the undoubted financial savings and improved services for patients that would result from clinical portal technology and telehealth solutions, it seems inconceivable that progress towards their implementation has been so slow and patchy at a time of rapidly advancing technology. The speedy exchange of patients’ health information—be that their medical history or information about their allergies and drug sensitivities or the medication that they are currently receiving—must be of immense benefit to patients, particularly in an emergency situation when they may be in the care of health professionals who are not familiar with their records. The rapid transmission of test results to a hospital or GP will help to ensure speedy diagnosis, treatment with appropriate drugs based on accurate information and the ending of the common practice—which Ian McKee, Richard Simpson and I know all too well—of repeating a barrage of tests every time that a patient presents in hospital. That will surely result in significant savings in junior doctor and laboratory time and costs.

I fully understand the concerns of the BMA and others about the risks of breaching patient confidentiality and the need for a proper identity and access management system across the NHS. With that in place, and a reliable system to ensure the application of ethical standards of confidentiality, I can see only benefits from clinical portal technology in the NHS, although the caveats from Ian McKee and Jamie Stone cannot be ignored.

The committee appears to be somewhat at odds with the Government in recommending strongly that efforts should be directed towards a single portal system across all health boards, rather than the incremental approach towards a maximum of four portals that is currently proposed. Although there is a need for the speedy implementation of clinical portal technology, health boards are in different states of readiness for it and there are difficulties in merging existing systems into one national portal, as Dr Kelly, the Scottish Government’s e-health clinical lead, explained to the committee. I therefore see why the Government has opted for a portal that draws relevant patient information from a variety of systems at the point that it is required by the patient’s clinician rather than going with the committee’s recommendation, although the Government states that it shares the committee’s desire for more sharing and greater commonality of systems.

Cost and value for money are particularly important at this time of financial constraint and I welcome the committee’s stated intention to focus on the financing of clinical portals when it considers the Government’s draft budget for next year, given that information on the capital costs for the development and implementation of projects is not readily available.

I am appalled that telehealth and telemedicine are still not available right across the NHS in Scotland. I remember being excited about the possible applications of telehealth solutions way back in my early days as a doctor in Aberdeen when Nelson Norman, who was at the time a senior lecturer in surgery at the university, pioneered their use in connection—if I remember rightly—with the oil industry. He did so initially from a tiny room at the back of my husband’s health centre.

Over the years, as technology has improved, and largely due to the enthusiasm and hard work of clinicians such as Jim Ferguson at Aberdeen royal infirmary, telehealth solutions have increasingly been used, in the north-east and elsewhere, in the diagnosis and treatment of skin disease, the management of epilepsy, the interpretation of X-rays sent from remote centres and in empowering patients to manage their long-term conditions at home.

There are so many benefits for patients, particularly in remote and rural communities, and there is still enormous potential for the future, provided that the communications infrastructure—up-to-date broadband technology, in other words—is available, as Jamie Stone stressed in his contribution.

I visited the Scottish centre for telehealth with Mary Scanlon a couple of years ago, and I still remember Jim Ferguson’s frustration at being hampered in the roll-out of services by what can only be described as the vested interests of senior clinicians who were afraid of losing their fiefdoms to modern technology. Surely patients’ interests must come first, even if clinical empires have to fall by the wayside to accommodate them.

During the committee’s consideration of telehealth development, it became clear that there was a lack of national assessment criteria on which to base assessment of the impact, effectiveness and cost sustainability of telehealth projects in the delivery of health care. For example, the potential benefits of telehealth solutions in providing GP out-of-hours cover in remote and rural areas are well recognised, but that is one instance in which the lack of national assessment criteria is proving to be a stumbling block in the transition of telehealth pilot projects into permanent delivery tools for health care across the country. A key element of the telehealth strategy must therefore include such criteria to allow for the effective analysis and delivery of telehealth solutions in the health service.

I very much hope that the incorporation of the Scottish centre for telehealth into NHS 24 will allow rapid progress to be made in realising the full potential of what is a magnificent technology. Patients deserve no less, and the pioneering work of the NHS personnel whom I have mentioned deserves no less. I was excited by the report that we are discussing and I hope that the Government will implement many of its recommendations, which I am sure will allow the best modern diagnosis and treatment to become available to patients wherever they live in Scotland and ensure best value in the use of our precious NHS resources.

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