Official Report search · Parliament Workbench

Chamber

Meeting of the Parliament 19 September 2012

19 Sep 2012 · S4 · Meeting of the Parliament

Item of business

Patient Care

McNeil, Duncan Lab Greenock and Inverclyde Watch on SPTV

We have heard from colleagues who have touched on a number of areas where patient care has fallen below acceptable standards. In my brief speech, I will focus on the levels of care for elderly patients with dementia or cognitive impairment. Concerns were identified by Healthcare Improvement Scotland during its recent inspection of wards across the country and have been raised by Alzheimer Scotland—Action on Dementia and the Royal College of Physicians of Edinburgh.

I have taken time to analyse some of Healthcare Improvement Scotland’s reports and, although it is important to note that the inspection watchdog has often highlighted the positive interactions between staff and patients, unfortunately it has also underlined a number of areas where the health boards must and need to improve.

Ten inspection reports have been published so far, and I hope that the facts arising from them will not be disputed by the SNP front bench. Some concerns occur again and again. Patients are not being routinely assessed for dementia or cognitive impairment upon admission. Indeed, the Royal College of Physicians of Edinburgh recently reinforced that concern by stating that almost half of elderly patients on wards have dementia but have not been diagnosed. Care plans are not always put in place; health records are often incomplete; the number of times a patient is moved from one ward to another is not monitored; and the environment in the wards is not suited to the needs of patients with dementia.

The result of those failures is that there will be elderly patients who, during their stay in hospital, will feel confused, frightened and isolated, which culminates in, as described earlier by Jackie Baillie, a loss of dignity to them as individuals, upset to their families and great reputational risk to the national health service. Those patients will not only feel a sense of helplessness, but be put at risk. The Royal College of Physicians has warned that the 1,600 patients with dementia who are in Scotland’s hospitals at any one time are “highly vulnerable” and at higher risk of death while in hospital.

Now that I have covered some of the issues and concerns that have been raised by the reports, I will say a few words about the role of the health boards and Healthcare Improvement Scotland. Health boards need to understand the reasons for the poor level of care that has been identified by HIS, to ensure that they develop action plans that fully address the problems. However, at this time, I do not have full confidence that that is happening. HIS recently confirmed to me that it does not ask the health boards to examine the reasons for the inappropriate care that has been identified. Furthermore, HIS does not appear to monitor the action plans produced by the health boards. Moreover, it does not have the power to enforce action if the boards are failing to meet their own standards. It also appears that HIS does not have to validate the claims in the health boards’ self-assessments.

I could go on and on. The minister, in his opening remarks, said that we should judge a Government by its actions. The question is, in light of the evidence, why has there been so little response? Why is there even less action? Why are we waiting for action in what is a serious situation?

16:24

Search Hansard contributions

Meeting of the Parliament 19 September 2012

In the same item of business