Hansard

We are already looking into it, and a number of pilot schemes have been carried out in Midlothian. In one GP surgery, the patients preferred not to have an appointments system at all but to go back to days gone by, when they could just turn up and take the risk of having to wait half an hour or even an hour. My view is that we should look at what works best but leave it more up to local decision making and not have it centrally imposed through targets or otherwise by the Cabinet Secretary for Health and Wellbeing.

In primary care modernisation, throughout our health and social care system there are many great examples of innovation and improvement that are delivering for their local area. I have heard of examples from inner city Glasgow to rural Aberdeenshire and from the Isle of Arran to suburban Edinburgh, all of which suggest new ways of working and new models of care. For instance, the deep-end practices, ably led by Professor Graham Watt, are 100 practices that work in Scotland’s poorest communities and take a genuinely bottom-up approach. They demonstrate some of the very real health inequality challenges that are faced by our most deprived populations and suggest how we must begin to address them.

I have also heard about an initiative in Buckhaven that is based on the Alaskan nuka model of care, which puts the needs of the community at the heart of the healthcare system and assists both in finding solutions to seemingly intractable healthcare challenges. A number of initiatives like the Alaskan model, such as patient access, productive general practice and managing patient flow, show that the solution lies in primary and social care teams focusing on the needs of the people whom they support. That is challenging for us, but it is at the heart of our moves towards the integration of health and social care and the legislation that we are introducing to make that happen.

To make that a reality, we must understand what works, why it works and how it works. We must invest in developing new models of care and ensure that we spread the learning from the approach far and wide. That is why I am today announcing a modernisation programme to support innovation and best practice in primary care. I am also delighted to announce that, in year 1, there will be pump priming of £1 million to pilot the new developments and move the agenda forward, along with the massive resources that we already have in primary care.

The first stage of that modernisation will be in commissioning strategic assessments of primary care from each of our health boards as part of their normal planning process. It will be a modernisation programme that truly delivers change. The transformation of primary care needs to be delivered in partnership across health and social care, and the mutual NHS model that we have in Scotland is the right one for delivering safe, effective and person-centred care.

There is a sharp contrast between our approach, which is based on the founding principle of services being free at the point of care, and that in England, where privatisation is growing ever more pronounced and damaging. Although we have abolished prescription charges, in England they remain, with the result that some people on low incomes are forced to choose which of their prescribed medicines they can afford. We have legislated to ensure that there is no privatisation of GP services in Scotland, and we have banned the privatisation of cleaning contracts, which we have supported by providing more than £23 million of additional resources since 2009 to pay for the hundreds of additional cleaning staff who keep our hospitals safe. Free personal and nursing care, to which patients in England are not entitled, currently improves the lives of more than 77,000 older vulnerable people in Scotland. Those are achievements that not just the Government but the Parliament can be proud of.

I have set out our ambitious approach to person-centred, safe and effective care and have announced a clear direction for the transformation of primary care to match our 2020 vision. Given the increasing divergence between what happens north of the border and what happens south of it, I hope that every member will agree that ours is the right way forward. I began by outlining the serious strategic challenges that health and social care services in Scotland face. We need to create a health and social care system that is fit for purpose in the 21st century. That is why we are taking forward our 2020 vision. My ambition is not just to have the safest health service in the world—which, according to the world’s leading expert on the issue, we already have; it is that the Scottish people will have the best health service in the world by 2020.

I move,

That the Parliament recognises the importance of person-centred healthcare in delivering the best health outcomes possible; supports measures to ensure that individuals are supported to be active partners in their own care; agrees that all parts of the healthcare system should be focused on the patient, and that should include both community and hospital care, and further supports Scotland’s modernisation programme to test measures to make GP services more accessible for patients, while reducing bureaucracy for GPs and freeing their time to focus on patients.

14:26