Hansard

I am delighted to speak in today’s debate on person-centred care. As deputy convener of the Health and Sport Committee, I often meet stakeholder groups in health and social care—be they doctors groups, nurses groups, allied health professionals, pharmaceutical companies, pharmacists, social workers, addiction workers or occupational therapists. I could go on and on, but do not worry, Presiding Officer, I will not.

I mentioned that list of groups because I am sure that for all those stakeholders, the user—the patient—is their primary concern. However, every group also has a specific interest and a specific point of view that sometimes contrasts with and is different from the interests and views of other stakeholders. Person-centred healthcare and social care should see the interests of such stakeholders—vested interests, if you like; I mean that kindly, not negatively—as being secondary to the needs of the constituents; the people we represent, who are the service users.

Progress has been made: for instance, GP surgeries are now open for longer and their hours are more flexible. I have listened to some of the concerns that have been raised, but it is now easier, in many cases, to see a GP than it was previously. That is a positive change.

I am pleased that the HEAT—health improvement, efficiency and governance, access and treatment—target that was introduced in 2007 to ensure that all patients see an appropriate member of the GP practice team within 48 hours has been met in almost every health board; Fife just missed out. That target’s having been met means that more than 90 per cent of patients see an appropriate person within 48 hours.

There should, however, be no complacency about that; targets tell only part of the story, which is why I am delighted that the Cabinet Secretary for Health and Wellbeing has looked for unintended consequences from that 48-hour target and is considering more imaginatively how we can use the GP contract better to meet the needs of our constituents. On that last point, I also took part in the keys to life debate on learning disabilities, and I know that the Scottish Government is actively considering the possibility of having a quality and outcomes framework in relation to people with learning disabilities and the special attention and support that they need from GPs.

I welcome that possibility, but this is not just about GPs. Perhaps health centres more generally should consider services beyond 9 to 5 and 5 days a week. Why should we single out GPs? Associated support services also have to be in the health centre; if a person has to see a community nurse after they see their doctor, does not it make sense to have community nurses in the health centre on Saturday morning if GPs are working on Saturday morning? We have to think more imaginatively about how we can use the overall resource. I am delighted to know that there are on-going discussions on how we might do that.

I am also encouraged that the Scottish Government has established a person-centred health and social care collaborative; its third meeting will be held shortly. I am sure that the 500 stakeholders will consider how services can be developed in the long term. I looked at the remit of the collaborative and was delighted to see that one aspect of the remit is to focus on what we can do now, because sometimes when such things are set up, it is “Mañana”; it is about what can be done in two years, three years or four years. However, the collaborative is actively looking at what can be done in the short term—-in the months and the years ahead—and not just in the long term, important though long-term planning is.

I also welcome the fact that the Scottish Government is giving £4 million to five health boards, including NHS Greater Glasgow and Clyde in my area, to look at innovative ways of delivering a seven-day health service and of enhancing round-the-clock care. Let me give two examples of that—although I should perhaps first, like Mr Findlay, declare a slight interest, in that my wife is a nurse in a high dependency unit in Glasgow, and has worked in a variety of capacities in surgical nursing.

If a patient is ready for discharge, but staff cannot get hold of the pharmacist because the pharmacy is closed, that can lead to a delayed discharge. If, before going home, a patient needs to be declared fit and capable, or able to use appropriately and safely any support equipment that he or she has been given, the patient cannot go home if the physiotherapist is not around. Therefore, we need to look more imaginatively at when various health professionals are on ward, on call, in the hospital or in the health centre. I hope that that £4 million will help us to think of good ideas for how to do that.

I am also pleased that the Scottish Government is looking to make both health and social care more person centred. That is welcome, given how liberating self-directed support can be for individuals. Self-directed support has had some negative press, because a number of local authorities have introduced it as a cost-cutting exercise rather than because they adhere to its principles. It is therefore only reasonable that I mention how my local authority has treated people with learning disabilities in the context of its day-centre reforms and closures.

In its briefing for today’s debate, the Health and Social Care Alliance says that there should be shared decision making when changes happen, but there was no shared decision making between Glasgow City Council and learning disabled individuals and their families, who were just told that their centres would close. That approach goes completely against the principles both of person-centred care and of self-directed support. As the Learning Disability Alliance Scotland has said, in designing services we should apply the principle, “Nothing about us without us”, but that was simply not the case in Glasgow.

I thank the cabinet secretary for offering Glasgow City Council the chance to think again about the proposals to close three day centres, and for offering to work in partnership with the council, but I am disappointed that the council seems to have snubbed that offer. However, we live to fight another day on that one.

To come back to the positive aspects of person-centred care, I should mention some good work that already takes place. Revive MS in Glasgow already offers person-centred care not just to people who have multiple sclerosis, but to families who support MS patients. However, person-centred care is always work in progress. For example, my constituent Mr James Jamieson has contacted me about the need to support people who are living with hidradenitis, which is a brutal skin condition, and how we can improve care for such patients. I am in correspondence with the cabinet secretary to seek to improve that, but there are a lot of good things already happening.

Let me finish off by saying that, with £300 million already spent through the reshaping care for older people change fund moneys, and with a £100 million fund on the table to help with health and social care integration, I am really excited about the opportunities that lie ahead, but I also have it in mind that we need to scrutinise the changes that we make in order to ensure that they deliver what we said they would deliver. What we want is truly 24/7 health and social care that meets the needs of my constituents and constituents across the country.

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