Meeting of the Parliament 22 January 2015
I agree that the integration of health and social care will be the biggest catalyst, and the money that the cabinet secretary announced is welcome. However, as I am sure she will agree, the 2020 vision is a lot broader than that.
The current A and E crisis, the persistent and continuing health inequalities that we see across Scotland every day and the tragedy of patients dying on delayed discharge lists are immediate front-line problems that need to be fixed before we can make any real headway on the 2020 vision. The Health and Social Care Alliance Scotland and the Royal College of Nursing have said that, and Labour has raised the issue in the chamber time and again. When people’s lives, health and wellbeing are at stake, it is unacceptable to have to wait a few more months for the necessary improvement.
A front-line fund would allow hospitals that face extra pressure to move to a fully functioning seven-day-a-week operation. It would free up beds, with the result that patients would get better care more quickly while pressure on staff would decrease and patient flow through the hospital would increase, which the cabinet secretary knows as well as I do is a critical factor in tackling delayed discharge.
A key issue in the 2020 vision—that of health inequalities—persists. I acknowledge that the cabinet secretary touched on the matter, but how will the task force that the Scottish Government set up work more on the ground to eradicate health inequalities? The crux of health and social care integration involves opening our arms and inviting our communities into our health service. The RCN has said that, given the aims of the 2020 vision, it is deeply worrying that Audit Scotland’s review, “Reshaping care for older people”, found that
“There is little evidence of progress in moving money to community-based services and NHS boards and councils need clear plans setting out how this will happen in practice.”
We must also look to the tireless and committed workforce that will help us to achieve such integration. Nurses, for example, are instrumental in connecting health and social care in primary and secondary care. When we look at the figures from the RCN’s staff survey, which show that 81 per cent of nurses have an increased workload compared with a year ago and 58 per cent feel that they are under too much pressure at work, we can see how unfair additional pressure on our hard-working workforce would be.
The NHS’s own staff survey, which the cabinet secretary announced before Christmas, reported that only 25 per cent—a quarter—of our nurses and midwives agreed that there were enough of them to allow them to do their jobs. Vacancy rates for nursing and midwifery—which stood at 3.6 per cent in September—remain a problem across the country. That is a problem that could persist, given the Scottish Government’s cuts in nursing student numbers over recent years. As we announced a few weeks ago, if it is elected in May 2015, Labour will introduce a mansion tax that will fund an additional 1,000 nurses in Scotland.
At First Minister’s question time, we heard the First Minister address the issue of an understaffed NHS, but I was left wondering whether she and the cabinet secretary are working from different baselines or different information. At FMQs, the First Minister stated that staffing had gone up by 6.5 per cent, while the cabinet secretary said last week that it had gone up by 7.6 per cent. I hope that she or one of her ministers might be able to clarify that.
As I emphasised yesterday and will continue to emphasise, if we are to improve the state of our NHS, more resources are needed and they must be used as effectively as possible. NHS Greater Glasgow and Clyde faces costs of £167 million in backlog maintenance just to keep its buildings fit for purpose. We know—it was raised in the chamber earlier—that, this winter, that board has had to resort to using a portakabin for A and E patients.