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Chamber

Meeting of the Parliament 10 June 2015

10 Jun 2015 · S4 · Meeting of the Parliament
Item of business
Health

I welcome Jenny Marra’s consensual tone. My amendment seeks to build on that tone, and I hope that it will be received in that spirit.

Presiding Officer, I hope that you will give me a little latitude later in my speech to deal with the A and E issue that Jenny Marra raised, because it is important to set out some facts on that matter.

I am pleased to update the Parliament on my announcement on 22 January of a public debate on health and social care. I said then that, among many others, I would work with colleagues across the political spectrum to seek as much consensus as possible on the shape of health and social care by 2030. I am open to all constructive ideas for the future; I hope that some such ideas will be put forward during the debate and that we make some initial progress towards consensus. I will continue to engage with colleagues across the Parliament as I take forward more detailed work that is informed by the wider public debate.

The debate will be based on this Government’s solid record on the NHS. We have cemented universal provision, which is largely free at the point of use, and we have rejected the internal market and privatisation agenda. We have protected health funding in the face of considerable challenge—in this financial year, health resource spending has increased by more than £400 million to a record level of £12 billion.

We have made a strong start on integrating health and social care through the roll-out of integration joint boards, and we have provided them with £500 million of investment to help them to develop services that we know will make a difference to local communities by allowing them to take charge of their own health and wellbeing in innovative ways.

In addition, we are performing well above the developed world average in relation to access to healthcare, waiting times and planned care. We have more staff in the NHS than we have ever had—staffing levels have gone up by 10,500. Therefore, we have a good platform on which to build. However, I am the first to acknowledge that the increasing demands on the system require us to look at new, more innovative models.

At this point, I want to respond on the issue of A and E. Targets have their place. I am certainly up for a debate about targets. We have to have the right targets, but targets are important. Before there were targets, people routinely waited 18 months for an appointment and another 18 months for procedures. I remember regularly raising such cases in the early days of the Parliament, so we have come a long way in reaching a position in which we have some of the lowest waiting times.

We still face challenges in meeting some of the targets, and Jenny Marra highlighted the issue of A and E waits. In that respect, I want to respond specifically on the Ninewells issue. As I cannot let it stand without a response, I will—unfortunately—have to take a bit of time to explain things.

It is important to remember that the Ninewells system has been operating since 1998 and that the four-hour target was introduced in 2004. It is therefore quite wrong for anyone to suggest that somehow the Ninewells system has been developed in response to that target; in fact, it predates it.

Moreover, during routine feedback from trainees, the General Medical Council was made aware of some of the bullying issues that were highlighted last year. In response, it looked at the issue in quite some detail and concluded in its report that it

“found no evidence that there was a culture of undermining and bullying in the general surgery and trauma and orthopaedic units”

and that

“Overall, the doctors in training that we met were very positive about their experience at this Hospital.”

Nevertheless, the GMC encouraged “improvements to be made”, and those improvements have been made to ensure that trainees can get feedback in a safe environment.

That said, when any concerns are raised with me, I want to ensure that we have asked all the questions and that we have seen the situation for ourselves. That is why I have asked the chief medical officer to visit Ninewells on Monday, see for herself what is happening there, investigate the matter, ask questions, speak to the staff and trainees concerned, and then report back to me. However, we have to be very careful that we do not undermine one of the country’s best performing emergency departments or that these concerns do not affect patient safety, which I believe is absolutely key to what is done at that fantastic hospital.

In the same item of business

The Deputy Presiding Officer (Elaine Smith) Lab
The next item of business is a debate on motion S4M-13416, in the name of Jenny Marra, on health. I invite members who wish to contribute to the debate to pr...
Jenny Marra (North East Scotland) (Lab) Lab
I and other Labour members have approached today’s debate in a conciliatory way, hoping to reach a consensus on the way in which we take forward the debate o...
John Mason (Glasgow Shettleston) (SNP) SNP
Will the member give way?
Jenny Marra Lab
I would like to make a little more progress, but I will do so later. Those are significant and considered interventions from experts who do not use such str...
John Mason SNP
Does the member agree that one of the decisions that must be made and in which the public certainly must be involved is whether we put more resource into pre...
Jenny Marra Lab
There is a great consensus in all the reports that we have seen about the shift to preventative spend. We will approach the public debate with a programme of...
The Cabinet Secretary for Health, Wellbeing and Sport (Shona Robison) SNP
I welcome Jenny Marra’s consensual tone. My amendment seeks to build on that tone, and I hope that it will be received in that spirit. Presiding Officer, I ...
Jenny Marra Lab
I thank the cabinet secretary for her considered response, and I welcome the fact that the chief medical officer is visiting Ninewells on Monday. However, do...
Shona Robison SNP
Of course. Indeed, that is why we have set up the whistleblowing helpline. However, that does not mean that the concern that is raised is always correct or t...
The Deputy Presiding Officer Lab
I can give you two minutes back.
Shona Robison SNP
We face a number of challenges to our health and social care system including poor patterns of health, health inequalities, rapidly changing demography, high...
The Deputy Presiding Officer Lab
Will you draw to a close now, please, cabinet secretary?
Shona Robison SNP
Yes. That level of open engagement will seek consensus on a reform plan for health and social care by 2016, with further engagement beyond then on into impl...
Nanette Milne (North East Scotland) (Con) Con
We very much welcome this debate. Like everyone here, Scottish Conservatives greatly value the work and dedication of the staff in NHS Scotland and Scotland’...
The Deputy Presiding Officer Lab
We turn to the open debate. I ask for speeches of six minutes, please. There is not a lot of time in hand. 15:16
Bob Doris (Glasgow) (SNP) SNP
I start by referring to targets in the NHS, which was a theme in the opening speeches. The briefing that the royal colleges prepared for the debate specifica...
The Deputy Presiding Officer Lab
Mr Doris, you really must close.
Bob Doris SNP
That is a hobby horse of mine. I hope that the cabinet secretary has listened to my sales pitch for the care sector. 15:23
Lewis Macdonald (North East Scotland) (Lab) Lab
The challenge of matching NHS resources to demand for healthcare is tough everywhere, and nowhere more so than in NHS Grampian. I know the service well, not ...
John Mason SNP
I take the member’s point about population being important. Does he agree that need and deprivation are also important?
Lewis Macdonald Lab
Absolutely, and that is exactly what the NRAC formula is intended to reflect—population growth, need and deprivation and urban and rural populations. The Gov...
Linda Fabiani (East Kilbride) (SNP) SNP
I welcomed the text of Jenny Marra’s motion when I read it after it was published last night, and I welcome the generally consensual and positive speech that...
Jim Hume (South Scotland) (LD) LD
I welcome this debate on health. At a time when we often take a narrow focus and address only separate elements of the NHS, I believe—as the Royal College of...
The Minister for Sport, Health Improvement and Mental Health (Jamie Hepburn) SNP
Mr Hume has raised the issue of mental health valiantly on many occasions, and more power to his elbow in doing so, but I reiterate the point that parity bet...
Jim Hume LD
I have replied that it does not repeat what has been done elsewhere to state the need for parity between physical health and mental health. I am happy to for...
Dennis Robertson (Aberdeenshire West) (SNP) SNP
Just yesterday, directors of finance from some of our NHS boards gave evidence to the Heath and Sport Committee, and at one point I started to feel very sorr...
Jim Hume LD
Dennis Robertson said that I am not listening, but although the Mental Health (Scotland) Bill states that there should be improvements in mental health, it d...
Dennis Robertson SNP
That proves my point to some extent, because we have interpretation. The issue will be about our coming together to try to make improvements. Our nurses—perh...
Jenny Marra Lab
Dennis Robertson referred to my remarks on the timescale of the public conversation that the RCN has called for. He is saying that we are looking for solutio...
The Deputy Presiding Officer (John Scott) Con
And your point is?