Hansard

I hope to be commendably brief, Presiding Officer.

Although I support Jim Eadie’s motion on family nurse partnerships, I will raise some concerns about the consequences—John Mason expressed views about that, which I very much share. I support the family nurse partnership because of its focus on the preventative agenda; after all, all the evidence suggests that, if we are to make savings in our health service to ensure that it can cope with the wider challenges that we know it will face with an ageing population, we have to become much more successful in our preventative strategy. Although Mr Eadie is right about family nurse partnerships—the programme’s track record in the United States, which Malcolm Chisholm referred to, and in England shows that it can have dramatic results—it is neatly targeted and focused on young mothers under the age of 19, and it has a consequence for the wider health visiting strategy.

The Scottish Conservatives have expressed concern about our approach to health visiting. Each of our 14 health boards can determine its approach to that and the resource that it puts towards it. We moved away from a nationally GP-attached service to one that works in teams. The consequence was that the skill set that previously existed in individual health services, with health visitors being attached to GP practices, was slightly diminished by a range of skill sets in the broader teams that were then brought to bear.

Some of those skilled health visitors have now applied to be family nurse partnership specialists, which has further diminished skill sets in the health visiting service. Moreover, more than 40 per cent of the family nurse partnership staff are aged 50 or over, and a significant age issue is arising in national health visiting as well.

The Scottish Conservatives support family nurse partnerships. We believe that such targeted and focused assistance to the group involved is important. However, we also believe in a universal GP-attached health visiting service that takes children through to the age of seven, because there is a lot of compelling evidence to suggest that trends that develop in young children beyond the age of two—from the age of three and beyond—that lead to obesity, potential future addictions or even offending rates, can be dealt with through such intervention and support.

We believe in a universal service so that all children have access to it, but we also believe that there should be a concentration on areas with high levels of health inequality and deprivation, because that is where the service is needed most. There are young mothers who are vulnerable, deprived and over the age of 19, and they do not have the benefit of a family nurse partnership, but they need the support of a well resourced health visiting service if we are to succeed in the much wider spectrum of prevention in young persons’ issues.

I fully support the family nurse partnership programme and would like it to be rolled out further but, in the wider debate that we are having—I hope that the minister accepts that this is not a criticism but part of what we hope is a constructive approach to the shape of the health service going forward—I do not necessarily believe that this is, as John Mason said, a question of hospitals closing down. The whole point about a health prevention strategy is that we can—with a different model of GP facilities and with a successful health prevention strategy—reduce the incidence of people presenting at A and E and potentially the cost burden to the health service of type 2 diabetes, for example, because we could prevent that with a better approach to young people’s health and by avoiding issues of obesity.

I hope that the minister accepts my remarks in the spirit in which they are meant. I am concerned and I feel that, in the next parliamentary session, as we look at how this new model of healthcare develops, we need to roll out family nurse partnerships, which I believe are successful, in conjunction with a wider availability of service to a much wider target group of people, universally, and particularly where vulnerabilities and health inequalities exist.