Hansard

Like the cabinet secretary, I begin by paying tribute to the staff who will be working extremely hard over the winter and the Christmas season. As I noted in a previous debate, I doubt very much that they will be watching our debate this afternoon—they will likely be far too harassed and, if they are not, I hope that they have better things to do—and I hope that they understand that my tribute is heartfelt and well meant. Over the past two or three winters, we have come to appreciate that the demographics are changing so rapidly that any pandemic or major health concern that emerges places enormous strain on hospitals and our NHS staff.

I thought long and hard about it and I decided not to lodge an amendment. Instead, the Conservatives will support the Government’s motion. I made that decision because there is no point in my going to meetings with nurses, allied healthcare professionals and doctors and saying that I will take the politics out of health, only to come here and be highly belligerent about the situation that we are in. There is a distinction between the day-to-day health issues, around which I might have issues with the Government, and the strategic plans for the future of the health service, in relation to which it is necessary that we stop being partisan and seek to find as much common agreement as we can.

Since it is Christmas, however, we will also support Mr Simpson’s amendment, even though I read Labour’s “Fit for the Future” document and felt that it had a whiff of, “Labour said this, Labour did that, Labour thought the other,” and “If only we had listened to Labour—yada yada yada—we wouldn’t be where we are today.” I do not think that that entirely gives us a measure of the issues and problems that we collectively face.

Although Professor Sir Lewis Ritchie’s report concerns out-of-hours care, its themes reach right across the primary care debate. Towards the end of it, it lays out age demographics. I noticed that, in 2039—when I would be 80, if I were to live that long; I have previously cheered the chamber by informing members that Carlaw men do not—there will be twice as many people of the age of 80 than there are today. My sons will be in their 40s and there will be just as many people in their 40s then as there are today. We constantly fail to paint a picture that people properly grasp of just how huge a shift in the demographics of the Scottish population lies ahead and the revolution that is required in our approach to primary care, with those elderly people becoming part of a detailed patient cohort that will need a great deal of individual attention and just that bit more time.

I have spoken to people in the professions and know that they can get into that approaching-old-man syndrome where they say, “The trouble is all these new doctors coming through now just don’t have the same commitment and work ethic that we had when we came in. We believed it was a vocation and we would work through the night if it was necessary, and this new lot—my goodness—you can scarcely drag them out of their beds to get them to the shift that they’re supposed to be on.” However, I was encouraged last week when I met the leaders of the Scottish junior doctors committee and the Scottish student doctors committee: I was enormously impressed to find that that attitude is absolutely not the case. What has changed is that there is a different perception of work-life balance across all of Scotland’s workforce. We must ensure that the contract renegotiation and the structure for GP primary care that we put in place attract people, because we cannot dragoon them into it. That is why the job that the cabinet secretary has ahead of her is so important.

When Professor Sir Lewis Ritchie says that the funding will not grow in line with the service demand, he makes an important point. As I will touch on in my closing remarks, much more focus must therefore be put into the preventative agenda to stop people having to see a doctor in the first place and much more effort must be put into the whole NHS asset, beginning with community pharmacy care and the role that it can potentially perform to alleviate the pressure on GPs.

I am very attracted by the concept of the resource hub. I also like the emphasis that Sir Lewis Ritchie puts on the definitions of “urgent” and “emergency” care and our job as politicians, and within the health service, to educate the public about the difference. At the moment, too many people are—rightly or wrongly—dissatisfied with the level of primary care provision as they see it and the opportunities that there are for that.

It was very interesting to read in the report patients’ reasons for not accessing various services. Although many of those reasons were prejudicial rather than based on fact, some real things need to change there, too. It was interesting to see that, in people’s minds, we are driving them—not literally—to hospitals rather than using the whole network. It reminded me that the Scottish Conservatives have advocated that, along with the annual council tax bill, there should be a health board statement in each region. Such a statement would not only detail what has been happening, in general terms, with health care in that region but would educate people and direct them to the correct access point for the service need that they have at any given time.

I will come back later to other issues. I finish now by saying that this is the great health debate—it is the big strategy decision that we have to make and it will dominate the next session of the Scottish Parliament. It is worth getting it right.