Hansard

We have had a debate in the chamber before about a shift to a preventative service, but the crux of the issue is about services being delivered locally and that preventative approach being integrated.

I was talking about the statistics that were released by the Scottish Government a couple of weeks ago. We have seen an increase in operations cancelled for non-clinical or capacity reasons; that was addressed at this afternoon’s health questions. We have seen missed targets for adults starting psychological therapies and—this is an important point—only 70 per cent of children and young people who need mental health treatment have started that treatment compared with the Government’s target of 90 per cent, which is very worrying.

Health boards across the country are facing millions of pounds-worth of cuts or savings, with my own health board seeking to save £27 million-worth of costs over the next couple of years due to rises in agency nursing costs, which the cabinet secretary knows about, and primary care prescribing. There are huge savings to come, with the real impact yet to be felt.

We can all agree that we face many challenges in our healthcare services, and our NHS staff are doing a fantastic job in difficult and pressing circumstances. However, the pressure on our staff and the NHS is set only to grow. What else will give unless we find additional revenue and resource?

Many of my colleagues from across Scotland sit waiting for decisions on services in their local areas. Big question marks hang over services in Lightburn hospital in Glasgow and St John’s hospital in Livingston, as well as over many other local wards and services. The injustice of those question marks, and the reason for our bringing this debate to the cabinet secretary, is that it is simply not fair that those questions persistently hang in the air. It is certainly not fair that those question marks will hang in the air until after the May election.

Honest Governments make decisions that are in people’s best interests and work with them to manage any change that those decisions bring, but they should have the courage of their convictions and the confidence of their argument. However, it is not right that all those crucial decisions are left in the balance because the Government does not want to be asked any difficult questions or face any opposition from local groups before the May election.

I expect that this afternoon’s debate could be more highly charged than usual—let me explain why. When there is doubt over local services, people need their representatives to stand with them and represent their concerns. There has been a lot of discussion in early hustings meetings, and in panel meetings between the four main parties, about taking politics out of the health debate. Jackson Carlaw is a particularly strong proponent of that. If I may poke a bit of fun at him, that is an interesting position for a Conservative health spokesperson, given the political hot water that Jeremy Hunt finds himself in in England.

Johann Lamont made a similar argument not too long ago, and I think that, mostly, it has worked well. There is a general consensus across the chamber on what needs to be done in the future: health and social care need to be integrated; there needs to be a move away from acute provision; there should be more preventative services based around primary care; pharmacies should have an expanded role around primary care; allied health professionals should have greater involvement; and there should be a much-needed focus on preventative health policies and public health.

We had a good debate in June last year, in which we said that we would support the Government when we agreed with it and when consensus was required to make progress, and that we would hold it to account when necessary. That is our job and our democratic duty.

When change is proposed, and especially when there is uncertainty, people in communities need their representatives to stand shoulder to shoulder with them to represent them through that change or to ask questions of those in power on what the change is, why it is happening and why they do not have the information that they need. Especially when there is uncertainty, there is a danger that rumour and myth will fill the void, and a good Government should do its best to avoid that.

It is that basic right that brings us to the chamber today, because it has simply been abused—I do not use that word lightly—in some of the instances that members will hear about from my colleagues. The fact that decisions that have been on the cards for months have been delayed and delayed for no good reason can lead us only to the conclusion that they are being delayed until the votes have been counted. The truth will remain hidden until any potential electoral consequences have been safely avoided. I do not think that that is a fair and honest way to run the country or our health service. The Scottish people deserve honest government.

It is not just decisions on the provision of local services, as detailed in the motion, that have been on hold. On several occasions, we have raised the fact that the cancer strategy is months overdue. Even the Tories in England managed to publish their cancer strategy last summer, when both strategies were due, and it includes commendable measures on diagnosis, care and treatment, but we are still waiting for ours, which has been delayed by not far short of a year.

The cabinet secretary has said that the national conversation must be completed, but the cancer strategy was due for publication before she came up with the national conversation, so that is no good reason for its delay. I sincerely hope that the strategy will be published this side of the election, so that people can see it before they cast their votes. That is the crux of the matter—people should have the information that they need on their Government’s intention on their local services. We are talking about the most simple democratic transaction.

The Scottish Government has a choice. Will it be brave enough to ask the people of Scotland to pay more for quality local services in the future, or will it be honest and admit that it plans to cut local services after the election? Will the Government allow the people of Scotland to make a judgment on its record on and vision for the health service and the specific decisions in question, or will it try to sneak through the next few weeks without making the hard decisions and expressing its intentions, only to spring them on people after their votes have been cast? That would be a very unfair way to proceed, and I hope that the cabinet secretary will be able to provide us with clarity on that.

I move,

That the Parliament acknowledges the commitment and dedication of Scotland’s NHS staff, care sector workers, GPs and other health professionals; believes that people and communities deserve fully-resourced services in their areas; is deeply concerned by reported plans for the potential closures of wards and hospitals in various communities across Scotland, and calls on all parties to ensure the continuation of current services such as the Royal Alexandra Hospital children’s ward, the emergency care services at the Vale of Leven Hospital, Lightburn Hospital in Glasgow and the children’s ward at St John’s Hospital in Livingston.