Hansard

I am delighted to open for the Scottish Conservatives in this very important debate. I am pleased that we are finally having it, since it originally appeared in the Business Bulletin several weeks ago.

I have said many times in this chamber that, on issues across health and beyond, our party will act as a strong Opposition, scrutinising the actions of the Scottish Government at all times. We will critique the Government when we feel that it is not performing to standards expected by the people of Scotland and, similarly, we will welcome positive achievements that make a real and tangible difference to people’s lives.

In that spirit, we on this side of the chamber fully support the Scottish patient safety programme and its aims and objectives, and we will continue to support it as its remit grows. That means ensuring that every Scottish citizen who enters a hospital, whether that be for an out-patient appointment, for minor treatment or for a longer stay, should have a right to outstanding treatment, professional care and, above all else, know that they are safe from further illness or complication where that can be prevented.

The need for every patient in our health service to be safe is obvious and paramount. However, context is important in understanding why the Scottish patient safety programme came into being in the first place. Before the programme was introduced, it was recognised that the number of hospital deaths was too high, and that the number of people succumbing to infections or other complications was excessive.

In fact, the Scottish patient safety programme acknowledged that there are many severe risks in Scotland’s hospitals. In 2008, it was estimated that around 2,000 falls occurred in Scottish acute hospitals every month, accounting for a third of all reported patient safety events. In 2011, NHS statistics showed that around 22 per cent of all healthcare acquired infections were urinary tract infections, with 4 per cent of patients developing life-threatening bacteraemia or sepsis as a result. Those statistics range over different timelines and different conditions, but all highlight that there are always risks in hospitals, proving the need for a monitoring body to ensure that those risks can be reduced as much as possible.

Given the original aims of the Scottish patient safety programme when it was established—to oversee reductions in infections, life-threatening developments and, sadly, deaths in acute hospitals—there have been many successes that must be welcomed and that I am happy to welcome. Since 2007, there has been a 16.5 per cent reduction in the hospital standardised mortality ratio and it is good that the up-to-date information that the cabinet secretary just provided confirms that that is on-going. In plain English, there are now fewer avoidable deaths in Scotland’s hospitals, which is testament to the hard work and commitment of our NHS staff, and we should all welcome that.

The remit of the patient safety programme has expanded in the past 10 years to include the monitoring of healthcare associated infections, maternity and neonatal services, the safer use of medicines, mental health services and primary care services. There have been many notable achievements in primary care, including the fact that 93 per cent of all general practices regularly participate in the Scottish patient safety programme’s safety climate survey. That allows practices to monitor their performance against that of other practices, enabling patient safety to develop within a practice. Practices can also check not just safety within the practice but the perception of safety within the practice.

I will talk only briefly about maternity services because I have colleagues who want to elaborate on the issue later. It is notable that since 2007 stillbirth rates have fallen. There are many achievements to praise, and I cannot stress enough that we on the Conservative benches and, I am sure, all members across the chamber support our NHS front-line staff and the phenomenal work that they carry out in keeping patients safe in ever-changing and difficult circumstances.

However, it is also right that we talk about what we need to do better to ensure that the aims of the programme are and continue to be fully met. While many of the overall statistics are delivering better outcomes for patients, there remain inconsistencies in the performances of individual hospitals. My local hospital, the Belford in Fort William, had a significantly higher mortality ratio than the national average in the first quarter of 2016. Dr Gray’s hospital, the Inverclyde royal, the Royal Alexandra and the Vale of Leven were all recorded as being above the upper warning limit for the mortality ratio in the most recently available information.

The cabinet secretary mentioned the chief medical officer’s report that came out this week. In that report, the CMO noted that between 2011 and 2015, the incidence of E coli rose by 5.2 per cent, and that half of the near 4,600 cases of E coli in 2015 were associated with healthcare. Public confidence is important and it remains an issue. As last year’s in-patient experience survey notes, one in five people say that they experienced problems during a hospital stay, and nearly a quarter of people felt that their condition worsened while they were in hospital.

It is clear that, while much progress has been made on patient safety, there is still a lot to do. Any debate on patient safety must consider current levels of NHS staffing, and it is here that I have to adopt a more critical tone.

It is no coincidence that every Opposition amendment to the motion mentions staffing. The amendments were lodged without any collaboration, so there are clearly huge concerns about the issue across the chamber. We need to ensure that the great work that is being carried out by NHS staff is supported and aided by ensuring that the NHS has the right number of front-line staff to deliver those changes.

NHS staff cannot be expected to deliver a Scottish patient safety programme and reach its targets when there are so many unfilled vacancies across the board. We have been consistent in our calls for a solution to that crisis and have highlighted it time and again. That is why we lodged our amendment. The terms of the Government’s motion are entirely laudable but, given the crisis in staffing, we cannot leave matters as they stand. It is only realistic to expect progress.