Meeting of the Parliament 03 April 2019
Last year, we rightly celebrated 70 years of the NHS. This year, we need to look forward as well and consider what kind of health service we want and expect for the next generation. Some things are bound to change. People are living longer, which means there are new challenges for health and care as well as a different demographic balance.
New technologies are part of the way forward. This morning’s The Press and Journal highlighted the potential for GP consultations going online at Countesswells in Aberdeen, where internet speeds of one gigabyte per second will provide fast and secure connections. The same newspaper also highlighted the decline in the number of GP practices in Grampian. It is down by more than 10 per cent in the last ten years. GP practice numbers have also fallen in many other areas, from Lanarkshire to Orkney and the Western Isles.
The future delivery of care in communities will require not just enough GPs but also a whole range of other healthcare professionals, from pharmacists and physician associates to occupational therapists and advanced nurse practitioners. This is, therefore, a good time to consider what primary care will look like in the next thirty years, what staff and skills it will need and what support those staff will require. The Health and Sport Committee is doing just that, and I hope that many of our constituents who are listening to the debate will take the opportunity to go to the Scottish Parliament website to tell the committee their views.
Hospital care, too, faces real challenges right now, many of which are also fundamentally about staff. One thing that has changed very little since the inception of the national health service is the extent to which we depend on the dedication and commitment of healthcare staff. Monica Lennon and others mentioned issues that staff organisations such as the BMA and the RCN have raised. They tell very similar tales. Nurses in Scotland and across the NHS have described how often they have to cope with inadequate staffing levels and how often they have to do more than their planned shift to ensure that patients receive the care that they need. Doctors talk about going the extra mile to cover for ill or absent colleagues or long-term vacancies. Even though, through those actions, they keep the NHS afloat, they feel that they get little thanks for doing so.
All of that is bound to affect the quality of care. It also risks the kind of reputational damage that makes recruiting the next generation of healthcare professionals to the NHS all the harder. Whatever we call them, those are challenges that must be faced and addressed sooner rather than later; otherwise, we will risk exhausting the good will and commitment of the staff that are so important to the NHS.
We must acknowledge, too, the issues that the social care workforce faces. The Health and Care (Staffing) (Scotland) Bill, which Emma Harper mentioned, acknowledges the need for parity between health and social care as part of the process of health and care integration, but as we have heard, when it comes to pay and support for staff, social care is still the poor relation of the NHS. The Joseph Rowntree Foundation says that 15 per cent of the social care workforce live in poverty. Enable describes that situation as
“Scotland’s most vulnerable people being cared for by Scotland’s most vulnerable workforce.”
It is clear that that must change.
When we look to the future, we need to think about how to close the gap between the NHS and social care at the same time as addressing the staffing challenges within the NHS. We can create the high-quality integrated health and care sector that we all want and need only if we start by supporting those who work there, now and in the future, and making the sector an attractive place to work for the next generation.
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