Hansard

I welcome this debate on what is an important issue for patients across Scotland.

There can surely be no doubt that I have been very clear from the outset that long waits are unacceptable and that improving performance against waiting times is one of my three key priorities. I therefore take this opportunity to again offer my unreserved apologies to everyone who is currently experiencing, or has experienced, a delay anywhere in the health system.

As I have said previously, too many people are waiting too long for out-patient appointments and treatment. I know only too well the impact that that has on the physical and mental health of the patient, and on their families. However, knowing that is not enough; people quite rightly expect us to do something to change it. My determination to do just that is exactly why I published the waiting times improvement plan in October last year to substantially and sustainably improve waiting times, particularly for those waiting the longest, backed by significant additional financial investment.

While we increase capacity in the NHS to deliver on that plan, for those people who have to wait longer than 12 weeks, health boards need to ensure that each and every person is given a realistic timeline from the very beginning of their journey and kept up to date with any changes that affect that timeline. Around a year ago, my predecessor, Shona Robison, said that health boards should be advising patients of their likely wait and the reasons for delay. We committed to reinforcing that through the revision of “The Charter of Patient Rights and Responsibilities”, which is routinely reviewed every five years, with the latest review beginning in 2017. That revision has gone through a rigorous engagement process, including with stakeholders such as the patient advice and support service. I am pleased today to advise members that the revised charter will be laid in Parliament before the summer recess and will be applicable from autumn this year. We have also been working with our health boards and key stakeholders across the country to deliver on our commitment to give patients clarity on the length of time that they can expect to wait before treatment, and the revised letter and guidance will be used nationally and issued to boards by the end of this week.

Since the introduction of the waiting times guarantee, around nine out of 10 patients have been seen and treated within 12 weeks. That is more than 1.7 million patients, and every bit of that achievement is down to the staff working in the health service. Recognising that matters, but it does not and will not deflect from my determination to see improvement. Our work to improve performance is not confined to the treatment time guarantee but extends to mental health, our cancer targets, and attendances at accident and emergency departments. Our A and E performance is the best anywhere in the United Kingdom and has been so for more than four years, despite a significant and sustained increase in A and E attendances. However, there is more to do: continuing our work with the Royal College of Emergency Medicine in Scotland; consistently implementing the six essential actions across Scotland, with no variation; and improving hospital flow and discharge.

Since October, we have invested £26.7 million from the total of £850 million to make immediate reductions in waiting times across a range of procedures and, importantly, to focus board by board on the most pressing areas of longest wait. That varies board by board, and it is important that the resources are targeted in that way. Last month, I announced a further £70 million for this year. That will see additional recruitment of specialists and healthcare professionals, increased numbers of orthopaedic and cataract procedures and an increase in the number of out-patient appointments and diagnostic procedures. All of that is aimed at meeting the first waiting times milestone this autumn.

However, although increasing activity is important, we need to build resilience into the system so that we have future sustainability. That comes by increasing capacity through the network of elective and diagnostic centres that we are creating and the work of the Scottish access collaborative, which brings together clinicians, healthcare professionals and others to ensure that the design of our patient care and pathways are as streamlined and effective as they can be. NHS Scotland is recognised as a world leader in quality improvement—it is the central underpinning of our patient safety programme. It must therefore be embedded in the delivery of all our improvement programmes, including the waiting times improvement plan. Alongside all that I have outlined—and much more besides—runs our access quality improvement work to increase our capacity to consistently improve patient pathways and patient experience and existing access improvement programmes.

Our performance on waiting times must improve, and I believe that our commitment to that is clearly evidenced by the many actions that we and staff across the NHS are taking. All of that—the immediate activity and the long-term sustainable solutions—is focused on delivering the care that patients need in the timeframe that they rightly expect and in reaching a better balance between demand and capacity, so that we are better placed with sustainable solutions now and for the future.

I move amendment S5M-17281.4, to leave out from “Government’s legally-binding” to end and insert:

“Government offers an unreserved apology to any patient who waits longer for treatment than they should do; further notes that this extends beyond patients covered by the treatment time guarantee to those receiving any form of NHS care, including through outpatient, A&E, and mental health services; believes that every patient should be given a realistic estimate of their waiting time in writing, that anyone not being seen within their target should receive an apology in that letter, and that this should be underpinned by updating the patients’ charter; understands that the Scottish Government’s waiting time improvement plan sets a trajectory of investment and recovery, and believes an early aim of this work should be to ensure that there are no patients with very long waits for treatment.”