Meeting of the Parliament 16 January 2025
I agree. I do not have time to go into this in my speech, but I would argue that some of the centralisation in relation to community treatment and care nurses and mental health support has not worked, because local teams are better at making local decisions.
Too often, the pressures that we are put under in rural Scotland manifest themselves in unfair treatment of staff, who are part of our rural communities. That is never acceptable. However, I understand that patients are anxious, worried and in pain and that they are never getting appointments or are, perhaps, being sent further away for treatments. We need to reflect those concerns in the Parliament and through our national health service boards. Health professionals on the ground should never face punishment for lack of delivery by those who sit on the Government benches here. I have a small plea: rather than leaving behind frustration or anger the next time that we need healthcare, let us consider leaving a packet of biscuits or a cake—maybe even a thank you.
We need bold, brave and common-sense policies that can deliver real and lasting change. If we want more doctors in our rural communities, we need to incentivise them to come. If we want rural healthcare to be strong and sustainable, we need to accept the costs that come with that and to provide working environments that offer educational opportunities and a fair work-life balance. We need to ensure that, in 21st century Scotland, we are providing the services that people need.
Other countries have been successful: in Estonia, the Government has developed an artificial intelligence-powered health information system; Brazil has taken on large volumes of community health workers; Chile has put in place a rural practitioner incentive programme, which provides financial and housing incentives and professional development opportunities; and Australia has the Royal Flying Doctor Service. The four key themes that underpin those global approaches are decentralisation, the use of technology, the use of incentives and ensuring community involvement. We need a campaign that brings all that together, continues to raise awareness and brings together people from across Scotland to show what is happening with absolute clarity. That is why I will start an awareness campaign for rural healthcare.
What I have said is no political trickery. It is a reality that must be fixed. We do not need more talk; we need positive action. Our communities feel the daily pain of a weakening health system, our staff are too often exhausted, district general services are depleted and health boards seem to have adopted an attitude of, “You come to us—we do not come to you.”
One person in the chamber could change that. They could grab those four themes and go wild with common-sense and actionable policies, shake up the system, support our rural staff and provide the change that is needed. If the cabinet secretary does not do that, I hope that the people of Scotland will let the Scottish Conservatives do it in 16 months’ time, because—rest assured—we would.