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Chamber

Meeting of the Parliament 16 January 2025

16 Jan 2025 · S6 · Meeting of the Parliament
Item of business
Health and Social Care (Rural Scotland)

I start, as others have, by congratulating my colleague Tim Eagle on bringing this hugely important matter to the chamber.

We are all aware of the pressures that the Scottish health service is under and the incredible work that our healthcare professionals do in such a difficult environment. Those pressures are magnified when trying to deliver healthcare in rural areas. There is much that we could discuss in the debate, and much already has been discussed, but I want to focus on the part that technology could and should play in the health service, especially as a major solution for rural healthcare delivery.

We need a health service that effectively delivers healthcare across our country, and that delivers an environment that supports our healthcare professionals. We need to recognise that delivering effective and efficient care will require different approaches and adaptations for rural and urban settings. The development and adoption of technology into the health service in the United Kingdom has lagged way behind the rest of the world, and Scotland lags behind the rest of the UK. The inability to share data across health boards and between primary and secondary healthcare, pharmacy and the third sector seriously hampers our ability to deliver effective and efficient healthcare.

However, the problem that we are trying to solve is one of time. How do we give our healthcare professionals more time to deliver healthcare, as opposed to swamping them with administration and red tape? First, we need a Scotland-wide technology platform with a basic architecture that allows for interoperability between health boards and facets of healthcare, with different and appropriate levels of access. Once that is in place, we will have the ability to take out duplication that occurs in back office administration across health boards. We will also have the ability to share good practice and access patient records directly, and once that is in place, we can start to look at how we take services to the people, rather than insist that people come to the services in all cases, as was raised by Tim Eagle.

We have the ability to deliver scans, pharmacy and vaccinations, as was highlighted by Fergus Ewing, and even the ability to deliver doctors’ surgeries, from mobile units. With a basic communication and collaboration platform, those mobile units could be directed to any hotspots, and a workforce plan for rural communities could be easily established. Tim Eagle highlighted the specific problems of small teams and staff shortages. If we layer AI on top of that, diagnosis from scans can be almost immediate. While we are on the subject, imagine being able to remotely access consultants from a mobile doctors’ surgery. Multilayered access to healthcare currently takes months of appointment making, with the patient having to travel from pillar to post. That is especially relevant for people who have to take a ferry or drive hundreds of miles for a 15-minute appointment.

Those options are not fantasy or science fiction—they have been available for years. That is how we deliver access to healthcare for all. It is how we create a rural healthcare system that encourages people to stay in a rural setting, and it is how we reduce the intolerable strain on our health service.

As the old saying goes, the definition of madness is doing the same thing over and over again and expecting a different result. Continuing to increase investment in the health service without a long-term plan, as Audit Scotland said in its report on the SNP health service, is unsustainable. Change the delivery mechanism. Give more time to our healthcare professionals to do what they do best. Otherwise, all the Scottish Government is doing is continuing to manage the decline of healthcare in this country, which is felt ever more acutely in our rural communities.

17:59  

In the same item of business

The Deputy Presiding Officer (Liam McArthur) LD
The next item of business is a members’ business debate on motion S6M-14408, in the name of Tim Eagle, on improving access to health and social care in rural...
Tim Eagle (Highlands and Islands) (Con) Con
I remind members that my wife is a general practitioner partner in a practice in Buckie and that I previously served for five years as a councillor in Moray....
The Deputy First Minister and Cabinet Secretary for Economy and Gaelic (Kate Forbes) SNP
In the spirit of commending workers in rural areas, I note that one advantage of smaller teams is that they are able to adapt, innovate and trial things more...
Tim Eagle Con
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 nurse...
The Deputy Presiding Officer LD
Before we move to the open debate, I advise members that we are heavily oversubscribed for this debate. It is inevitable that we will have to extend it by ha...
Fergus Ewing (Inverness and Nairn) (SNP) SNP
I thank Tim Eagle for, as he said, giving us all the opportunity to raise important matters. I wish to focus, as I have intimated to the cabinet secretary, o...
The Cabinet Secretary for Health and Social Care (Neil Gray) SNP
Will the member take an intervention?
Fergus Ewing SNP
Yes.
The Deputy Presiding Officer LD
Be very brief, cabinet secretary.
Neil Gray SNP
I have met Fergus Ewing and those GPs’ colleagues, whose advice I am very grateful for. I hope that he will accept that I have also provided clear guidance a...
The Deputy Presiding Officer LD
You need to conclude.
Fergus Ewing SNP
I appreciate that the cabinet secretary’s intentions are entirely honourable and good. I entirely accept that. However, as a former minister, I gently say to...
The Deputy Presiding Officer LD
We need to move on. I call Finlay Carson. You have up to four minutes. 17:15
Finlay Carson (Galloway and West Dumfries) (Con) Con
I congratulate Tim Eagle on bringing this crucial topic to the chamber. Living in rural Scotland remains a massive challenge and it is certainly not getting...
The Deputy Presiding Officer LD
You need to conclude.
Finlay Carson Con
In nobody’s mind is 90 miles “close to home”.
The Deputy Presiding Officer LD
You need to conclude.
Finlay Carson Con
Once again, I urge the cabinet secretary to consider an urgent review of the matter.
The Deputy Presiding Officer LD
Neither of the last two speeches has been within four minutes. We will need to do better, otherwise members who want to speak in the debate will be deprived ...
Douglas Ross (Highlands and Islands) (Con) Con
I congratulate Tim Eagle not just on securing tonight’s debate but on the tour de force speech that he gave on issues affecting his constituents—our constitu...
Rhoda Grant (Highlands and Islands) (Lab) Lab
I, too, thank Tim Eagle for securing the debate. Access to health and social care in the Highlands and Islands is poor, which is borne out by the Scottish H...
Neil Gray SNP
On Rhoda Grant’s point about social care, the progress that we are seeking to make in relation to a national care service is about enshrining a human rights-...
Rhoda Grant Lab
I agree that a human rights-based approach to budgeting must be taken at all levels to meet people’s human rights. That was clear from the Scottish Human Rig...
Jamie Halcro Johnston (Highlands and Islands) (Con) Con
As other members have done, I thank Tim Eagle for bringing the debate to the chamber. The number of speakers and the pressure that is being brought to bear h...
Neil Gray SNP
I hope that the member will recognise that, along with the constituency member, Kate Forbes, I met residents and family members at Moss Park and that interve...
Jamie Halcro Johnston Con
Saved for how long? That is the problem. What will the loss of care provision mean for the Belford hospital, which is itself in need of replacement? I joine...
Rachael Hamilton (Ettrick, Roxburgh and Berwickshire) (Con) Con
I am grateful to my colleague Tim Eagle for bringing forward this debate on rural healthcare. At 5 past 4 this afternoon, just over an hour ago, I received ...
Neil Gray SNP
Will the member write to me with the details of that case? We are investing in making sure that we can get through the waiting lists and are using the nation...
Rachael Hamilton Con
I am very grateful to Neil Gray for that response and will certainly write to him. I have also written to him in the past couple of days to invite him to com...
Beatrice Wishart (Shetland Islands) (LD) LD
I thank Tim Eagle for raising this important topic in the chamber. In addition to the list of facilities that need replacement that is included in the motion...