Chamber
Plenary, 28 Nov 2001
28 Nov 2001 · S1 · Plenary
Item of business
Community Care and Health (Scotland) Bill: Stage 1
I welcome the minister's point about increases in funding, but as I think all members of the Health and Community Care Committee have said, we are looking for increases in outcomes. The figures are horrific, by anyone's account. They fly in the face of Government policy, which emphasises care at home. That point cannot be missed.
In the Highlands, where 170 people are left in hospital when they should be in the community, we note that the Highland Council's proportion of net community care expenditure on home care for all ages is the lowest in Scotland at 8 per cent. We should also consider that. In comparison, Falkirk Council's proportion is 31 per cent. We need to consider the allocation of those budgets and why some councils allocate so much less than others.
The Highland Council tells us constantly that delayed discharge is all the health board's fault. On Monday, we were told that the fault lay with the council. That is not joint working, and patients are suffering. That could be overcome by accepting the Health and Community Care Committee's recommendation that a single body should be the budget holder, to achieve accountability and transparency and ensure a single point of entry for services.
The Conservatives would like that budget to be managed by the NHS, as the NHS carries the cost of councils' inability to accept that they must provide appropriate care and support to many people. The result is rising waiting lists in hospital and inappropriate care.
We fully endorse and welcome the recommendation of direct payments, which will empower and enable carers and families to purchase the care that they need, when they need it, and to choose the provider of that care. It is unfortunate that the number of people taking up direct payments in Scotland is just over 207. Of those people, 93 per cent are from the 18 to 64 age group. Half Scotland's local authorities do not participate in the scheme. I understand that eligibility depends on a person's being designated disabled, but nonetheless, a positive approach to direct payments must be taken, to maximise the success that the minister spoke about.
It is unacceptable for councils to monopolise referrals to their own homes at a weekly charge of £361 when, in the private, voluntary and independent sectors, the average cost is about £278. Direct payments would allow people to exercise choice in care and the quality of that care.
The Scottish Conservatives endorse, welcome and acknowledge the principles in the bill.
In the Highlands, where 170 people are left in hospital when they should be in the community, we note that the Highland Council's proportion of net community care expenditure on home care for all ages is the lowest in Scotland at 8 per cent. We should also consider that. In comparison, Falkirk Council's proportion is 31 per cent. We need to consider the allocation of those budgets and why some councils allocate so much less than others.
The Highland Council tells us constantly that delayed discharge is all the health board's fault. On Monday, we were told that the fault lay with the council. That is not joint working, and patients are suffering. That could be overcome by accepting the Health and Community Care Committee's recommendation that a single body should be the budget holder, to achieve accountability and transparency and ensure a single point of entry for services.
The Conservatives would like that budget to be managed by the NHS, as the NHS carries the cost of councils' inability to accept that they must provide appropriate care and support to many people. The result is rising waiting lists in hospital and inappropriate care.
We fully endorse and welcome the recommendation of direct payments, which will empower and enable carers and families to purchase the care that they need, when they need it, and to choose the provider of that care. It is unfortunate that the number of people taking up direct payments in Scotland is just over 207. Of those people, 93 per cent are from the 18 to 64 age group. Half Scotland's local authorities do not participate in the scheme. I understand that eligibility depends on a person's being designated disabled, but nonetheless, a positive approach to direct payments must be taken, to maximise the success that the minister spoke about.
It is unacceptable for councils to monopolise referrals to their own homes at a weekly charge of £361 when, in the private, voluntary and independent sectors, the average cost is about £278. Direct payments would allow people to exercise choice in care and the quality of that care.
The Scottish Conservatives endorse, welcome and acknowledge the principles in the bill.
In the same item of business
The Presiding Officer (Sir David Steel):
NPA
Our next item of business is a debate on motion S1M-2247, in the name of Susan Deacon, on the general principles of the Community Care and Health (Scotland) ...
The Minister for Health and Community Care (Malcolm Chisholm):
Lab
There have been many significant developments in community care in this Parliament's lifetime, and the Community Care and Health (Scotland) Bill marks a furt...
Nicola Sturgeon (Glasgow) (SNP):
SNP
I welcome the new minister to his post and wish him well in the job. I congratulate the two new deputy health ministers, although it is perhaps appropriate t...
Mary Scanlon (Highlands and Islands) (Con):
Con
Does the member recognise that all 19 Conservatives voted in favour of free personal care? Will she endorse that fact?
Nicola Sturgeon:
SNP
I accept that, but it was the 19 years that preceded those 19 votes that led to me to make that judgment about the Conservative party. The real threat to fre...
Mary Scanlon (Highlands and Islands) (Con):
Con
I congratulate the new minister. That he has gone from being a member of the Health and Community Care Committee and back-bench rebel to Minister for Health ...
Malcolm Chisholm:
Lab
I want to point out that that was not correctly transcribed because, if members think about it, what I said was that free personal care could be regarded as ...
Mary Scanlon:
Con
My quote came from the Official Report.Page 67 of the Sutherland report states that personal care"falls within the internationally recognised definition of n...
Malcolm Chisholm:
Lab
I am sure that the member will accept that clinics are hardly an institutional setting. Does she accept that not only the number of visits but their length a...
Mary Scanlon:
Con
I welcome the minister's point about increases in funding, but as I think all members of the Health and Community Care Committee have said, we are looking fo...
Mrs Margaret Smith (Edinburgh West) (LD):
LD
I welcome Malcolm Chisholm to his new job as Minister for Health and Community Care. As Nicola Sturgeon said, that is one of the most difficult jobs in Gover...
The Deputy Presiding Officer (Mr George Reid):
SNP
We move now to open debate. Sir David announced that time would be tight, but some speakers have dropped out since then, so I shall allow up to five minutes ...
Margaret Jamieson (Kilmarnock and Loudoun) (Lab):
Lab
I record my congratulations to Malcolm Chisholm, Mary Mulligan and Hugh Henry on their appointments, and I look forward to working with them in the coming mo...
Tricia Marwick (Mid Scotland and Fife) (SNP):
SNP
I congratulate Malcolm Chisholm on his appointment. We have known each other for a long time in different roles and I am sure that he will bring to the job h...
Janis Hughes (Glasgow Rutherglen) (Lab):
Lab
I echo the comments that have been made elsewhere in the chamber and offer my congratulations to Malcolm Chisholm and to the two new Deputy Ministers for Hea...
Bill Aitken (Glasgow) (Con):
Con
When this matter was first debated, there was a consensus that the bill was an important piece of legislation. It is a sad fact that none of us is getting an...
Dorothy-Grace Elder (Glasgow) (SNP):
SNP
I do not know why Bill Aitken is so worried about blank cheques. He knows perfectly well that one has been issued to pay for the new Parliament. Anything tha...
Nora Radcliffe (Gordon) (LD):
LD
I congratulate the new health team, wish them well in their work and pay tribute to Susan Deacon for her contribution as our first Minister for Health and Co...
Irene Oldfather (Cunninghame South) (Lab):
Lab
I offer my congratulations to the new minister and his two deputies. I also extend my good wishes to Susan Deacon. As Margaret Smith said, two of the three m...
Alex Fergusson (South of Scotland) (Con):
Con
I take part in the debate with great personal pleasure. That is partly because, as I am now on the wrong side of 50, I am keen to ensure that as much as poss...
Colin Campbell (West of Scotland) (SNP):
SNP
I want to reiterate the point made anent the £20 million attendance allowances that are being held back by the UK Exchequer, to which the people of Scotland ...
Ben Wallace (North-East Scotland) (Con):
Con
If Scotland was independent, will Mr Campbell tell us where he would find the £20 million? Whom would he tax to get the £20 million to provide free personal ...
Colin Campbell:
SNP
We have already paid the money in tax to the United Kingdom Exchequer; it is sitting there as part of the totals that we have already paid in. Good try, Mr W...
The Deputy Presiding Officer:
SNP
If members want their time to be extended, permission will gladly be given on this occasion.
Karen Whitefield (Airdrie and Shotts) (Lab):
Lab
I add my congratulations to Malcolm Chisholm and his two new deputies. I wish them well in their new role. I pay tribute to the work of Susan Deacon, our for...
Mr Keith Raffan (Mid Scotland and Fife) (LD):
LD
I welcome the minister to his new post. When I first became a spokesman on health, there seemed to be at least two health debates a week. I was thrown in at ...
Members:
Go on.
The Deputy Presiding Officer:
SNP
Order. Carry on, Mr Raffan.
Mr Raffan:
LD
A lot has happened since then, not least in the past few days—so that period is almost pre-history. We have come a long way since the Minister for Parliament...
Nicola Sturgeon:
SNP
Will the member give way?