Chamber
Plenary, 12 Dec 2007
12 Dec 2007 · S3 · Plenary
Item of business
Health Strategy
That is better than how members sometimes refer to me outside the chamber—at least, it is better than how Margaret Curran sometimes refers to me.
Ross Finnie raises a number of important issues. I am glad that he was able to read the statement at lunch time, but counting the number of words in it was perhaps a step too far—he might have been better having lunch instead.
Ross Finnie made some points about participation. I am glad that the Liberal Democrats agree that it is important further to involve not just the public and patients, but NHS staff, in the way in which the health service is delivered. Rightly, Ross Finnie expressed concern that we should not have too many separate consultations. The other side of that argument is that we must ensure that the arguments relating to issues such as patients' rights—some of which have been made by Ross Finnie—are properly explored.
We will undertake three main consultations over the next few months. One—the consultation on embedding independent scrutiny in all future proposals for major service change—is already under way. Next year we will launch a consultation on the possible contents of a patients' rights bill. I know that Ross Finnie, in particular, will take a close interest in that. The third consultation will be on a local health care bill, which will be published very early in the new year. That will look at how we can enhance the existing arrangements for public and patient participation and will cover our proposal for direct elections to health boards, which raises a number of complex issues to do with governance, accountability and relationships with existing non-executive board members. It is important that those issues are properly and adequately explored.
The relationship of the ministerial task force on health inequalities with the early years strategy is an important issue. The task force is already up and running, is well into its programme of work and will report to Cabinet next year. There is close alignment between its work and work on developing the early years strategy—the two are feeding into each other. Adam Ingram, the minister in charge of the early years strategy, is a member of the ministerial task force, so there is deliberate integration of the two, which is important.
I dealt substantially with the issue of mental health in my answer to Mary Scanlon's question, but I stress again that we are concentrating more on outcomes than on inputs. No funding has been abolished—we are simply changing the arrangements for funding local authorities. We are increasing accountability through the increased number of targets, which will ensure that we can be held to account on the delivery of those important objectives.
On Ross Finnie's point about the need to further shift the balance of care—the split infinitive is, I think, the responsibility of Professor David Kerr who wrote the report in which the phrase was first coined—he is right that the concept must be about more than rhetoric and must have some substance. When he has time to read the action plan in more detail, he will see that much of the substance is in measures to keep people out of hospital by, for example, ensuring support through good-quality community services and providing more local community-based diagnostic services, which will be critical for delivering our 18-week waiting time target. I agree that we need to ensure that budgets follow the aspiration of shifting the balance of care. He will note that the action plan's section on community health partnerships talks about the need to devolve more resources to those partnerships to allow them to give reality to that concept. I hope that he will find a lot to assure him when he reads the action plan.
Ross Finnie's final question was about targets. I certainly take his point, as I believe that it is right and proper that the Parliament can hold the Government to account, and that the Government can hold the health service to account, not just annually but more regularly. I will certainly reflect on that.
However, previous practice is not quite as Ross Finnie remembers it. Many of the previous Administration's targets for the health service fell to be met at the end of December this year, which is some seven months after the election at which that Administration was voted out of office. I can assure him that I will ensure that I am subject to parliamentary scrutiny that is much more regular and meaningful than that.
Ross Finnie raises a number of important issues. I am glad that he was able to read the statement at lunch time, but counting the number of words in it was perhaps a step too far—he might have been better having lunch instead.
Ross Finnie made some points about participation. I am glad that the Liberal Democrats agree that it is important further to involve not just the public and patients, but NHS staff, in the way in which the health service is delivered. Rightly, Ross Finnie expressed concern that we should not have too many separate consultations. The other side of that argument is that we must ensure that the arguments relating to issues such as patients' rights—some of which have been made by Ross Finnie—are properly explored.
We will undertake three main consultations over the next few months. One—the consultation on embedding independent scrutiny in all future proposals for major service change—is already under way. Next year we will launch a consultation on the possible contents of a patients' rights bill. I know that Ross Finnie, in particular, will take a close interest in that. The third consultation will be on a local health care bill, which will be published very early in the new year. That will look at how we can enhance the existing arrangements for public and patient participation and will cover our proposal for direct elections to health boards, which raises a number of complex issues to do with governance, accountability and relationships with existing non-executive board members. It is important that those issues are properly and adequately explored.
The relationship of the ministerial task force on health inequalities with the early years strategy is an important issue. The task force is already up and running, is well into its programme of work and will report to Cabinet next year. There is close alignment between its work and work on developing the early years strategy—the two are feeding into each other. Adam Ingram, the minister in charge of the early years strategy, is a member of the ministerial task force, so there is deliberate integration of the two, which is important.
I dealt substantially with the issue of mental health in my answer to Mary Scanlon's question, but I stress again that we are concentrating more on outcomes than on inputs. No funding has been abolished—we are simply changing the arrangements for funding local authorities. We are increasing accountability through the increased number of targets, which will ensure that we can be held to account on the delivery of those important objectives.
On Ross Finnie's point about the need to further shift the balance of care—the split infinitive is, I think, the responsibility of Professor David Kerr who wrote the report in which the phrase was first coined—he is right that the concept must be about more than rhetoric and must have some substance. When he has time to read the action plan in more detail, he will see that much of the substance is in measures to keep people out of hospital by, for example, ensuring support through good-quality community services and providing more local community-based diagnostic services, which will be critical for delivering our 18-week waiting time target. I agree that we need to ensure that budgets follow the aspiration of shifting the balance of care. He will note that the action plan's section on community health partnerships talks about the need to devolve more resources to those partnerships to allow them to give reality to that concept. I hope that he will find a lot to assure him when he reads the action plan.
Ross Finnie's final question was about targets. I certainly take his point, as I believe that it is right and proper that the Parliament can hold the Government to account, and that the Government can hold the health service to account, not just annually but more regularly. I will certainly reflect on that.
However, previous practice is not quite as Ross Finnie remembers it. Many of the previous Administration's targets for the health service fell to be met at the end of December this year, which is some seven months after the election at which that Administration was voted out of office. I can assure him that I will ensure that I am subject to parliamentary scrutiny that is much more regular and meaningful than that.
In the same item of business
The Presiding Officer (Alex Fergusson):
NPA
The next item of business is a statement by Nicola Sturgeon on the Scottish Government's health strategy. The Deputy First Minister and Cabinet Secretary for...
The Deputy First Minister and Cabinet Secretary for Health and Wellbeing (Nicola Sturgeon):
SNP
I am delighted to publish today our new action plan for health and well-being. "Better Health, Better Care" sets out a clear vision for the national health s...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
I thank the minister for an advance copy of her statement.I have one note of significant disappointment—although there are perhaps a few others—that minister...
Nicola Sturgeon:
SNP
I thank—or at least I think that I should thank—Margaret Curran for those questions. It is slightly depressing that although I have just published a wide-ran...
Mary Scanlon (Highlands and Islands) (Con):
Con
I, too, thank the cabinet secretary for the advance copies of her statement and the action plan. I put it on the record that the Scottish Conservatives ackno...
Nicola Sturgeon:
SNP
I thank Mary Scanlon for her questions and for asking them positively. I accept that all members will want more time to read the action plan—on recent eviden...
Ross Finnie (West of Scotland) (LD):
LD
I, too, thank the cabinet secretary for the advance copy of her statement and action plan. Like others who received them, I thought that the 3,328 words of t...
The Presiding Officer:
NPA
Before I call the cabinet secretary to reply, I remind members that they may refer to her in many ways—as "cabinet secretary", as "minister" or as "Nicola St...
Nicola Sturgeon:
SNP
That is better than how members sometimes refer to me outside the chamber—at least, it is better than how Margaret Curran sometimes refers to me.Ross Finnie ...
The Deputy Presiding Officer (Alasdair Morgan):
SNP
A large number of members have pressed their request-to-speak buttons, so questions should be brief and focused. I call Christine Grahame.
Christine Grahame (South of Scotland) (SNP):
SNP
I do not know why that is always said just before I get up to ask a question, but there we are.Quite rightly, the cabinet secretary stressed the commitment t...
Nicola Sturgeon:
SNP
I thank Christine Grahame for asking perhaps the most important question that could be asked about the action plan. She will recall that when the Cabinet Sec...
Helen Eadie (Dunfermline East) (Lab):
Lab
The cabinet secretary has focused on making waiting times shorter for people to get into hospitals, but I have evidence of a sudden increase in patient waiti...
Nicola Sturgeon:
SNP
I assure the member that this Government gives absolute priority to tackling delayed discharges. Indeed, we have spent a long time discussing the topic in th...
Helen Eadie:
Lab
Absolute nonsense.
The Deputy Presiding Officer:
SNP
Order.
Nicola Sturgeon:
SNP
That administration then set a budget to bring the overspend down to nil. That is the reality of what the new administration in Fife inherited—Interruption.
The Deputy Presiding Officer:
SNP
Order.
Nicola Sturgeon:
SNP
I know that the member might not like hearing the truth, but she might do well to listen. That is the reality of what the new administration inherited, and i...
Ian McKee (Lothians) (SNP):
SNP
It is clear from the cabinet secretary's speech that the Scottish Government is looking for an NHS that is responsive to people's needs and available at the ...
The Deputy Presiding Officer:
SNP
Order.
Ian McKee:
SNP
What I would like to say—if I am allowed to—is that, as a former GP, I am interested in and agree entirely with the cabinet secretary's proposal to extend GP...
Nicola Sturgeon:
SNP
I thank Ian McKee for those questions. I would have to come into the chamber wearing earmuffs in order not to hear the moans and groans of the Labour Opposit...
Cathie Craigie (Cumbernauld and Kilsyth) (Lab):
Lab
The cabinet secretary's 25-minute statement to Parliament contained little more than we already knew, apart from new words for the principle—already accepted...
The Deputy Presiding Officer:
SNP
There should be a question, Ms Craigie.
Cathie Craigie:
Lab
When will the Government initiate a debate on health? The SNP supported Bill Butler's member's bill on direct elections to NHS boards in the previous parliam...
The Deputy Presiding Officer:
SNP
The member has spoken for long enough. Minister, will you answer, please?
Nicola Sturgeon:
SNP
Cathie Craigie is absolutely right that my party supported Bill Butler's bill on direct elections. Unfortunately, her party did not, which is why the bill fe...
Cathie Craigie:
Lab
No, you haven't.
Nicola Sturgeon:
SNP
Let me give her a few highlights of what we have done on health since the election in May.