Chamber
Plenary, 05 Jun 2008
05 Jun 2008 · S3 · Plenary
Item of business
Remote and Rural Health Care
I am grateful to the minister for that reassurance. I am sure that the people of Caithness will be grateful for it, too.
The report states that there has been a rise in hospital admissions because of the failure of out-of-hours care in remote and rural areas. We all know that it costs five times more to deliver out-of-hours care. The rise in hospital admissions when such care fails adds to the costs that rural health boards bear. When funding is cut in real terms, it does not reflect the real costs of delivering rural health care, and leaves little room for ambition. Delivering services as close to people as possible in remote and rural communities means higher costs. Consultants who travel to patients in rural areas cost more; they are travelling rather than seeing more patients. We should acknowledge that they cost more, but we must also be clear that such an approach is right. It is difficult for people to travel long distances to access health services. They are often worried about receiving bad news, and being a long way from home makes a bad situation a lot worse.
The report's emphasis on telemedicine and the use of other technologies is welcome. Such technologies will also have benefits in delivering health care in more urban settings. Where possible, such services should be delivered at home or as close to home as possible.
The report also talks about team working, which should surely be happening already, but when health care staff are few and far between, that presents a challenge for team working, as people seldom work together. The report mentions multiskilling and the current review of community nursing, but the pilots have just begun and it would be sensible to await their outcome before proceeding. All staff groups, especially those that are most directly affected, should be involved in implementing the measures.
The report makes a passing reference to what I would term one of the really good models of rural health delivery. The Howard Doris centre in Lochcarron provides care for all parts of the community, from nursing home care and sheltered housing to respite care and medical beds. That means that some people do not need to be admitted to hospital and ensures that those who do can move closer to home more quickly. The centre delivers health and local government services seamlessly, so why does it merit only a passing reference in the report? I fear that it is because it is a community-led initiative. In providing cross-service care and the level of service that local people require, it is a model that really delivers. If the Government is keen on matching rhetoric with action, it could do an awful lot worse than use that model in areas where there is little or no in-patient support.
The report states that there has been a rise in hospital admissions because of the failure of out-of-hours care in remote and rural areas. We all know that it costs five times more to deliver out-of-hours care. The rise in hospital admissions when such care fails adds to the costs that rural health boards bear. When funding is cut in real terms, it does not reflect the real costs of delivering rural health care, and leaves little room for ambition. Delivering services as close to people as possible in remote and rural communities means higher costs. Consultants who travel to patients in rural areas cost more; they are travelling rather than seeing more patients. We should acknowledge that they cost more, but we must also be clear that such an approach is right. It is difficult for people to travel long distances to access health services. They are often worried about receiving bad news, and being a long way from home makes a bad situation a lot worse.
The report's emphasis on telemedicine and the use of other technologies is welcome. Such technologies will also have benefits in delivering health care in more urban settings. Where possible, such services should be delivered at home or as close to home as possible.
The report also talks about team working, which should surely be happening already, but when health care staff are few and far between, that presents a challenge for team working, as people seldom work together. The report mentions multiskilling and the current review of community nursing, but the pilots have just begun and it would be sensible to await their outcome before proceeding. All staff groups, especially those that are most directly affected, should be involved in implementing the measures.
The report makes a passing reference to what I would term one of the really good models of rural health delivery. The Howard Doris centre in Lochcarron provides care for all parts of the community, from nursing home care and sheltered housing to respite care and medical beds. That means that some people do not need to be admitted to hospital and ensures that those who do can move closer to home more quickly. The centre delivers health and local government services seamlessly, so why does it merit only a passing reference in the report? I fear that it is because it is a community-led initiative. In providing cross-service care and the level of service that local people require, it is a model that really delivers. If the Government is keen on matching rhetoric with action, it could do an awful lot worse than use that model in areas where there is little or no in-patient support.
In the same item of business
The Presiding Officer (Alex Fergusson):
NPA
Good morning. The first item of business is a debate on motion S3M-2056, in the name of Nicola Sturgeon, on remote and rural health care. I remind members th...
The Deputy First Minister and Cabinet Secretary for Health and Wellbeing (Nicola Sturgeon):
SNP
I am happy to open yet another health debate. I suspect that there are members here this morning who have not been home since last night's member's business ...
Jeremy Purvis (Tweeddale, Ettrick and Lauderdale) (LD):
LD
I have heard that mantra on many occasions. It is, however, disingenuous. Although the baseline grant has not been affected for this year, boards such as Bor...
Nicola Sturgeon:
SNP
Jeremy Purvis came in right on cue when I was talking about irresponsible members. What I said is not a mantra; it happens to be the truth. No health board w...
Rhoda Grant (Highlands and Islands) (Lab):
Lab
Will the cabinet secretary take an intervention?
Nicola Sturgeon:
SNP
No—I have to move on and discuss the Liberal Democrat amendment. The amendment is sensible, because a funding formula should not be static. It should be kept...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
On what I hope is a consensual note, I begin by saying that Labour feels that this is certainly a welcome debate on an important issue. Health care in remote...
Nicola Sturgeon:
SNP
I am more than happy to engage in debate, but debate usually involves suggesting solutions as well as making criticisms. Does Margaret Curran agree that she ...
Margaret Curran:
Lab
I think you should pay attention to the exact details of what I said. My argument is not about the amount but about the share, and you know that full well, c...
The Minister for Public Health (Shona Robison):
SNP
Will the member take an intervention?
Margaret Curran:
Lab
No. I did Nicola Sturgeon the courtesy of taking an intervention, but she did not do me the same courtesy. I would prefer it if you would allow me to pursue ...
Shona Robison:
SNP
Will the member take an intervention?
Margaret Curran:
Lab
No, thank you.We are talking about the range of resources from funding for ambulance services to funding to ensure equal access to major Government commitmen...
Nicola Sturgeon:
SNP
Margaret Curran makes an important point, but will she acknowledge that the appointments in NHS Western Isles that have attracted much criticism were made un...
Margaret Curran:
Lab
I say with the greatest respect that the cabinet secretary has missed the point. The point is not party political. Laughter.
The Presiding Officer:
NPA
Order.
Margaret Curran:
Lab
The point is not political. It is about the NHS's management. The NHS's appointments procedures are governed not by politicians, but by its administration. W...
Mary Scanlon (Highlands and Islands) (Con):
Con
Margaret Curran talked about Western Isles NHS Board. On behalf of all of us and for the sake of NHS staff and patients in the Western Isles, I hope that peo...
Ross Finnie (West of Scotland) (LD):
LD
I am delighted that we are having a debate on rural health care, as this is the first occasion since the new Government was formed on which I have been able ...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
Will the member give way?
Ross Finnie:
LD
No—I will press on, because I want to make a point about the purpose of our amendment that I hope will be helpful to Mary Scanlon and other Conservative memb...
The Presiding Officer:
NPA
We move to the open debate. Speeches should be around six minutes, please.
Christine Grahame (South of Scotland) (SNP):
SNP
I welcome the temperate and considered speech that my colleague on the Health and Sport Committee, Ross Finnie, has just made.The foreword to "Delivering for...
Margaret Curran rose—
Lab
Christine Grahame:
SNP
I want to move on. I have only six minutes in total.On staff issues, we should consider the delays in implementing the agenda for change. That is not a Scott...
Rhoda Grant (Highlands and Islands) (Lab):
Lab
I am pleased to take part in this debate on remote and rural health care and I welcome the report. The cabinet secretary is pleased to endorse its recommenda...
Shona Robison:
SNP
The member has just said that the report referred to the minimum level of service that we would expect. Where there are more comprehensive services, we would...
Rhoda Grant:
Lab
I am grateful to the minister for that reassurance. I am sure that the people of Caithness will be grateful for it, too.The report states that there has been...
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD):
LD
The Howard Doris centre is funded jointly by NHS Highland and Highland Council. Does Rhoda Grant agree that there is a question mark over Highland Council's ...
Rhoda Grant:
Lab
Indeed. However, my point is that if the community had not brought forward that initiative, there would be no joint funding. It was the community that raised...