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Plenary, 08 Nov 2006

08 Nov 2006 · S2 · Plenary

Item of business

Community Health Projects

Scott, Eleanor Green Highlands and Islands Watch on SPTV

I add my congratulations to my colleague, Mark Ballard, on securing the debate. Mark has given us a good overview of the sort of projects that we are talking about and the problems that they face. It is clear from the briefing that we all received from Voluntary Health Scotland that organisations face real difficulties. The Executive has a stated commitment to work in partnership with voluntary and community-based groups. However, in practice, it is not an equal partnership. Groups face particular difficulty in securing the core funding that would give them a certain future and would allow them to plan their projects effectively.

We all have local examples and here is mine. In Scotland, we tend to think of deprivation as an urban or central-belt problem, but in 2003 the seventh most deprived ward in Scotland was Merkinch in Inverness. The community got a five-year lottery funding package to convert the janitor's house at Merkinch primary school into a healthy living centre, known—because we are down-to-earth folk in the Highlands—as the janny's hoose. The janny's hoose is led and managed by a user group from the community. It offers a variety of services, including education on diet and dental health, with a school toothbrushing programme; a variety of activities to promote good mental health, including stress management and counselling; support for parents; and joint work with the school and professionals in the community.

I will quote from a representative of the janny's hoose:

"At this stage it is uncertain whether we will continue. The Health Minister maintains that funding for these projects should come from local sources (Community Planning Partnership and Community Health Partnership). The CHP say they have only just over £2,000 for health promotion, the council have problems with us as we don't fit into their structure anywhere."

The project might get some funding from the regeneration fund, and possibly some from the community health partnership, but nothing is certain. An organisation cannot continue to be effective if it is on a continual funding knife edge. If the janny's hoose folds, the progress that has been made in tackling health inequalities in that deprived area will be lost.

I turn to another aspect of the partnership between the NHS and community groups in delivering community health projects. I understand that the Minister for Health and Community Care will publish the Executive's review of nursing in the community next week. It has become clear that the final report is likely to contain a proposal to move away from health visitors, district nurses and so on towards generic community nurses, but many professionals have deep concerns about that.

I remember working as a school doctor with triple-duty nurses, who combined the roles of health visitor, district nurse and school nurse. When the pressure of work meant that something had to give, as is always the case in the NHS, it was always the health promotion activity that went. Such activity is no less important than reactive health activity, but it is less immediately urgent. Whenever we had a single-duty school nurse who had no other duties and could do the health promotion work that was so necessary, that was always hailed as a huge benefit.

The national strategy that Mark Ballard proposes would ensure that health promotion and community health could not be allowed to slide off the bottom of budgets or be left on a funding knife edge. It is not enough to give money to local authorities and health boards in the hope that it will find its way down to such projects. Our communities need projects such as the janny's hoose and nurses whose specific role is to engage with the community. We must ensure that they get those.