Chamber
Plenary, 06 May 2004
06 May 2004 · S2 · Plenary
Item of business
National Health Service Reform (Scotland) Bill
I thank the clerks and other Parliament staff who have helped in the process of bringing the bill to this stage and I thank those who gave evidence as part of that process.
The National Health Service Reform (Scotland) Bill contains much that is to be welcomed, so I am pleased to be able to support it. One of the main principles that underpins the bill is the removal of unnecessary barriers and bureaucracy from the national health service. The bill will devolve more power so that services can be delivered in communities. The NHS should not be a one-size-fits-all service.
The bill will facilitate much more local decision making. In part, that will be achieved by the creation of community health partnerships. CHPs—which will replace the current local health care co-operatives—will require the establishment of joint working with local authorities and other partnership agencies as part of the community planning process. They will have budgetary control and dedicated staff to allow the development of services that best meet local needs in communities and that can be integrated with social care and other local services.
Another important aspect of the bill concerns public involvement in decisions that affect service development and delivery. We have already heard much about public involvement today. In recent years there have throughout Scotland been major changes in the way health care is delivered. For many reasons—too many to go into today—change is necessary, but it is often not without pain, and consultation methods have varied greatly among health boards. Although the Executive has produced guidelines in the form of policy documents, those have not always led to meaningful consultation. The bill will enshrine the need to secure the public's involvement in the planning and development of their health services.
In addition, the bill will place a duty on health boards to co-operate with other health boards and other agencies in planning and providing services. In recent months, there has been much criticism of the lack of regional planning of services. Health boards have taken in isolation decisions that have had effects on neighbouring boards. Although I welcome the measures in the bill, I would like further guidance from the Executive on the consultation process. I hope that the minister can give some assurances on that when he sums up.
One aspect of the bill that I welcome particularly is the promotion of health improvement. As I have said before in the chamber, health improvement has for too long been the Cinderella of the health service. Often, it is the first area to be targeted when money is short. The bill will impose a duty on ministers and health boards to promote improvement of the physical and mental health of the Scottish public. I very much welcome that and I hope that we will in the near future see more details on how that will be done, especially on how boards will work with key partners, such as those in the voluntary sector.
During the Health Committee's evidence-taking meetings on the bill, the British Medical Association, the Royal College of Nursing, Ayrshire and Arran Primary Care NHS Trust and others highlighted the fact that staff governance had been omitted from the bill. The Health Committee raised that issue with the minister at stage 1. I am pleased that the minister took our comments on board and that the duty for staff governance will, after today, be enshrined in legislation.
In conclusion, the bill contains much that is to be welcomed. It brings together a number of recent health care policy developments, such as the joint future agenda, "Designed to Care" and "Partnership for Care". It also addresses a number of concerns that we have had about issues such as consultation and regional planning. I believe that the bill will do much to improve our health service and I will be pleased to support it today.
The National Health Service Reform (Scotland) Bill contains much that is to be welcomed, so I am pleased to be able to support it. One of the main principles that underpins the bill is the removal of unnecessary barriers and bureaucracy from the national health service. The bill will devolve more power so that services can be delivered in communities. The NHS should not be a one-size-fits-all service.
The bill will facilitate much more local decision making. In part, that will be achieved by the creation of community health partnerships. CHPs—which will replace the current local health care co-operatives—will require the establishment of joint working with local authorities and other partnership agencies as part of the community planning process. They will have budgetary control and dedicated staff to allow the development of services that best meet local needs in communities and that can be integrated with social care and other local services.
Another important aspect of the bill concerns public involvement in decisions that affect service development and delivery. We have already heard much about public involvement today. In recent years there have throughout Scotland been major changes in the way health care is delivered. For many reasons—too many to go into today—change is necessary, but it is often not without pain, and consultation methods have varied greatly among health boards. Although the Executive has produced guidelines in the form of policy documents, those have not always led to meaningful consultation. The bill will enshrine the need to secure the public's involvement in the planning and development of their health services.
In addition, the bill will place a duty on health boards to co-operate with other health boards and other agencies in planning and providing services. In recent months, there has been much criticism of the lack of regional planning of services. Health boards have taken in isolation decisions that have had effects on neighbouring boards. Although I welcome the measures in the bill, I would like further guidance from the Executive on the consultation process. I hope that the minister can give some assurances on that when he sums up.
One aspect of the bill that I welcome particularly is the promotion of health improvement. As I have said before in the chamber, health improvement has for too long been the Cinderella of the health service. Often, it is the first area to be targeted when money is short. The bill will impose a duty on ministers and health boards to promote improvement of the physical and mental health of the Scottish public. I very much welcome that and I hope that we will in the near future see more details on how that will be done, especially on how boards will work with key partners, such as those in the voluntary sector.
During the Health Committee's evidence-taking meetings on the bill, the British Medical Association, the Royal College of Nursing, Ayrshire and Arran Primary Care NHS Trust and others highlighted the fact that staff governance had been omitted from the bill. The Health Committee raised that issue with the minister at stage 1. I am pleased that the minister took our comments on board and that the duty for staff governance will, after today, be enshrined in legislation.
In conclusion, the bill contains much that is to be welcomed. It brings together a number of recent health care policy developments, such as the joint future agenda, "Designed to Care" and "Partnership for Care". It also addresses a number of concerns that we have had about issues such as consultation and regional planning. I believe that the bill will do much to improve our health service and I will be pleased to support it today.
In the same item of business
The Deputy Presiding Officer (Trish Godman):
Lab
The next item of business is a debate on motion S2M-1095, in the name of Malcolm Chisholm, that the National Health Service Reform (Scotland) Bill be passed,...
The Minister for Health and Community Care (Malcolm Chisholm):
Lab
The passage through Parliament of the National Health Service Reform (Scotland) Bill has been assisted by a great many people and I would like to thank those...
Shona Robison (Dundee East) (SNP):
SNP
I thank all those who gave evidence during the passage of the bill. I also thank the Health Committee clerks, who did a great deal of work in getting us to t...
Mr David Davidson (North East Scotland) (Con):
Con
I join Shona Robison in thanking the clerks and those who gave evidence to the Health Committee; we were well supported during the scrutiny of the bill.I am,...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
The bill will fundamentally reform the organisation and management of the NHS in Scotland. It will abolish the last traces of the Tories' discredited interna...
Mr Davidson:
Con
Mike Rumbles is missing this point: if there is health service failure, does not the patient have the right to go elsewhere? We should make the health servic...
The Deputy Presiding Officer:
Lab
Mr Rumbles, you must wind up now.
Mike Rumbles:
LD
I want to respond to David Davidson. He is quite right to say that patients have rights when the service fails, and that is why the power of ministerial inte...
Janis Hughes (Glasgow Rutherglen) (Lab):
Lab
I thank the clerks and other Parliament staff who have helped in the process of bringing the bill to this stage and I thank those who gave evidence as part o...
Christine Grahame (South of Scotland) (SNP):
SNP
In the interests of brevity, I will speak only in support of the SNP amendment.As my colleague Shona Robison pointed out, the budgets of three health boards ...
Carolyn Leckie (Central Scotland) (SSP):
SSP
The Executive is either burying its head in the sand or wilfully under-resourcing the NHS. To suggest that the bill has no financial implications and that NH...
Mrs Nanette Milne (North East Scotland) (Con):
Con
The problem with the NHS in Scotland today is not funding, but that it is driven from the centre and has constantly to respond to centrally set priorities an...
Christine Grahame:
SNP
Will the member take an intervention?
The Deputy Presiding Officer:
Lab
The member is winding up.
Mrs Milne:
Con
We question the Executive's claim that the bill will be cost neutral. It is a particular concern that health boards could incur the costs of intervention at ...
The Deputy Minister for Health and Community Care (Mr Tom McCabe):
Lab
This has been an important debate for the future of the NHS in Scotland. I express my thanks to those who have been involved in the passage of the bill.The b...
Shona Robison:
SNP
Will the minister give way?
The Presiding Officer (Mr George Reid):
NPA
No—he must conclude.
Mr McCabe:
Lab
Okay.I will give the example of the dissolution of trusts. We know that Dumfries and Galloway NHS Board saved £500,000 in one year after its move to single-s...