Chamber
Plenary, 25 Apr 2002
25 Apr 2002 · S1 · Plenary
Item of business
Primary Health Care
As Brian Fitzpatrick knows, the Conservatives in the United Kingdom voted against the increase in the budget. We do not believe that spending such large sums of money without those sums being attached to reform is the best way to go. In five years' time, Scotland will be the highest spender, as a proportion of its gross domestic product, on health care in Europe.
In five years' time, we expect that there will be no waiting lists, no staff shortages and no bed shortages. That is the target that the Government has set. It has not set a target of shorter waiting times. It has set out to achieve the very best. I am happy to say that in Scotland we deserve the very best. Dorothy-Grace Elder alluded to patient service in Germany. Look at the German system. That is not the system that has been fixed by Gordon Brown in an attempt to keep hold of his power and put his unions and paymasters before patients.
We believe that fundholding is the right way to go. We believe that LHCCs should be allowed to commission care from the private, voluntary and public sectors and we are not the only ones. Our amendment today is taken word for word—apart from the fact that we inserted LHCC where he said primary care trusts—from Alan Milburn's statement in the House of Commons last Thursday. The statement has not been fiddled, fixed or skewed. John McAllion obviously now finds Alan Milburn as offensive as the Tories. I will quote Alan Milburn's exact words, so that the Deputy Minister for Health and Community Care cannot wriggle out of the situation by saying that we fixed them:
"Primary care trusts will be free to purchase care from the most appropriate provider - be they public, private or voluntary."
Those are the words of Alan Milburn; the other words in our amendment are from Alan Milburn too. Today, Labour in Scotland will reject new Labour or it will carry on trying to make amends, but without having the guts to say that it has got it wrong. To dance on the head of a pin about contracting is not to address the issue of the internal market. Whether there is electronic contracting, whether the funds are held for secondary care within the primary care trust or whether they are held in acute care is not the issue. The internal market was characterised by the Griffiths report in the 1980s, which stated that if purchaser and provider were split and commissioning was allowed, that was the internal market. The Executive is returning to that. It cannot dance on the head of a pin and say that a computer will do it instead of a contract manager; it is still commissioning care.
The Deputy Minister for Health and Community Care could perhaps alleviate John McAllion's fear by saying that primary care teams are not allowed to buy care from anybody except the public sector. That may go some way towards alleviating John McAllion's fear, but does that mean that primary care teams will be allowed to buy care from the voluntary sector, the not-for-profit sector and the private sector? We will see from the minister's answer. Nicola Sturgeon said that primary care must be the engine for change. The Conservatives said that in the 1980s, so I welcome that.
I do not think that there is anything that Stewart Stevenson or his family has not done. A relation of his probably carried the cross at the crucifixion. If we had a debate on that, I am sure that he would tell us. He is fast becoming the Walter Mitty of the Scottish Parliament, and the less said about that, the better.
The choice will be whether to back the amendment that we have lodged, which is very much in the vein of new Labour and Alan Milburn, or to reject it. Will members go back to old Labour or come on board and recognise that the internal market delivered better outcomes, was a better use of money and put the patients first? I support Mary Scanlon's amendment.
In five years' time, we expect that there will be no waiting lists, no staff shortages and no bed shortages. That is the target that the Government has set. It has not set a target of shorter waiting times. It has set out to achieve the very best. I am happy to say that in Scotland we deserve the very best. Dorothy-Grace Elder alluded to patient service in Germany. Look at the German system. That is not the system that has been fixed by Gordon Brown in an attempt to keep hold of his power and put his unions and paymasters before patients.
We believe that fundholding is the right way to go. We believe that LHCCs should be allowed to commission care from the private, voluntary and public sectors and we are not the only ones. Our amendment today is taken word for word—apart from the fact that we inserted LHCC where he said primary care trusts—from Alan Milburn's statement in the House of Commons last Thursday. The statement has not been fiddled, fixed or skewed. John McAllion obviously now finds Alan Milburn as offensive as the Tories. I will quote Alan Milburn's exact words, so that the Deputy Minister for Health and Community Care cannot wriggle out of the situation by saying that we fixed them:
"Primary care trusts will be free to purchase care from the most appropriate provider - be they public, private or voluntary."
Those are the words of Alan Milburn; the other words in our amendment are from Alan Milburn too. Today, Labour in Scotland will reject new Labour or it will carry on trying to make amends, but without having the guts to say that it has got it wrong. To dance on the head of a pin about contracting is not to address the issue of the internal market. Whether there is electronic contracting, whether the funds are held for secondary care within the primary care trust or whether they are held in acute care is not the issue. The internal market was characterised by the Griffiths report in the 1980s, which stated that if purchaser and provider were split and commissioning was allowed, that was the internal market. The Executive is returning to that. It cannot dance on the head of a pin and say that a computer will do it instead of a contract manager; it is still commissioning care.
The Deputy Minister for Health and Community Care could perhaps alleviate John McAllion's fear by saying that primary care teams are not allowed to buy care from anybody except the public sector. That may go some way towards alleviating John McAllion's fear, but does that mean that primary care teams will be allowed to buy care from the voluntary sector, the not-for-profit sector and the private sector? We will see from the minister's answer. Nicola Sturgeon said that primary care must be the engine for change. The Conservatives said that in the 1980s, so I welcome that.
I do not think that there is anything that Stewart Stevenson or his family has not done. A relation of his probably carried the cross at the crucifixion. If we had a debate on that, I am sure that he would tell us. He is fast becoming the Walter Mitty of the Scottish Parliament, and the less said about that, the better.
The choice will be whether to back the amendment that we have lodged, which is very much in the vein of new Labour and Alan Milburn, or to reject it. Will members go back to old Labour or come on board and recognise that the internal market delivered better outcomes, was a better use of money and put the patients first? I support Mary Scanlon's amendment.
In the same item of business
The Deputy Presiding Officer (Mr George Reid):
SNP
Good morning. The first item of business is a debate on motion S1M-3022, in the name of Malcolm Chisholm, on modernising primary health care in the national ...
The Minister for Health and Community Care (Malcolm Chisholm):
Lab
Our agenda of investment and reform is a collaborative venture that involves patients and front-line staff wherever they are based. Our focus is the patient ...
Ben Wallace (North-East Scotland) (Con):
Con
I am grateful for the minister's comments on our amendment. He will know that the amendment uses the words of Alan Milburn, not those of the Scottish Conserv...
Malcolm Chisholm:
Lab
I do not know what Iain Duncan Smith or Liam Fox would think about it, but time and again the Conservatives talk to me about Alan Milburn. They often misrepr...
Tommy Sheridan (Glasgow) (SSP):
SSP
On the time limit for an appointment with the appropriate primary care professional, where does physiotherapy fit into the Executive's plan? Constituents who...
Malcolm Chisholm:
Lab
Tommy Sheridan has highlighted another part of the primary care reform agenda. Sometimes, people must go through too many stages before they reach the approp...
Mr David Davidson (North-East Scotland) (Con) rose—
Con
Malcolm Chisholm:
Lab
I had better keep going because time is passing at an alarming speed. Other examples include cancer care, stroke care, services for the elderly and mental he...
Nicola Sturgeon (Glasgow) (SNP):
SNP
The Scottish National Party is committed to developing and improving primary care. We support and endorse the report of the primary care modernisation group....
Malcolm Chisholm:
Lab
With respect, I think that I was clear about that issue. The GP and the patient will decide together, using the waiting times database, whether the patient s...
Nicola Sturgeon:
SNP
The problem is that many people in the front line in primary care would disagree with that. They say that they are in practice denied that power. I will come...
Malcolm Chisholm:
Lab
I will be brief. Currently, patients and those who refer them do not have the information and that is why the database is crucial. When the information is av...
Nicola Sturgeon:
SNP
That is how the Scottish Executive analyses the situation, but the British Medical Association analyses it differently. The BMA thinks that to give patients ...
Mary Scanlon (Highlands and Islands) (Con):
Con
The debate is interesting. I cannot quite make up my mind whether Malcolm Chisholm wants to admit that he has gone back to GP fundholding, devolved budgets a...
Malcolm Chisholm:
Lab
This is the first time that we have had a discussion on the issue. I welcome the discussion. We must be absolutely clear that when we talk about devolving fu...
Mary Scanlon:
Con
I am pleased that the minister agrees with some of what I said.The minister said that he is passionately committed to primary care. GPs in the Highlands are ...
Malcolm Chisholm:
Lab
I am sure that Mary Scanlon does not need reminding that no new money has been allocated over and above what has already been announced, which is an increase...
Mary Scanlon:
Con
We need only look at the figures to see what is happening. The proof of the pudding will be when GPs and others stop walking away from the health minister. W...
The Deputy Presiding Officer:
SNP
Order. I will not allow the private dialogues that are taking place behind the member who is making her speech.
Mary Scanlon:
Con
Mike Rumbles could not behave if he tried, but we have got used to that.The Highlands did well out of the Arbuthnott formula, which provided additional fundi...
Tommy Sheridan (Glasgow) (SSP):
SSP
The Minister for Health and Community Care said that his speech was a statement on the direction of travel in which the NHS is moving and the direction of th...
Mr Davidson:
Con
Is Tommy Sheridan proposing that we nationalise all the services provided by community pharmacies, dentists and everyone else? They are all private sector co...
Tommy Sheridan:
SSP
The member will be aware of my position in relation to pharmacies and the pharmaceutical industry. GlaxoSmithKline announced its profits only last week. It i...
The Deputy Minister for Health and Community Care (Hugh Henry):
Lab
I will attempt to answer some of the questions put by Tommy Sheridan, but it would help me in trying to frame those answers if he could indicate exactly what...
Tommy Sheridan:
SSP
I am specifically proposing a number of things, to which I hope the minister will reply. One of them is that we end the moonlighting of consultants, which ha...
Mr Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
Where is all the money for those plans to come from? I am still waiting for Tommy Sheridan to respond to my last intervention on him, when he promised that h...
Tommy Sheridan:
SSP
Last week, the Chancellor of the Exchequer announced a 1 per cent rise in national insurance contributions to generate £8 billion across the country. If he h...
Mrs Margaret Smith (Edinburgh West) (LD):
LD
I am not quite sure how to follow that. We often get fantasy politics from Tommy Sheridan; this morning we got fantasy pharmaceuticals. The idea that the cou...
Tommy Sheridan rose—
SSP
Mrs Smith:
LD
Tommy has had enough of a chance. The drugs companies would come back at us for doing as Tommy suggests, and the cost of existing drugs would go through the ...