Meeting of the Parliament 05 March 2014
I am delighted to speak in the debate, as I believe that the NHS in Scotland is on a positive and exciting journey. I support the approach that Hugh Henry outlined and the comments from Stewart Stevenson.
At least some of us will recall that, not all that long ago, patient and medical details were required to be held in folders, files and documents. I remember authorisations that required multiple signatories, and patient data being created with time gaps and completed on different media types. That had to be reviewed and then passed along to the next person in the medical cycle, whether that was a porter, nurse, doctor or consultant, each of whom had a different frame of reference on the patient’s activity, health, safety or welfare. A lot of that militated against meaningful patient benefit.
Today, we have moved on and have embraced new technologies in many areas, such as radiology, which Richard Simpson mentioned, and in the use of new data analysis and collection techniques and communications. Scotland has always had a reputation for pioneering medical research and, as members have said, innovation. That reputation was and still is international. However, it would be wrong to be complacent. The reputation has to be enhanced and we should be in the van on that. We should recognise that that must be one of the foundation stones as we build on the constancy of change that our society and health provision and service demand.
We have the innovation; the research capability in our universities and hospitals; the provision and results of educational research; and a robust life sciences industry. Above all, we have a skilled and professional health service team. Throughout the coming period of significant change, we will need to harness all those aspects and increase the connectivity between them if we are to create the world-leading health service for the 21st century that I believe we can produce, and which I believe could be an exportable health service.
President Obama is talking of spending $12 billion on an electronic medical records programme, which would be an important step for the USA, but Scotland has made an average investment of £110 million a year—which is nearly £800 million over the past seven years—and has already taken some major steps. However, we still face many challenges if we are to see and grasp our vision for 2020. We face the challenges of demography and finance, but we are in a good place to start that process.
We have made recent progress on improving quality. Of course, things are not perfect yet and there are still many challenges, but we should all embrace the fact that successive Scottish Governments have shared an inherent compassion and capacity to succour the sick and elderly—all those Governments should be applauded for that. I say to all members that the healthcare community is a cord that I hope binds us all. I do not believe that there is one member of the Parliament—although there might be—who is not committed to the values of a publicly provided national health service, and nor is there one who does not wish to see patients, customers, clients, family, friends and neighbours at the heart of the service. As I said, we still face challenges. We face a radical future change in healthcare provision as well as financial and demographic challenges.
With your indulgence Presiding Officer, I will focus on two specific situations. East Ayrshire Council, which to my mind is a progressive council, has as part of its tripartite transformation strategy what we call the Dalmellington project, which aligns with the strategic imperative to consider how best to support older people to live more independently in the community. There are many key actions in the strategic priorities report. The project involves working with the third sector, which is important, to allow older people to participate in and contribute to the community. There is also a determination to implement support for older people to live not just in the community but in their own home.
That dovetails with NHS Ayrshire and Arran’s plan, which has been recognised by the Scottish centre for telehealth and telecare and the Scottish Government, to lead on projects that allow communication directly into the homes of the elderly to allow monitoring of their health. The aim is to secure their wellbeing through a range of connected technologies, all of which are remotely connected to a response centre.
No matter how good the digital interconnectivity network is, ultimately it depends on people: professionals in the health service. Patient safety, efficiency and care—both integrated and direct—all depend on teamwork, openness, transparency and participation without fear or favour of performance appraisal at all levels. That means change built on continuous improvement, founded on outcomes rather than targets, constructed on a programme of continuous training and education, so that we have the right skills in the right place, married to a single source of correct data that is provided at the right time and in the right place. It also means that we need strong leadership to drive that change in the NHS, which will see a professional, technology-driven, unified and interconnected health service that puts the patient’s wellbeing, health and safety at the heart of its purpose.