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Meeting of the Parliament 24 February 2011

24 Feb 2011 · S3 · Meeting of the Parliament

Item of business

Patient Rights (Scotland) Bill

McKee, Ian SNP Lothians Watch on SPTV

One of the criticisms that is sometimes made of the national health service is that, as a monopoly, it runs the risk of ignoring the genuine needs and concerns of patients. If we are being honest, we know that that has sometimes been the case.

Other countries have attempted to put the patient in the driving seat by introducing competition and privatisation into health services, but that brings other problems—too numerous to list now—and Scotland has, rightly in my opinion, avoided going down that route.

How do we avoid the trap that many monopolies fall into of becoming an organisation for producers rather than consumers? The answer is by constant vigilance, and the Patient Rights (Scotland) Bill is an important tool that can help. It is perhaps significant that much of the opposition to the bill has come from producers, whereas patient organisations—the consumers—largely support it.

At stage 1, I found very persuasive the argument that the bill could be confusing, even misleading: although it is entitled “Patient Rights”, it does not list all patient rights. Although I recognise the argument by the minister and others that existing rights that are not enshrined in the bill are not weakened by that omission, it seems sensible to include in the bill the establishment of a charter, so that the average patient on the Morningside omnibus knows his or her entitlements. Therefore, I welcome the adoption of a charter at stage 2 and its continuing presence at stage 3.

The star attraction in the bill is the treatment time guarantee. Lawyers and others might quibble that a legal guarantee without legal redress is worthless, but most of us agree that neither patient nor NHS will benefit if the health service in Scotland becomes a rich feeding trough for lawyers, as is now the case in some other countries.

The attraction to patients and patient organisations of specifying a treatment time guarantee in the bill is that it gives waiting times much more importance in the minds of those who provide health care and so makes it much more likely that such a guarantee will be observed.

Another worry of mine when the Health and Sport Committee was taking evidence on the bill was whether strict attention to fulfilling the guarantee for patients nearing the end of the guarantee period might delay an operation or procedure for a person whose health could be seriously put at risk by such a delay. For instance, it would obviously be wrong for an operating list to be full of relatively minor operations that needed to be performed urgently simply to meet the terms of the guarantee, if that entailed putting off an operation or operations that were clinically urgent but which had been on the waiting list for a much shorter time.

I am pleased to say that the bill makes it clear that clinical needs must always be given priority in such situations—and, if such a situation exists, that is an acceptable ground for breaking the treatment time guarantee. That is a commonsense stipulation.

I praise the establishment of robust mechanisms for collecting patient feedback and providing patient advice and support. For too long we have encouraged an environment in which complaints have been the main form of feedback. Although it is important that complaints are received and acted upon, there are many pieces of advice or observations from patients that are far removed from being complaints that could help in the running of the health service. It is right that we pay attention to those. Being in hospital or on the end of health care delivery, from whatever source, can be a bewildering experience, so a robust, independent patient support service is very welcome.

We must not let ourselves be beguiled by the notion of a free health service. The NHS is not free; it is paid for by the taxes of those who use it. It is vital to establish mechanisms to protect the rights of those who not only use the NHS but pay for it, and the bill goes a long way towards doing that.

Like other members, I had concerns on first reading the bill at stage 1. That we can now all agree that the bill should be passed speaks well of the Government, the Health and Sport Committee and the Parliament. I ask the Parliament to support the bill.

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