Committee
Health and Sport Committee, 17 Sep 2008
17 Sep 2008 · S3 · Health and Sport Committee
Item of business
Health Inequalities Inquiry
Thank you. I will ask one question on rural areas and one on urban areas. With regard to rural areas, the NHS Highland submission mentions access to services. Dr Baijal talked about telemedicine being in its infancy, but I was involved in a telehealth project more than 30 years ago, which is almost a professional lifetime. Given that there is a very good chance of telehealth services vastly improving the quality of advice and care that can be given to people in remote communities, I wonder why it is still regarded as being in its infancy.There are some people in rural areas who need to go to hospital, sometimes reasonably urgently. However, I know from evidence that I have seen before that the co-ordination between hospital out-patient departments and patient transport systems is fairly appalling, resulting sometimes in patients not being able to keep their appointments. Sometimes, in remote areas, helicopter access is required. However, I know of an impoverished rural community that is having to raise the money—between £6,000 and £8,000—for helicopter landing lights, so that a helicopter can land in the hours of darkness, which there are a lot of in the winter. My point is that, in practical terms, there are simple things that could be done before the more abstruse things, but they are not being done. Do you agree? Once you have answered that, I will ask my urban question.
In the same item of business
The Convener:
SNP
Under agenda item 2, we continue our health inequalities inquiry. With us on the first of two witness panels we have Ian Murray, the head of community learni...
Mary Scanlon (Highlands and Islands) (Con):
Con
I do not know about other people, but I am having difficulty in coming to terms with the new single outcome agreements, which are quite complicated. NHS High...
Dr Eric Baijal (NHS Highland):
I think that we are on a journey; it is not about starting partnership working afresh. We have a good partnership working arrangement with both the local aut...
Ian Murray (Highland Council):
The single outcome agreement gives an opportunity for a variety of single-sector plans to be monitored and brought together in one place. For example, the ch...
The Convener:
SNP
Can you say something more about the children's plan? Members of the committee might be fully aware of it, but I am not.
Ian Murray:
Each local authority is required to produce a children's plan. Ours is called "For Highland's Children", and we are on the third version of it. The plan brin...
Mary Scanlon:
Con
Highland Council's submission says that, under the current system,"only 16% of income deprived people are identified".Why does the current system work in tha...
Ian Murray:
I confess that I do not know the absolute detail of how the Scottish index of multiple deprivation areas are worked out, but the effect is that people who li...
Mary Scanlon:
Con
I am looking for clues that will help me to understand why such a low percentage of people living in poverty is identified—obviously, the issue is important ...
Ian Murray:
I am sorry, but I am unable to answer.
Dr Baijal:
The main issue with the SIMD is that it does not pick up on issues around remoteness. For the SIMD, car ownership, for example, would be a marker of affluenc...
Susan Russel (Mid-Highland Community Health Partnership):
My point is on the SIMD. Given that the data zones are conglomerates of about 200 to 500 people, communities in the Highland area may not trigger any indicat...
Mary Scanlon:
Con
That is helpful.NHS Highland says in its submission:"Many of the recommendations relate to ‘doing things differently', however we will need to be clear what ...
Dr Baijal:
It is about the big issue of investment prioritisation. The NHS invests a significant amount in cure and care. We welcome the current guidance and drive towa...
Mary Scanlon:
Con
I understand the need for prioritisation, but I am still unclear on the other comment. Can you give us an example of where you will disinvest resources and t...
Dr Baijal:
One good example is child and adolescent mental health services, in which the balance needs to be shifted. We need to shift resource from a hospital-focused ...
The Convener:
SNP
I have a question on a point that I thought Mary Scanlon would raise in her questioning on rural remoteness and the SIMD. I am thinking of ways in which to r...
Dr Baijal:
Absolutely. We have a good engagement with our colleagues in Government and NHS Health Scotland. The committee can take it as read that everyone has a good a...
The Convener:
SNP
But discussions are being held on how to remedy the situation and identify those pockets of deprivation.
Dr Baijal:
Absolutely. We are working well together, as Pip Farman can ably explain. As far as research is concerned, the well north projects are moving us towards some...
The Convener:
SNP
Is that the case, Ms Farman? You have been passed the ball.
Pip Farman (NHS Highland):
The well north projects are funded projects that are allied to the keep well programme, but which recognise that, on anticipatory care, we might need to do t...
The Convener:
SNP
Other members have been waiting, so I will let Mary Scanlon back in later.
Mary Scanlon:
Con
I just have a brief point to make.
The Convener:
SNP
Okay. Richard Simpson has been extremely patient.
Mary Scanlon:
Con
If Governments recognise the issues around remote and rural funding, why is it that we did well under the Arbuthnott formula, but the new formula has resulte...
Dr Baijal:
I hesitate to comment in detail, because we know that the NRAC formula is extremely complicated. In fairness, Government has sought to implement the formula ...
The Convener:
SNP
Those are good questions, but it might be better to put them to the minister when we ask her about policy and political priorities.
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
I am sure that we will return to the issue when we consider the budget. If only 16 per cent of income-deprived people in rural communities are being identifi...
Dr Baijal:
A good specific example is measles, mumps and rubella, on which we in Highland have done detailed work with local primary care teams to identify specific fam...