Hansard

Yes, I acknowledge that. I have no problems with the ambulatory care and diagnostic unit, which we have always wanted. The only thing that we are arguing for is to keep beds at Stobhill.

Morale in the health service is low and nurses are concerned when the word "privatisation" is used. Members of the RCN, which has been mentioned, and Unison feel that they have not been involved in the discussions and that they could do something to shorten waiting times by working in acute clinics, which have increased in number.

To my mind, the private sector is about profit. If something is not profitable, it is not done. Nursing homes close when they do not manage to make profits. Nurses and doctors are trained in the NHS, not in the private sector. Often they are poached from the NHS, to be sold back into it. Agency nurses are a great example of that. They are trained in the NHS, but somebody makes great profits by selling back their services. Why cannot the NHS keep nurses and the profits?

All the nurses to whom I speak get upset when agency nurses are used. They feel that their wards are understaffed and that the agency nurses who come along do not know the ward to the same extent as the nurses who work in it. Therefore the burden of work is put on the NHS nurses and the agency nurses get off lightly. That is nothing to do with their training; it is just that they do not know the ward and their surroundings. When nurses are offered good conditions, such as those that apply in NHS 24 and promoted posts, they take them up, leaving other gaps in primary care, in the wards and, sometimes, in coronary care.

I wish that the pressures on waiting lists were discussed within the health service, because I believe that the problems could be solved by the consultants and nurses who work there. Rumours go round and in The Herald today one of the surgeons at Yorkhill said that, when the hospital had a surgeon for eight months, the waiting time went down from 67 weeks to 18 weeks. Waiting times can be reduced if we have the staff.

When orthopaedic surgeons went to Glasgow royal infirmary, that was supposed to ensure that the waiting lists would be shortened. In fact, the same number of surgeons were using fewer theatres and each surgeon specialised in hips, knees or whatever. It does not take a lot of arithmetic to work out that 20 surgeons cannot do very much in three or four theatres. When we reduce the number of buildings, we reduce capacity in beds and theatres.

It is not fair to expect people with chronic illness to wait for more research to be done. I would like to see more about that in the future plans. I know that the Executive approves of the report on chronic pain by Professor McEwen and I would like to see a national strategy for chronic pain and for diagnosis.

Last night, I attended a meeting of the cross-party group on kidney disease. We have reduced coronary heart disease and stroke, but if we could devise a blood test, which would not be too expensive, to check people for hidden kidney disease, that would also lower the stroke rate.

People who are in chronic pain do not have quality of life and they do not work. If we put a little money into chronic pain clinics, we would find that nurses and psychiatrists, along with doctors and physiotherapists, might reduce the drug bill. Professor McEwen's report puts the bill at £1,000 per person a year, which is a staggering figure. If we could reduce the number of drugs that people use and give them other means of dealing with their pain, we would save money.

Specialist nurses and physiotherapists give tremendous support to clinics such as musculo-skeletal units, which also screen for osteoporosis. That disease affects men as well as women as we become older. Not many can avoid it and if it is a family trait for someone, they are in trouble. Reducing the number of people who are at risk of osteoporosis would also reduce the risk of fractures. Glasgow has had a good programme of establishing who may be at risk of osteoporosis, and who knows what the orthopaedic waiting list would be like if that programme had not been undertaken. I would like screening for osteoporosis to take place all over the country.

I commend education in primary care. What Carolyn Leckie said about poverty is true. We must address all such matters. As for conveying information to patients, we have only to think of asthma and chronic obstructive airways disease clinics, which keep people out of hospital. Anything that can be done in the primary care sector and for which money is provided in information technology and clerical services makes a great difference.

I like much of what the minister says. I am scared of privatisation, because it lowers morale. I am pleased to hear that the Executive is trying to turn the situation round. Some figures are good. I do not expect us to manage to do everything tomorrow, but I am pleased that people have noticed that the system needs increased capacity.

I like to think that we can go forward together with open minds, because things change quickly in medicine. We might keep some of the beds that we intend to close when we realise that we could make good use of them for bread-and-butter matters and to declog the more specialist centres, to allow them to get on with their work. With the help of people in the NHS, I hope that waiting lists will reduce.

I move amendment S2M-2155.2, to leave out from first "supports" and insert:

"welcomes the additional investment on health promotion, including its targeting of heart disease, cancer and stroke; however, urges the Scottish Executive as part of its next steps strategy and to fulfil its aim of returning all patients to the heart of the NHS, to include as part of the strategy a comprehensive review of services dedicated to palliative care and chronic conditions and, further, develop a national programme of diagnostic care, all of which continue to be under-resourced and under-funded, and believes that such a review will save the NHS money by identifying, treating and controlling such conditions in a more structured, preventative and cost-effective manner which will alleviate the consequent pressure on hospital beds and in-patient services."