Hansard

I want to start by thanking the Cabinet Secretary for Health and Sport for the time that she has given to me on this subject. I know that she agrees with me on many of the problems that we identify in the motion. Although we cannot support the amendment in her name, because it would delete much of the reference to the problem, I welcome its tone and the apology that is in it.

There is a law that this Parliament passed, which this Government has broken more than 190,000 times since the Patient Rights (Scotland) Act 2011 received royal assent. The legal bonds of the legally binding treatment time guarantee are routinely broken—upwards of 200 times every single day.

Let me put that in the local context. In NHS Lothian, 34,000 people have had to wait for longer than 12 weeks this year. In NHS Greater Glasgow and Clyde, the number is 32,000 and in NHS Grampian, it is 27,000.

There is no sanction for that. No minister has resigned and no one gets a fine. It is a legally binding guarantee in name only. However, the human cost of the issue is measured in anxiety, frustration, pain and suffering. Lives are put on hold and potentially life-saving treatment is put just out of reach.

The issue comes up every week in all members’ constituency surgeries. Every one of those patients has been let down by the false hope that this Government offered them, and each patient tells a similar story.

A letter arrives shortly after diagnosis, advising them of their legal guarantee to have treatment begin within 12 weeks. For most people, that sounds manageable. Twelve weeks is a season; they could get their diagnosis in early spring and be seen before the holiday in July. It might mean spending a bit longer on pain medication than they had hoped, but they can tough it out.

Accordingly, the person plans for their recovery, as everyone would do. They plan for the time after convalescence, when—free of pain and disease, they hope—they can start to live their lives again. They accept wedding invitations. They agree to host Christmas for the family. They book a holiday in six months’ time, because—according to that letter—they will be well out of the woods by then.

After about nine weeks, they begin to wonder why the hospital has not yet booked them in. A gnawing sense of doubt begins to creep in, so, perhaps on the Monday of week 10, they phone the surgical ward.

That is when they get the bombshell. They are not going to be seen in two weeks’ time after all. More to the point, they are not likely to be seen for at least another 40 weeks, in some cases. That must be devastating to hear. The person asks about their holiday and is told, “Don’t leave the country.” They ask about the wedding that they plan to go to and are told, “Don’t risk it; you might get a cancellation.” They ask about Christmas and are told, “It’s doubtful, because with any luck you’ll just be coming out of surgery by then.”

Aside from all the havoc that that causes a person in the basic administration of their lives, there is all the pain or immobility that they might be suffering. There might also be anxiety about the condition getting worse and even becoming life threatening.

I could offer many, many real-life examples from west Edinburgh of what I have described, and I am sure that every member in this chamber could talk about a case in their constituency. I will single out one person.

In December, I was contacted by Jane Ross. Over the past three years, Jane has suffered several failures of the treatment time guarantee, in relation to urology at the Western general hospital in Edinburgh. After developing bladder issues, she waited six months for a consultant appointment, then was referred for tests, which took more than a year to be performed. By that time, her bladder was so inflamed that it had shrunk to a fifth of its normal size. The pain was so severe she had to control it by not drinking at all until around 4pm in the afternoon, which allowed her to struggle through her part-time job. Dehydration started to affect her kidneys and gave her heart palpitations. It caused issues with her diabetes.

In August last year, after the test results came back, she and her consultant agreed that she would need to have her bladder removed and a urostomy performed. Like most people, she received a notification about her rights under the treatment time guarantee. And so she waited, in a worsening state of physical health and suffering.

All told, it took 36 weeks for her to have her operation. The wait was bad enough, but she had to lurch from week to agonising week, existing in this excruciating state, under the misapprehension that treatment was just around the corner. I wanted to weep for her. Hers is one of the hardest cases I have dealt with.

To its credit, the Government has set great store by the concept of realistic medicine, and I am a fellow traveller on that, believing in the basic precept that we should give patients all the facts and options about their condition and credit them with the maturity and mental capacity to direct their care. That should not be just about end-of-life issues; it should apply to every aspect of a journey through our national health service.

People are not stupid. They know that our NHS is oversubscribed and that, in all likelihood, they might have to wait for a protracted period for treatment. That is not really what bothers them—they accept that and understand. That is part and parcel of why our NHS is deservedly still the most well-regarded institution in our country. Patients just want doctors and politicians to be straight with them.

To have someone tell them from the outset that their wait will be 40 or 50 weeks would mean that they could plan accordingly. Some people might well decide to go private when faced with that reality, which might relieve pressure on other waiting lists and give other people a shorter waiting time to treatment by freeing up capacity.

Whatever our world view, I hope that we all agree that we cannot go on giving people false hope like this. I understand that aiming to stop breaking its own guarantee by 2021 might be an unavoidable reality for the Government, especially given workforce issues, the strain on capacity, our ageing population, the various issues that we are facing and the fires that we are fighting. I accept that, but all I ask is that the Government stops sending out letters that give people false hope. It should explain to them why their treatment has been set back and apologise for the discomfort that that causes.

People are mature and they understand that the NHS is under pressure, but they still value it immensely and give thanks every single day for those hard-working staff toiling for hours and hours for days on end to make them well and to get through those waiting lists. We just need to be straight with people, because they deserve to know where they stand.

I move,

That the Parliament notes that the Scottish Government’s legally-binding 12-week treatment time guarantee has been broken at least 190,000 times since its introduction; notes that it is currently being missed by the largest ever margin, approximately 200 times a day; understands that the Scottish Government currently plans to stop breaching its own law by 2021, a full decade after the Patient Rights (Scotland) Act 2011, which established it; is concerned that there is no effective redress for patients or penalty for the Scottish Government in the event that it is breached; believes therefore that every patient who is subject to the treatment time guarantee should be given a realistic estimate of their waiting time from the outset, and calls for every patient for whom the 12-week legally binding guarantee is missed to be sent a letter by the health secretary apologising for the Scottish Government’s failure to abide by its law and providing details of how many times the 12-week target has been missed to date.