This website was established while I was a Member of the Scottish Parliament. As the Parliament has been dissolved there are no Members of Parliament until after the election on 5 May 2016.
Earlier this month, I had the pleasure to visit the Cyrenians Fair Share food depot in Leith. There. The charity is doing brilliant with their cooking classes, where people learn new skills, build confidence and get together to share and enjoy food.
The Cyrenians are just one of the many organisations around Scotland who are working to try and give people access to better, more nutritious food. I believe we need a radical rethink of Scotland’s food system to make sure quality food is available to all of us.
Last week, I led a debate on the right to food in Scotland in the parliament. You can read my full speech below.
Meeting of the Parliament 17 March 2016
I welcome the opportunity to debate in Parliament Scotland’s food future, and I thank colleagues who have made that possible by supporting my motion.
My motion highlights the work of the Scottish food coalition and its report “PLENTY: Food, Farming and Health in a New Scotland”. The coalition is made up of several organisations whose contribution to improving the health and wellbeing of people in Scotland is widely recognised, and deservedly so. The report is a landmark report that should be discussed far and wide, and steps should be taken to implement it. It begins with the statement:
“We have plenty of land in Scotland, and plenty of sea, and plenty of skilled people, scientists and innovators. There’s no reason why we shouldn’t have plenty of good food for everyone.”
It is absolutely the case that, as the report states,
“At the moment, our food system is characterised by inequalities and exploitation.”
Given the importance of food—it really is one of the few things that we cannot live without—our food system should be founded on the principles of social and environmental justice. A food system that is founded on those principles would enable us to address inequality, climate change, declining wildlife, animal welfare and poor health.
Some people may be of the view that business as usual is “Just grand, thank you very much”, but if we are what we eat, many people in Scotland are clearly not eating well. In a country with
“plenty of land … and … sea”,
why is that the case? Why are 65 per cent of people in Scotland overweight or obese, and why is it that in 2014-15 almost 120,000 people required emergency food aid and almost a third of those were children? That reliance on food aid exists in a country that rightly celebrates its food and drink sector. However, the focus is very much export based, with much ado about whisky and salmon—despite the environmental damage that fish farms create in Scotland—to boost the profits of companies, many of which are based outside Scotland. I would like to see more focus on an agroecology approach and more investment in growing our organic sector.
Fifteen per cent of Scottish households do not own cutlery. Such is the concern about our food culture, which is impacting terribly on our health, that leading consultants have coined the new term “diabesity”, which reflects the relationship between obesity and diabetes. That epidemic, which has a global reach and impact, also has a very local one. It costs health and happiness and, like demographic change and population increase, puts our national health service budget under increasing pressure.
Corporations can and do make huge profits from dominating the food market, often with unhealthy food and unsustainable ways of growing and producing the food that we eat. However, the public purse pays for the pollution and ill health. Lobbying at the highest levels of Government has created the perverse logic that is needed for our leaders to think that international deals such as the transatlantic trade and investment partnership deal are a good idea for our food system.
It does not have to be that way. We are all aware of amazing projects in our communities; there is in the Lothians region a fantastic collection of those projects and community energy, which connect people to Scotland’s true food future. Community gardeners are taking over Granton’s street corners to create mini gardens, vegetable plots and communal meals. The Broomhouse Health Strategy Group and the Pilton Community Health Project work with people on budgeting, cooking skills, getting them more active in their daily lives and much more. Leith Community Crops in Pots is building a more rural feeling from concrete patches in Leith. We can grow almost anywhere. The Cyrenians at the Royal Edinburgh hospital and its Leith FareShare depot and kitchen are doing an excellent job helping people to learn to cook, enjoy food together and appreciate all the wondrous things that food can do.
Musselburgh Transition Toun is another example. It is working wonders with a wee community garden by the river. Edinburgh Community Food is building a network across the city, and many other groups are doing fantastic jobs providing emergency food relief. I want to mention two of them: Transition Edinburgh South and the wonderful walled garden at Gracemount. There are undoubtedly many more that I have failed to mention, and they are all working wonders.
Food should help us to grow and to get well when we are not well; it should make us feel good. Really nutritious food helps us to keep well and gives us the ability to deal with busy lives, no matter how old we are. It gives us personal resilience. Local food networks are vital to the development of resilience at community level. We need to think about the future and about our ability to produce the food that we need closer to home.
In yesterday’s stage 3 proceedings on the Land Reform (Scotland) Bill, I spoke about the situation of the smallholder Jim Telfer, who is a tenant farmer who fears losing both the land that he rents and his livelihood, because his land is where the film studio that was discussed at First Minister’s question time, which is the subject of a speculative proposal, would be located. Is his farm on poor-quality land? No—it is on prime agricultural land. I hope that that will be recognised and valued, and that the film studio will be built elsewhere. Cumbernauld has been discussed as a possible location, but Shawfair, which is nearby, has excellent transport links and a school that focuses on the creative industries. Members of the local Damhead community have rallied round Jim and have campaigned hard. The vision that they have for the land where they live is for it to be formally recognised as Edinburgh’s food belt. We need to think about the idea of urban crofts. Green-belt land has never faced such development pressures, but we need to think about where the food that citizens within and outwith Edinburgh’s green belt eat comes from.
The food belt is a compelling idea—it represents a much better way of thinking about the value of our green belt and its benefits. Land in the food belt is a way of connecting us to our food. Land here could have many more local businesses providing employment to people in cities and in more rural areas. For too many people, the green belt is a patch of land that they commute through without giving it much thought. We can rethink that land.
I hope that the minister understands not just the power of ideas, but the power of money. Yesterday, I learned that the funding that allowed the Scottish food coalition to form has been cut—in fact, it has been completely removed: Nourish Scotland’s funding has gone from £90,000 to nothing.
Nourish Scotland would like to tender for work, but it turns out that the only tender that is available to it is one that wraps up a massive amount of work on local food in a £3 million contract, which is inappropriate for small and medium-sized enterprise bidders.
I congratulate and thank all those who are working to make us a better food nation, from our school dinner ladies to the Soil Association. Let us make sure that we are not just a well fed but a properly nourished population.
I would be grateful if the cabinet secretary could address the funding situation that I outlined when he closes the debate.
This week I spoke in a debate on the NHS. It is universally acknowledged that the NHS and our network of social care services in every local authority are an incredible national asset. In the debate I acknowledged the contribution of all NHS staff, our GPs and our carers, who really are at the heart of the service.
Read on for the rest of my speech.
Funding is absolutely key, so the Greens will set out our long-term fair and progressive tax proposals within the next two weeks. This morning, we welcomed the Government’s having fallen into line with the proposals that the Greens made—during the recent budget process—on vacant land, a fairer council tax and ending the council tax freeze.
Of course, as colleagues have mentioned, the most cost-effective measures are those that prevent ill-health in the first place. Addressing poverty and health inequality is paramount. Wellbeing must be at the centre of Government policy, because being healthy is not simply about not being sick.
The focus on a truly healthy life starts before conception, by supporting the growth of community-based projects such as the Pregnancy and Parents Centre in south Edinburgh, which is a welcoming not-for-profit organisation that works with parents-to-be and their families, and by supporting organisations such as the Cyrenians, that work with people who find themselves homeless or vulnerable. We increase our national health by supporting local authorities to provide free fruit and practical food education—through the growing schools initiative, for example—and by working towards free school meals for all primary pupils. I welcome the progress that is being made in some of those areas.
Physical activity is key too, and we can make it easier for our young people to be active by investing—as the Royal Society for Public Health’s directors urge—10 per cent of the transport budget on walking and cycling, which would ease congestion and cut air pollution. Air pollution is causing more than 2,000 deaths each year, but action by the Scottish Government to address that invisible killer is dangerously slow. We can also encourage physical activity by working with local authorities to create exciting outdoor play spaces in our schools and more affordable access to sports facilities, which are prohibitively expensive for many people.
We have to address poverty and inequality if we want Scotland to be well. When over 200,000 children live in poverty, and the Institute for Fiscal Studies advises us that that figure will rise by 100,000 due to on-going austerity, we have to use every means at our disposal to mitigate the impacts. I am hopeful that we will use the powers that are coming to Parliament to do so, at least in part by abolishing benefits sanctions.
While we focus on reducing health inequalities in Scotland, we need to focus, too, on ensuring that we work with all those who deliver healthcare in order to enable them to continue to deliver the high standard of care that everyone in Scotland should expect. A living wage plus for carers is important.
We have heard that bed blocking is costing us a fortune, and every week in Edinburgh, some 5,000 hours of social care go unmet. That has to change.
A focus on primary care is essential because 90 per cent of patient contacts are with GPs and other primary care professionals in our communities. We have to act to ensure adequate training, recruitment and—which is important—retention of GPs, because the world is very eager to recruit our well-trained medical professionals.
I welcome the relationships that are being built across parties by the BMA, the RCGP and the RCN. Last night I was pleased to take part in a debate on public health with colleagues from across the parties and the Royal College of Paediatrics and Child Health. The manifestos of those organisations leave us in no doubt as to their experience-based and well-evidenced views on how the Government and Parliament can improve health outcomes and deliver the broader national consensus of which Jackson Carlaw spoke.
Engagement among clinicians, Parliament and the public is essential and welcome. As we have heard, public meetings are taking place this month as part of a review of in-patient hospital care for children in NHS Lothian, which has a deadline of 18 March. The independent expert review is being undertaken by the Royal College of Paediatrics and Child Health, which was asked to do so by NHS Lothian. However, all our citizens—young and old—are entitled to safe, effective and sustainable patient care.
With the increasing birth rate and West Lothian’s growing population, it is essential that paediatric services at St John’s hospital be protected and properly resourced. The West Lothian population is expected to increase by 25,000 within the next 19 years, so this is not the time to diminish or centralise services, or to ask people to travel to services in Edinburgh, for example, where National Records of Scotland estimates population growth is set to outstrip previous growth forecasts, with an expected increase of more than 28 per cent over the next 25 years, including a 27 per cent increase in children under 15. Andrew Burns, the leader of the City of Edinburgh Council, has rightly noted that that growth, which is
“not far off a one-third increase in the population … comes with massive challenges.”
A future-proofed health service, with facilities that are as local as possible, is essential for dealing with that challenge.
The cabinet secretary has assured Parliament that there are no proposals for closure, but nor is there a guarantee that, for example, paediatrics at St John’s will not be downgraded or closed. Delay and uncertainty cause unnecessary stress for patients and staff. Staff concerns led to a downgrading of the ward last summer. Reliance on expensive locums and increased overtime requirements demonstrate the need for a fully resourced plan for the future. There is understandable dismay that the people of West Lothian will not find out until after the election what the future holds for them and for St John’s. I ask the cabinet secretary and NHS Lothian to take every step to ensure that the report is published before the election.
In closing, I say that we all have a duty to do all that we can to improve Scotland’s national health. In order to do so, we must invest in and properly support all those who look after us, whether at home or in our hospitals.
I took part in yesterday’s Holyrood debate discussing the Boycott, Divestment and Sanctions campaign (BDS), that aims to put pressure on the Israeli state to end the oppression of Palestinians.
The debate provided an opportunity to outline why the Scottish Green Party is supportive of BDS as an effective strategy, inspired by similar action in apartheid South Africa.
The video of my speech is here, and you can read the full text below.
The Scottish Green Party supports the boycott, divestment and sanctions campaign because it is a very effective tool for supporting the Palestinian people in their struggle against oppression.
There has long been an international failure to hold Israeli Governments to account for disregarding international law and ignoring the health, safety and human rights of Palestinians.
As the Palestine Solidarity Campaign highlights, the 2005 call for boycott came from leading Palestinian cultural and academic figures, who urged their counterparts in civil society and “people of conscience all over the world” to undertake “initiatives against Israel similar to those applied to South Africa in the apartheid era.”
By putting economic pressure on the Israeli Government, we can join a worldwide campaign that calls on corporations that profit from Israel’s occupation of Palestinian territories to pull their funding.
Boycott is a legitimate form of protest, and of course it is one that we do not undertake lightly. As my colleague John Wilson points out in his motion opposing restrictions on the right to protest, similar campaigns helped to weaken the apartheid regime in South Africa.
As was said by my colleague John Finnie, this is not a boycott against Israeli artists who are not being used to support brand Israel—the Israeli propaganda strategy that is designed to whitewash human rights abuses—but a boycott of the Israeli state and those who seek to normalise the occupation of Palestine.
It is important that we understand that a deep and unwavering commitment that none of us should ever forget or downplay the atrocities of the Holocaust and the oppression of Jewish people is entirely consistent with opposing any abusive actions by the Israeli Government or, indeed, any Government. To argue otherwise obscures the genuine attempts of those who want to see a secure and lasting peace in the middle east and who believe that the biggest obstacle to achieving that is oppressive Israeli state action.
Mr Carlaw suggests in his motion that we should pursue greater cultural links with Israel rather than boycotts that make clear that Israel’s treatment of the Palestinian people is unacceptable. However, to do that while the oppression of Palestinians continues would be to sweep under the carpet the Israeli attacks on Palestinian culture, including vandalism, destruction, the closure of and military attacks on Palestinian cinemas and theatres, the banning of cultural events and restrictions on the movements of Palestinian artists.
It is truly alarming that it is still, in this day and age, impossible to express solidarity with desperate and oppressed people without facing accusations of bigotry against their oppressor.
I do not agree with Mr Macintosh and Mr Carlaw that there is growing hostility towards Israel. Absolutely every person on this planet—not just in Scotland but globally—is entitled to a peaceful existence. I want to work with all parties that can contribute to the end of the occupation of Palestine by non-military means. A just peace in Israel and Palestine could be the catalyst for achieving wider peace in the region and across the world. Efforts to criminalise boycotts or publicly smear those who express support for the Palestinian people serves only to hinder any progress towards peace.
We have the choice of following those such as Archbishop Desmond Tutu, who fought to end South African apartheid and who supports the BDS campaign, or of failing to play any part in the efforts to end the apartheid in the middle east.
The cultural boycott of Israel is moderate in its objective, which is simply to ensure that Israel observes international humanitarian law.
Last week, I had the chance to visit the Museum of Fire in Edinburgh. In my opinion, it’s one of our city’s hidden gems.
It’s housed in a gorgeous old fire station on Lauriston Place, and takes visitors back to the dramatic past of city fire fighters who saved lives as part of the oldest Municipal fire brigade in all of the UK.
This is a history to be proud of. Before the Edinburgh Fire Brigade was established in 1824, fires were extinguished by insurance companies who all owned their own engines. In today’s Scotland, a system where only those with the relevant insurance would be rescued from deadly fires, seems ludicrous. We owe a big thank you to the decision-makers and firefighters who pioneered a fire service for the common good.
The Museum of Fire showcases wonderful old fire engines and firefighting equipment. All these artefacts are in their beautiful original setting, the station that has been standing in the Old Town since the early 1900s.
Places like the Museum of Fire are what make Edinburgh such a magical city. Full of human history, unexpected finds and fabulous old architecture.
Now the Museum is under threat of closure. It’s owned by the Scottish Fire and Rescue Service (SFRS), who are considering selling the building and relocating its contents to other museums. Dedicated volunteers who have kept the museum going for decades have started a campaign to keep the museum in its original home, and I am very happy to support them.
In times where budget cuts are hitting our public services hard and people are struggling to make ends meet, defending spending on museums and other cultural institutions can be an extremely hard sell.
But we need to recognise the importance of hanging onto our cultural treasures – they make our cities more attractive to visitors; they provide free and accessible places for people to visit in their spare time; they remind us about our past and help us think about the future. I urge the SFRS to reconsider its options and hold onto this brilliant bit of local history.
I have lodged a motion in the Scottish Parliament to draw attention to the trouble the Museum of Fire is in, and hope that my MSP colleagues will support it.
This week I spoke in a debate in Parliament on Missing Voters.
I began by pointing out that political parties tend to focus on the number of votes that they might get, and we pay too little attention to the number of votes that could be cast but which are not cast, even by people who are registered.
Read on for the full text of my speech.
Of course, there are recognised barriers to voting, including literacy problems, lack of access to information technology, ill health, homelessness and work and family commitments.
However, given the importance of people voting in any democracy that is worthy of the name, we have to push that lack of engagement up the agenda and acknowledge that although we here enjoy a fairly advanced level of democracy, there is much that can be done to progress it. For example, we have to ask how democratic we actually are when large numbers of our population are not taking part in the operation of our democracy. What are we doing—or failing to do—to get the missing millions back? The changes to voter registration on which the motion focuses are clearly having a negative impact on the number of voters who are registered in Scotland, and that negative impact must be addressed.
Some of us in the chamber might well have experienced—or know someone who has experienced—a problem with the new system. I know people who, after completing the verification process, have received a letter demanding that they do so and telling them that they are not yet registered. Some of those people were concerned individuals who wanted to know that they were registered and therefore insisted on written confirmation that they were on the register, which, although understandable, resulted in time-consuming and expensive work.
I want to use the short time that remains to cover some broader issues relating to non-participation in our democratic process. Perhaps in his closing speech the minister might tell us more about why some companies are given access to the register for marketing purposes—I know that that is a concern for many people—how much money is raised through such practices and where that money goes. It might be helpful if some of that money were to be ring fenced to increase voter turnout or to improve registration, because we have to start to bring down the numbers who are not registered and the numbers who are registered but who simply choose not to vote. Why do people feel that voting is a waste of time? Is it because they become disillusioned when they have taken part in umpteen consultations and their views have been rejected out of hand?
The turnout in the 2011 elections to the Scottish Parliament was just over 50 per cent, so almost 2 million Scots who could have voted chose not to. That is right: they chose not to. We take the freedom to vote for granted, but it has been very hard won by many people. How might Scotland change if those non-voters were to exercise their democratic right—if we could do more to convince them that voting is worth while? We need to look at sharing power downwards and outwards. The size of areas and the population numbers that are considered local in Scotland would be regarded as regional and would be a level above local government in most other European nations.
Perhaps our winner-takes-all political culture is an unappealing turn-off for many people. It is a system that values conflict. We have roaring and cheering in this very chamber, and an adversarial Punch and Judy show. In no other walk of life would that be even considered.
The German constitution forbids national Government interference in regional government matters; Angela Merkel could not suggest a council tax freeze, for example. Regardless of what we think about the impact of that freeze, it means that power is taken away from local people.
We have an unelected House of Lords and an outdated and divisive electoral system that forces politicians to ignore huge parts of the population. We need a democracy that encourages a culture in which we collaborate with people and include everyone. To a great extent, the referendum demonstrated that the millions who do not vote in local, national and UK elections are interested and are more than engaged when they believe that they have the power to change things.
It is important that we as a Parliament take all the action that we can take to ensure that individual registration is properly resourced and administered, and that no one loses their right to vote. Let us do all that we can. This is not a party-political issue. We have to encourage everyone in Scotland to participate in our democratic process.
Reacting to news that plans to turn the Royal High School in Edinburgh into a luxury hotel have been rejected, Alison Johnstone, Scottish Green MSP for Lothian, who spoke at today’s planning hearing, said:
“I’m so pleased that members of the planning committee were not seduced by arguments about economic benefit, instead recognising that much of our visitor economy is based on the carefully cherished landscape of our city: an inheritance which this development would have squandered.
“A perfectly feasible alternative is waiting in the wings in the shape of a new music school which much more respects the building and setting. and is more likely to widen public access. Let’s get to that quickly.”
This week I took part in the Stage One debate on the Government’s Land Reform Bill. I would have liked to have seen the Government’s response to the stage 1 report before the debate. The Bill as it stands needs serious improvements.
Read on for the full text of my speech.
Land is limited. It is also emotional and personal. Our homes are on land, we live off the land and nations are defined by their land. We all need land, but access to and ownership of it are unequal. The land inequity in Scotland today is vast and totally out of step with the situation for many of our European neighbours. Patterns of land ownership in our neighbouring nations are typically 1,000 times less concentrated than in Scotland. Not only do relatively few people own most of Scotland but around a quarter of all estates over 1,000 acres have been held by the same families for more than 400 years.
That is the history that we live with today and which the Parliament is slowly beginning to overcome. As we have heard, land reform is a broad topic that covers rural and urban areas as well as the marine environment. The issue is inextricably linked to local democracy, fiscal policy, land prices and human rights. Scottish Greens have always seen radical land reform as a vital element of the journey towards a more sustainable, equal and prosperous Scotland. I hope that the bill is the start of the Scottish Parliament taking a renewed and sustained interest in the issue, whether that is through greater devolution, empowering local authorities through tax reform or community empowerment.
The provisions on transparency are important. The question of who owns and benefits from land is a key one, and I believe that the electorate are entitled to full transparency about who really owns Scotland. There is no simple way to deliver complete transparency but, unfortunately, the Government’s proposal is unworkable. Section 35 limits those who can make requests for information and section 36 contains no measures to compel any company in, for example, Grand Cayman to reveal anything at all about who is in control of it. The proposal is unenforceable and will continue to allow Scottish landowners to be involved in complex schemes of tax avoidance and evasion and secrecy. The best option on the table by far is to allow only EU-registered companies to own land. We welcome the committee’s recommendations on that point.
Fiscal reform is also a core part of land reform. I fully support bringing shootings and deer forests back on to the valuation roll. Of course no one likes to pay tax, especially if it is a tax from which they have had an exemption, but there is more than enough evidence that that should happen. As the land reform expert Andy Wightman puts it,
“Why should caravan sites, pubs and local shops subsidise those who occupy shootings and deer forests?”
He says that
“the hair salon, village shop, pub and garage are subject to rating”,
“deer forests and shootings pay nothing.”
As the land reform review group made clear:
“there is no clear public interest case in maintaining the current universal exemption of agriculture, forestry and other land based businesses from non-domestic rates.”
The conclusions of a House of Commons Scottish Affairs Committee report this year raised similar concerns that the exemptions are not having the desired impact, that they should be open to the same level of scrutiny as other Government spending and that they could in fact be pushing up land prices and undermining the Scottish Government’s commitment to increase the amount of land in community ownership.
Bold land reform is needed for Scotland, and it could help to deliver more affordable homes. Current rates exemptions for vacant and derelict land and for empty industrial buildings incentivise people to keep land in urban areas vacant. All of that land could be used for homes for people. There is almost 11,000 hectares of vacant or derelict urban land in Scotland and a massive demand for affordable homes. We heard earlier today that 54,000 households in Scotland are homeless.
What about the appalling situation in which Andrew Stoddart and his family found themselves? It brought tenant farming rights up the agenda again, and rightly so. Poor housing issues jumped out during the RACCE Committee’s evidence gathering, and I learned that homes under agricultural tenancies are exempt from the minimum standard. Clearly, there are improvements to be made in that area, and I support the calls for a tenant’s right to buy in specific circumstances.
I will flag up a couple of things that Scottish Greens think should be included in the bill. There are numerous examples of common land that is not on the register passing quietly into public ownership. We should create a new protective order for land without an identifiable owner, which should require the keeper to conduct a public consultation, to help to ascertain the true legal status of the land well before any title is registered. Finally, we have left on the statute book a piece of legislation called the Division of Commonties Act 1695. It was one of the legal tools that were used to privatise vast tracts of common land. The 1695 act should be repealed to protect the few patches of common land that remain and to signal our break from the land grabs of the past.
We will support the bill today, but there is much to be done before stage 2.
This week I took part in a parliamentary debate on the NHS and Redesigning Primary Care.
I stressed the importance of everyone in Scotland having the means and services to enable them to enjoy optimal health, and a properly resourced health service there when we need it. We know only too well the impact of inequality on health.
Read on for the full text of my speech.
It really is essential that we do all that we can to ensure that everyone in Scotland has access to a GP when they need one, yet, as we have heard, that is becoming more of a challenge than ever before. This year, here in Lothian, practices in Ratho and Bangholm have struggled to provide primary care to patients. At the time, a constituent who lives in Ratho village wrote to me and told of the
“extraordinary position that we find ourselves in living in Ratho Village”,
“We will have no doctor in the surgery for the next week. We have only had a doctor for two days a week for the six weeks beforehand.”
My constituent advised that he had been offered an alternative surgery in Leith, which involves a journey of about 10 miles one way. In terms of cost and travel time, not to mention time off work or school, it is difficult to imagine a less convenient option.
Like many people, my constituent wants to understand the events and circumstances that led to that, and he asks that the local health board provides an explanation of the systems and planning that have led to the situation. He asks:
“Why has this happened?”
He used the word “extraordinary”, and the lack of access to a GP is indeed unexpected, unusual and extremely worrying. There are many reasons why it has happened, but I am pleased to say that there are solutions.
We have moved from a position where there was intense competition for GP positions and several applicants for each post to one where, as reported in MSP meetings with NHS Lothian, interview dates have been cancelled due to a lack of interest in and candidates for an advertised post.
As GP vacancies increase, the burden on existing staff increases, adding to workloads that the BMA describes as being “already unsustainable.” The BMA tells us, too, that morale among GPs is at an all-time low, that more GPs than ever before are leaving mid-career and that senior GPs are retiring early. I know one such GP, who told me recently that the bureaucracy that he was dealing with meant that he simply could not do the job that he had been doing before and the job that he wanted and needed to do. Unfortunately, he felt that he could not carry on. He worked in a practice in an area with many social challenges, and the loss of his skill, passion and experience will have a negative impact. I am pleased that the burden that is QOF is being removed.
We have heard, too, that there are practices with restrictions on their lists. For example, potential patients may be able to register only on certain days of the week. Lack of access to primary care often results in patients seeking assistance at hospitals, sometimes heading straight to accident and emergency departments. In some cases, because patients have been unable to access primary care, an initially non-serious illness becomes acute and requires attention in hospital.
I welcome the Government’s commitment to address the issue and the on-going work to agree a new GP contract from 2017, because it is clear that action is required. It is really important that we listen to and work with the profession to ensure that we get the change right. The Royal College of General Practitioners, the BMA and the Royal College of Emergency Medicine have been working hard on engaging with Government and parliamentarians.
Martin McKechnie, the vice president of the Royal College of Emergency Medicine, asks us to invest in GP training and retention in order to ensure that fewer patients head to accident and emergency departments for care. He credits the Government with increasing consultant numbers and asks that even more is done so that every hospital in Scotland can provide a 365-days-a-year service. He highlights the loss of graduate emergency registrars, a lot of them to Australia, and the RCGP tells us that many qualified GPs are leaving to practise abroad, and that insufficient numbers are undertaking GP specialty training. The RCGP has told us that GPs want to look after their patients and not the books. They want a more appropriate replacement for the QOF to evolve—one that works for patients and GPs. Further, the BMA asks us to recruit, train and value doctors and wants all parties in this chamber to work with it to support Scottish general practice.
We need to make being a GP in Scotland a really attractive career that attracts people in the way that it did before and to which GPs who take a break will return. I hope that the current work on agreeing the new contract will take those factors and more into account.
GP practices have worked on a small-business model since the 1960s. That might be the preference of many practices, but more and more GPs do not want to be partners and do not want to work full time; they might prefer to be employed by the practice or by the NHS. New models and changing contracts could make being a GP a more attractive career to a greater number of people.
Working with and listening to health professionals in this country will give us the possibility of developing and delivering a healthcare model that will better support those working in the NHS, helping them to keep our growing and ageing population well. Sir Lewis Ritchie’s out-of-hours model makes a lot of sense and fully involves a range of allied health professionals in primary care in a transformative way that will have positive impacts on in-hours care.
It is important that, foremost in all debates on health, we focus on the need for a preventative approach. In that regard, the BMA’s suggestion of providing a portion of fruit or vegetables to all primary school children in Scotland every day is well worth looking at, as is the living wage.
I was delighted earlier this week to welcome guests to the Parliament to celebrate the 90th anniversary of Fields in Trust. Thanks to Fields in Trust there are now 2443 protected sites across the UK. I was joined by the Fields in Trust Scotland Committee, and ex-Scotland rugby international Rory Lawson.
Green spaces have never been under such pressure from development. The aims of FiT are close to my heart – to ensure that everyone regardless of their age, ability or mobility has access to free, local outdoor space for sport, play and recreation.