A future-proofed health service

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.

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