Health centres and hospitals and complaints that the service patients receive in both were the main topic at First Minister’s questions for Tory leader Russell Findlay and John Swinney.
By Bill Heaney
An Audit Scotland report that was published today lays bare serious problems with general practice care in Scotland [see report in The Democrat earlier today].
Conservative leader Russell Findlay asked First Minister John Swinney for assurances that the multiple explicit recommendations made in that report, including five that should be completed by the Scottish Government within a year, will be delivered.
The First Minister replied that the Government will consider the recommendations in the report — “We are taking forward a series of investments to strengthen access to healthcare in Scotland. General practice is one of the areas in which access is most critical.
“The Government’s investment through the primary care improvement fund, for example, and other steps that have been taken to expand the workforce in general practice are among the practical steps that we are taking to address these issues.”
Russell Findlay said: “Those commitments should be delivered so that patients can get a face-to-face general practitioner appointment when they need one.
“The independent Auditor General’s report states that the Government has not met previous pledges, which should have been delivered by 2021. The report calls for “a clear delivery plan for general practice by the end of 2025 that includes specific actions, timescales and costs.”
He asked: “Will the First Minister confirm that he will bring forward that plan by the end of the year, for the benefit of patients across Scotland?”
Mr Swinney replied: “As I set out in my speech on the national health service in late January, the Government will make a number of different interventions to improve access to healthcare services.
“At the heart of that will be access to GP services. The Government has set out our intention to explain the specific interventions that we will make in that respect. That information will be shared publicly very soon.
“We start from a high platform, in the sense that Scotland has the highest number of GPs per head of population in the United Kingdom. We are determined to build on that.
“We are also determined to expand the workforce in general practice. For example, we have employed more than 3,500 whole-time-equivalent staff in other primary care teams. That is designed to boost access to healthcare.
“We have also employed an additional 1,300 whole-time-equivalent staff to support general practice through health boards.
“Issues about the manner in which members of the public are able to access general practice—which I accept are important—are being responded to by the investments that the Government is making.”
Russell Findlay added that just today Healthcare Improvement Scotland detailed serious concerns at NHS Greater Glasgow and Clyde accident and emergency units.
He said: “Those problems are consistent with what is happening at hospital emergency departments across Scotland. The regulator says that it has become routine for ambulances to queue up outside the Queen Elizabeth university hospital and for patients to be treated in corridors.
“The HIS report says that patient safety is being “seriously compromised”. Does the First Minister agree that that is unacceptable? Will he explain what steps he will take to put patient safety first?”
Mr Swinney told him: “Patient safety is a fundamental prerequisite of our healthcare system. Healthcare Improvement Scotland’s report was designed to address the legitimate concerns that have been raised by representatives of staff in NHS Greater Glasgow and Clyde emergency departments.
“I expect the board to implement and address the findings of the report, and I am confident that it will do so.
“There has been an entire change of leadership in NHS Greater Glasgow and Clyde, with a new chair, a new chief executive and a new medical director in place. As the chief executive of the health board has made clear publicly, the board is taking forward the necessary reforms at pace and at scale.
“On the wider question, I understand the concerns about access to accident and emergency services. I reassure members of the public that, for some weeks, the performance of A and E units against the four-hour standard has been improving as we recover from the significant disruption as a consequence of the flu outbreak that dominated over the Christmas and new year period and well into January.
“The position in A and E departments is strengthening. On the question about Healthcare Improvement Scotland’s report, I expect the recommendations to be addressed by the board.”
Russell Findlay persisted: “For its report, Healthcare Improvement Scotland surveyed NHS doctors and nurses who were working in three separate hospitals.”
The survey revealed what has been concealed for many years – that the GP and NHS hospital services are performing at a level scandalously below the level of patient requirements.
Mr Findlay added: “Shockingly, the majority of those who were surveyed said that patients rarely receive care that is either appropriate or timely.
“The report makes a number of suggestions for NHS Greater Glasgow and Clyde as well as national recommendations for the Scottish Government.
“The report advises the Government to define new standards and introduce new guidance to improve the quality and safety of patient care. Those are sensible suggestions that could improve patient experiences and reduce NHS Scotland waiting times. Will John Swinney take the necessary and decisive action to make those changes? If so, by when?”
The First Minister assured the Tory leader: “Those are urgent priorities for me, because they go to the heart of what I think is the key issue that is affecting the performance of our healthcare system in a number of respects, which is our ability to manage flow within healthcare settings.
“For example, if a hospital is at full occupancy and congested, it is difficult for staff in an emergency department to admit individuals into the hospital, and if we do not have enough social care provision in the community, we will have delayed discharges from our hospitals.
“There is an integrated link between emergency departments, hospital occupancy and delayed discharge. I assure Mr Findlay that all three of those elements relating to flow within the healthcare system are priorities for the Cabinet Secretary for Health and Social Care [Neil Gray] and me as we undertake weekly scrutiny of the health system’s performance and the work to reduce waiting times.
“We also want to strengthen access to general practice, which was the point that Mr Findlay made in his first question, so that individuals with healthcare requirements can get appropriate treatment and support at the earliest possible opportunity.
“Of course, a wide variety of treatments and support are available through pharmacies, general practice and other allied health professionals to whom we wish to improve access.”
Top of page: Health Board headquarters at Gartnavel Hospital on Great Western Road.
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