Scottish Patient Safety Programme

Part of the debate – in the Scottish Parliament on 2nd March 2017.

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Photo of Elaine Smith Elaine Smith Labour

Nye Bevan said:

“Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community.”

That was why Labour created our NHS, which remains one of the most valued assets of people across Britain. People expect to be safe when using it so, although Scotland’s once-unique patient safety programme is welcome, we must consider it closely and strive always to improve it.

It is also important to make it clear that, although our hard-working NHS staff deserve our thanks for all that they do, they are under extreme pressure. The use of agency staff has increased, and spending on that has rocketed over the past four years, despite Audit Scotland’s warning that

“Agency staff are likely to be more expensive than bank nurses, and also pose a greater potential risk to patient safety and the quality of care.”

I am sure that everyone who is taking part in the debate agrees that improving our hospitals, keeping staff well trained and maintaining staff numbers at safe levels takes investment and long-term planning, which is something that we all want to see.

The patient safety programme has the worthy goal of the safer use of medicines, but that goal is not well served by not providing people with the correct medicines in the first place. As the cabinet secretary mentioned, Scotland’s chief medical officer, Dr Catherine Calderwood, said on Monday that doctors should spend more time listening to their patients in order to avoid giving them unnecessary treatments. Dr Calderwood called that realistic medicine, which focuses on quality of life, not the efficiency of treatment. However, that is not realistic for some patients if they cannot get the medicine that they need to live a normal life. For example, too many thyroid patients, who are mainly women, are not being properly diagnosed or are being refused access to liothyronine, which means that they are forced into buying desiccated thyroid hormone on the internet. That can hardly be called safe and it is not putting patients at the heart of their own care.

It is common for some patients with thyroid illness to be prescribed antidepressants, perhaps because their GPs do not have the time to listen to them and therefore cannot reach a proper, safe and correct diagnosis. That is an example of patients with chronic disabling or life-threatening conditions being deprived of treatment because of costs, the closed-mindedness of the medical establishment and NHS boards, or GPs being under immense strain. That issue should be considered further, and the Public Petitions Committee is considering it.

Getting patients into and out of hospitals safely and having them there for the right amount of time is a key concern for patient safety. Back in January, Labour obtained official figures that showed that, between the start of March 2015 and the end of September 2016, 683 people died in hospital after being deemed medically fit to leave. Of course, we have promises to end the practice of bed blocking.

At present, even getting into hospital for desperately needed operations is a problem. In NHS Lanarkshire, there is a wait of up to 24 weeks for an initial appointment for a hip replacement. That is 24 weeks of being in extreme pain for older people who will then have another long wait for the operation, and that is despite the Government giving a 12-week guarantee, although I accept that that is not legally binding.

What happens afterwards? The figures may show a decrease in acquired infections, but I am becoming increasingly concerned that I am hearing about people with such infections, which may need to be looked at. I am also concerned about those who tell me that aftercare is poor, which seems to be a result of staff shortages and, in some cases, low morale. A recent disturbing story involved a constituent who waited 30 minutes, while pressing her buzzer, and who then suffered the indignity of having to wet herself.

It is important to consider the kind of people who are dying in our hospitals and how we might be able to prevent that. For example, we know that Scots who are from poorer backgrounds are 64 per cent more likely to die from cancer and that general health outcomes for those in our deprived areas—specifically those in greater Glasgow—are some of the worst in Europe. Those inequalities must be addressed.

If we are to improve patient safety in our hospitals, we need not only to tackle workforce planning but to ease the tensions that affect hospitals, and that requires prevention, as has been said. The 2015-16 NHS audit report found that many NHS boards across the country struggled to achieve financial balance and, overall, NHS Scotland failed to meet seven out of eight key performance targets. That is not exactly a picture of health and it will only get worse if we do not continue to take action and make improvements.