NHS Tayside (Mental Health Services)

Part of the debate – in the Scottish Parliament on 9th May 2018.

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Photo of Elizabeth Smith Elizabeth Smith Conservative

The tone of the preceding speeches speaks volumes about why this debate is taking place and its importance. I pay tribute to all the previous speakers.

I add my welcome to the genuine commitment to an independent review, and I agree with the comments that others have made about its being vital that we take with us the families of patients who feel that they have had a raw deal or that they have been badly let down and not listened to. If we do not do that, we will not make any progress at all.

The Mental Welfare Commission for Scotland has stated that it is every patient’s right and, indeed, every family’s right to expect the highest standards of care when someone is in a very vulnerable situation. Exactly the same expectation should be evident in any part of the health service.

In that context, I come to this debate from my constituency work across three parliamentary sessions. I am sorry to say that, in several cases, it has been very clear that patients did not receive the highest standard of care. Obviously, I cannot speak about the individuals concerned because of the need to maintain confidentiality, but I want to highlight three areas in which reform is needed and which, as it happens, tie in with the findings of the Mental Welfare Commission’s report.

As Alison Johnstone and Jenny Marra have rightly said, there are staffing issues. We know that there are significant pressures on staff across Tayside. The result is that there are currently 21 locums in place, with the additional expense that that brings. More important, there are the difficulties of patients not having a consistent link to a member of staff who can deal with their specific problems, so that they end up having to retell their story several times over. Obviously, that adds to the stress of the situation.

The issue of care plans and their lack of consistency is related to that. The Mental Welfare Commission reported that there was very variable information in patients’ care plans. Although some were described as “excellent”, one patient told the commission about having to fill in forms with no assistance from any member of staff, because the staff were too busy doing other things. That was certainly the experience of two of my constituents, whose care was very patchy in its quality. The recommendations made by the commission in that respect are extremely important and I hope that they will provide essential support to patients and their families at their most vulnerable time.

Like many other professions, mental health care can bring with it a great deal of time-consuming paperwork, which often prevents the carers from spending time with their patients. That is just another reason to hasten the improvements in the electronic records system.

We all understand the desire to help patients at home and in the community as far as possible. However, for the 6 per cent who require hospital treatment we need to ensure that there are better standards of care across the board. We also need to understand that there is much more work to be done to improve the situation when there are crisis admissions. I hope that the independent commission, which was brought in to review matters, will ensure that there is greater liaison with the police, who are almost always in the front line of such cases.

The recent Samaritans report, which says that suicide is not being treated seriously, could hardly be a starker warning to us all.

I will finish on the issue of the conflicting requests from health and social work. It comes down to mental health management and, again, I think that it is relevant to the problems within the structures of integration joint boards, which I spoke about in last week’s debate about NHS Tayside. MSPs discussed the issue yesterday with John Brown and Malcolm Wright. I hope that we can address the matter soon. Good-quality mental health care depends on clear lines of responsibility and accountability for staff, and on patients and families knowing exactly what they are.

There is no time at all to waste. I support the motion, the Government’s amendment and the amendment in the name of Miles Briggs.