Hospital Television Charges

– in the Scottish Parliament on 17th January 2019.

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Photo of Linda Fabiani Linda Fabiani Scottish National Party

I ask people who are leaving the gallery to do so quietly.

The next item of business is a members’ business debate on motion S5M-14486, in the name of Edward Mountain, on fairer hospital television charges. The debate will be concluded without any question being put.

Motion debated,

That the Parliament believes that charges for bedside televisions in hospitals must be proportionate and affordable for all patients; understands that many hospitals in the Highlands and Islands and across Scotland are charging adult patients up to £9.90 per day to access bedside television; considers that accessing bedside television in hospitals can be prohibitively expensive for long-stay patients; understands that NHS boards receive no income for providing this service, and notes the calls for all NHS boards to renegotiate bedside television contracts when they are next up for renewal to ensure the best possible value for money for patients across Scotland.

Photo of Edward Mountain Edward Mountain Conservative

I am very pleased that we are having the debate at this time, and I thank the members of other parties who supported my motion—in particular, David Stewart, Monica Lennon, Neil Findlay, Mike Rumbles and Liam McArthur.

I am disappointed that no Scottish National Party politician signed my motion, but I am not deterred. I believe that, despite their reticence about standing up and being counted, the majority of SNP members will support me in my wish to end unfair hospital television charges. This is a cross-party issue that should unite us all.

Since I raised the issue of TV charges, I have received a huge response. There is a huge amount of interest in the matter not only in the Highlands and Islands but across Scotland. I welcome now the people who are following the debate live on the BBC. To people who are in hospital and are having to pay to watch the debate, I say that I hope that their Parliament can make a real change.

I decided to raise the issue after visiting a friend in Raigmore hospital. He has spent all his life in the countryside, which makes his time in hospital difficult. After two months of being confined to bed, he is longing to go home. As I chatted to him, I saw the bedside TV unit, and I tried to console him by saying that at least he had something to watch. He responded with a laugh and said, “You’ve got to be joking. The costs for using that thing are ridiculous.”

It is hard to explain to members who have avoided having to spend a long time in hospital the boredom that the routine of eating, sleeping and being treated creates. I remember sitting with my father during the last weeks of his life; he would have welcomed the distraction of a TV. Moreover, when I was in Dr Gray’s hospital in Elgin five years ago, I had to wander off my ward to find a TV to break the monotony of lying in bed, and I gave up counting the amount of times that I was rebuked by nurses for doing so to watch a TV that was not there for patients.

In the Highlands, many patients are moved from their communities to Raigmore hospital, which makes visits from their families difficult and creates a feeling of social isolation. The ability to watch local news and general TV helps to remove that feeling. That, to me, makes TV an important part of hospital life and recovery.

Some people might think it odd for me to criticise provision of a service by a private company. Let me be clear: I do not and will never believe that we should ever support a private contract that compromises the service that an individual receives. I am standing here today because, to put it simply, the cost of bedside television in NHS Highland is extortionate and prohibitive. No one can justify a charge of £9.90 a day, especially when we compare that with the price of online provision of films and entertainment: firms that supply such online services charge less per month than is charged per day in a hospital.

I do not want to be accused at the end of the debate of mincing my words. Hospitals have a captive audience. I believe that the charges for bedside TV are a rip-off for short-stay patients and are just daylight robbery for long-stay patients. The situation has gone on for way too long. Health boards such as NHS Highland signed exclusive contracts for 15 years. Moreover, we should not forget that all the revenue from bedside TV goes to the suppliers. The NHS receives nothing—not a penny. The Scottish Government should ensure that that never happens again.

The contract for bedside TV is up for renewal in NHS Highland in June 2019, so now is the time to secure a better deal for patients, which is why today I am launching a petition for the campaign for fairer hospital TV charges. It reads simply:

“We believe that bedside television in hospitals is vital to prevent social exclusion and feelings of isolation for patients.

We call on local health boards to secure a fair deal with companies providing bedside television and to provide free WiFi for patients in hospitals to allow them to access television via video streaming services.”

I urge all MSPs to go out and get people to sign up to my petition if they do not want to extend the extortionate fees that are being charged at the moment.

I welcome the promises that the Cabinet Secretary for Health and Sport made only last week to work with NHS Highland to ensure that patient television is more affordable, and to identify the feasibility of supplying free bedside entertainment via wi-fi across NHS Scotland. Those promises are a huge step forward, but they need to be delivered.

However, that is not the whole solution. Offering free wi-fi assumes that every patient has access to tablets and laptops to use the services. To me, that is a big assumption. We also need to question how we can make devices available to patients who do not own them. The Scottish Government and our local health boards need to think outside the box about how to address the issue.

Hospital TV charges would make Dick Turpin blush. They are not only highway robbery, but are daylight robbery of a captive audience who are often vulnerable due to illness. The time is right for change: it is right for patients, it is right for our health boards and, I believe, it is right for Scotland.

The Deputy Presiding Officer:

We move to the open debate. I ask for speeches of four minutes, please.

Photo of Gordon MacDonald Gordon MacDonald Scottish National Party

I thank Edward Mountain for bringing the debate to the chamber and for giving me the opportunity to speak on the subject of hospital television charges.

When I spent two 10-day spells in hospital back in 2017, I found that being able to watch television between spells of reading helped to offset the boredom that Edward Mountain mentioned. It helped me to recover in the hospital ward and made my stay more bearable by taking my mind off my medical issues.

In my time in hospital, I was admitted to St John’s hospital in Livingston and the Western general hospital in Edinburgh. Neither of those hospitals charges for watching television. The response from NHS Lothian to a freedom of information request in 2015 stated that only patients in the Royal infirmary of Edinburgh, which was private finance initiative funded, had to pay to watch television, due to a contract with Patientline UK—now Hospedia Ltd—that had been signed prior to the hospital opening, in 2001. NHS Lothian confirmed that no other patients in acute hospitals in the Lothian area were subjected to television charges.

I agree that the up to £9.90 per day that is charged by Hospedia to access bedside television is prohibitively expensive. Comparing the cost of the 25 channels that are provided by that company with what is available from a major satellite television provider that charges £22 per month for access to hundreds of channels highlights just how much patients are being ripped off.

A survey that was carried out by the Consumers’ Association—or Which?—in 2011 found that hospital bedside entertainment systems were “expensive” and “confusing” for patients, with 61 per cent of respondents stating that they were very poor value for money and one third finding them confusing to use. Some patients were also unhappy about the quality of the service and the inflexibility of buying credits to watch television.

The issue of expensive bedside television provision relates not just to a number of hospitals in Scotland. Hospedia provides the same service to 160 NHS locations—or 75 per cent of acute NHS hospitals—across the UK, in which more than 65,000 patient bedside entertainment units are installed. The UK Government has taken no steps to cancel those contracts.

Hospedia claims that it is the market-leading provider of bedside communication and multimedia services to hospitals in the UK, with up to 10 million patients a year making use of its services. In 2010, the company was taken over by the Los Angeles-based firm, Marlin Equity Partners. The level of that foreign-owned company’s involvement in our national health service cannot be blamed on the introduction of PFI contracts by John Major’s Conservative Government in 1992, and nor can it be blamed on the subsequent Labour Government’s continued use of PFI contracts. The contracts have cost the UK public purse £110 billion to date, and future payments up to the 2040s will cost a further £199 billion. No. The situation developed under the last Labour Government, which stipulated that all hospitals across the UK should offer a bedside television and telephone service. However, the difficulty was that it provided no funding for them to do so. Health boards and hospitals therefore had no option but to enter into 15-year to 20-year contracts with companies to provide the service, which was funded by patients and their families.

I am thankful that a number of the Hospedia contracts in Scotland will end this year. I welcome the fact that NHS Scotland is investigating the feasibility of free wi-fi enabled bedside entertainment units. It is great news that patients in NHS Lothian will trial the new free patient service, which includes access to video streaming. I look forward to seeing health boards across the UK follow Scotland’s example, if it is successful.

Photo of Monica Lennon Monica Lennon Labour

I thank Edward Mountain for securing the debate. My colleague David Stewart is, unfortunately, unwell this week. He was keen to speak in the debate. I hope that Edward Mountain’s friend has made a good recovery.

When we think about the pressures on the NHS and the daily needs of the service, hospital televisions are not what springs to most people’s minds. However, when I saw that Edward Mountain had secured the debate, I was keen to speak in it because my mum has spent a huge amount of time in and out of hospital recently—this week she was even in a side room on her own—so I know that having access to a television, mobile phone and connection with the outside world is really important.

This week, I have learned that the situation in respect of hospital TVs varies across the country and within health board areas. My mum was a patient in Hairmyres hospital, in NHS Lanarkshire, where she did not have to pay to use the television but where the set is absolutely tiny, you have to be about 8 feet tall to reach it and there is no remote control. I had to warn my mum several times, “Don’t you dare stand on a chair to change the channel.” The nurses are rushed off their feet and patients do not want to disturb them to ask them to turn over the telly. I thought that it had got a bit much when I phoned her and she said that she was trying to watch “Coronation Street” but it had taken her two hours to watch it on her phone because the wi-fi was so poor.

There are many pressures on the NHS, but we know that people in hospital tend to be very sick and that our older citizens are the ones who tend to be in hospital for longer. I was visiting the Royal infirmary of Edinburgh recently and chatted to senior nursing staff about delayed discharge. They talked about people who had been in hospital for a year or even longer. For someone in that situation, access to a TV—preferably a free service—is absolutely vital.

Gordon MacDonald has set out some of the historical context, which is important, but the Government has been in administration for 12 years—this is 2019—and we know how important it is for people to be well connected.

I welcome the Government’s work on the strategy on tackling loneliness and social isolation. When people are in hospital, they are extremely vulnerable. It is not just about people being able to watch “Coronation Street”—as important as that is—but about their having access to wi-fi and being able to use their phones. Often, people are co-ordinating what is happening in their life, putting in place arrangements for family members and perhaps managing caring responsibilities.

I hope that we continue to consider the issue. I am interested in hearing more about the pilot in NHS Lothian. Even in Lanarkshire, in my constituency, there is variation, so, although in Hairmyres hospital there is no charge to watch the small, high-up televisions, patients in Monklands hospital have to pay to access the service from Hospedia. The charges are not as expensive as the ones that Edward Mountain mentioned, but there are people in my region who simply cannot afford even £2 or £3 a day.

I know that, from her clinical and professional background in mental health, the minister will have lots of knowledge of and expertise in the subject and will know the importance of ensuring that people do not feel lonely and isolated or a burden when they have to ask staff to change the channel so that they do not miss “Coronation Street”. I am therefore interested in hearing what the minister has to say.

I will look at Edward Mountain’s petition, and I thank him for bringing the issue to the Parliament’s attention. There is something here that we can all work together on.

Photo of Miles Briggs Miles Briggs Conservative

I congratulate my friend and colleague Edward Mountain on securing the debate and on all his campaigning across the Highlands and Islands. He is rapidly becoming the voice of the Highlands and Islands NHS in Parliament, which is a positive thing. I know that clinicians and patients in the Highlands and Islands are grateful for his work and on-going support.

As has been outlined, having access to bedside television and telephone services is a subject on which many of us will have received letters and emails from constituents and their families who have spent time in hospital. Recently, two family friends of mine spent time in Ninewells hospital, in Dundee, and in Foresterhill hospital, in Aberdeen. I visited them both, and there was a clear difference in the patient experience in those two hospitals. It is clear from today’s debate that there is a real postcode lottery in the provision of television in hospital, from Foresterhill in Aberdeen, where patients have access to bedside television, to Ninewells, where they do not.

It is clear that loneliness, boredom and isolation in hospital is impacted by people not having access to such services, especially as more of our hospitals look to move to single-patient rooms. Long stays in hospital can be dull for patients, so access to bedside television—probably at bedtime—and wi-fi is important for letting them keep in touch with loved ones and know what is happening in the outside world.

Like Edward Mountain, I welcome the cabinet secretary’s constructive comments to date on the situation in NHS Highland and the need to secure a better deal for patients who are splashing out on extortionate fees to watch television at Raigmore hospital, in Inverness.

I will use my time to highlight the situation in my own health board, NHS Lothian. At present, hospital bedside television is provided by Hospedia, with a basic bundle costing £17.50 for two days and—amazingly—£5 for just two hours. I hope that NHS Lothian will look at getting a better price for patients in Lothian when the contract is next up for negotiation.

It is also important that we look to the future. As has been outlined, patients are increasingly bringing their iPads into hospital, and there is the potential for those who do not have that technology to be given an iPad while they are in hospital.

Following research by the Scottish Conservatives, we discovered that NHS Lothian is the only health board in Scotland that does not provide free wi-fi to patients. It is an issue on which I have campaigned since I was elected, and I have called for wi-fi to be made available in NHS Lothian hospitals. The wi-fi pilot at St John’s hospital in May 2018 was a success, and the wi-fi was used by 4,635 different devices over the month. NHS Lothian has told me that the Western general hospital will have wi-fi rolled out in August and that the Royal infirmary of Edinburgh planned to have wi-fi by the end of last year. I have today asked NHS Lothian for an update on the delivery of that wi-fi. It is important that we make sure that there is wi-fi to which patients have access, and I welcome the health board acting on that.

I am pleased that NHS Lothian has also committed to having operational wi-fi in place for when the Royal hospital for children moves to its new site—and, I hope, opens—later this year.

I hope that today’s debate can highlight the opportunities for NHS boards to renegotiate bedside television contracts when they are next up for renewal, to ensure the best possible value for money for patients and families across Scotland. The Scottish Conservatives support a review of the provision of television across the NHS Scotland hospital estate, and I hope that is something that the minister, in her response, will undertake to look at with health boards.

As has been outlined, nobody wants to be in hospital, but, when they are, we have a real opportunity to make sure that their time there is not full of loneliness and boredom. Having access to television is part of that.

Photo of Clare Haughey Clare Haughey Scottish National Party

I add my thanks to Edward Mountain for bringing the issue to the chamber and for providing the opportunity to take part in this debate, which allows me to update the chamber on our plans to enhance the patient experience across NHS Scotland.

As we have heard, NHS Scotland’s patient entertainment services currently vary, depending on the locations and the specialties of the hospital sites. Each NHS board provides free access to communal televisions and telephones across its hospitals, either at ward level or in day rooms. In addition, some NHS boards—including NHS Highland, as we have heard—have opted to contract out the provision of entertainment to Hospedia, which provides bedside entertainment to patients on a pay-as-you-go basis.

The Hospedia contract term is 15 years, during which time Hospedia will provide and maintain bedside entertainment systems. Patients are charged to use those facilities, and, as Mr Mountain correctly stated, the NHS boards receive no income from providing the service. There is no provision within the contracts for early termination, which would have to be done via negotiated settlement and would likely be prohibitively expensive, diverting funds from front-line healthcare.

Photo of Edward Mountain Edward Mountain Conservative

I thank the minister for clarifying that. It is exactly as I understood it. Can she confirm whether this Government and previous SNP Governments have looked at buying their way out of those contracts and, if so, what the results of that have been?

Photo of Clare Haughey Clare Haughey Scottish National Party

As I have stated, the contracts are negotiated by the individual NHS boards.

Although daily equivalent charges can be reduced by purchasing longer-term packages, I agree that the services need to be reviewed. The Scottish Government therefore expects all NHS boards to assess and adopt a patient-centred approach on the expiration of the contracts, with consideration given to both value for money and, importantly, the patient experience.

We recognise that televisions provide respite to many patients while they are in hospital. We should also recognise that technology has moved on since the contracts were introduced and that technology is important in enabling patients to remain connected to the outside world. It is particularly important in helping to prevent feelings of isolation and loneliness in patients who are admitted to hospital for lengthy periods of time and in allowing them—when they are able to—to continue their work or studies if they wish to do so.

With that in mind, and given the prevalence of mobile phones and tablets, a more effective policy might be for NHS boards to allow patients access to free wi-fi so that they can connect to online services through their own devices. NHS Lothian is in the process of piloting patient and visitor wi-fi throughout its major acute sites. That project was stimulated by the board’s having received patient feedback that often highlighted the lack of wi-fi and suggested that the availability of wi-fi would improve patients’ experience while they were in hospital. The body that looks after NHS Lothian’s endowment funds, Edinburgh and Lothians Health Foundation, has supported that project, and it is providing additional funding to enable the board to purchase a large wi-fi package. At St John’s hospital and the Western general hospital, patients have been able to stream live television, watch on-demand box sets using services such as BBC iPlayer, the ITV Hub, All 4 and My5, and sign into any accounts that they have purchased for at-home use, such as Netflix, BT Sport and Sky Goal, which can be watched on personal devices.

In addition to supporting media streaming, that provision of wi-fi has supported connectivity with the outside world and has reduced patients’ isolation while they are in hospital—which, as we have heard from members, is a concern. Patients and visitors are now able to communicate using messenger services, emails and social media without worrying about limits and charges associated with personal data packages. They can also access news websites to keep up with current affairs and can continue to run their daily lives by doing things such as paying bills, working remotely and shopping online.

I acknowledge that other NHS boards might not have the same level of endowment funding, but I stress that all NHS boards should balance patient-centred options with value for money.

Photo of Monica Lennon Monica Lennon Labour

I want to raise a practical point. I mentioned telling my mum not to get up on a chair to turn over the TV. I have a genuine concern that some people might overstretch themselves or stand on a chair. I have been told that, over the years, all the remote controls at Hairmyres hospital have disappeared. I know that the minister, too, has a local interest in the matter.

Could we ask NHS Lanarkshire to look at that particular issue? I know that there are universal remote controls. Such a simple measure could make a difference and prevent people from injuring themselves.

Photo of Clare Haughey Clare Haughey Scottish National Party

I agree that NHS Lanarkshire should consider that, particularly if people attempting to change the channel is a health and safety issue. We certainly do not want staff, patients or relatives to fall while they are in hospital.

I spent a considerable amount of time visiting my father in hospital over Christmas and the new year, so I appreciate how important it is for patients to have access to TVs and to have entertainment available. At that point, such access was free and he was able to access his television by touching it rather than by using a remote control.

Last week, the Cabinet Secretary for Health and Sport announced that she expects NHS Highland to actively consider providing free wi-fi services or other suitable alternatives to the current Hospedia contract. We recognise that the Highlands and Islands region is subject to inconsistencies in internet provision, so it is important to ensure that any option for future patient entertainment that is selected has the appropriate infrastructure in place to support it. That does not mean that the Scottish Government would be supportive of NHS Highland taking out a further 15-year contract with Hospedia under the current terms. It is expected that the continuation of any such contract should be an interim solution based on maintaining services.

We are in agreement with Mr Mountain’s request for all NHS boards to review bedside television contracts when they are next up for renewal. Indeed, we would go further than that and stress that it is our expectation that boards will not simply renegotiate existing contracts but will consider all available options, putting patients at the centre of any decision that is made.

The Scottish Government is also in agreement with Mr Mountain that any charges for bedside television in hospitals must be proportionate and affordable. In addition to striving to reduce or eliminate patient charges, we urge boards to explore options for putting in place services that will provide more than just television and that will keep patients connected to their friends, their families and their lives.

13:14 Meeting suspended.

14:30 On resuming—