Primary Care

Part of the debate – in the Scottish Parliament on 3rd March 2021.

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Photo of David Stewart David Stewart Labour

It has been a great honour to serve on the Health and Sport Committee for the past few years. I, too, thank all fellow members—I see that several of them are in the chamber—the hard-working clerks, SPICe and, of course, the Government minister Jeane Freeman, who is standing down at the next election. I thank the cabinet secretary for all her efforts over the past number of years.

This has been an excellent debate, with thoughtful and insightful contributions from across the chamber—not least from my Labour colleagues Sarah Boyack and Alex Rowley and, of course, the convener, Lewis Macdonald, who has convened the committee in a very helpful and affable way.

As the cabinet secretary said, the report is a very helpful contribution not just because of its contents but because of the way in which the committee gathered the information. I will say a little bit about that later. Those comments were echoed by Donald Cameron, who focused on general practice and talked about the future workload crisis. There were also helpful contributions from Sandra White and David Torrance.

As we have heard, and as the cabinet secretary said, primary care is often people’s first point of contact with healthcare services. In many cases, we equate primary care with general practice and all the excellent work that is carried out in that regard. However, if the global pandemic has confirmed anything—if confirmation is necessary—it is that healthcare is a 360-degree package. It is about mental health care, emergency care, preventative care and long-term palliative and recovery work, which all need to knit together on a multidisciplinary basis to ensure healthy lives for people in Scotland.

For many years, I have been concerned about the appalling health inequalities in Scotland, where, in simple terms, the poor die younger than the rich. When I was working on my members’ business debate on the Dewar report—the 1912 inquiry into health services in the Highlands and Islands—I was struck by the appalling problem of health inequalities in the Highlands and Islands at that time. We might argue that the problem exists now to a different degree, but it still exists and we need to tackle it. That will certainly be a job for the new Government and the Parliament in its new session after the election.

As we heard, the report that the committee published in 2019 predominantly focused on the experiences and views of members of the public—the service users of healthcare. Although I have been on lots of committees over my 14 years in the Parliament, it was probably the first time that I have been involved in such an innovative way of interacting with the public. If I remember correctly—I am looking at Lewis Macdonald—we spent a very pleasurable day in Inverurie, talking to ordinary members of the public about what they wanted to see in relation to health. We planned it like something in the first year of a planning degree. I thought that the visit was extremely useful, and the feedback was extremely good. I hope that the new Parliamentary committees consider that structure carefully. Across the board, there was a resounding call for a more patient-centred approach as well as an increase in preventative wellbeing care.

We considered the role that technology should play. A number of members have considered that issue. As I represent the Highlands and Islands, I have been concerned about it for some time.

I refer members to the fit homes project, which many of them will be aware of. The concept behind it is that a home should adapt to the changing needs of its residents. If members have an opportunity, I recommend that they look at Invergordon Carbon Dynamics, which makes homes for that fantastic project.

Technology in healthcare is key in the Highlands and Islands, as the rurality and peripherality of many of my constituents often makes access to the right health professional at the right time difficult.

Clearly, Covid-19 has had a drastic impact on our healthcare, and it was right that we took stock and focused on the pandemic in front of us. That led to divorce diversion. I said “divorce diversion”, but I meant to say “resource diversion” and staff burn-out—[


]. Many a true word is said in jest, Presiding Officer.

There needs to be a process of rebuilding and renewal. However, we cannot go back to normal business.

The Government responded to the report on 1 March and, as far as my quick reading went, it looks like it responded positively to the recommendations. I look forward to seeing the action taken on this great report, and I remember the words of Thomas Edison, who said:

“Opportunity is missed by most people because it is dressed in overalls and looks like work.”

Let us roll our sleeves up and get to work.