Speech in the Scottish Parliament
3 June 2010
To return to the topic in hand, the delay in being clear about the number of jobs that are to be lost in NHS Scotland because of SNP cuts has brought anxiety and confusion.
For example, NHS Tayside announced in one week that 500 jobs were to go over two years and, the following week, it announced that the 500 posts were to go over a single year.
We need clarity on what is happening and why it is happening, not confusion.
The Scottish Government is quoted as saying—and repeats—that staffing levels have gone up by more than 10,000 under the SNP, and that cuts are now needed to make health boards more efficient.
However, in a comparable period, between May 2001 and the end of 2003, the number of staff who were employed in the NHS under Labour rose not by 10,000 but by 11,800. Is the SNP's mantra just an attempt to soften the blow of the cuts?
Where does the 10,000 figure actually come from?
To repeat one of the important points that Jackie Baillie made, it appears to come from the public sector employment survey.
Between the first quarter of 2007 and the end of 2009, there was indeed an increase of about 10,000 staff, but those are head-count figures that do not distinguish between part-time and full-time staff. Once that is taken into account, the 10,000 extra head count shrinks to about 8,200 full-time equivalent staff.
Let us compare that with the figures that were released recently by three health boards: 1,200 full-time equivalent posts are to go in NHS Greater Glasgow and Clyde over the next 18 months, 700 full-time equivalent posts are to go from NHS Lothian, and 500 full-time equivalent posts are to go at NHS Tayside.
That is already 2,400 posts, with next year's figures still to come—and that is on top of the ward closures that have already been announced, including in Tayside.
Shona Robison: I am not sure whether Marlyn Glen is referring to the Royal Victoria hospital. Does she acknowledge that the clinicians there have said that they support the move to Ninewells? They want to be assured that the quality of service there will be as good as that at the Royal Victoria. It is misleading to suggest that they oppose the ward move.
Marlyn Glen: Sadly, it is not just the ward at the Royal Victoria that we are talking about—it is also ward 31 at Ninewells. That has been in the press, and Gerry Marr has been involved. There is huge concern about the matter.
To recap, there are the employment figures, and there is what we know so far about ward closures.
It is clear already that thousands of posts will be lost in NHS Scotland, even more than the 2,000 posts in teaching that have been lost so far under the present Government. The SNP has shown that it cannot even protect public services in the good times, when its budget is rising.
The SNP refused to publish the information swiftly, so we must listen instead to what the people who work in the NHS are saying.
They say that NHS Greater Glasgow and Clyde plans to replace more than 380 registered nurses with about 220 nursing assistants, which is more than 160 fewer staff over the next three years.
NHS Grampian is to freeze vacancies for nurses this year, as has already been mentioned.
If the NHS supposedly has too many staff now, and it needs to be made more efficient, why do professional bodies such as RCN Scotland report otherwise?
Why do the Scottish results of the Royal College of Nursing's 2009 employment and morale survey show that 44 per cent of nurses think that patient care is compromised at least once or twice a week, 51 per cent think that there are not enough staff to meet the needs of the patients for whom they care, and 52 per cent think that they are too busy to provide the quality of patient care that they want to provide?
We hear from the Government that NHS services are being redesigned to improve efficiency and quality.
We are not against change just because it is change. I am sure that some services can be redesigned to be more efficient.
However, changes must be costed and supported, and it is self-evident that if change is to be successful there must be full and proper consultation of staff.
The releasing time to care initiative pilots have enabled the time that nurses spend on direct patient care to increase by up to 40 per cent.
That is good news.
However, at a time when health boards are being ordered to make millions of pounds of so-called efficiency savings, how will the Government guarantee the finance that will enable the initiative to be introduced successfully in all health boards?
We must consider SNP cuts in services and posts in relation not just to current provision but to the promises that the SNP made but did not keep.
I will give three examples.
First, in its 2007 election manifesto the SNP promised to double the number of school nurses.
There were 221 school nurses in 2007, but in two years the SNP increased the number by just 36.
Secondly, the SNP promised to reduce the use of antidepressants by 10 per cent by 2009.
According to the manifesto, that was to be achieved through the use of counselling and talking therapies in each community health partnership area.
The initiative would be backed with ring-fenced funding to health boards and local authorities.
However, in reply to my inquiries, Dundee City Council and Angus Council said that they had received no such funding from the Scottish Government for those services in 2008-09.
Thirdly, in December 2006 the SNP website carried a commitment to introduce a breast screening programme for women over 40—the current approach is to screen women over 50.
That has not happened, either.
Meanwhile, in England, the NHS breast screening programme has been phasing in the approach from this year.
It is disappointing that it has taken a Labour debate to force the cabinet secretary to publish the workforce projections.
The cabinet secretary must urgently intervene to prevent cuts to front-line NHS services and to promote the best possible patient care.