Speech in the Scottish Parliament debate

9 November 2011

I very much welcome the debate.

We have spoken in Parliament many times about shifting the balance of care.

Re-enablement and rehabilitation are crucial to that, through enabling people to get their lives back after they have been unwell.

We also need to ensure that we include self-management, independence at home and people‘s social wellbeing.

We have an ageing population and we need to ensure that health and social care providers work together to deliver joined-up services that fit the person‘s needs.

From my experience of trying to organise care for family members, when I not only had to go between the health service and council social care services but had to speak to different services within those organisations, I know that it becomes very clear that there is no joined-up care.

As an MSP, I am used to working with those organisations when I represent constituents, and I have found the process to be hugely difficult, so elderly people who do not have families must find having to deal with those services and trying to get care packages in place nigh on impossible.

We must do something about that if we are to consider the whole person.

John Finnie : Does Rhoda Grant accept that co-location of teams from different spheres of the care sector is a benefit in delivery of care? We have that in the Highland Council area and it happens in Orkney, too.

Rhoda Grant: Co-location is a benefit, but we also need better communication.

We need to ensure that service providers speak to each other, so that when they have identified a need it does not remain with that provider but is passed through the system.

Services should be geared to the person, not to the tickbox and to whoever is delivering the service.

We also have challenges with service delivery in rural areas.

We need generalists and every service has grappled with how to provide services when the population is not large enough to have specialists in place.

To train generalists and put them in place is challenging because they are not recognised professionally and they are certainly not recognised financially, because payment tends to attach to the level of qualification and the specialism.

We need people who can treat the whole person and we need to recognise their skills.

We must also recognise that there is an added cost in delivering services in rural areas.

I have been banging on for a number of years about the need for a health funding formula that acknowledges that added cost; we need to do something about it.

It has been too long and there have been too many reviews.

Something now needs to happen to ensure that funding is in place and that it is fairly distributed.

We must also involve communities in the services that they receive.

My postbag is full at the moment as communities are complaining about how they are receiving services and about how changes to services are being managed.

Communities in Ardnamurchan are considering their emergency out-of-hours services, as are communities in Glenelg and Arnisdale, and although that might not directly impact on today‘s debate, people living in those communities who want to be independent and to be reabled and rehabilitated might not have the confidence to move home if they feel that services are not there to back them up.

One service that could really impact on rural areas includes telehealth, telemedicine and telecare. We can use it to monitor conditions and information can be sent to the patient and the practitioners so that health conditions are recognised and deterioration is dealt with quickly.

It can also be used to get information to patients about their conditions through CDs and DVDs so that when they need the information, it is available.

We could also consider videoconferencing.

I have seen physiotherapy classes being delivered by videoconference, which is hugely enabling to people with long-term conditions who might not wish to travel.

That has a real benefit for rural areas, but to deliver it properly we need connectivity.

Broadband is not an infrastructure problem; it is a health and local government problem.

We need good broadband to deliver that care to the people who require it because such care not only improves services but alleviates the cost of delivering them.

At a time of very tight budgets, there are huge savings to be reaped across all our public services, health and local government by investing in that type of infrastructure.

The Government must look at the Audit Scotland report on how we deliver telecare and telehealth and then set a strategy and targets, which must join up with its targets on the roll-out of broadband to rural areas.

I will touch briefly on prevention, which several members have discussed already.

Access to services such as physiotherapy could offer huge cost savings to the health service.

For instance, if patients with issues were triaged by a physiotherapist, they would probably never have to see a consultant, which is a costly service, but they would be seen quickly before any complications occurred and they would be back to being independent and working without having had to wait.

The Presiding Officer is looking at me, so I must wind up.

There are many other issues that I could speak about, but it is important that we deliver patient-centred services to ensure that people are independent and have good quality of life.

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