Speech in the Scottish Parliament

21 January 2010

I am pleased to take part in the debate.

It could be viewed as a debate on two separate topics, unless one agrees with the Conservatives that one policy directly influences the other.

I do not, but both issues are important and I am grateful for the opportunity to debate them.

As my colleagues outlined earlier, the Labour Party in Scotland has long advocated that the Government should make prescriptions free for cancer sufferers.

That is the case in England and Wales, and we believe that that should be a priority for Scotland.

It should happen now rather than be phased in.

It is unacceptable that, due to the Government's policy, cancer sufferers north of the border still have to pay prescription charges.

Rhoda Grant: I am not creating artificial divisions.

I am not talking about stopping the minister's policy of free prescriptions for all; I am talking about rebalancing her policy and phasing it in differently, in a way that would allow cancer patients to have free prescriptions now.

It would mean that people like me would have to wait a little longer to get free prescriptions, but I, for one, would be willing to do that so that cancer patients could be prioritised.

Cathy Jamieson mentioned the well-known fact that cancer patients suffer economically due to lengthy periods off work and the cost of their illness.

Macmillan Cancer Support and Citizens Advice Scotland have considered the issue of fuel poverty, but there are many other costs—a point that a CAB report a couple of years ago made strongly.

Free prescriptions would alleviate some of that financial pressure at a difficult time.

Rhoda Grant: I do not think that the member has listened to a word I have said.

I suggest free ear syringing for him.

The motion talks about health visitors, and suggests that the money that would be used to reduce the prescription charge could instead be used to increase health visitor numbers.

As Christine Grahame mentioned, the Health and

Sport Committee recently carried out an inquiry into child and adolescent mental health services.

It became obvious that health visitors had a crucial role to play, both by identifying children in their early years who were developing mental health issues and by identifying mothers who were suffering from post-natal depression.

I think that most of us would agree that we need more health visitors.

Those resources need to be targeted towards families in most need, and the current policy needs to be refocused to ensure that it is universal for longer.

Families need a minimum service throughout the early years.

At the moment, some families fall through the safety net because of where they live or because their family is seen as not being in a priority group.

It is obvious that a family needs a high level of intervention if they live in deprivation or have a drug or alcohol problem, but the universal service lasts only eight weeks, which means that families who develop problems after eight weeks have little or no support.

One of the problems is that the number of people training as health visitors has fallen.

Although we had a high in 2001-02, it has been falling steadily ever since.

Unless we increase the number of people in training, we will not be able to fill any additional posts that we create.

In places such as Highland, no health visitors are being trained because of the review of nursing in the community pilot, which seeks to assimilate the health visitor role into the new community nurse role.

Fewer people will consider health visiting as a career because of the uncertainty hanging over the profession.

Rhoda Grant: Yes, there certainly is.

I ask the minister to intervene to ensure that health boards that have stopped training reverse that retrograde step so that the career of health visitor is retained and recognised.

Our nursing and health visiting professions have an age profile that means that large numbers will retire at the same time in the near future.

I have raised that with the minister to ensure that we have enough training places for newly trained midwives to fill the gap. We need to do the same with health visitors.

I return to the review of nursing in the community pilots.

I am puzzled that health visitors were included when community midwives were not, although their roles are interlinked.

Rather than creating a new community nurse role, I suggest that we look at developing a team that works closely together and includes social workers, midwives, community nurses and health visitors.

That would be more challenging in rural areas, but we have heard of GPs and nurses who are highly skilled generalists working in that way.

I ask the minister to look at how highly skilled generalists are rewarded and how their careers can progress. Specialists with similar levels of training have that recognised in their qualifications and therefore their pay, but skilled generalists are not recognised in a qualification, which means that they do not have the same career progression or pay.

I ask the minister to reflect on those issues and hope that she will find a solution for rural areas.

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