Over 100 days of GP sessions not covered in the last 3 months

New research from Scottish Labour has found that more than 100 days’ worth of out of hours sessions for general practice were not staffed in the last 3 months.

An out of hours session is a GP covering a period outside of the normal working hours of 9 to 6. These sessions tend to be 3-4 hours long and with longer sessions through the night.

Information uncovered by Dr Richard Simpson found that there had been 826 unfilled sessions in the last 3 months.

Taking each session at three hours, these 2,478 hours of unfilled sessions equates to 103 full days.

In NHS Lanarkshire, where out of hours services have been reduced from 5 to 2 centres, there were 209 unfilled sessions.

In Tayside where the centres in Perth & Angus are partly closed there were 275 unfilled sessions

The news comes after a summer which has revealed a crisis in Scottish general practice, which saw:

• Investment in General Practice having fallen by over £1 billion since 2005/06.

• Around 2 million patients in Scotland served by understaffed and under resourced practices

• For the first time Scotland having less GP’s per head than the North East of England

• Scottish domiciled medical students entry cut by 15%  since 2008/09, reversing the trend of the previous Labour-led Scottish Government.

• More practices without GP partners and vacancies increasing for both partners and sessional doctors and now under direct Health Board control. More practices restricting new patient registration.

• One in five trainee GP posts vacant. 

Central Scotland Scottish Labour MSP Siobhan McMahon said: “GP surgeries are the first port of call for families in Lanarkshire but the truth of the matter is that under this SNP Government we are facing the biggest crisis in general practice for a generation.

“Our research suggests that more than twenty days’ worth of GP sessions have not been filled in the last three months in Lanarkshire

“Under the SNP Government we have seen a drop in funding totalling over £1 billion, fewer medical students, fewer trainee vacancies being filled and now fewer out of hours sessions being staffed.

“This problem is only going to get worse in the next decade and SNP Ministers need to get to grips with it.

“Action now is vital because general practice in trouble will affect every part of our NHS, from missed waiting times for mental health to increasing pressure on A&E because people can’t see a local doctor. These figures reflect the situation in the middle of summer; if it is still this bad in winter we will begin to see real problems.

“Since the SNP came to power they have squeezed health spending in Scotland harder than the Tories in England and our communities are feeling the effects.” 

 

 

GP Out of Hours FOI

Question 1) How many GP out of hours centres do/did you operate in (a) 2013/2014, (b)2014/2015 and (c) currently

Question 2) What is the normal number of GP sessions expected to cover the centre each week in (a) 2013/2014, (b)2014/2015 and (c) currently

Question 3) How many out of hours GP sessions have you been unable to fill in the last three months by centre

“Scottish GP surgery teams carrying out an estimated 24.2 million consultations each year — an 11% rise over ten years.  At the same time, the share of NHS funding spent on general practice in Scotland has been falling year on year. The GP percentage has fallen from 9.8% in 2005/06 to a record low of 7.8% in 2012/13. This drop has led to a real terms cumulative loss of investment of £1.1 billion into Scottish general practice compared to a scenario where funding had remained at 9.8%.”Research from the Royal College of General Practitioners has shown that investment in GP services has fallen by a cumulative total of over £1 billion since 2005/6, with demand rising by over 10% during the same time period.

Source: http://bit.ly/1ew9qyb

Siobhan McMahon MSP – “Waiting Time Figures Show Crisis in NHS Lanarkshire”

Central Scotland Labour MSP Siobhan McMahon has today called for the Scottish Government to take urgent action to halt to the crisis in A&E departments in Scotland’s NHS.

Ms McMahon made her calls following the publication of official figures on A&E waiting times which showed that NHS Lanarkshire had the worst results in Scotland.

The figures showed that fewer than half of Scotland’s health boards met the target of A&E patients being seen within four hours. The percentage of patients being treated in A&E in four hours or less dropped from 93.5% in December 2013 to just 89.9% in December 2014.

However, NHS Lanarkshire had the worst average figure over the period at 85.5%, with the figure at just 83% during the month of November.

In advance of tomorrow’s Budget vote in the Scottish Parliament, Scottish Labour has set out a plan for a £100 million Frontline Fund for our NHS. This would be used to make more NHS services available at evenings and weekends.

Scottish Labour’s first General Election pledge is also to use the proceeds from a UK-wide Mansion Tax on homes worth more than £2 million, 95% of which will be raised from London and the South-East of England, to fund an extra 1,000 NHS nurses in Scotland.

Ms McMahon said “These figures expose the crisis that NHS Lanarkshire is in under the SNP. The Scottish Government’s own target for A&E departments is for at least 95% of patients to be seen within four hours. The fact is that this fell to less than 90% in December and it’s simply not good enough.

“It is deeply worrying but sadly not too surprising that NHS Lanarkshire has the worst A&E waiting time results in Scotland. The health board has faced repeated problems and it’s the patients in Lanarkshire and the hardworking and dedicated staff who are paying the price.

“We have heard some of the recent horror stories coming out of A&E departments across the country and something needs to be done to relieve the pressure on our fantastic but under resourced NHS staff who are struggling to cope with the ever increasing demand on their services.

“I would therefore urge the Scottish Government to adopt our £100 million Frontline Fund. Only radical action will be enough to avert the crisis in our NHS and only Scottish Labour has this vision.”

 

Further Information:

Official figures published today show that fewer than half of Scottish health boards met the 95% four hour waiting time target. The national average for December 2014 was 89.9%. This is a significant drop from the 93.5% performance in December 2013.

When the SNP Government launched their referendum campaign in May 2012, the number of patients being seen within four hours at A&E was 94.7%, compared to just 89.9% in December 2014.

Today’s figures confirm that A&E waiting times in Scotland are now worse than in England.

 

Month	England	Scotland
September	94.7%	93.5%
October	93.76%	91.8%
November	93.45%	91.8%
December	90.2%	89.9%

 

Scottish figures – http://bit.ly/1D8FC3Y

English figures – http://bit.ly/1iksxg0

A&E target background

A&E departments in hospitals across Scotland have a target of treating 95% of patients within four hours. The target was introduced in April 2013. In data published for that quarter 93.6% of A&E patients were seen within four hours.

When waiting time figures were published previously in September 2014, the average figure for Scotland was 93.5%.

The 95% target was originally intended to be temporary and was due to rise to 98% last September. However, it was reported at the weekend that this target has now been abandoned by the SNP.

Source: http://www.bbc.co.uk/news/uk-scotland-scotland-politics-31062418

 

Scottish Labour’s Frontline fund 

Our NHS faces pressure by squeezing treatments into a 9-5 schedule.

Scotland has 22 hospitals with full front facing A&E provision; Scottish Labour’s Frontline fund would be used to support spreading elective surgery over more days to avoid the weekday congestion, this would help both scheduled and unscheduled care.

A Frontline Fund would target £100m for the incremental delivery of weekday equivalent services on evenings and weekends, starting with Trauma Hospitals.

Weekend and night services are provided by junior doctors. Scottish Labour’s Frontline Fund could be used to ensure under pressure hospitals have consultants on shift which they do not currently cover.

Developing this approach would also allow for patients to have a health service that suits their lives, such as elective surgery out with their working hours.

Scottish Labour said that these changes should be done in conjunction with clinical staff to ensure it delivers more efficient care to patients and reduces the very real demands and pressures on staff.

Policy	Total
NHS Frontline Fund   To allow hospitals facing extra pressure to have planned surgery at the weekends and diagnostics in the evening.	£100 million
Resilience Fund   For times of crisis for Scotland’s crucial industries when large scale job losses are threatened.	£10 million
Scottish Office for Budget Responsibility	£1 million
TOTAL	£111 million

 

What the SNP Government in Edinburgh have spent:

Policy	Total
Territorial Health Boards	£65 million
Delayed Discharge	£30 million
Specialist MND Nurses – supporting Scottish Labour’s call	£2.5 million
Total Barnett consequentials	£211 million
TOTAL AVAILABLE	£113 million

 

The SNP have cut the NHS budget, protecting it less than David Cameron, according to impartial analysis from the IFS.

The SNP have cut spending on health, while it rose in England:

– “Between 2009-10 and 2015-16 spending on the NHS in England will, on currently announced plans, have risen by about 4% in real terms despite an overall fall of 13% in English departmental spending.”

– “But the Scottish government has chosen to protect the NHS in Scotland slightly less than it has been protected in England. Spending on the NHS in Scotland has fallen by 1%.”

– Nicola Sturgeon was health minister during this period, serving from 2007-2012.  

The IFS confirm that Barnett has protected Scotland’s budget:

– “Over the same period the vagaries of the Barnett formula mean that Scotland will have had to cut overall public service spending by less – by about 8% rather than 13%.”

 Source

Scotland’s NHS gets around 10 per cent more spending per head of the population than in England.

That means that yearly health spending is around £200 per person higher than the UK average.

Source

A report from the Euro health consumer index concludes that despite more public spending, the Scottish NHS is performing worse than the English NHS.

The report measures healthcare performance in 36 European countries — ranking England 14th, with Scotland trailing in 16th position.

The Scottish NHS is rated below the Czech Republic.

Source here

Nicola Sturgeon and the Scottish Government on Scotland’s NHS:

“I believe that our NHS can and will outperform the privatised experiment south of the border.”

March 2012, University of Glasgow Speech

Source: http://bit.ly/1vpUvxR

“A party that is now in its second term of office cannot avoid taking responsibility for its own failings.”

12 December 2011, Scottish Parliament

Source: http://bit.ly/1K6LHzC

 “Scotland’s hospital A&E departments are performing ahead of all of the rest of the UK. At core A&E sites in September, performance against the four-hour treatment target was 92.7 per cent in Scotland, 92 per cent in England, 83.1 per cent in Wales, and 75.7 per cent in Northern Ireland. At the same time, Scotland outperforms all of the rest of the UK on a range of waiting times figures.”

Scottish Government Spokesperson, 7th January 2015, Scotsman

Source: http://bit.ly/1u0xrEN

High mortality rates a concern at Lanarkshire Hospitals

Last Thursday (12th September) in Parliament I questioned the Scottish Government over the revelations that two NHS Lanarkshire hospitals recorded the highest levels of mortality in the country. I asked the Cabinet Secretary for Health and Wellbeing Alex Neil what action the Scottish Government was taking to ensure patient safety at Monklands, Wishaw and Hairmyres hospitals.

My question came shortly after the news that Monklands, in the Cabinet Secretaries own constituency, and Wishaw were singled out for their ‘high standardized mortality ratios’ in the official data on hospital deaths published on the 27th August.

Whilst these figures must be met with a great deal of scrutiny, we must look underneath the numbers and find out what is really going on.

I welcome the news that a review will be carried out by Healthcare Improvement Scotland and I look forward to reading the findings of their investigation. In the meantime I would urge the Scottish Government to do everything in its power to ensure that all the necessary steps are taken to reverse this worrying trend. The priority here is that the highest quality of care is provided to the people of Lanarkshire as patient safety is paramount.

My question and the response I received can be read on pages 6 and 7 of this document.

Nothing but respect for Monklands Hospital

In an article and letter in this week’s Airdrie and Coatbridge Advertiser I was accused of having some kind of “agenda” against Monklands Hospital.

The accusation related to the Modernising Mental Health proposals currently undergoing review by NHS Lanarkshire at the behest of the Cabinet Secretary for Health and Wellbeing, Alex Neil (who is also MSP for Airdrie and Shotts).

This accusation is, to be frank, complete and utter nonsense. As a young child I spent a lot of time of at Monklands, and I have nothing but respect and gratitude for the hospital and its staff.

It saddens me that some people – including those who should know better – feel the need to turn any debate about health provision within NHS Lanarkshire into a debate about Monklands Hospital.

For what it’s worth (and as I made clear in the response I gave to the Advertiser) at no point have I ever called for services to be removed from Monklands Hospital. What I do want, however, is what is best for patients throughout the whole health board area.

NHS Lanarkshire’s Modernising Mental Health proposals were the product of a lot of hard work and a lengthy consultation process. They were supported by health professionals and service users and the previous Cabinet Secretary for Health, Nicola Sturgeon MSP. They were also in line with the Scottish Government’s own Mental Health Strategy.

As such, I was surprised and disappointed that just 10 days after becoming Cabinet Secretary for Health, Mr Neil ordered NHS Lanarkshire to suspend and review the proposals. The cost of that decision can be seen by the fact that, almost six months on, no alternative plans have been produced.

Some people will continue to resort to petty and personal attacks. I prefer to deal in facts.

I believe decisions over local health services should be taken locally; that Scottish Government policy should not be changed at the drop of a hat (or the reshuffle of a cabinet); and that a health board has a duty to act in the best interests of all of its patients, wherever they happen to live.

Consistency is key in provision of health services

I was pleased to have the opportunity to speak in last week’s debate in the Scottish Parliament on the Scottish Government’s Mental Health Strategy. My contribution to the debate can be viewed here, at 44.50.

Mental health is still dogged by stigma and ignorance, with many people still unwilling to admit its legitimacy or potential severity.

Mental health problems are closely linked to, and exacerbated by, stress and anxiety. With the economy stagnant, jobs at a premium and welfare reforms and revised capability assessments cutting away at the social fabric, today’s society is, for increasing numbers of people, especially in poor and deprived areas, a worrying place to be.

It comes as no surprise, then, that a study conducted by a group of Glasgow based GPs has reported a stark rise in the number of patients reporting with poor mental health.

Against this backdrop, I welcome the Scottish Government’s commitment to improving Scotland’s mental health, as outlined in its Mental Health Strategy.

But a Mental Health Strategy is of little practical use if it is not adhered to.

For the past few years NHS Lanarkshire has been working to improve its mental health services and to shift the emphasis of care from inpatient to community based provision (as recommended by the Mental Health Strategy).

NHS Lanarkshire’s Modernising Mental Health proposals, which had the full support of the previous Cabinet Secretary for Health, Nicola Sturgeon, as well as that of local service users, were due to be presented to the NHS Lanarkshire board in September 2012.

However, the new Cabinet Secretary for Health, Alex Neil MSP, intervened and instructed NHS Lanarkshire to revise the proposals. According to an email sent last September (2012) by officials in the Scottish Government’s health department, a final decision will be made “soon”. It is now Janauary 2013, and we are no further forward.

As a local MSP – for Airdrie and Shotts – Mr Neil was a vocal critic of NHS Lanarkshire’s proposals. However, as the Ministerial Code makes abundantly clear, Ministers should exercise extreme caution before intervening in portfolio matters within their own constituencies (a fact that Mr Neil recognised, albeit belatedly).

Given that the plans were supported by Mr Neil’s predecessor, I find this apparent volte face by the Scottish Government both frustrating and confusing.

Consistency is a valuable commodity in politics, as in life. This is perhaps especially so in the provision of health, where the right decisions are not always the easy ones.  

There is little use in publishing a Mental Health Strategy only to refuse to implement it in practice, whatever the underlying reason.

I do not know what the future holds for the future of mental health provision in NHS Lanarkshire. All I want is what is best for service users. That is what they deserve, and I hope that is what they get.

More information needed for Hemiplegia

In late 2012 I met with representatives of HemiHelp, the UK charity for Hemiplegia, to dicuss what I could do to help them raise awareness of a condition that remains little known.

Hemiplegia, which affects approximately 1 child in 1000, affects one side of the body (similar to a stroke),  resulting in weakness or partial lack of control.

The exact causes of Hemiplegia are unknown, although it is generally thought to originate from damage caused at some point during pregnancy.

Understanding Hemiplegia, and how it can affect your child, is vital, and that is why I wrote to NHS Lanarkshire regarding the provision and prominence of information about the condition in NHS Lanarkshire hospitals.

NHS Lanarkshire’s response was encouraging, and I have been assured that consultant paediatricians do everything possible to ensure that parents receive verbal and written direction to the HemiHelp website.

To make accessing the appropriate information easier, the Board has also included a link to the HemiHelp website on the internal NHS Lanarkshire website.

I hope that other Scottish NHS Boards will follow the example set by NHS Lanarkshire, and do everything they can to ensure that those affected by Hemiplegia have all the support and information they need.

Action needed to tackle rising incidence of suicide in Lanarkshire

It is well known that Scotland’s suicide rate is higher than the UK average. In an attempt to address this, the previous Labour administration introduced a target in 2002 to achieve a 20% reduction in suicides by 2013.

 It seems that this has reaped partial dividends: over the past 15 years, the suicide rate in Scotland has followed a consistent downward trajectory.

However, there is one worrying exception.

NHS Lanarkshire is the only health board area where suicide rates have risen over three consecutive periods, from 395 deaths between 1997 and 2001, to 444 between 2007 and 2011 (an increase of 12.4%). Over the same periods, the average Scottish rate fell from 4391 to 3980 (a decrease of 9.4%).

Research on suicide shows that the rate tends to be higher in areas suffering from high deprivation and unemployment; it is especially high amongst men under the age of 35.

Lanarkshire (where there is a high level of unemployment amongst young males), reflects this: the rate of suicide amongst men is considerably higher than amongst women, with 64 male suicides in 2011 compared to 30 female.  

Any suicide is a tragedy which has a devastating impact on all involved.

On a local level, I would like to see an investigation into why suicide rates within Lanarkshire continue to rise. I would also like to see an increased emphasis – both in terms of publicity and finance – on anti-suicide initiatives such as Choose Life, and charities such as Papyrus and the Samaritans.

No one should ever be left to feel that suicide is the only option.

Time to reign in excessive salaries

 

Given the recent swathe of voluntary redundancies and the well publicised travails of NHS Lanarkshire’s 3 Accident and Emergency departments, I was surprised and somewhat disappointed to learn of the high salaries being paid to NHS Lanarkshire’s executive board members.

10 board members are paid a combined annual total of £1.69million – a sum exceeded only by NHS Lothian, and well in excess of that paid by NHS Greater Glasgow and Clyde, whose board members collect .

Whilst a case can be made for highly skilled clinicians to receive a good salary, it is less easy to justify the number of Executives and Board Members earning in excess of £100,000.

Moreover,  I cannot understand why NHS Lanarkshire has 4 more Executives and Board Members on over £100,000 than Glasgow, especially given that Glasgow has more than 3 times the number of senior clinicians in the highest salary bracket – 920 compared to Lanarkshire’s 253.

 It seems that the salary structure in NHS Lanarkshire is weighted more towards the management than the medical staff.

 No one objects to individuals being well paid when they produce good results, but given the staffing shortages in Accident and Emergency and Mental Health within NHS Lanarkshire, I am not convinced that this is in fact the case. I will be meeting with senior management over the next few weeks and will certainly seek their views on this issue.

Report shows shortage of staff at Monklands

I was extremely concerned by the recent report from NHS Lanarkshire that revealed the extent of the staffing shorthall at Monklands A&E, and indeed across NHS Lanarkshire.

The report described the situation at Lanarkshire’s 3 Emergency Medicine Departments – at Monklands, Haimyres and Wishaw General – as “very fluid and vulnerable”, with the position within Monklands A&E referred to as “particularly fragile”.

Whilst I was alarmed at the scope and scale of the staffing shortfall, it is important to emphasize that the concerns raised in the report are not new. NHS Lanarkshire knew in 2007 that it lacked the resources to sustain existing Accident and Emergency services; yet, despite the clear and ongoing impact this has had on patient care, over the past four years Nicola Sturgeon has failed to invest the additional £50 million that NHS Lanarkshire said was needed to maintain all three A&Es.

 This failure did not prevent Alex Neil from spending his entire election campaign scaremongering about Monklands A&E; but, once again, neither he nor Nicola Sturgeon promised to find the money to deal with the problem they caused, and the response from NHS Lanarkshire, which actively discouraged people from using A&E departments, is truly alarming.

NHS Lanarkshire clearly needs help to find a financial solution to the difficulties caused by this SNP Government, and I intend to meet with NHS Lanarkshire Chief Executive Tim Davison at the earliest opportunity. I have also written to Nicola Sturgeon to find out what action she is taking to address the challenges facing NHS Lanarkshire.