I got the train yesterday from Cupar to Edinburgh and a walk down the Canongate to Scottish Parliament, via the Scottish Storytelling Centre for a bowl of mushroom soup. I’d booked tickets for the chamber debate on the Health & Social Care Integration, and spectated in the public gallery from 2.30-5.00pm.
I took notes and here are some of the points that stood out for me:
- About 20-25 MSPs taking part in debate, some sitting at back typing in to iPads and the like.
- Shona Robison, Cabinet Secretary for Health, was a home care organiser job wise. In her opening speech announced another £100million for 2nd and 3rd year, integrated care fund. SPICE indicators published yesterday, person-centred outcomes.
- Ayrshire and Arran was mentioned often, in positive terms regarding their integration launch, by many of the speakers, different political parties. Fife wasn’t mentioned at all, as I recall.
- BMA briefing report highlighted by a number of MSPs – GP leadership, capacity building, outcomes, investment.
- Neurological conditions was a popular topic, I think because an organisation has a display in parliament just now
- Nanette Milne highlighted GP leaderships roles, silos and changes in culture, delayed discharge (a common theme along with bed blocking). Voluntary Action Orkney Befriending, reducing isolation.
- Jim Hume used the phrase “ticking time bomb” to describe increased elderly population in future. Other MSPs ribbed him on this phrase.
- Bob Doris talked about visiting Tommy Taylor, a gentleman of 100yrs old, and celebrating his birthday. Cash is not always quality. He highlighted the advantages of multi-disciplinary teams, AHPs alongside nurses and doctors, that H&SC Alliance raised issue of money not being mainstreamed.
- Malcolm Chisholm also spoke of culture change and leadership. No clarity in locality arrangements, no statutory guidance. The need for clear frameworks and responsibilities, devolved budgets. Mentioned A Stitch in Time, Lothian.
- Sandra White reminded her colleagues about the benefits of being old “put younger people to shame”, the talents and capacity of all. That one size doesn’t fit all. To think of bottom up, patient centred, culture change. To remember housing providers so they may be fully utilised in partnerships.
- John Pentland talked of visiting Lanarkshire Links, said that “transparency is pivotal”.
- Kenny McAskill spoke passionately, phrases I recorded: aging bones – departed from this earth – tragedy befell that child – silos and tin hats – law of unintended consequences – not thrown out with the bathwater – microcosm – child sex exploitation. Mentioned criminal justice and social work, not to forget them.
- Gil Paterson described the “two massive beasts” of health and social care, and how in West Dunbartonshire the agencies overcame cultural barriers
- Paul Martin’s birthday the day before, 48yrs old. Said “we do all agree with each other”. Said that Marie Curie does good work. 60% who are terminally ill want to die at home.
- Christina McKelvie spoke of her great interest in and support for the MND condition. People rather than structures. Legislation as framework.
- Joan McAlpine said about Dumfries & Galloway coming up with a “most ambitious” plan for integration.
- Elaine Murray also spoke about Dumfries area, of Nithsdale with no services there, of Moffat, Thornill and the challenges of rural areas.
- Richard Lyle on Health & Sport Committee talked of “cross shunting” between councils and health boards, how the integration should help.
- Jim Hume came in again, mentioned mental health care and capacity. Parity of esteem between mental and physical health treatment. Quoted a health professional who said “hell mend you if this does not go through”.
- Jackson Carlaw made some quips re Bob Doris, described the NHS as a “sea of shifting sands”. Talked of his mother’s recent discharge from hospital, the difficulties of getting a GP appointment. How it would be worse for people who “haven’t got the wits” to challenge issues. Mentioned the CHPs and the “goodwill eroded”.
- At 5pm all the government ministers came into the chamber to vote. And I went off to Waverley to catch the train home.