My Dunfermline Press column for 29th May 2014: Care in the community is not a cheap option.

LAST week a motion was put to parliament proposing that the parliament had no confidence in the Cabinet Secretary for Health and Wellbeing, Alex Neil. This motion came as a result of his failure to disclose his involvement in the decision to reverse the planned closure of mental health services at Monklands Hospital; a decision taken by his predecessor Nicola Sturgeon.

Whilst I understood the basic complaint, I decided not to sign the motion as supporting such a call is a very serious step and I wanted to hear what was said in the debate before reaching a view.

I listened to the debate and what was said and, sadly, there was no satisfactory explanation given as to why the health secretary had behaved in the way he did.

I concluded that he had clearly mislead the parliament and used his ministerial position to force a decision and then hide behind his junior minister, claiming he had withdrawn from the decision due to possible conflicts of interest.

It seems to me that any parliament in any democracy cannot tolerate a situation where government minsters think they can at best, mislead, and at worst, deliberately deceive.

But I do have wider concerns about the approach of the health secretary in that he seems to be in denial of the massive issues facing health and social care authorities across Scotland.

I will be working for a Scottish Labour government to be elected in 2016 and I am under no illusions about the challenges in the area of health and social care regardless of the political colour of the government but the starting point is surely to acknowledge the problems and issues.

All I have witnessed from the health secretary and indeed First Minister Alex Salmond when questioned on the issues in parliament is to bluster, shout, harp back to previous governments and generally not answer the questions.

Here in Fife we continue to see too many people having a poor experience when accessing health and social care.

When Labour took control of the council two years ago I immediately challenged the NHS Fife proposal to reduce the hospital beds by 200 and asked for a review.

This review concluded that to meet the four-hour waiting time target we needed to keep the 200 medical beds proposed to be reduced and indeed needed to add a further 50 new beds.

Part of the strategy for the future of health and social care is to support more people to live and be cared for in the community and therefore reduce the costs on the hospital services within the NHS.

The rationale behind this approach is that more money can be saved in the acute side (hospitals) and transferred across to the community.

In practice this is not happening and in part is why we have seen a massive rise in the overspends of social work services across the country as they struggle to purchase more care home places and pay for more and more care packages to be put in place. The health secretary is in denial when the facts are put to him.

And, the demographics tell us the demand is going to grow. Take Fife as an example; currently there are 67,153 people aged 65 and over – some 18.3 per cent of Fife’s total population – and this is predicted to increase by almost two thirds by 2035, with the biggest increase being seen in the oldest age group of 85-plus.

For the last financial year, NHS Fife had an overspend in the acute services of almost £8 million which, whilst offset from other areas of the budget, demonstrates the real difficulties in being able to transfer monies into the community side of care.

Care in the community is not a cheap option and must be properly resourced.


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Post Author: Alex Rowley