Teething Troubles

There are two subjects which engage politicians and public alike. And on which both will readily express firm views. The Health Service and Schools.

Why? Because we both experience them at some time in our life. And because both touch us at our very core.

Schools are the responsibility of our local councils. Although the quality of the service they can deliver is very much determined by whether the Scottish Government, the Executive, provides enough money.

Although I certainly receive a fair number of contacts about school issues, the numbers are far outweighed by those on health.

Because it increasingly seems that the National health service is in poor health. Just like too many people all across Scotland. And it is unlikely that we can improve the health of our people without racking up the quality of our health service.

The health minister, Malcolm Chisholm – who carries the sobriquet “Jessie” in the Parliamentary press gallery – has, in fairness, not sought to hide some of the problems.

For example, he has acknowledged that cancer services are way below the standards of achievement elsewhere in the ‘developed’ world. And I believe he has honestly set out to do something about it.

The Beatson in Glasgow is an institution with a world class reputation. In part, I imagine, due to the astonishment of international visitors at what can be achieved in decrepit Victorian buildings.

But that is changing and new premises are partly commissioned.

Is it too little and too late?

In a world where cancer specialists are in very short supply, resignations have made the headlines over the last couple of years. New doctors have been reluctant to come to a hospital, however great its past achievements, if that meant substantially harder work to make up for the present shortfall in staff numbers.

Determined efforts by health managers and tightly focussed support by the Minister have to led to what may be the beginning of a turn-around.

But the Beatson is not alone. It is merely more in the public eye, perhaps more in the eye of the press, than most parts of the health service.

And although the Minister might, just might, be achieving improvements, welcome improvements, at the Beatson, the picture elsewhere is dismal.

A recent sequence of answers to questions I have posed is revealing.

The problems with lack of dentists in the North East is not something with which we are unfamiliar.

While in Manchester they have one dentist for just over 1,000 people and Edinburgh is near one for every 2,000, we crunch along with a ratio around one for 4,000. And the shortage means that lists for NHS patients are all but closed. Even private dentists’ lists are closing.

So just how aware are the Scottish Government – and their Liberal and Labour backbenchers – of the problem?

Question – how many 16-year-olds have dental decay? Government answer – don’t know. That is answer S2W-2032 in case you want to see the complete wording.

Question – how much do dentists earn from the NHS? Government – don’t know. (S2W-2355)

Question – how long do people have to wait to get on a dentist’s list? Government – don’t know. (S2W-626)

Question – how many people are waiting to get on an NHS dentist’s list? Government – don’t know. (S2W-625)

Question – how many foreign dentists are working temporarily for the NHS? Government – don’t know. (S2W-2356)

Question – how far do patients have to travel to get NHS dental treatment? Government – don’t know. (S2W-2352)

And most astonishingly – How many dentists are there? Government – don’t know. (S2W-2353)

But they seem to know that there is a problem. For over a year there has been a “Golden Hello” scheme to provide extra payments to dental practices who – somehow – manage to recruit an additional dentist.

It can pay up to £10,000 over three years to these lucky practices.

So how many payments have been made? Six in total. In the health board areas of Forth Valley, Lothian, Greater Glasgow and Dumfries & Galloway.

Absolutely none in Grampian or Highland which it appears are the worst served areas.

When the depth of ignorance about dental provision is revealed by Parliamentary answers, one has to wonder whether there is a NATIONAL health service at all. There is certainly little evidence of one for dental health.

So it is all OK elsewhere then?

Perhaps not. GP vacancies are rising too. Around 50 across Scotland – I await the definitive figures but that is what ‘insiders’ say – and rising. And once again it seems that these shortages are concentrated in our remoter communities where access to hospital emergency services is much more difficult than in our cities.

Maybe the Government fails collect the data on our failing NHS because it already knows the answers.

Whatever we think about that, it is clear the problems are deep-rooted.

Harnesses

Summer recess over - Scottish Parliamentarians have returned to Edinburgh and to debate big issues.

But not everyone has returned in quite the same spirit.

The heat might be to blame. Or was it the exertions of summer tours around constituencies. Or what? But the effect has been to send three of our parliamentary colleagues back with practical experience of one or another country’s health service.

My political colleague – and Shadow Deputy First Minister – Roseanna Cunningham “Beckham’ed” herself when she stepped awkwardly off a pavement . A broken metatarsal and an early end to her holiday.

One Labour member is wearing a sling and another is wheelchair-bound with a “stookie” on her foot. I have not dared to ask what has been going on.

But the insanity does not seem to be confined to breaking legs and arms.

The similarly named Tory, Struan Stevenson, is a member of the European Parliament. Confusion of names can lead to the occasional hilarious phone call. Some to people who think it is him when I call. And when people call me to ask about Tory policies. I always rise to the bait on the latter.

But there is nothing remotely hilarious about his latest move.

As part of my pack of information from SNP HQ in preparation for our National Conference in Inverness at the end of the month, I have been sent a 160-page book which is the proposed new European Constitution. Every one of the over 1,000 conference attendees will get one.

The proposal in there that sticks in the craw is on fishing. It proposes to make the Common Fisheries Policy a “sole competency” of the EU. In other words to remove for ever – for a generation at least – the prospect of our being able to repatriate control over our fishing grounds to our own government. It would make permanent the EU regime that has wreaked havoc with fish stocks and damaged the interests of all in the North-East.

And Tory Struan Stevenson’s crime?

As Convenor of the EU Fishing Committee, he is supporting this move.
Parliamentarians may be back in harness after their break. But it does not seem to have done some of them much good.

Food, Glorious Food

I am old enough to remember food rationing. The first day after the ending of the “sweetie ration” was one which sticks in my memory. Having enough money rather than having enough points became the issue. And a very welcome problem for a small boy!

Today our problems with food are largely those of excess. Too much fat, too much cholesterol, too much sugar, too much salt.

During World War II, we had a dreary but adequate diet. It was balanced and people were actually much less likely to be unhealthy through diet than they are now.

We do think, we do worry, much more about our diet than we used to. And with many more taking an interest in food, we have seen a wheen of rules about how it may be produced passed into our law in recent years.

In particular, regulations governing the welfare of farm animals such as pigs is now very tight. And quite costly for farmers. Fine if that is what the we want.

But having passed laws protecting pigs, and other animals, from inhumane conditions, why does government buy from producers in other countries where standards are lower than our own? And why does the public?

The reality is that picking up a packet of processed food in the supermarket is no substitute for asking the butcher about his or her meat. They will know.

But the bacon wrapper does not tell the buyer what standards applied to the production of the contents. And despite our apparently operating under a common set of regulations across the EU, they differ materially.

Can our government do anything?

Actually they can. Contracts for purchasing can specify the standards to which products need to be produced. They could demand that food must have been packed with the 24 hours before delivery.

All simple and sensible steps that would help local producers. All ways in which consumers could know whether the food they buy meets the standards they have demanded.

I am going to make an issue of this in coming weeks.

Teething Troubles

I continue to ask questions about dentistry. And continue to amazed at the lack of knowledge professed by our government.

There must be real doubts as to whether there is a national health service in relation to teeth.

Too many ministerial answers repeat the mantra – “The information is not available centrally” or “This is a matter for local Health Boards”.

With more dentists’ retirements in prospect and longer journies for patients for treatment, we look in vain for government engagement in the issue.