:00:21. > :00:27.Scotland. Coming up ash hope for people who suffer from chronic
:00:27. > :00:35.pain. A pledge that special care will come from the Health Secretary.
:00:35. > :00:40.Scotland follows suit despite regulation that same sex legislation
:00:40. > :00:47.-- same-sex marriage legislation was on ice. George Osborne announces
:00:47. > :00:49.that savings had been made but he still has to find billions more.
:00:49. > :00:54.People who suffer from long-term pain will find out this afternoon if
:00:54. > :00:57.they will get more help from the NHS. More than 700,000 Scottish
:00:57. > :01:05.people suffer from chronic pain making it one of the country's
:01:05. > :01:10.biggest health issues. We report on one young man's struggle.
:01:10. > :01:17.36 euros Martin is preparing for an important trip. Despite a cocktail
:01:17. > :01:26.of painkillers he is in pain every day due to form of bifida. He is
:01:26. > :01:32.going 400 miles to a specialist clinic. -- spina bifida. It is
:01:32. > :01:42.Martin's last hope. Doctors say there is nothing more they can do to
:01:42. > :01:46.
:01:46. > :01:53.help, leaving him housebound and reliant on his family. I do not want
:01:53. > :02:00.to think, I really don't. A month later and Martin is back in Glasgow.
:02:00. > :02:06.I still have the same pain. But I know how to handle it now. This
:02:06. > :02:12.afternoon, MSPs will debate whether Scotland should have a specialist
:02:12. > :02:17.centre. It has -- Martin has a message for them and for the people
:02:17. > :02:23.in Scotland suffering from long-term pain. If you have the opportunity
:02:23. > :02:28.and Scotland does have a centre, go for it! It will not help your pain,
:02:28. > :02:34.but it will give you a better life. At the end of the day, I can handle
:02:34. > :02:37.that. We are joined by our health
:02:37. > :02:45.correspondent and are political commentator Campbell Gunn, the
:02:45. > :02:55.recently retired medical editor of The Sunday Post. -- political
:02:55. > :02:57.
:02:57. > :03:00.editor. What is chronic pain? might be in pain but chronic pain is
:03:00. > :03:06.something that lasts for more than three months, beyond that timescale
:03:06. > :03:10.for you might expect the body to heal itself. It is a huge problem in
:03:10. > :03:16.Scotland, for one in six Scottish people suffer from long-term pain of
:03:16. > :03:21.that kind. It is a massive burden on the whole system and is one of the
:03:21. > :03:24.most common reasons why people visit the doctor. You have a lot of people
:03:24. > :03:30.who suffer from chronic pain and end up on benefits because they are not
:03:30. > :03:39.able to work. How is chronic pain currently dealt with? Some people
:03:39. > :03:43.have to go elsewhere for treatment. Until recently, it was not even
:03:43. > :03:50.recognised as a condition within itself. It has been recognised but
:03:50. > :03:55.we still have left over its systems from before that. People often find
:03:55. > :04:01.they are left to the specialisms that have left to the pain -- led to
:04:01. > :04:05.the pain, such as cancer or arthritis. In fact they could go to
:04:05. > :04:12.specialist units. In England and Wales people can go to a special
:04:12. > :04:17.residential unit where it they get tips on how to manage pain. It will
:04:17. > :04:25.not be a cure for the pain, but it does help in managing it. Scotland
:04:25. > :04:30.does not have a system like this. People have two go to England and
:04:30. > :04:35.that is what campaigners are hoping we will be promised this afternoon.
:04:35. > :04:41.The Health Secretary will speak this afternoon. There is uncertainty as
:04:42. > :04:46.to what he might say. The Health Secretary first backed the pain
:04:46. > :04:50.campaign in the early days. He is now the man with the budget and
:04:50. > :04:56.power to do something about it. The question is what will he do?
:04:56. > :05:00.Campaigners are positive and confident that he will announce not
:05:00. > :05:04.only a residential service in Scotland, but also better services
:05:04. > :05:08.throughout the country instead of the postcode lottery be happy. When
:05:08. > :05:13.I spoke to the health Department yesterday, they stepped back from
:05:13. > :05:17.that and said he would announce a consultation which, although we need
:05:17. > :05:26.to get right, it might be a disappointment to campaigners who
:05:26. > :05:34.have been waiting 20 years or so for something to be done. Campbell Gunn,
:05:34. > :05:39.it is a fascinating issue. There are people watching this programme who
:05:39. > :05:45.are probably affected by it. It has taken a long time to get to this
:05:45. > :05:50.stage. 700,000 people are estimated to suffer from chronic pain. It is
:05:50. > :05:56.an issue which has dogged the Scottish parliament since its
:05:56. > :06:04.inception. A cross-party group was set up in 2001. In 2002 there was a
:06:04. > :06:08.debate in Parliament. After that the website crashed because it got so
:06:08. > :06:13.much response. It is an issue which successive governments have failed
:06:13. > :06:19.to tackle and we will see what happens later. The Health Secretary
:06:19. > :06:26.has a series of options. It could be a consultation, it could be a mobile
:06:26. > :06:30.centre, it could be a centre, we do not know. Thank you both for now.
:06:30. > :06:34.We will have full coverage of the debate shortly. The Scottish
:06:34. > :06:38.Government has confirmed it will introduce a bill to allow same-sex
:06:38. > :06:44.couples to marry. The Health Secretary told MSPs the necessary
:06:44. > :06:47.legislation would be in place within a month. There will be well -- there
:06:47. > :06:52.will be legal protection for organisations which do not wish to
:06:52. > :06:59.conduct such ceremonies. We will be introducing the marriage
:06:59. > :07:06.and civil partnership Scotland Bill within the 2012, 2013 Parliamentary
:07:06. > :07:13.session and the bill will be introduced before the summer recess.
:07:13. > :07:16.This bill offers equality for all and for those diverse faiths who
:07:16. > :07:22.believe in same-sex marriage and are currently prevented from holding
:07:22. > :07:26.such ceremonies. I recognise just as these faiths wish to perform
:07:26. > :07:31.same-sex marriage, many do not or are divided on the issue. What
:07:31. > :07:36.progress has been made on ensuring necessary changes to the UK equality
:07:36. > :07:46.act, to safeguard the right of each religion to govern itself
:07:46. > :07:46.
:07:46. > :07:52.accordingly on this matter? We made substantial progress on the matter
:07:52. > :07:59.with the UK government and I hope to be in possession on publishing the
:08:00. > :08:08.bill itself, to confirm the details of the amendments that will be put
:08:08. > :08:13.to the UK Equality Act. The Cabinet Secretary will be aware of claims
:08:13. > :08:20.that have been made around the cost and time scale of equalising civil
:08:20. > :08:27.partnerships. A key aim of the campaign in Scotland has been to
:08:27. > :08:31.secure same-sex mix to partnerships as well. No groups should be singled
:08:31. > :08:35.out by legislation. What consideration has he given to this
:08:35. > :08:40.issue and will he order our review or other work to be done to assess
:08:40. > :08:45.the potential impact should Parliament express that its wish is
:08:45. > :08:50.to open up civil partnerships to same-sex couples? As he will be
:08:50. > :08:53.aware, the culture secretary has ordered a review held on to the
:08:53. > :08:59.legislation for same-sex marriage south of the border. That will cover
:08:59. > :09:03.devolved matters in respect of England, but also reserved matters.
:09:03. > :09:09.I will consider how we should address this issue and I would hope
:09:09. > :09:13.to make an announcement soon. Lettuce debate this further with Tom
:09:13. > :09:23.French, a campaigner for same-sex marriage. He is the policy
:09:23. > :09:24.
:09:24. > :09:29.co-ordinator at the policy network good afternoon. -- let us. Had you
:09:29. > :09:34.been thinking this was kicked into the long grass? Absolutely not and
:09:34. > :09:38.we welcome the progress that has been announced. We look forward to
:09:38. > :09:42.seeing it introduced into the parliament so that MSPs can look at
:09:42. > :09:47.the evidence, scrutinise the bill and pass it with a significant
:09:47. > :09:53.majority. We have not seen the results of the consultation. Have
:09:53. > :09:56.you an idea when this would come out? We do not know but I suspect it
:09:56. > :10:02.will come out and about the same time as the bill before the summer
:10:02. > :10:05.recess. From our perspective we know that people who support same-sex
:10:05. > :10:11.marriage responded to the consultation and would hope for a
:10:11. > :10:15.progressive well on the back of that. We saw the debate at
:10:15. > :10:19.Westminster when it was going through the House of Commons. Are
:10:19. > :10:26.you surprised at the strength of opposition particularly amongst
:10:26. > :10:31.conservatives? Could we see that here? I suspect there is more unity
:10:31. > :10:34.in Scotland on this issue. We know that a high proportion of the
:10:34. > :10:39.population supports same-sex marriage according to opinion polls.
:10:39. > :10:49.We have seen a large majority of MSPs saying that they will vote for
:10:49. > :10:53.it. It is disheartening to see some of the debates going on South of the
:10:53. > :11:01.border. But of course everyone has a right to speak out and say how they
:11:01. > :11:04.feel. Is there a generational view that younger people are more likely
:11:04. > :11:11.to support it? I think that was a point that was majoring the debate
:11:11. > :11:15.at Westminster? Absolutely. If you look at the opinion polls, across
:11:15. > :11:22.the general population about two thirds of people support same-sex
:11:22. > :11:28.marriage, but when you look at those under 55, that goes up to as much as
:11:28. > :11:35.80%. President Barack Obama said his mind had been changed on the issue
:11:35. > :11:39.by speaking to his daughters. Amongst young people, there is a lot
:11:39. > :11:44.of support and in the decades to come, people will look back and
:11:45. > :11:48.wonder why be needed a debate! People who are opposed to it are
:11:48. > :11:53.concerned that churches and religious organisations will be
:11:53. > :11:59.protected from having to conduct same-sex marriage is. You want to
:11:59. > :12:04.see the safeguards in the bill as well? Absolutely. We want to see a
:12:04. > :12:07.situation where religious freedom is protected and extended. Those groups
:12:07. > :12:14.that want to conduct the same-sex marriage are told by the state that
:12:14. > :12:24.they cannot. We want to see a bowl -- a bill that will allow them to
:12:24. > :12:25.
:12:25. > :12:30.conduct same-sex marriage if they want. What is your view about Sybil
:12:30. > :12:35.partnerships for mixed sex couples? Lord Tebbit made some inflammatory
:12:35. > :12:45.statements at Westminster. Do you think despair that happens? -- civil
:12:45. > :12:46.
:12:46. > :12:51.partnerships. Scotland's equal marriage campaigners always included
:12:51. > :12:54.opening up civil partnerships to mixed sex couples as well. We
:12:54. > :12:59.support that and we are pushing for it to be introduced in Scotland
:12:59. > :13:05.because we believe in equality for all. That includes mixed sex couples
:13:05. > :13:07.as well as same-sex couples. It would be bizarre to have a situation
:13:07. > :13:15.where it same-sex couples ended up having more rights than mixed sex
:13:15. > :13:23.couples. Thank you. I am joined by our political commentator Campbell
:13:23. > :13:28.Gunn. Interesting to hear that are guest did not think it had been
:13:28. > :13:32.kicked into the long grass? We are kicking the subject around wondering
:13:32. > :13:37.if the Scottish Government did not want to happen before the
:13:37. > :13:42.referendum? There is some opposition from the churches but there is broad
:13:43. > :13:51.support across the Parliament. It is the same in Parliament. It is
:13:51. > :13:56.happening across the world. Tonight is the first gay marriage in France.
:13:56. > :14:00.It will come in in Westminster and it will be passed in Holyrood as
:14:00. > :14:07.well. There are people who are opposed to it and Cardinal Keith
:14:07. > :14:10.O'Brien was a leading light in this campaign. Has his demise change the
:14:10. > :14:15.political perspective? I do not think so. I think the Catholic
:14:15. > :14:20.church will still oppose it as well parts of the Church of Scotland. The
:14:20. > :14:25.vast majority of people in the wider community are relaxed about it and
:14:25. > :14:31.in favour of it. It is the same within the Scottish Parliament.
:14:31. > :14:37.discussed this with Tom French about civil partnerships for mixed sex
:14:37. > :14:42.couples. Lord Tebbit made those extraordinary request about marrying
:14:42. > :14:52.his son or so on, to protect his inheritance! Would you think that
:14:52. > :14:53.
:14:53. > :14:56.might happen here? Tom French is in favour of civil partnerships for
:14:57. > :15:04.mixed couples. It seems a logical way to go, equality across the
:15:04. > :15:07.board. Now right at the beginning of the programme we talked about how
:15:07. > :15:10.patients with chronic pain were going to receive improved specialist
:15:10. > :15:19.care. Let's see what the Health Secretary Alex Neil has to say about
:15:19. > :15:26.that live in the chamber. Alex Neil is on his feet at the moment,
:15:27. > :15:31.representatives in the gallery from organisations fighting for action on
:15:31. > :15:39.chronic pain. On residential treatment, he says 20 patients a
:15:39. > :15:43.year go to Bath, the example mentioned in the report, he wants to
:15:43. > :15:49.put an end to that and provide residential facilities in Scotland,
:15:49. > :15:52.a single centre covering all of Scotland, a mobile service, a range
:15:52. > :15:57.of centres across Scotland but he promised one of those will happen
:15:57. > :16:05.and there should be no need in the future for patients to go to Bath.
:16:05. > :16:07.Let's pick up on it. I encourage people to participate and tell us
:16:07. > :16:12.what their preference would be because I want this to be as much as
:16:12. > :16:19.possible driven either needs of the people who require the services as
:16:19. > :16:23.far as we can. And we will very clearly take into account the views
:16:23. > :16:31.of patients and other stakeholders before we make any final decisions.
:16:31. > :16:37.But I am determined that we will make a decision on which model
:16:37. > :16:40.around September time, I do not want this to drag on. We will have
:16:40. > :16:44.consultation, we will listen to what people say but then we will make a
:16:44. > :16:54.decision and deliver on the promise to have an alternative to Bath in
:16:54. > :16:54.
:16:54. > :17:00.Scotland. I thank him for giving way, especially in full flow! I
:17:00. > :17:03.welcomed the remarks about other stakeholders. Because folk who have
:17:03. > :17:10.chronic pain know they have chronic pain. A lot of the doctors treating
:17:10. > :17:14.them do not know how to treat it. Can I suggest that as well as
:17:14. > :17:24.patients learning to cope with pain, some medical staff do a course as
:17:24. > :17:29.well. That is a very fair point she makes. One of our clear objectives
:17:29. > :17:34.is to raise awareness in the medical profession about chronic pain and
:17:34. > :17:38.what can be done to help people who suffer from chronic pain. The second
:17:39. > :17:45.major point I want to make is that we have already reduced waiting
:17:45. > :17:51.times from over 80 weeks to 60 weeks for psychological services and we
:17:51. > :17:55.will continue to drive to significantly reduce waiting times
:17:55. > :18:00.for those services which are so crucial to the sufferers of chronic
:18:00. > :18:09.and. I do not believe it is right that people have to wait that length
:18:09. > :18:16.of time for essential services which they need urgently. Thirdly, looking
:18:16. > :18:21.at the petition submitted by Susan Archbold and those who supported the
:18:21. > :18:24.petition, one of the key points made is in delivering services for
:18:24. > :18:29.sufferers of chronic pain, we should not just think in terms of a medical
:18:29. > :18:34.health model at the social model as well. Let me say that we are
:18:34. > :18:38.committed to that principle. And the bill published today for the
:18:38. > :18:44.integration of adult health and social care should help us deliver
:18:44. > :18:49.an integrated health and social care service delivery for sufferers of
:18:49. > :18:56.chronic pain. If there ever was an example of where the integration of
:18:56. > :19:01.services is important is in relation to dealing with chronic pain. I want
:19:01. > :19:05.to set out some of the work going on and approaches been taken but in
:19:05. > :19:11.saying that, I do recognise there is still a wide variation in Scotland
:19:11. > :19:18.in terms of access to certain services. And one of our key policy
:19:18. > :19:24.objectives is to make sure there is no postcode delivery of services, we
:19:24. > :19:28.want a consistent delivery of high quality services in primary and
:19:28. > :19:34.acute sectors for the sufferers of chronic pain. Clearly, an approach
:19:34. > :19:39.is required because most of the service will not be in the acute
:19:39. > :19:43.sector, most service delivery inevitably will be in the primary
:19:43. > :19:49.sector. We have long advocated the role of a managed clinical network
:19:49. > :19:53.and the role it has in coordinating a multidisciplinary approach to
:19:54. > :20:00.service provision. We also need to ensure those cynical networks give a
:20:00. > :20:04.strong voice to patients in shaping service delivery -- clinical
:20:04. > :20:09.networks. We will place an obligation on the territorial health
:20:09. > :20:14.boards to provide a minimum level of services, good quality services but
:20:14. > :20:20.in doing so we will require them to discuss the shape of the local
:20:20. > :20:26.services with local populations and stakeholder groups representing the
:20:26. > :20:32.sufferers of chronic pain. There are some areas making more progress and
:20:32. > :20:36.have made more progress than others. NHS in Clyde, the clinical network
:20:36. > :20:41.has been operating for five years and has demonstrated real
:20:41. > :20:45.improvements including the development of a pain management
:20:45. > :20:51.programme, setting standards for services, developing primary care
:20:51. > :20:55.guidelines, and more recently setting up specialist nursing
:20:55. > :21:00.clinics to provide care more locally for patients. So obviously, that is
:21:00. > :21:08.a good example of the kind of ambition we have in delivering this
:21:08. > :21:16.service. We actually recently have also, if we look at the figures
:21:16. > :21:20.published yesterday, we have seen an increase in appropriate skills and
:21:20. > :21:25.occupations in the health service in servicing sufferers of chronic pain
:21:25. > :21:31.and others. For example, there's been a 5% increase in the number of
:21:31. > :21:37.cynical and other psychologist working in health service compared
:21:37. > :21:41.to last year. The mental health strategy for Scotland for the next
:21:41. > :21:47.three years also makes a commitment to continue to deliver fast access
:21:47. > :21:51.to psychological therapies and the programme to deliver this is
:21:51. > :21:57.delivered locally but supported nationally including support for
:21:57. > :22:03.service improvements in existing resources. The territorial boards
:22:03. > :22:08.are receiving a real terms increase in budget this year and next said
:22:08. > :22:14.the resources should be in place to allow them to deliver the quality of
:22:14. > :22:22.services that we are demanding. We are supporting the development of
:22:22. > :22:26.service improvement groups with �50,000 a year over two years, to
:22:26. > :22:33.put together a local plan for improvement in the area. So far, the
:22:33. > :22:38.following health boards have anticipated, Ayrshire, Dumfries &
:22:38. > :22:43.Galloway, Lanarkshire, Lothian and Teeside who cover 72% of the
:22:43. > :22:49.population. Our aim is to have 100% coverage of the population in this
:22:49. > :22:57.programme to prepare and make sure the local service delivery plans are
:22:57. > :23:01.in place from next year at the latest. The main priority of these
:23:01. > :23:07.groups is to focus on and accelerate the implementation of the Scottish
:23:07. > :23:13.service model, particularly looking to improve links with primary care
:23:13. > :23:18.paediatric services in the voluntary sector and patient participation
:23:18. > :23:24.will be an essential feature of their work. Some of the work is in
:23:24. > :23:29.its early stages, in NHS Ayrshire they are working to improve chronic
:23:29. > :23:34.pain services and it's been lined with musculoskeletal services
:23:34. > :23:40.redesigned. That allows early identification, rapid triage and
:23:40. > :23:43.assessment with timely referral into appropriate services including
:23:43. > :23:49.chronic pain management, self-management support and the
:23:49. > :23:56.working health service. In Fife they are working on proposals for they
:23:56. > :24:00.groups, NHS Fife has integrated chronic pain management services
:24:00. > :24:06.which have been established three years and fulfils a number of of the
:24:06. > :24:10.approach. Clearly, we will be working with them and other groups
:24:10. > :24:16.to take the programmes forward to ensure in Thai coverage in Scotland.
:24:16. > :24:21.I have told boards to accelerate progress and to set an expectation
:24:21. > :24:26.that improvement plans will be in place for every board by the end of
:24:26. > :24:33.this month. In addition, as advanced that I will be calling for updates
:24:33. > :24:38.on progress when I meet them in June and looking to them to identify and
:24:38. > :24:42.seek solutions to any barriers in delivery. I have commissioned work
:24:42. > :24:48.to consider how to efficiently include chronic pain in the local
:24:48. > :24:52.delivery plans for each board from 2014 onwards and to ensure there is
:24:52. > :24:58.a clear reporting mechanism to monitor progress through the annual
:24:58. > :25:02.NHS board review process. They're on any other initiatives I could
:25:02. > :25:06.mention but no doubt others will do so and my colleague, the Minister
:25:06. > :25:12.for Public health, will cover a number of the ones I have not
:25:12. > :25:18.reached. I just want to spell out on behalf of Michael Matheson and
:25:18. > :25:21.myself are commitment to improving the chronic pain service throughout
:25:21. > :25:28.Scotland and making sure we have the indigenous services in Scotland that
:25:28. > :25:38.our patients need to deal with this very debilitating illness.
:25:38. > :25:47.
:25:47. > :25:51.I to welcome the opportunity to participate in the debate, not just
:25:51. > :25:58.on behalf of my party but also as one of the co- conveners of the
:25:58. > :26:02.group on chronic pain. I stuck by echoing the Cabinet
:26:02. > :26:09.Secretary's comment welcoming those from across Scotland to parts of the
:26:09. > :26:11.group that are in the gallery this afternoon. Some of you may spot a
:26:11. > :26:16.former Parliamentary colleague who championed the cause of chronic pain
:26:16. > :26:22.in the first Parliament that led to the formation of the cross-party
:26:22. > :26:25.group. The campaign is not new, some of us think it's been rather a long
:26:25. > :26:29.haul and many campaigners who have been seeking change for more than a
:26:29. > :26:32.decade are impatient to see a difference on the ground. We've had
:26:32. > :26:39.numerous reports over the years commissioned by different
:26:39. > :26:43.governments, Professor McEwan, a group report and they've highlighted
:26:43. > :26:48.the gaps in provision. The frustration has been the lack of
:26:48. > :26:52.action. We do have a postcode lottery of care, where you receive a
:26:52. > :26:56.service and whether you receive a service depends on where you live
:26:56. > :26:59.and much of what the Cabinet Secretary has said is therefore
:26:59. > :27:05.welcome. Let me start with a residential pain centre in Scotland,
:27:05. > :27:07.Scottish Labour was the only party to pledge we would create a
:27:07. > :27:17.residential service in Scotland and end the ordeal of any pain patients
:27:17. > :27:21.being sent as far-away as Bath in Somerset. We often... I am
:27:21. > :27:27.delivering on her manifesto commitment! I encourage him to read
:27:27. > :27:31.the mess -- rest of the manifesto and if he deals on the rest of it I
:27:31. > :27:37.might have more praise for him in future. He and I share this
:27:37. > :27:42.objective because we often think about people travelling 800 miles, a
:27:42. > :27:47.return journey to get a service, the distances can be longer. We
:27:47. > :27:51.understand one sufferer was sent from Shetland, a marathon return
:27:51. > :27:59.journey of over 1600 miles. Although the patients are small in number,
:27:59. > :28:03.they are subjected to such gruelling travel, they are at the worst end of
:28:03. > :28:09.suffering. Labour speaking live in the chamber.
:28:09. > :28:17.Let's get some thoughts on that with Campbell Gunn once again. Alex Neil
:28:17. > :28:22.announcing a consultation in September. It is a halfway house. He
:28:22. > :28:26.has not announced the centre today but he has said it will be in
:28:26. > :28:31.September so we have a consultation, short-term, something will be
:28:31. > :28:34.announced in September. We still don't know what but it is progress.
:28:34. > :28:38.There will be something, either a mobile centre or a specialist
:28:38. > :28:43.centre. This is what the consultation is to decide, whether
:28:43. > :28:48.there should be one centre or whether it should be a mobile centre
:28:48. > :28:54.which can move around. He also asked health boards to set up specialist
:28:55. > :29:01.pain units themselves because there is, as both of them say, it is a
:29:01. > :29:05.postcode lottery. When Jackie Baillie was speaking and Alex Neil
:29:05. > :29:15.said he was delivering her manifesto commitment, successive governments
:29:15. > :29:15.
:29:16. > :29:23.and executives before have been trying to deal with this issue.
:29:23. > :29:25.Labour work in power there were many campaigners who fought vigorously to
:29:25. > :29:33.have this work come to fruition. Thank you.
:29:33. > :29:37.Staying with health, the Health Secretary has been busy, he has been
:29:37. > :29:47.reassuring MSPs that there is robust systems in place to tackle waiting
:29:47. > :29:50.
:29:50. > :29:54.lists. It follows an audit Scotland report alleging that manipulation.
:29:54. > :30:03.We had a number of checks and balances within the system to make
:30:03. > :30:11.sure it was running smoothly. One board has decided that there will be
:30:11. > :30:17.a monthly waiting list audit taken were data is sampled and
:30:17. > :30:22.unavailability will be recorded. We must insure the system is robust and
:30:22. > :30:29.that will be done monthly. That was one of the recommendations for every
:30:29. > :30:35.health board in Scotland. What reassurances can the government give
:30:35. > :30:40.that it will work in partnerships with every board to make sure it
:30:40. > :30:46.that checks and balances are reinforced? Rather than give a
:30:46. > :30:53.reinsurer -- the reassurance I will give you a commitment. We are doing
:30:53. > :30:59.it at national level and it now takes place at a monthly meeting
:30:59. > :31:08.involving my officials and others. We monitor progress and on
:31:08. > :31:12.limitation in a detailed way. We will also examine any potential
:31:12. > :31:19.issues that need to be addressed in how statistics are interpreted and
:31:19. > :31:24.how rules are implemented. At both national level and board level,
:31:24. > :31:32.there is now, on a monthly basis, detailed scrutiny of the figures to
:31:32. > :31:42.make sure they are bust. We must provide relevant information and
:31:42. > :31:51.information that can be believed by the boards and the general public.
:31:51. > :31:57.The report is quite clear. What we saw was an increase in social
:31:57. > :32:06.unavailability from its introduction in 2008 all the way through to a
:32:06. > :32:16.peak in December 2010. There was a decline, slow at first and then
:32:16. > :32:23.quicker subsequently, down to more or less its current level. When
:32:23. > :32:30.something like that happens, does someone not look at it? Does someone
:32:30. > :32:40.not say these are not proper, there are massive variances. What happens
:32:40. > :32:41.
:32:41. > :32:46.when something like that is brought to your attention? There are number
:32:46. > :32:54.of issues with them that question. There has been a range of scrutiny
:32:54. > :32:58.of these kind of issues over a long period. Audit Scotland has done a
:32:58. > :33:02.number of examinations and raised issues about the variances of social
:33:02. > :33:07.unavailability. There were issues about recording of social
:33:07. > :33:15.unavailability. They did not raise concerns about the level of this.
:33:15. > :33:21.There was nothing in the pattern, that increase over 2008 through
:33:21. > :33:27.22010, that leapt off the page and said you have a problem. It all
:33:27. > :33:33.happened within your health board at that time and it was of no real
:33:33. > :33:43.concern to you? You felt confident there was nothing going wrong and
:33:43. > :33:45.
:33:45. > :33:49.did not discuss that? In the report, it is quite clear that we did not
:33:50. > :33:57.raise any alarms are concerns about the increase in social
:33:57. > :34:04.unavailability over that period. know what the committee said, but we
:34:04. > :34:09.as a Health Committee were looking beyond that and saying can we trust
:34:09. > :34:13.the boards and the processes when obviously there were codes not
:34:13. > :34:18.entered properly, insufficient information put into the system and
:34:18. > :34:25.fraudulent pride this in your health Department. There was no fraudulent
:34:25. > :34:34.practice and my health Department. Manipulation, is that too strong?
:34:34. > :34:37.That took lace in NHS Lothian, not in my health Department. There was
:34:37. > :34:44.evidence of deliberate manipulation in NHS Lothian, but not in my
:34:44. > :34:54.department. But is that not bad enough? We have to understand that
:34:54. > :34:55.
:34:55. > :35:04.Cabinet Secretary said to me in his opening remarks that we understand
:35:04. > :35:14.what happened in NHS Lothian was unacceptable. Did we meet the new
:35:14. > :35:14.
:35:14. > :35:21.targets? What we are saying is we must get to 95% before we get to
:35:21. > :35:28.98%, obviously? A number of boards are 98%. Across Scotland as a whole,
:35:28. > :35:33.the figure is 92%, so that is not as high as I would like to see it, but
:35:33. > :35:39.it is certainly moving in the right direction. We need to get to 98%,
:35:39. > :35:44.that is our objective. Fatos Hamsaraj Westminster is still in
:35:44. > :35:49.recess so no prime ministers questions and MPs are back in their
:35:49. > :35:56.constituencies but David Porter is on College Green for us. It may be
:35:56. > :35:59.quiet down there but there is lots going on in the corridors of power
:35:59. > :36:04.in Whitehall! George Osborne is preparing for the spending review
:36:04. > :36:09.next month. Behind the scenes and in the department they are looking at
:36:09. > :36:14.the budget ahead of the spending review next month. The Chancellor
:36:14. > :36:18.came out and said he had a couple of billion pounds of savings and is
:36:18. > :36:27.looking for 11.5 young pounds worth of savings he still has some way to
:36:27. > :36:34.go. To discuss how he will do that I am joined by two guests. This is
:36:34. > :36:42.Iain Martin and Kate Devlin. George Osborne said he had done some of the
:36:42. > :36:49.job but there is still a long way to go? A long way to go and he still
:36:49. > :36:54.has a few of his ministers who are refusing to give him a figure on how
:36:54. > :37:02.much they will cut in 2015, 2016. They have entered a period of
:37:02. > :37:12.negotiations. He is threatening to call them in front of Start Chamber.
:37:12. > :37:16.It is a stand-off at this stage. They have one month to go when he is
:37:16. > :37:21.supposed to stand up in Parliament and lay this out. It is starting to
:37:21. > :37:27.get very tight. This is a deadline he cannot miss as far as Scotland is
:37:27. > :37:33.concerned. It will have a knock-on effect on the block grant, probably
:37:33. > :37:38.in the region of a couple of hundred million pounds. It is hard to tell
:37:38. > :37:44.at this stage how much it will be because we do not know how much the
:37:44. > :37:48.final tally will be and we do not know the subject areas. How much the
:37:48. > :37:56.Defence Secretary decides to cut could have significant impacts on
:37:56. > :38:04.Scotland. We are talking about big figures, 11.5 billion, but in the
:38:04. > :38:09.overall scale of things, it is not that huge, is it? That is right and
:38:09. > :38:16.there is this huge row about �11.5 billion which sounds like a lot of
:38:16. > :38:22.money. It is to us individually, but in the context of the government
:38:22. > :38:32.spent, it is a drop in the ocean. The deficit is �120 billion this
:38:32. > :38:34.
:38:34. > :38:38.year. The national debt is about to hit 1.4 trillion. An argument about
:38:38. > :38:44.the type of spending, is he spending the money he has got on the right
:38:44. > :38:48.wings? There is an argument in Whitehall about if they should be
:38:48. > :38:53.spending more on infrastructure. I think it is probably too late for
:38:53. > :39:01.that. The government is making noises on spending more on
:39:01. > :39:08.infrastructure. It is too late to reverse major decisions in time for
:39:08. > :39:13.it to have any real impact. reduction in spending will be jumped
:39:13. > :39:22.on by the opposition. As far as Scotland is concerned, you can
:39:22. > :39:27.almost see the press release? You're shortchanging Scotland. Absolutely
:39:27. > :39:36.and this will kick in in an election year. It is interesting to see what
:39:36. > :39:40.the parties will do with it. When it comes to trying to tell the voters
:39:40. > :39:46.in an election year exactly what is happening and how it has affected
:39:46. > :39:52.them, that is where the political opposition will have to kick in.
:39:52. > :39:56.Staying with the politics of it, how difficult will it be for the Labour
:39:56. > :40:01.Party to differ from these figures are a Babel stick with whatever
:40:01. > :40:05.spending measures the Chancellor comes up with? That is tricky for
:40:05. > :40:09.Labour. The matter how difficult it gets for the coalition, David
:40:09. > :40:13.Cameron and George Osborne can turn round and say what will you do
:40:13. > :40:18.instead? It is clear from the opinion polls that the public does
:40:18. > :40:24.not have faith in them or their economic agenda, sold Labour is
:40:24. > :40:31.stuck. It is a charge that you hear a lot, but the Conservatives will
:40:31. > :40:38.say that the Labour answer in a borrowing crisis is to borrow more.
:40:38. > :40:43.Another story occupying our minds is the tensions in Afghanistan. It has
:40:43. > :40:49.emerged that something like 90 Afghan people are being detained by
:40:49. > :40:53.British forces without charge. is a difficult one for the Defence
:40:53. > :41:00.Secretary. It emerges some of these people have been held without charge
:41:00. > :41:05.for Ford team months. He says this is a situation they had foisted upon
:41:05. > :41:15.them essentially, because they cannot hand them over to the Afghan
:41:15. > :41:17.
:41:17. > :41:23.authorities. #14 months. We are planning to pull out of Afghanistan
:41:23. > :41:29.at the end of this month. Why these processes and systems have not set
:41:29. > :41:33.up is quite a difficult question. His argument and the organ and from
:41:33. > :41:39.the MoD is that the UK government has to pull out and ordered to allow
:41:39. > :41:49.the Afghan authorities to step up to the plate. -- the argument from the
:41:49. > :41:50.
:41:50. > :41:56.MoD. The authorities are sensitive to any comparisons made to
:41:56. > :42:02.Guant?namo Bay. You must consider the context in terms of the terror
:42:02. > :42:09.threat at the moment. In terms of wider public opinion, government
:42:09. > :42:13.ministers are not bothered. They argued that Labour made use of this
:42:13. > :42:21.facility beforehand. Thank you both very much. That spending review is
:42:21. > :42:27.on the 26th of June in about one month's time and there will be lots
:42:27. > :42:31.of arguments in the run-up to that date. Thank you. Normal service
:42:31. > :42:36.resumes at Westminster next week. Young people leaving care are being
:42:36. > :42:40.failed by the system designed to help them stand on their own feet,
:42:40. > :42:48.according to opposition MSPs. They are responding to a report from the
:42:48. > :42:53.Equal Opportunities Committee. Leaving the care system when ready
:42:53. > :42:58.should be a new start for any young person and offer an exciting
:42:58. > :43:01.challenge into adult hood. But we have heard that this is rarely the
:43:01. > :43:11.case. Automatic homelessness exists as a result of disjointed care and
:43:11. > :43:14.housing services. We heard from one account that in some local
:43:14. > :43:19.authorities, young people are still routinely discharged through the
:43:19. > :43:25.homeless route rather than with a pathway plan that has been worked
:43:25. > :43:31.out for them. The Princes trust echoed this claim by stating there
:43:31. > :43:41.is an inconsistent picture of support for young e-book. Transition
:43:41. > :43:41.
:43:41. > :43:45.needs to be managed better. Children are leaving care far too early and
:43:45. > :43:49.someone aged 16 or 17 is too young to leave the care system, especially
:43:49. > :43:55.given that many looked after children are vulnerable young people
:43:55. > :44:00.with different levels of maturity, still developing mentally possibly
:44:00. > :44:05.as a result of suffering from a traumatic life experience, offering
:44:05. > :44:12.-- often through no fault of their own. A former care leader explains
:44:12. > :44:15.why he believes the age limit is too low. He stated that it is impossible
:44:15. > :44:19.that people, even if they have lived with their mother and father, would
:44:19. > :44:25.have the appropriate life skills at that age, the age limit for people
:44:25. > :44:28.going into homelessness should not be 16, it should be 18. That would
:44:29. > :44:38.give people more of a chance to learn the skills that would help
:44:38. > :44:48.them to look after themselves. Scottish Parliament's, Miss
:44:48. > :44:48.
:44:48. > :44:57.commitment has been met stating that homeless people are entitled to some
:44:57. > :45:04.form of redress. Our approach has contributed to a significant fall in
:45:04. > :45:14.recorded homelessness in Scotland. But that still makes up a third of
:45:14. > :45:18.all homeless people, although the figures have reduced. I know that is
:45:18. > :45:26.not enough and I know there is a lot that still needs to be done to get
:45:26. > :45:32.the numbers coming down. committee has made a number of
:45:32. > :45:39.recommendations in terms of data, preventative work and successes in
:45:39. > :45:44.removing obstacles. The report says people leaving care of honourable. I
:45:44. > :45:51.am sorry to say we continue to fail these young people in care in terms
:45:51. > :45:56.of future life chances, education, employability and the likelihood of
:45:56. > :46:01.becoming a offender. We must develop a more holistic approach to
:46:01. > :46:10.supporting young people in care and I believe that was one of the
:46:10. > :46:17.conclusions which the group also drew from their work. To cover a few
:46:17. > :46:19.issues which may be others will not cover, I start by saying it would be
:46:19. > :46:25.too simplistic to suggest building more houses would be a solution to
:46:25. > :46:28.the problem of homelessness among young people. Given the Scottish
:46:28. > :46:35.government poor record on house construction, it is probably just as
:46:35. > :46:41.well. The issue is an important one. The issue here is important. While
:46:41. > :46:45.the current government boast they have done more to ensure more
:46:46. > :46:50.council houses are built, the truth is there's been a significant cut in
:46:50. > :46:54.the budget and if we look at the houses previously been constructive
:46:54. > :47:00.by housing associations, the number of houses being built has dropped
:47:00. > :47:06.significantly. Given issues like under occupancy charge it could also
:47:06. > :47:10.be questioned if government policy is leading to the construction of
:47:10. > :47:16.homes that are suitable for the demand we expect in years to come.
:47:16. > :47:26.That was the Scottish Conservative. Let's get political reaction to
:47:26. > :47:26.
:47:26. > :47:32.today's news stories. Fiona McLeod, Drew Smith and Mary Scanlon. Thank
:47:32. > :47:38.you for joining me. Fiona, we are looking at the issue of chronic
:47:38. > :47:41.pain, Alex Neil making that announcement trying to get services
:47:41. > :47:45.for people in Scotland and he has announced a consultation which
:47:45. > :47:53.reports in September, is this clicking the issue into the long
:47:53. > :47:58.grass again? No, September is only four months away. As someone who
:47:58. > :48:03.suffers from pain, I can appreciate the long trek down to Bath. The fact
:48:03. > :48:07.we will have an answer by September if something that all 800,000
:48:07. > :48:12.chronic pain sufferers in Scotland have waited a long time for and to
:48:12. > :48:16.get it right and especially as the Cabinet Secretary said to consult
:48:16. > :48:24.with patients to hear what their views are on the three options,
:48:24. > :48:27.September is tomorrow in chronic pain terms. You say it's happening
:48:27. > :48:34.quickly but these people in Scotland who suffer from chronic pain, it is
:48:34. > :48:39.surprising that there is another delay. You can't magic and
:48:39. > :48:46.in-service overnight. To say we will have it by September, I think that
:48:46. > :48:52.is moving absolutely fast. Health Secretary moving at speed and
:48:52. > :48:58.maybe it sounds more than what the Labour Liberal Democrat executive
:48:58. > :49:03.managed to do when they were in power. I am in the chamber at this
:49:03. > :49:07.afternoon so I can be there for the debate. For the people in the public
:49:07. > :49:12.gallery and those who suffer, it has been a 12 year wait. There was a
:49:12. > :49:17.range of progress under the previous executive and has been some progress
:49:18. > :49:24.now, it goes back to the tail end of the previous executive where we have
:49:24. > :49:26.not seen the urgency we need. I understand we want to consult with
:49:26. > :49:32.patients and the best service but a lot of these patients who suffer no
:49:32. > :49:37.what the answer is, we need a service in Scotland to save people
:49:37. > :49:42.on long journeys to England to get treatment. Alex Neil said he was
:49:42. > :49:48.delivering on Labour manifesto promise. Labour would be only party
:49:48. > :49:54.to connect to an inpatient facility. We are delighted they have adopted
:49:54. > :50:00.the policy. It was something you haven't done. They've been in office
:50:00. > :50:04.for six years and we asked in 2012 whether Nicola Sturgeon would commit
:50:04. > :50:09.to an inpatient facility for sufferers of chronic pain in
:50:09. > :50:14.Scotland and she refused. It has been a long-running issue for
:50:14. > :50:19.campaigners, we are pleased we can see progress this year but we need
:50:19. > :50:24.to go on. We know what part of the solution is. We need an inpatient
:50:24. > :50:33.facility in Scotland to stop the trek to Bath for the sufferers.
:50:33. > :50:38.Scanlon, a former MSP colleague was watching this debate, I remember the
:50:38. > :50:44.debates in 2001 on chronic pain, is it a failure of devolution that
:50:44. > :50:48.nothing has been done in 14 years? have to be fair and say it is not
:50:48. > :50:54.true nothing has been done. Not enough has been done but I also have
:50:54. > :51:01.to say it is great credit to Dorothy, she is in the gallery but
:51:01. > :51:05.when she left in 2003 she made me solemnly promise I would share the
:51:05. > :51:09.group for the next eight years which I did. We did make some progress,
:51:09. > :51:18.there were various action plans and strategies and reviews and also we
:51:18. > :51:24.got a pain czar. There was never in patient and residential pain
:51:24. > :51:28.services throughout Scotland. We had today from Alex Neil, the pain
:51:28. > :51:32.services in Glasgow are wonderful, the pain services in Dundee are
:51:32. > :51:37.first class. But if you go back a few years, ten years, the only pain
:51:37. > :51:40.services in the Highlands where if you are terminally ill, that has
:51:40. > :51:44.improved, there have been improvements over the years but it's
:51:44. > :51:52.not enough. I welcome this consultation and we will be looking
:51:52. > :52:00.to make sure there is no postcode lottery in future. Fiona, the
:52:00. > :52:04.Scottish governmentpozz-macro health policy, is unravelling, Alex Neil
:52:04. > :52:10.defending NHS Lothian for fiddling waiting lists and he was defending
:52:10. > :52:18.the one in ten patients in accident-macro patients not treated
:52:18. > :52:24.in the target time, is he in charge or Hassey Pienaar dealt a ticking
:52:24. > :52:28.timebomb? -- Accident and Emergency. The Cabinet Secretary was clear,
:52:28. > :52:35.anybody that does not manage to get treatment within the waiting time,
:52:35. > :52:41.anyone who waits longer on a trolley, everyone as individual is a
:52:41. > :52:45.tragedy but overall we are hitting targets of 90% for almost all
:52:45. > :52:52.waiting times. Yes, there's more to be done but we have made a huge
:52:52. > :52:56.difference. Drew Smith, a huge difference from the SNP, Labour
:52:56. > :53:02.trying to pick holes in the SNP health policy that you may
:53:02. > :53:07.remember, the previous executive, long waiting times, the SNP have
:53:07. > :53:12.done a pretty good job when it comes to health. The difference in waiting
:53:12. > :53:17.times is a twig what the government says the target is and what is
:53:17. > :53:24.happening on the ground. The target is 98% being seen in 4-macro hours,
:53:24. > :53:32.that is a long time to sit in Accident and Emergency. The Scottish
:53:32. > :53:38.government change that and are still not meeting it. If you are one of
:53:38. > :53:46.those people, this is not picking holes in the Scottish policy, this
:53:46. > :53:52.is about my constituencies, hospitals experiencing huge weights,
:53:52. > :53:56.they should not be happening. Scanlon, the Health Secretary doing
:53:56. > :54:02.the best job he can, he is facing another budget cut for the
:54:02. > :54:05.Chancellor when it comes to the spending review. You always know the
:54:05. > :54:11.SNP are running into difficulties when they blame Westminster. They do
:54:11. > :54:16.have a budget here and they decide on the priorities and Alex Neil does
:54:16. > :54:19.not shirk from his responsibility. In terms of chronic pain, one major
:54:19. > :54:24.issue apart from pain is the isolation and for many that leads to
:54:24. > :54:28.depression. I was pleased to hear him talking about psychological
:54:28. > :54:35.services, in some areas you can wait two or three years to see a
:54:35. > :54:41.psychologist, the waiting times for psychological services will be 26
:54:41. > :54:44.weeks and that is not implemented until December 2014 so there's still
:54:44. > :54:50.a way to go in terms of psychological psychiatric services
:54:50. > :54:57.and support for people with depression, it is often caused by
:54:57. > :55:04.chronic pain. Briefly, the same-sex marriage legislation, sooner rather
:55:04. > :55:09.than later. Quick reaction. Well, it is fine, it is to be welcomed, I
:55:09. > :55:13.look forward to the debate. Personally I am undecided, we have a
:55:13. > :55:19.free vote in the party which is a range of views, the last time we
:55:19. > :55:26.were up the road and we had a vote on civil partnerships are at stake.
:55:26. > :55:30.Drew Smith, you must be pleased it coming in soon. I am really pleased.
:55:30. > :55:35.It's been a long process but personally the Scottish government
:55:35. > :55:39.have my support in bringing in equal marriage rights. That is where most
:55:39. > :55:44.people in the country are. It's reasonable particularly in light of
:55:44. > :55:49.the fact the vote in the House of Commons demonstrate the rest of the
:55:49. > :55:55.UK is getting ahead of us. We are pleased to see this coming on. It
:55:55. > :56:01.will be an advancement for equality. Fiona, I am sure you echo
:56:01. > :56:07.that. Might there be civil partnerships for mixed sex couples?
:56:07. > :56:14.My commitment is to equality and I am so pleased we have supported it
:56:14. > :56:21.and we will see it in Scotland so we are a more equal society. OK, thank
:56:21. > :56:31.you very much all three. Good to talk to. Finally, some thoughts from
:56:31. > :56:31.
:56:31. > :56:39.Campbell Gunn. A story today about Alex Salmond's vision for Scotland
:56:39. > :56:47.falls short of any meaningful concept of independence. They were
:56:47. > :56:50.cited as favourite economists. have always been mentioned but I
:56:50. > :56:55.think you would perhaps class them as more on the fundamentalist side
:56:55. > :57:03.of the independence argument and this is perhaps going back to the
:57:03. > :57:07.old fundamentalist difference within the SNP. Scottish Socialist Party
:57:07. > :57:14.would probably agree with them and people on the socialist side of the
:57:14. > :57:19.independence debate are less enthusiastic about an independent
:57:19. > :57:27.Scotland using the pound, keeping the Queen, being part of NATO and
:57:27. > :57:30.the U. I suppose the SNP would say we are being pragmatic, we are
:57:31. > :57:35.trying to entice people into the idea of independence so we have to
:57:35. > :57:42.keep things to things people are familiar with. Of course, the
:57:42. > :57:47.Salmond will try not to change too much after independence, he says,
:57:47. > :57:51.economic powers without losing the Queen and the pound. Softly softly
:57:51. > :57:57.into independence if Alex Salmond has his way. Not scaring the horses
:57:57. > :58:04.approach. Of course, there's wide range of views I suppose even within
:58:04. > :58:14.the SNP. There are some people who are not royalist, not keen on the
:58:14. > :58:16.
:58:16. > :58:21.EEA and not keen on NATO. But, for most of them in the Yes campaign,
:58:21. > :58:26.these things will be subsumed in the greater aim of getting independence
:58:26. > :58:32.for Scotland. And the wider arguments will continue. OK,
:58:32. > :58:39.Campbell Gunn, good to have you on the programme. Thank you for your
:58:39. > :58:45.contribution. So, that's all we have time for. We are back next week,