Malcolm comments on progress made in delivering Scotland's Health Service, and looks ahead
Debate on Making the Health Service localMalcolm Chisholm (Edinburgh North and Leith) (Lab): I warmly welcome the announcement from the Minister for Health and Community Care on the embedding and extension of keep well integrated, anticipatory care in local communities, which is already benefiting my constituents in Leith, Pilton and Granton.

The keep well initiative is a key new part of the NHS's action to close the gap between the richest and the poorest, which is at the heart of the Executive's health policy. It is one of many exciting developments in integrated local care, many of which are mentioned in the motion, including dramatic improvements in the management of long-term conditions. One example that I read this week is that the optimum control of cholesterol levels in the Lothians has increased from 20 per cent to 75 per cent over the past 10 years. Many other examples could be given, including the exciting development of partnerships with the voluntary sector that the Minister for Health and Community Care emphasised in his speech.

There have also been dramatic developments in the provision of local facilities. I am pleased that the minister mentioned the Leith community treatment centre, which I know he enjoys visiting. The centre has performed invaluable work for my constituents during the past three years. It has not just sorted my back; it has provided community-based teams and a community-based consultant, who offer regular appointments and community-based access to diagnostics. The centre is warmly appreciated by my constituents in Leith.

The emphasis on anticipatory care that underlies the keep well programme was a key recommendation of the David Kerr report, which set out a more general vision in which continuous integrated care in local settings would take over as far as possible from reactive, episodic care in acute settings. One of my most important actions as Minister for Health and Community Care was the appointment—indeed, the hand picking—of the members of the David Kerr group. The clinicians, managers and patient representatives who formed the group were committed to the delivery of the maximum possible amount of care in local settings. The group delivered the blueprint and "Delivering for Health", which followed, took the general approach that they had recommended. Members of the Parliament signed up to the David Kerr report.

I have been interested to learn that many people across the border have been taking a great interest in the David Kerr report. Two or three weeks ago, I saw an advertisement in the Health Service Journal for a conference in England—where there is much controversy about the reconfiguration of services—at which a session on learning lessons from Scotland was to be led by David Kerr and a senior official from the Health Department. It is unfortunate that Opposition parties in the Parliament have not always learned the lessons in the David Kerr report—that might not be obvious in this debate, but it was obvious in the most recent parliamentary debate on health.

A great deal remains to be done to make the NHS local. The motion mentions the role of community health partnerships. CHPs were a key development in the National Health Service Reform (Scotland) Act 2004, which was passed after the most recent election. They are delivery agents for shifting the balance of care further, as the motion emphasises, and we look forward to their further development in that regard. CHPs will also be agents for more local decision making. I was interested to read that during the past couple of weeks NHS Lothian shifted the management of more front-line services to CHPs. CHPs are at the cutting edge of approaches to decentralise care and deliver it more locally.

I hope that members and people further afield appreciate the strengths and achievements of the Scottish health system. Last week, I spoke to a senior clinician who has just moved up from England, who said, "You have a better system here. It is more integrated." Integration is the key word for the Scottish health service. We should appreciate the benefits of our system and, more important, we should appreciate the delivery that we have witnessed during the past few years. Tributes should go to the Minister for Health and Community Care, to the Health Department, to NHS boards throughout Scotland and, most important, to NHS staff throughout Scotland for their total focus on delivery, which brings spectacular results.
February 15th 2007, (Columns 30266-7)