I start by commending Murdo Fraser for his sterling defence of SNP policy. It is clear that that alliance is alive and well. It certainly augurs well for their political future, although whether it does anything for Murdo remains to be seen.
Those of us who have been members since the early years of the Parliament will recall the numerous complaints that we received in our constituency postbags and at our surgeries about health-related problems. People were concerned about the length of time they had to wait for an appointment to see medical staff and about the quality of care and facilities. Those complaints justified the very real investment in the health service that the Labour-Liberal Democrat coalition Executive made to address those problems.
Was the investment justified? It was. Did it work? I think that it did. If members think of the inquiries that we receive from our constituents, I suspect that most of us would say—or would have said until recently—that there has been a significant fall in the number of health-related complaints. That is not so say that such complaints have been eliminated completely or that we will not receive individual complaints about things that cannot be justified, but the general picture is that the volume of such complaints has reduced. However, like many other MSPs, I am beginning to see a recurrence of complaints about waiting times, waiting lists and the level of service and other general concerns about the health service.
Murdo Fraser was right to say that we should measure outcomes and not look only at inputs. Ian McKee ably identified where progress can be made and has been made in the health service over many years. The problem is not that new techniques and methods of health service delivery are resulting in staff no longer being required; it is that advances mean that conditions can now be addressed that previously could not be addressed. Despite the progress that Ian McKee described, demand for our health service has not reduced. People now, rightly, have a higher expectation that the health service can meet their needs and demands. That is what we have to address.
We will always be faced with the perennial problem of whether we should have a bottomless health budget that allows any medical condition to be treated, irrespective of the cost. That is a philosophical and ethical debate and it will, no doubt, continue for many years. Yes, it is right for us to look at outcomes and not only at maintaining health service jobs, but the demands on the health service are sufficient to justify maintaining the number of medical staff at existing levels.
Anne McLaughlin said that it is wrong to spread unnecessary fear and alarm among staff about their jobs, but I think that she missed a fundamental point about the concerns of health service staff. By and large, health service staff are dedicated to the health service—they are dedicated to their patients and want the best for them. When health service staff express fear and concern, they are talking not only about their own jobs but about the impact that colleagues' job losses have on their ability to deliver the service that they believe they should deliver for patients. Staff are concerned. I am sure that Anne McLaughlin has heard the same comments from medical staff that I have heard. People are worried about their ability to do their job if the cuts impact in the way that is being suggested.
As Ross Finnie rightly said, the debate should not be about only budgets and figures. He said that there was barely a reference to patients in the motion but, understandably, any debate on the NHS is predicated on the amount of money that is available and the number of staff who are required to do the work of our health service.
However, Ross Finnie was right in saying that it is the human story that is important in a debate such as this. I will conclude by raising some of the complaints that I am now hearing in increasing number in my constituency work—and I have no doubt that the situation is replicated elsewhere. All the complaints that I will raise relate to podiatry services, which can at times be dismissed as not being vital but which are critical to the quality of life of many people in our communities, particular the elderly. The first case is that of an elderly
gentleman who had received chiropody treatment at the Royal Alexandria hospital in Paisley. Recently, he had need to contact the podiatry service again but, when he did so, he was told that he would have to wait at least six weeks for an appointment. After telling staff that the nature of his problem meant that he could not wait that length of time, he was told, "You will have to go private then." Is that the answer that we now want to give to elderly people if they can no longer get the service to which they had been accustomed—just go private? Ministers need to reflect on that.
I was contacted by another constituent with diabetes. We all know the significance of the problem that diabetes causes and will continue to cause in Scotland. My constituent used to have his toenails cut every three months, as his mobility was made difficult if the nails were left to curl. He has not had a home visit since October of last year. His carer has tried time and again to make an appointment for him, but she was told, "Well, you can just cut his nails." Are we trying to shift the responsibility on to carers?
The third and final example involves a woman whose mobility was restricted as the result of a broken ankle. She contacted the podiatry service in Paisley only to be told that no home visits were available and given no appointment for a later date. That is the human impact that the cuts are having even before we start to see the consequences of a loss in staff numbers. That is something that the Parliament needs to address.