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  1. 2.30pm: Health and social care integration debate

Live Reporting

By Ailsa Brown and Craig Hutchison

All times stated are UK

Good night

And that concludes our live coverage of the Scottish Parliament on Thursday 19 March 2015.

Remember you can watch videos of the week's business from Holyrood at

BBC Scotland's Democracy Live.

Holyrood at night

We'll be back on Tuesday 24 March, until then have a good weekend.

Decision time

After a consensual debate on the integration of health and social care, all the amendments and the amended motion are passed unanimously.

Ministerial close

The health secretary says there has been a doubling of intermediate care beds.

Ms Robison says there needs to be widespread involvement in the integration of health and social care.

Woman carer and man

As the minister draws the debate to a close, she says she will be happy to look again at concerns of the Neurological Alliance.

Ms Robson closes by saying palliative care is very, very important and the integration can provide a much more coherent service.

Delayed discharge plan

Health Secretary Shona Robison says the plan for tackling delayed discharge has already begun over the winter period, but going forward the plan will vary across the country depending on challenges and resources.

Health Secretary Shona Robison
Health Secretary Shona Robison

Ms Robison says it is important the plans are tailored to meet local needs.

The £100m funding for tackling delayed discharge, over the next three years, she says.

Care home staff

Ms Grant says we also must invest in our home care staff and make sure they are trained for the job they do.

Labour closing

Labour MSP Rhoda Grant says there needs to be a culture change in health boards and councils to end the buck passing that occurs at the moment.

Labour MSP Rhoda Grant
Labour MSP Rhoda Grant

Ms Grant says there is a requirement for more health professionals to help.


Mr Carlaw says in all health care there is a growing recognition that something substantial has to change as well.

The challenge of integration sits alongside all the other challenges facing the health service, says the Tory MSP.

Conservative closing

Conservative MSP Jackson Carlaw says: "I agree".

Conservative MSP Jackson Carlaw
Conservative MSP Jackson Carlaw

Mr Carlaw says if he left it at that it might not be helpful to the chair, but it has been a consensual debate.

Lib Dem closing

Lib Dem MSP Jim Hume says there has been a mainly consensual debate today and he welcomes the additional £200m for the integration of health and social care.

Scottish Liberal Democrat MSP Jim Hume
Scottish Liberal Democrat MSP Jim Hume

Mr Hume says there is a misbalance between bed-blocking and the reduction in geriatric beds.

BACKGROUND: Health and Social Care Integration Funding

  • The government is also integrating and enhancing improvement support, bringing together Healthcare Improvement Scotland, the Joint Improvement Team and the Quality and Efficiency Support Team, and providing an additional £2.5m to support improvement in the new integrated health and social care landscape.
  • At least £7.7bn of health and social care resource will be integrated across the country to maximise people's outcomes.
  • The government is providing £100m in 2015/16 to support innovative integrated practice in partnerships, under the Integrated Care Fund.
  • Ms Robison announced the extension of the Integrated Care Fund for two further years.
  • £100m per year will be provided in 2016/17 and 2017/18.
  • The £200m is part of more than half a billion pounds of additional funding that we are providing, over the next three years, to support integration.
Money and health

BACKGROUND: Integration Schemes

All around Scotland, chief officers are being appointed to lead the work of the new partnerships, and consultation is underway on their Integration Schemes - their partnership agreements - which must be submitted for approval by 1 April.

BACKGROUND: Ageing population

  • In 2013 more than 425,000 people aged over 75 were living with a long term condition.
  • By 2037 we expect the number to rise by 83% to 779,000.
Old people

Palliative care

Mr Hume says resources must be put in place so integration can include those who are at the end of their life requiring palliative care.

Also people should be assured of support when they return home after long hospital stays, says the Lib Dem MSP.

He says he remains concerned that funding for general medical services has been cut to a record low.

Geriatric beds

Mr Hume says bed-blocking is still a threat to the maintenance of high quality quality health care provision in hospital.

Nurse in ward

He says he regrets government cutting one third of geriatric beds since 2010.


Lib Dem MSP Jim Hume says clearly the success of good integration will lie with the detail from the very beginning.

It is essential patients and communities receive necessary capacity and support, says Mr Hume.

Lib Dems

In his amendment Scottish Liberal Democrat MSP Jim Hume says it is the view of the British Medical Association that successful integration of health and social care needs long-term planning of investment in building capacity in community and social care services.

Scottish Liberal Democrat Jim Hume
Scottish Liberal Democrat Jim Hume

Effective and meaningful engagement and involvement of primary and secondary care clinicians on integration joint boards and integration joint monitoring committees is needed he says, and medical leadership and influence at the locality level.

Mr Hume calls on the Scottish government to outline how it will achieve these key objectives.

'Enormous challenges'

The Conservative MSP says the third sector also has a key role in the successful integration of health and social care and could make a very valuable contribution to service planning.

Ms Milne accepts there is wide spread support for integration but still enormous challenges to be overcome to achieve it.

'Integration is vital'

Conservative MSP Nanette Milne says it is clear there is complete agreement across all sectors that integration is vital.

Conservative MSP Nanette Milne

Ms Milne, formerly a GP, says there is still a considerable way to go to achieve the necessary integration.

GPs must have leadership roles locally, she stresses, as they are pivotal at directing care for their patients.

Conservative amendment

In her amendment Conservative MSP Nanette Milne says she acknowledges the enormous challenge that integration represents, and calls on those involved at all levels to work to overcome obstacles, real or imagined, of previous practice or prejudice, to ensure the most successful outcome for both patients and staff.


Labour MSP Jenny Marra says her party will support the government's motion, but calls for more detail on how the health secretary intends to tackle delayed discharges.

Care workers and nurses

Ms Marra says unless we properly resource hardworking NHS work and care workers we will continue to see a log jam in the system.

Science Photo Library

She says care workers should be earing the living wage and there needs to be more nurses in the NHS.

'Critical step'

Ms Marra says the establishment of integration boards is a critical step.

The Labour MSP raises the issue of nervousness around budgets as the two sides come together and thrash out the figures.

She cites the BMA who says structural reform is not an end in itself.


Health and Social Care integration should form part of a shift to a more preventative focus, says Ms Marra.

'Biggest challenge'

Ms Marra says she agrees that this is one of the biggest challenges in our health service at the moment.

Labour MSP Jenny Marra

The Labour MSP says it is a complex and difficult challenge on a local level to get things right.

Against the backdrop of an ageing population getting a smooth patient flow through our system is absolutely essential, she says.


Labour's health spokesperson Jenny Marra is leading the debate for her party.

In her amendment Ms Marra says she welcomes the health secretary's pledge to 'eradicate delayed discharge out of the system' over the course of 2015".

Delayed Discharges

Ms Robison says tackling delayed discharge remains one of her highest priorities.

The health secretary says she wants to eradicate the problem.

Integrated care fund

Health Secretary Shona Robison the integration will bring together the very significant resources the government commits to health and social care.

Ms Robison says additional resources have been provided to support innovation - £100m for 2015/16 to support innovation and integration practice.

She highlights the extension of the integrated care fund for a further two years - that's £100m per year for two years.

'Work really begins'

The health secretary says it is once the integration schemes are signed of that the work really begins.

Strong joint working

Ms Robison says the idea of integration is not new, it will bring together budgets and provision.

The minister say all around Scotland lead officers will be appointed to lead the work.

Doctor and patient

This will require strong joint working between the health board and the council, she says.


Health Secretary Shona Robison says health and social care integration is a national programme reform with people at its heart.

The integration is now moving in to implementation and it will go live in the next few weeks, says the minister.

'Live full lives'

The health secretary says she used to be a home care organiser so the subject of health and social care integration is of particular importance to her.

Ms Robison says that health and social care that is well joined up can be key for people to help them live full lives with complex conditions.

Health Secretary Shona Robison
Health Secretary Shona Robison

As people live longer integration is about adding quality of life to more years of life, she says.

The minister says the integration is about brining compassion and dignity to people and their families towards the end of their lives.

Government motion

In her motion Health Secretary Shona Robison highlights the progress toward the implementation of the integration of health and social care, with new integration joint boards being established from 1 April 2015 in line with legislation.

Ms Robison welcomes the resources that are being invested to deliver integration, supports the agreement between COSLA and the Scottish government on the core suite of indicators for integration and highlights the commitment for NHS boards and local authorities to work together to deliver benefits for their patients and service users.

She says she believes that integration is vital to realising the 2020 vision for health and social care, and providing the best caring environments for the people of Scotland.

The debate begins

Health Secretary Shona Robison is leading the debate on health and social care integration.

Health and social care integration debate

Integration of health and social care is the

Scottish government's programme of reform to improve services for people who use health and social care services.

Nurse and doctor talking in corridor

The aim of integration is to ensure that health and social care provision across Scotland is joined-up and seamless, especially for people with long term conditions and disabilities, many of whom are older people.

All health boards and local authorities are required to submit their Integration Schemes for ministerial approval by April 1, 2015.

The new Health and Social Care Partnerships across Scotland will be up and running by April 1, 2016.

Welcome back

Welcome back to BBC Scotland's Democracy Live coverage of the Scottish Parliament on 19 March 2015.


The Scottish government will shortly lead a debate on

health and social care integration.


The minister draws the debate to a close and that's lunch.

BACKGROUND: Year of food and drink 2015

According to

EventScotland, the Year of Food and Drink 2015 is a chance to "spotlight, celebrate and promote Scotland's natural larder and quality produce to our people and our visitors".

The intention is to capitalise on the momentum created by the previous Year of Food and Drink and Homecoming Scotland 2014.


It is a Scottish government initiative being led by

EventScotland and

Whisky Month will be for whisky related events taking place 1 May - 31 May 2015.

The world's largest bottle of single malt Scotch whisky
Tony Marsh


The minister says Arran is a microcosm of what Scotland has to offer.


He says the islands must capitalise on the Year of Food and Drink 2015.

Minister closes

Islands Minister Derek Mackay says he has been holidaying in Arran for about the last ten years, although he is not allowed to have a favourite island.

Islands Minister Derek Mackay
Islands Minister Derek Mackay

Mr Mackay says the cold water islands potential must be released and he to praises the Taste of Arran.

'Huge potential'

Conservative MSP Annabel Goldie says there is a huge potential for cold water islands.

Conservative MSP Annabel Goldie
Conservative MSP Annabel Goldie

Ms Goldie says the islands make a valuable contribution to the tourism experience.