The next item of business is a debate on motion S6M-16777, in the name of Neil Gray, on the adoption of innovation in health and social care.
15:22
In January, at the National Robotarium in Edinburgh, the First Minister set out our priorities for national health service recovery and renewal, which are to reduce the immediate pressures across the NHS; to shift the balance of care from hospital to the community; to take a long-term focus on prevention to tackle the root causes of ill health and disease; and—the subject of this debate—to use innovation, both digital and technological, to improve access to care.
We all know the tremendous pressures on our health and social care services in recent years. Those services face Covid-related backlogs and delayed discharges, and they are working hard to meet the increasing needs and demands of an ageing population.
The NHS requires reform to ensure that we can address changing needs and have a sustainable health service now and into the future. Later this month, the Scottish Government will publish an operational improvement plan, which will detail how we will deliver immediate improvement. That will be followed later in the spring by our population health framework, which will set out a long-term approach to primary prevention. Our medium-term approach to health and social care reform will then be published before the summer recess. Those three key documents will build on the health and social care vision that I set out to the Parliament last June and will demonstrate how we will plan services for our whole population over the short, medium and longer terms.
Adopting innovation will be central to delivery, and that is what this debate will focus on. We know that a scientific revolution is under way that has the power to transform healthcare. It offers genuine cause for optimism about the future. We are seeing rapid advances in the use of precision medicine, robotics and diagnostics and in the application of artificial intelligence to diagnose and treat disease, as well as to keep people healthier for longer.
Scotland’s life sciences and technology businesses, our universities and the NHS are driving that scientific revolution. A few weeks ago, Miles Briggs hosted Cancer Research UK at an event in the Parliament’s garden lobby. I had the privilege of speaking to a range of incredible cancer innovators who are partnered with phenomenal universities across Scotland. This is the embodiment of the triple helix that we want to thrive for the benefit of our people—industry, academia and the NHS working together. That night, Dr Iain Foulkes, the executive director of research and innovation at Cancer Research UK, described the potential for rivalling the golden triangle with our own platinum triangle in Scotland, such is the level of world-leading research, innovation and human talent that we have.
I saw that for myself on a recent visit to the Edinburgh BioQuarter. With funding from the Multiple Sclerosis Society, it is using robots to screen thousands of possible drug treatments to help researchers to prioritise those with the best chance of success in clinical trials. Such partnerships can also support economic growth through increased investment, business spin-outs and the creation of high-value jobs. When he closes the debate, Richard Lochhead will touch on our cutting-edge companies and the economic benefits in that space.
I agree with the cabinet secretary that we have a fantastic tech and innovation sector in Scotland, but we have always had that. The problem has been about taking that embryo of an idea or that small company and developing it and embedding it in the NHS. Even with the Digital Health and Care Innovation Centre, we have still struggled. How will we make sure that innovation is available to the healthcare service?
Brian Whittle has neatly pre-empted the paragraphs in my speech about how I want us to foster innovation to de-risk some of the investment decisions that are being taken, and how we can make sure that there is genuine partnership between industry, academia and the health service to ensure that what is being done is commercially viable and most applicable to our health and social care service. We want to get the economic benefit and, most importantly, the benefit for patients. I will speak about that in just a second.
To embed the work of the triple helix, we have established three regional innovation hubs. Together, they represent all 14 territorial NHS boards and provide support to those who want to test and develop new technologies in the NHS. The partnerships are already trialling the use of drones to deliver medications with a short shelf life and the use of artificial intelligence to improve chest X-ray screening, and they are working with CivTech to improve access to treatment for menopause.
However, we can no longer afford to have only islands of excellence in our health service; we must universalise the best service through the national adoption of proven innovations. That is why, in partnership with the NHS, we have established the accelerated national innovation adoption pathway. That brings together expertise from across our national health boards to identify proven innovations, produce robust business cases and, if those innovations are approved, support our territorial health boards to adopt them at pace across Scotland.
The pathway’s first programme was the creation of a national onboarding service for closed-loop systems. Closed-loop systems are an incredible asset for people living with type 1 diabetes. They not only improve sugar control and reduce the risk of long-term complications but remove a lot of the burden that people living with type 1 diabetes face on a day-to-day basis. Last year, we committed to supporting all children living with type 1 diabetes to access that technology and to increasing the provision for adults. We are on track to deliver closed-loop systems to more than 2,000 people in this financial year.
That was followed by our £1.8 million investment in the ANIA digital dermatology programme. Too many people in Scotland are waiting for a dermatology out-patient appointment. Launched in December, the pathway enables general practitioners to take photographs of a patient’s skin issues and securely attach those images to a dermatology referral. Evidence suggests that that will allow about half of those patients to be returned to their GP, with advice or reassurance, without the need for an in-person appointment with a consultant. Although some people will be fast tracked for testing based on assessment at digital triage, the programme will help to reduce waiting lists and to provide assurance to patients who are worried about their condition. For those with skin cancer, it will also reduce the time before they receive treatment and increase their chances of a positive outcome. The programme is already available to more than 400 general practices across six territorial health boards, and it will be rolled out across Scotland by the spring.
We must maintain momentum. That is why I am announcing today that the Scottish Government will commit a further £6.4 million to support the next two ANIA programmes. We will invest £4.5 million over three years to create a new national digital intensive weight management programme, which will significantly expand our weight management capacity and support 3,000 people who have recently been diagnosed with type 2 diabetes. We expect that more than a third of people will achieve remission at the end of their first year on the programme, with a majority benefiting from a clinically significant average weight loss of 10 per cent.
Reducing the number of people living with type 2 diabetes reduces pressure on the health service and has life-changing implications for those whom we can help to achieve and sustain remission. A diagnosis of type 2 diabetes at 40 lowers life expectancy by about 10 years. The first patients will be recruited on to the programme in January.
I am glad to hear about the work that is being done on diabetes and weight management in particular. What is the cabinet secretary’s position on the use of Ozempic for people who are overweight and have a body mass index of 40 or more?
We are still exploring such matters. As innovations come forward and improvements are made in weight management treatment, we must explore them, but we must do that in a clinically safe way.
We will also be supporting two pharmacogenetic programmes. Pharmacogenetics looks at how an individual’s genetic variation affects their response to specific drugs. About 30 per cent of people have a genetic variation that means that they do not respond to a drug that is commonly prescribed to patients who have recently suffered a stroke. The purpose of that drug is to reduce the risk of a secondary stroke, which can often be debilitating. NHS Tayside has developed a pathway to allow such patients to be tested and given the most effective treatment.
Over the next two years, we will invest £1.1 million to extend that innovation across Scotland. Once it has been fully adopted, it will impact about 20,000 patients per year, with an estimated 6,000 being moved to an alternative treatment, which will reduce pressure on our rehabilitation and social care services and the likelihood that those patients will suffer further harm. The programme will begin in October, and it will be rolled out to all territorial boards within 12 months.
We will also use genetic testing to improve care for our youngest citizens. About one in 500 babies are born with a genetic variation that could result in permanent hearing loss if they are treated with a common emergency antibiotic. Over the next two years, we will invest £800,000 to establish a pathway across Scotland that will use a point-of-care test to quickly identify whether critically ill babies have the genetic variation in question.
Once that programme has been fully adopted, more than 3,000 newborn babies a year will be tested, and those who require an alternative antibiotic will be provided with one. That will avoid such babies suffering unnecessary harm and will reduce the pressure on an NHS that will no longer need to provide them with additional care and support. The programme will begin in October and will be rolled out to all territorial boards within 18 months.
Patient safety is and will remain of paramount importance as we look to adopt new technologies in the NHS. I recently visited NHS Lothian to see its early implementation of the NHS Scotland scan for safety programme, which uses point-of-care scanning to provide rapid electronic traceability for implantable medical devices. Such scanning enables near instantaneous tracing of devices in the event of a safety concern.
If we are to take full advantage of the innovations that are emerging through ANIA and achieve the vision that was set out in the First Minister’s speech, we need to take swifter action in moving towards a digital first approach to reform.
We are already seeing the impact of that approach in the NHS. Exactly five years ago this week, we set out to the Parliament our plans to accelerate our Near Me service in support of remote video-based access to appointments. At that time, fewer than 20,000 appointments had been delivered remotely. Now, Near Me is embedded in nearly 2,000 services across more than 100 organisations and has been used for well over 2.5 million appointments.
I previously informed the Parliament of the First Minister’s commitment to launch an online app from December this year, starting with a cohort of people in NHS Lanarkshire. That will be the start of a five-year development of a digital front door to Scotland’s health and social care services. Health and care data will be presented digitally by connecting to a range of new and existing digital systems in primary, secondary and social care. That information will then be presented to the person who needs it in an accessible, understandable and inclusive way. Over time, the functionality of the app will be extended to include social care and community health. That is crucial to breaking down silos and delivering person-centred care. Full details of our plan to roll that out across the country will be finalised in the summer.
Now is the moment to grasp the transformational potential of scientific and technological innovation to improve our health and social care systems and the crucial services that they deliver for the people of Scotland. I am privileged to have opened this debate, and I welcome the contributions and thoughtfulness to come.
I move,
That the Parliament believes that there are significant health and economic benefits in supporting and adopting innovation in the health and social care service; recognises the urgent and critical need for health and social care recovery and renewal to meet the changing demands on the NHS whilst protecting its founding principles of remaining in the hands of the public and free at the point of need; agrees that reform can and must be accelerated by scientific and technological innovation and that rapid national adoption of research-proven innovations are essential to drive further improvements for patients, and welcomes partnership working between Scotland’s world class academic institutions, life sciences and technology businesses, the public sector and the NHS to improve health outcomes and support a thriving economy.
15:35
I remind members of my entry in the register of members’ interests: I am a practising NHS GP, which means that, every week, I see at first hand the consequences of the SNP’s failure to innovate in health and social care. I see patients left waiting, doctors stretched to breaking point, nurses and care staff battling with outdated systems and a healthcare system that is crying out for the very innovation that this Government claims to champion.
The Government talks about digital transformation, telehealth, artificial intelligence and electronic records, but, after 18 years of SNP rule, what do we actually have? We have a healthcare system that is running on outdated information technology, a Government that still cannot properly integrate patient records and an NHS Scotland app that was promised three years ago but that does not have even a supplier, let alone a launch date. Down south, 33 million people already use an app to book GP appointments, order prescriptions and track their health while, in Scotland, we are still waiting, still hoping and still being failed by an SNP Government that cannot bear to find solutions or to collaborate with the rest of the United Kingdom.
Instead, we are fed grand SNP announcements. For example, the now-abandoned national care service was supposed to be a flagship policy and a game changer in social care, but, after years of hype, what happened? It collapsed. The SNP promised transformation and delivered total failure. The only true innovation is to overpromise, underdeliver and then abandon ship when the mess gets too big to clean up, blaming someone else.
What about digital health? The SNP’s so-called digital health and care strategy was launched in 2018, but now, six years later, what do we have? We have chaos, a slow and inconsistent roll-out, health boards struggling, doctors and nurses trying to work with outdated systems that do not communicate with each other and patients waiting longer and longer because the SNP cannot deliver even the basics of modern healthcare. This Government has had 18 years to get its act together on digital health but instead has created a system in which even getting a GP appointment is a battle.
While patients are struggling, doctors and nurses are at breaking point. A recent British Medical Association survey found that 84 per cent of doctors believe that there are not enough staff to meet rising demand and that 86 per cent do not believe that the Government is committed to sustainable funding. It is no wonder—the SNP has overseen staff shortages, budget pressures and a growing funding crisis that has left NHS Scotland struggling to cope.
While the SNP fails to invest in real innovation, life-changing technologies are being left behind. Scotland was the first country to introduce AI in diabetes screening, back in 2011, but, in the past four years, AI adoption in our NHS has completely stagnated. Experts such as J D Blackwood from NHS Forth Valley have pleaded for stronger national leadership on AI, but what do we have instead? We have a health secretary who, until recently, was more interested in defending the chaos in his party leadership than in fixing our health service.
What about the SNP’s so-called digital front door, which the cabinet secretary spoke about? That was first promised in 2022 but has still not been delivered. The front door is still waiting for its hinges and for someone to hang it, although I am sure that the SNP would be able to find a way to cut the bottom of the door off.
Sandesh Gulhane mentioned James Blackwood and AI. I understand that he came here to give a presentation at a briefing organised by the Scottish Parliament information centre and is now engaging with NHS Dumfries and Galloway to look at rolling out some of the techniques and sharing his knowledge, so progress is being made. Would you not agree that the fact that he is now working with NHS Dumfries and Galloway shows that progress is being made?
Please always speak through the chair.
Wow. The member says that some progress is being made when, as I said, we were one of the first countries to use AI, back in 2011, but we do not have any strong national leadership on AI. Why is there work in one health board? Why are we not rolling out AI across all health boards? Progress has been painfully slow. Patients were told that they would have a new and streamlined way to access NHS services, yet, as of late 2024, no supplier has been selected to build that. By the time it finally arrives—if it ever does—it will be years behind schedule, while patients elsewhere in the UK have already moved on to the next stage of digital healthcare.
This Government is failing to invest in technology that could make a real difference. AI-powered diagnostics could revolutionise waiting times.
Sandesh Gulhane mentioned the app down in England. We do not have anything comparable up here. Is there any reason why we could not copy that app or even use the same one? Are there any technical reasons for that?
In my opinion, we need to be collaborating with the rest of the UK. Why on earth would we not do that, taking the best that it has and using it ourselves? We could even look to adapt it a little bit. However, this SNP Government is absolutely hellbent on doing things differently, as we have found time and time again to the NHS’s cost.
E-prescribing could transform how patients access medication, and fully integrated digital records could save lives. Just yesterday, I was at a pharmacy conference at which the Minister for Public Health and Women’s Health, Jenni Minto, told delegates that that was a top priority. However, she failed to mention that it should have been delivered decades ago and failed to give a delivery timetable. Under the SNP, those innovations remain far out of reach. Why? Because the SNP does not have the competence, the leadership or the vision to deliver them. While it wastes time and money on failed projects, the real cost is felt by patients.
A £1.5 billion black hole in the Scottish budget has led to delays of up to two years in crucial new facilities such as the eye hospital in Edinburgh and replacement hospitals for Fort William and Airdrie. The reality of administration under the SNP is cutbacks, delays and broken promises. The SNP loves to talk about innovation, but its legacy is a health service that is struggling under budget cuts, digital failures and a Government that is incapable of delivering the changes that it promises.
In his speech, the Cabinet Secretary for Health and Social Care forgot that this SNP Government has not created some basic IT platforms such as a platform that would allow hospitals, GPs and pharmacies to see the notes that we create. I welcome every piece of innovation that the cabinet secretary spoke of, but, in NHS Scotland, we too often hear companies telling us that, despite being approved by one health board, they have to go through the whole process again with every other board.
Will the member take an intervention?
Do I have time, Presiding Officer?
There is plenty of time in hand.
I will take the intervention.
I recognise the point that Sandesh Gulhane makes. When those who are innovating come forward with new ideas, medical devices or technologies, there is a need to make sure that we adopt them on a once-for-Scotland basis. Does he welcome the innovation around the ANIA programme, which is a pathway to make sure that innovation is rolled out across Scotland, rather than having to be approved 14 times by our 14 territorial boards?
I would welcome any programme that pushes good innovations and good pieces of technology that could be used by all of NHS Scotland.
The cabinet secretary mentioned a triple helix, but it is actually a quadruple helix that we need, because patients need to be involved. Patients need to trust that their data and what they are asked to be involved in will make a difference for them.
The Scottish Conservatives have a vision for, and a real commitment to, digital transformation. We understand what is needed and how to deliver it. The SNP record is clear—18 years of failure, broken promises and wasted opportunities. Innovation is not just about talking about the future; it is about delivering it. On that, the SNP has failed utterly, and Scotland deserves better. Our patients, our doctors and our nurses—in fact, our entire health and social care system—deserve better.
I move amendment S6M-16777.1, to insert at end:
“; acknowledges that much of the NHS’s existing IT infrastructure is outdated and suffers from interoperability issues, which harm productivity and create an additional burden on NHS staff; further acknowledges that a lack of modern, effective IT infrastructure has created challenges for GP practices and patients, including difficulties in easily booking appointments or ordering repeat prescriptions; believes that the introduction of an NHS Scotland app, a universal software architecture platform and a single shared digital patient records system to enable seamless transfer of medical information within and between NHS boards, local authorities and other care providers, would be transformational for all aspects of health and social care; understands the vast potential of artificial intelligence within health and social care to accelerate diagnosis, increase productivity and improve patient outcomes; recognises the significantly greater progress made in other parts of the UK and in European nations in developing and implementing these technologies, and considers it vital to the future of Scotland’s health and social care provision that adoption and innovation of new technologies within the sector is accelerated.”
15:43
I am pleased to open for the Labour Party in this debate. In an age of technological marvels—from artificial intelligence to identifying cancers earlier and advanced robotics that can turn what were once impossible surgical procedures into routine day cases—it is clear that innovation is vital for the national health service and for our wider population’s long-term health and prosperity. However, when we look across the past decade or so at innovation and who is truly leading the field, I am afraid that the Scottish Government, given its leadership of the national health service, can be considered something of a laggard by international standards. For example, we are told that we can expect the full roll-out of the NHS digital front door over the next five years, yet Estonia—a European country with less than a third of Scotland’s population—has already pioneered digital healthcare, embracing digitisation of its healthcare system as early as 2008.
We are told that the Government is building partnerships between itself and healthcare professionals, universities and technologists in a so-called triple helix of innovation, which the health secretary referred to, but, to an extent, that has always existed in this country. It seems that the Government is only announcing something that is already long established from when this country pioneered diagnostic ultrasound, back in the 1950s, for example. The test, truly, is how we are delivering improved at-scale patient outcomes and how we are achieving productivity enhancements across the healthcare system. There is huge unmet potential across the national health service.
On the point about how we are achieving that, does Paul Sweeney back Keir Starmer’s idea about scrapping NHS England, and does he think that we should do the same and scrap NHS Scotland?
As the member knows, the healthcare system in England—which has been a separate entity from the one in Scotland since its foundation, in 1948—is broadly modelled on a trust system. Scotland experimented with the trust model in the 1990s and moved to health boards in the early 2000s. Therefore, it is not a fair comparator. Scottish Labour’s policy is to rationalise the 14 current territorial boards into three, which would largely mirror the cancer pathways that are currently in existence. We feel that that is a more optimised scaling for the NHS in Scotland. With a population of 5 million or so, that seems like a more optimised balance. A direct comparator is not necessarily clear.
My point is about productivity across the system. We are not fully utilising the benefits that the national health service provides to Scotland and the UK—such as purchasing power and scaling ability—to drive improvements in patient outcomes. At present, the accelerated national innovation adoption pathway talks mostly to Scottish Government bodies and NHS boards. That seems like a very insular ecosystem. We are in danger of creating another echo chamber—one in which the same people with the same vested interests say the same things to the same Government bodies while the nation continues to drift ever further behind.
I agree with Paul Sweeney on that point. To follow on from the point that I made to the cabinet secretary, we had the DHI, which was supposed to be there to trial innovation, but the problem was in taking any successful trials and adopting them in the health service. That is the disconnect that we need to deal with.
There is an instinctive risk aversion about rapid prototyping and adoption, which the member rightly highlights. There could be greater achievements in that respect.
Mr Gulhane referenced the quadruple helix. He said that the key component—in addition to academia, Government and industry—is public and civic society buy-in. That was tested adequately, effectively and promisingly during the pandemic, during which we saw rapid introductions of NHS clinical interfaces that were readily accepted and adopted by the public. Who would have thought, mere months before the pandemic struck, that we would be engaging in such a national effort and unified purpose to improve national outcomes? I think back to the big public health initiatives such as the 1957 tuberculosis eradication campaign in Glasgow, during which the whole city got together to try to eradicate tuberculosis through mass X-ray campaigns. We could mobilise the population behind the agenda in a more effective way, and I encourage the health secretary to look at opportunities to do that.
To bridge the gap between what Brian Whittle mentioned in his intervention and what Paul Sweeney said in his response, I point to the Techscaler network, the NHS test bed programme and the integration of ANIA.
On the point about how we mobilise innovation to support the population, I encourage Paul Sweeney to look again at the digital dermatology programme, because that has the potential to accelerate productivity massively, as I set out in my speech, but also to improve patient care. I wonder whether the member has engaged with that yet. It is a clear example of the innovation that is going on in the health service.
It is perfectly fair that the health secretary highlighted those examples. The question is how quickly we can disseminate, integrate and rapidly roll those things out into operational improvements. That is where we could see significant improvement on a number of fronts.
One example in the NHS that is very promising but still tantalisingly underutilised is robot-assisted surgery. We have already achieved the breakthrough milestone of 10,000 robot-assisted procedures in Scotland, and, in the NHS Ayrshire and Arran health board area, more than 250 women have benefited from minimally invasive robotic surgery in the past year alone. That has transformed outcomes. They walk out the door within hours of the surgery, whereas previously it required convalescence for weeks.
That is testament to the skill of the NHS staff—the surgeons and clinicians—who are supporting those roll-outs and improvements. However, there is still underutilisation, because the bureaucratic inertia of the NHS means that it is not fully geared up to deal with such innovation and roll it out to its full potential. That is where the Government needs to push it further. Before we congratulate ourselves, we need to recognise that Scotland could be much better at that, and we should hold everyone to account for that improvement.
We need to look at international standards. It is not good enough just to meet the global standards of a decade ago and think that that is sufficient. That is why Labour’s amendment recognises that, for the past 18 years—nearly two decades—Scotland has been stuck following a technological innovation pathway rather than leading that pathway. Despite our world-leading research hospitals and universities, we often fail to turn research that is developed in Scotland into action. We must follow the lead of other nations and companies that are developed in other countries.
Even when we show promise, such as in the development of Touch Bionics, which was one of the first spin-outs of the NHS in 2002 and was sold off in 2016 to an Icelandic company, we do not build it into a unicorn—a major international technology company that could be headquartered and led from Scotland rather than from Iceland. We should do more to harness the Techscaler programme and make strategic investments that benefit the nation and its prosperity.
We are exasperated to hear NHS staff talk about computer update timescales in terms of decades, not years. Even basic things such as wi-fi and mobile signals in hospitals are so bad that modern smartphones cannot be used. The Scottish National Party came to power before the iPhone was invented, and it seems that, as far as the NHS goes, it has still not been invented. That is why staff in the NHS still rely on pagers—technology that has been scrapped, with the vendors keeping it in service purely because the NHS still needs it. The NHS would fall over otherwise. The default mode of communication is paper-based prescribing, and the goal of e-prescriptions is seemingly unachievable for a Government characterised by its satisfaction with analogue processes.
There needs to be much more improvement. We know that delays in the sharing of data between health providers are slowing down patients’ diagnoses. Those delays are also leading to duplication of work and are wasting NHS staff time and slowing patients’ treatment plans. The lack of an NHS app means that patients are often unaware of their own medical records. The lack of interconnectedness across the healthcare system in Scotland is not just hypothetical; it directly worsens the healthcare outcomes of many thousands of NHS patients and is acting as a drag on national productivity. We know that the equivalent of one in eight people in Scotland is on a waiting list for some sort of procedure. That is a huge national lag. The NHS workforce is equivalent to the population of one of Scotland’s biggest cities, Dundee. If that workforce is not efficiently harnessed, it affects national productivity. We already know about the pressures on our social security system as a result of chronic illness and that, if people are unable to access the workplace, it affects our national finances.
We could have a virtuous circle rather than a vicious cycle. The pandemic shows that, when Scotland is serious about its national mission to adapt and innovate in healthcare, it can bring everyone with it and mobilise the country to achieve public health objectives. Now is the time to show that Scotland—the birthplace of the enlightenment and the pioneer of so many technologies, such as diagnostic ultrasound, which has transformed the world—can, once again, lead the world in healthcare innovation.
I hope that Parliament will support the amendment in my name.
I move amendment S6M-16777.2, to insert at end:
“; regrets that the Scottish National Party administration has, after almost 18 years in office, allowed Scotland’s NHS to lag behind in adopting innovation, with end-to-end paperless and e-prescribing policies undelivered and dated medical diagnostics equipment still in use, and calls on the Scottish Government to move Scotland’s NHS and social care sector from analogue working to the digital age, starting by creating a shared care record system and empowering patients through an NHS app.”
I call Alex Cole-Hamilton to open on behalf of the Scottish Liberal Democrats. You have a generous four minutes, Mr Cole-Hamilton.
15:53
Forgive me, Presiding Officer. I missed the time that you said I had.
I said a generous four minutes. We have quite a bit of time in hand.
A generous four minutes. That is very kind of you. Thank you.
I am pleased to speak on behalf of the Scottish Liberal Democrats in this important debate. I am grateful to Neil Gray and the Scottish Government for making time for the debate this afternoon.
Scotland has always been a nation of medical pioneers. From the discovery of penicillin to the invention of the hypodermic syringe, we have a proud history of innovation that has saved millions upon millions of lives. Although we are rightly proud of our history, we must not lose focus on where we are heading. It is clear that we need action, investment and leadership to drive the next generation of medical breakthroughs and reform a national health service that has been operating in crisis mode for years.
Scotland’s medical technology sector is thriving, with more than 250 companies employing more than 9,000 people. It is growing at an impressive 8 per cent a year, against market conditions that we know all too well. However, while the industry moves forward, our NHS remains stuck in the past. It is slow to adapt and is being held back by outdated systems that do not speak to each other and a Government that is too risk averse to embrace change. We should be leading the way, but instead we are still lagging behind.
That has not been helped by the UK Government’s cancellation of £500 million in AI research funding. If we want to move forward, we need to back innovation—not cut it off at the knees. AI is not just an idea for the future; it is delivering results today. For example, in Mid and South Essex NHS Foundation Trust’s area, machine learning was used to cut did-not-attend rates and fill last-minute cancellation slots, thereby preventing nearly 600 wasted appointments in that small region of the country alone. Imagine what that could mean for the Scottish NHS: fewer missed appointments, shorter waiting lists, and more time spent giving patients the care that they deserve, in the time that they deserve to have it. We have already seen the potential. To give another example, the system developed through the GEMINI project—Grampian’s evaluation of Mia in an innovative national breast screening initiative—has boosted breast cancer detection rates by 10 per cent. Such technologies are already making a difference, and they are saving lives. We need to embrace them if we are to shift our NHS from being a reactive service that is constantly in crisis mode to a proactive one.
We also need to make NHS tech more robust across the board. Cyberattacks on our health service, particularly those carried out through ransomware, have cost the taxpayer tens of millions of pounds. A stronger, smarter electronic infrastructure would not only prevent such attacks but make the entire system more efficient and secure. I need not remind members that we live in an increasingly hostile world, where the online cyberlandscape is the new battlefield. New technologies present us with a real opportunity, and Liberal Democrats want to see us seizing that. To do so, we need real leadership.
Agreements such as those enabling the health and transformation partnership and the work of the accelerated national innovation adoption pathway are steps in the right direction. I am pleased that the Government is now considering that approach and taking it seriously.
I am also glad that, later this year, we will see the introduction of the NHS app, which we heard about earlier in the debate. Right now, our systems are outdated and rely on bits of paper. All members see that in our weekly surgeries. For example, I remember raising in the chamber the case of a woman who had been referred to the dental hospital with suspected mouth cancer. She presented me with a letter that had printed on it the date of its dictation, which was three months before the letter was typed up. We are still using technology from the 1970s. Those bits of paper are passed between patients and medical teams, getting lost on the way. Sometimes, for example, the use of a broken fax machine can mean patient care being delayed. That is right—a fax machine. The NHS must be the only arm of our public services that still uses those outdated and obsolete technologies. Patients and staff alike are fed up with the day-to-day friction that is caused by a startling lack of innovation. That is not the fault of our hard-working NHS practitioners or our care staff; it is just a constipation in the delivery of the technology.
Mr Cole-Hamilton makes an interesting point about NHS staff. My experience of interactions with NHS clinicians is that they have plenty of ideas for continuous improvement and making innovations in the system, but they are not listened to. Often there is no culture of organisational improvement in health boards, which is a real source of frustration, burnout and demoralisation. Does Mr Cole-Hamilton agree that that is often a factor in people in the system feeling burnt out?
As he typically does, Paul Sweeney makes a good point. He speaks to a frustration that exists right across the NHS, in every directorate and in every department. Innovation is not in short supply; there is lots of it in our health service. What we lack is the delivery and execution of such innovation. There seems to be a constipation, or a fear of delivery, which we need to break through. There is low-hanging fruit there, and relatively quick fixes can make a huge difference. Let us make use of the technology that exists and grasp the technology of tomorrow. Let us back our brightest minds, invest in cutting-edge research and embrace creative solutions to the problems that we face. The tools are there, and so is the talent. Now it is time for the political will and, more importantly, the delivery to match that will.
We move to the open debate. I advise members that, at this point, we have a fair bit of time in hand, so there is plenty of time for interventions and for colleagues to develop their arguments.
15:59
Although we have seen staggering innovation in the field of critical care in recent years, we need a real focus on earlier treatment. Central to that is early diagnosis. By detecting illnesses in their nascent stages, we can unlock a cascade of benefits.
Kevin Stewart makes an important point. We have been focusing in the debate on the technical and medical device innovation, but Kevin Stewart points to the pathway innovation. I pray in aid the example of the rapid cancer diagnostic services, which are diagnosing cancers earlier, saving people’s lives and giving people better outcomes.
I will follow on from that. Treatments are often more effective when administered early, leading to better outcomes and increased survival rates, with reduced long-term complications and improved quality of life for patients. Just as important as early detection is the fact that early diagnosis can lower healthcare costs by preventing expensive advanced treatments while reducing the burden on emergency services. Being more efficient allows the health service to do more with the same resources.
Innovations in diagnostics are coming thick and fast, and it is clear that AI will play an important role in the area.
For once I agree with everything that Kevin Stewart has said. He talks about different pathways and improved pathways. I am sure that he is aware that, in Aberdeen, the UCAN swift urological response and evaluation—SURE—unit is now delayed by 15 months because the NHS board wants to move where the unit will be. Will he join me in urging NHS Grampian to resolve the issue quickly, so that the unit can be set up as quickly as possible?
I urge NHS Grampian to move quickly and to stop mucking about on the issue. UCAN is another example of the use of new technology. The robots that are used for operations in UCAN are partly there because of lobbying that I did in the past to ensure that Government money went into those new technologies. I completely agree with Douglas Lumsden, and I say to NHS Grampian: get on with it.
Innovation must also be focused on the NHS of tomorrow, including the training of new healthcare workers. At the risk of being somewhat parochial and again bringing Aberdeen into the equation, I must acknowledge the great work that is being done at the centre for healthcare education research and innovation at the University of Aberdeen. CHERI is a research-based medical education centre that focuses on theory-driven research to inform new approaches to teaching and learning throughout the continuum of healthcare education. As such, it is a great example of how we can leverage the work of our universities that goes beyond simply new devices and gadgets.
I also want to talk about hospital at home, the acute clinical service that takes staff, equipment, technologies, medication and skills that are usually provided in hospitals and delivers that hospital care to people in their own homes. That is a real game changer for people and the NHS, allowing folk to receive the best medical care in their own home rather than in a hospital ward. As that trend expands globally and new developments allow more care to be carried out at home, we in Scotland are well placed to harness progress in the area thanks to the extra funding in the budget that will extend the hospital at home programme to 2,000 virtual beds.
Homes are important. We should not lose sight of the fact that a home is not just a roof over our heads but the foundation on which we build good health and social care. The reality is that many health and social care interventions are delivered in the home, but if that home is inadequate, unstable or non-existent, those interventions are compromised. That is why I am pleased that the budget includes not only an increase in the affordable housing supply budget, but increased funding for aspects of home improvement and adaptations, which is important.
We cannot be complacent in all this, and we must build on the hard-won gains that we have already seen. However, I suggest that we have a lot to be optimistic about—although, today, we have heard more of the pessimism than the optimism.
16:05
It is a privilege to contribute to the debate this afternoon on innovation in health and social care. The truth is that, in Scotland, we are at a critical juncture in how we are to deliver health and social care in the years ahead. We have a huge opportunity to transform our NHS and social care services through innovation, to ensure better outcomes for patients and alleviate the pressures on our dedicated healthcare professionals.
Innovation is not just a buzzword; it must be a commitment that is backed by action. I will add to what Mr Stewart and the cabinet secretary said, because I will throw social care into the mix and talk about the related social work sector. We know that our social workers are overstretched and overworked. There are many opportunities to utilise artificial intelligence systems to reduce their workloads, but our outdated systems do not have the capacity to ensure that we can capitalise on those developments. It is important that we broaden our spectrum away from and look beyond just medical innovation.
I thank Roz McCall for drawing attention to the importance of embracing innovation in the social care sector as well. At the start of my speech, I mentioned the work of the National Robotarium, where phenomenal businesses are exploring robotics and digital technologies that allow for more efficient, productive and supportive technologies in the social care environment. Is Roz McCall familiar with that work? If not, I will make sure that I point her in its direction.
I am aware of the National Robotarium, and I have visited it. It is fantastic. I cannot disagree with what the cabinet secretary says, and I thank him for his intervention.
In the past, the Scottish Government has repeatedly pledged to modernise healthcare through digital transformation and AI services, but the reality falls short of the promises that have been made. The SNP Government has been slow and inconsistent in rolling out its digital health and care strategy and, as we have already heard, Scotland has been left lagging behind. However, I note the points that the cabinet secretary made in his opening remarks. I hope that they come to fruition and are not just warm words, because Scottish patients deserve better. I also appreciate the comments that he has made regarding advancements in stroke treatment—as he knows, that is very important to me.
We also know that budget constraints and workforce shortages have further impeded progress, with 84 per cent of doctors reporting having insufficient staff to meet rising demands. Professor Mark Logan, the Scottish Government’s chief entrepreneurial adviser, stated that our health and care system is failing to innovate out of choice.
As has been mentioned by my colleague Dr Gulhane, J D Blackwood, an AI lead for NHS Forth Valley, has said that an absence of strong national leadership in artificial intelligence means that Scotland’s patients are not benefiting from the digital innovations that could transform their outcomes. He said:
“we must have committed leadership in government, the health sector, and social care.”
We cannot afford to stand still while other nations embrace the future of healthcare.
The Scottish Conservatives believe in harnessing innovation to create a truly modern and efficient healthcare system. We are proposing a 24-hour, seven-day-a-week digital health service by introducing the my NHS Scotland app. I know that it has been stated that it does not work, but more than 33 million people in England benefit from the system, and I know many for whom it works. Here in Scotland, the SNP has failed to deliver on the long-promised digital front door initiative. The my NHS Scotland app would allow patients to book appointments, check waiting times and access personal health records with ease. It seems an excellent way to embrace modern technology and, by dealing with everyday inquiries, benefit the patients of Scotland.
We would also invest in AI and data-driven healthcare, as AI has the potential to revolutionise diagnostics and treatment. I note the cabinet secretary’s comments on diabetes treatment advancements. Scotland was once a leader in AI-driven diabetes screening, but it has stalled and fallen behind in adopting further advancements. I welcome the comments, but time is of the essence.
We will bring forward a digital choice approach. Technology should be used to empower patients. We propose a permanent adoption of home healthcare technologies, including smart inhalers and remote monitoring, to reduce unnecessary hospital visits and improve the quality of life for those with chronic conditions.
The people of Scotland deserve a healthcare system that is modern, efficient and fit for purpose. We must take bold action to ensure that digital innovation is at the heart of our NHS, and the Scottish Conservatives are committed to delivering practical, patient-focused solutions to achieve that goal.
The time for excuses and warm words is at an end. It is time for action, now.
16:10
Today’s debate is timely, as this evening I am sponsoring an event on behalf of the Scottish Council for Voluntary Organisations and the Digital Health and Care Innovation Centre on the Digital Lifelines Scotland project. Digital Lifelines is a cross-sector initiative that seeks to improve digital inclusion and to design digital solutions that better meet people’s needs, improve health outcomes for people who use drugs and reduce the risk of harm and death. To date, the project has supported around 4,500 people who are at risk of drug harm to be digitally included, enabling access to services such as digital harm reduction information and overdose detection apps. It is a fantastic example of the powerful manner in which digital inclusion and digital services can be enabled to support individuals whose health is at risk of harm, and of the positive change that such projects can facilitate not only for individuals but for services as a whole.
I am also delighted to have the opportunity to highlight the excellent work that is under way in my Rutherglen constituency at Blantyre LIFE, which is a multimillion-pound development that was supported by Scottish Government funding. The facilities on the campus include a 20-bed intermediate transitional care unit and 20 technology-enabled homes, all equipped with state-of-the-art telecare systems that are designed to support independent living. It is a fantastic example of how digital technology can be used to provide increasingly sophisticated health and social care and help to manage system pressures while improving experiences and outcomes and helping to reduce inequalities.
Some tech solutions can be the smart consumer devices that are found in many homes, such as voice-activated lights and gadgets, smart speakers, tablets and video doorbells. Others can be more specialised, including remote alert and fall-detection systems or sensors and pressure pads that enable a prompt response from carers if required. The Near Me video consulting services and Connect Me remote health monitoring services enable people to monitor and manage their own healthcare and be well connected with their healthcare professionals. Taken together, those digital solutions can be game changers in empowering people to live independent lives for longer in the heart of their own community, interacting with health and social care services when needed, while avoiding unnecessarily prolonged hospital stays.
Blantyre LIFE also has a technology-enabled care—TEC—zone, a demonstration area that was designed and built as a first-of-its-kind partnership with the Glasgow Science Centre. Visitors to the TEC zone can test out technology and chat to a specialist team to learn about solutions to support themselves and their loved ones at home. The zone also facilitates regular technology-enabled care training sessions for staff, both online and in person. In a taste of things to come, the campus worked in partnership with the National Robotarium to welcome ARI, an early social robot prototype that aims to assist with post-injury recovery. That is cutting-edge technology, right at the heart of my community.
Last month, Blantyre LIFE celebrated supporting 200 people through re-enablement in its first year of operation. It has established a strong reputation for its pioneering work, welcoming several fact-finding missions from overseas as well as from across Scotland and the rest of the UK to see how technology is being used to make day-to-day living easier and safer.
Key components of Blantyre LIFE’s on-going work are the way in which it delivers services and the dedicated staff who work there. Blantyre LIFE has embraced the use of technology in its own facilities, and it has shared its learning and championed technology use with other providers and wider communities.
In a similar way, a crucial arm of the Digital Lifelines Scotland project is dedicated to upskilling staff and volunteers and providing support and funding to other organisations to develop digital tools and support.
All of that is key to our ultimate shared goal of enabling and empowering people to live more independent, longer and healthier lives.
I remind members of my entry in the register of members’ interests. I hold a bank nurse contract with NHS Greater Glasgow and Clyde.
16:15
I am glad to hear from the cabinet secretary about the improvements and investments in technology that are being made. The member who spoke before me gave excellent examples of how technology can be used. There are, indeed, great examples, and we welcome how technology is being used, but the point is that we need to embed that in what we do in the NHS across Scotland.
It is fair to say that, having been in government for 18 years, the SNP has had ample opportunity to keep pace with innovation and bring forward the technological changes that our NHS has needed for many years and that it desperately needs now. That is possibly the part that was missing from the cabinet secretary’s excellent speech—the recognition that we have not kept pace.
This Government debate on recognising the significant health and economic benefits of supporting and adopting innovation in our NHS is welcome. It can be seen from the Labour amendment that we support the Government in enabling that. However, on the ground, the motion must feel as though it is only warm words, because the issue is action and the implementation of the fantastic things that have been spoken about.
As we know, thousands of patients are stuck on NHS waiting lists and are waiting for tests and to be diagnosed. We need to do all that we can to embrace innovation and explore the potential of new technology not only to speed up treatment but to make best use of the accuracy in diagnosis and offer the best treatment plans.
The reality is that our NHS is stuck in what can be described only as an analogue age. We need to address the day-to-day technological challenges that are faced. We have magnetic resonance imaging and CT scanners that are decades old and theatres that lie empty due to poor scheduling. Technology could help with that. As we have heard, it is common for doctors and nurses to use pagers, despite there being much more efficient ways of communicating.
No one disputes that our NHS needs urgent action—the cabinet secretary himself is saying that. We need to keep pace with the technologies, but, at times, it is hard to imagine how we can get to that point. The basics, such as data gathering, are a challenge across the NHS. Scotland has a population of around 5.5 million, yet its 14 health boards collect data in different ways and the systems cannot speak to each other. The use of different IT systems creates administrative burdens, while issues in accessing patient records create major barriers to effective care.
The member makes an incredibly important point about the collection of data. Scotland’s healthcare service has phenomenal data-gathering capability, but it does not have the ability to scrutinise and utilise that data. Does the member agree that having different platforms that do not speak to each other is the problem?
I welcome the member’s intervention. That absolutely is the case. Practitioners on the ground, no matter what their profession, tell us every day that data systems being able to speak to each other would make a such a difference to patient experience and patient outcomes.
There has to be an ambition to upgrade NHS systems and equipment. That can be done only if there is leadership from the Government. I hope that the Government welcomes the Labour amendment’s call for
“a shared care record system and empowering patients through an NHS app.”
Does Carol Mochan recognise that quite a lot of work has already been done in the NHS to get systems to speak to each other? There is the EMIS system, whereby various clinicians can access each other’s records; there are the social work systems, which now allow healthcare staff to access those records; there is also the hospital electronic prescribing and medicines administration—HEPMA—system, which allows people throughout the hospital to see what a patient has been prescribed.
The member makes my point: we can talk about systems and examples in bits and pieces, but the reality is that, at this time, we should be much further advanced. That would make an incredible difference to our practitioners. I know that the member is a practitioner, so she will hear that at times when she works within the NHS. All the staff speak to me about that.
I know that I need to conclude. We support the Government in making the changes. The opportunities are endless. However, if we want to keep up with the rest of the UK and the world, we must be honest about where we are so that we can move forward and support our staff and our patients in realising this opportunity.
16:21
I am grateful for the opportunity to speak in the debate and to highlight some fantastic innovations in health and social care, particularly in Dundee. Blackwood Homes and Care operates more than 1,700 homes across 28 local authorities and is renowned for its innovative approach to accessible housing. Colleagues across the chamber will be familiar with Blackwood’s groundbreaking work, which is revolutionising the way in which technology and data are integrated into independent living solutions, offering transformative benefits for individuals.
I thank Joe FitzPatrick for drawing attention to Blackwood Homes and Care, which I visited in Edinburgh a couple of months ago. As he has set out in relation to its work in Dundee, Blackwood’s work to integrate data and digital technology for the benefit of its service users is remarkable. A testament such as that, as was requested by Roz McCall, indicates that this is an area that we absolutely must continue to support.
I was just about to mention the cabinet secretary’s visit, which I know was really appreciated by Blackwood. I had the privilege of visiting 66 new homes in Charleston, in my constituency. That £17.5 million housing project uses state-of-the-art technology and design features to help people to live as independently as possible.
Members might not be aware that Margaret Blackwood was a Dundonian. A remarkable campaigner for the rights of disabled people, she spearheaded the march on wheels protest along Princes Street in Edinburgh and addressed a rally in Trafalgar Square where she publicly demanded equality and recognition for disabled people’s rights. The first Blackwood home opened in Dundee in 1976, marking the beginning of a transformation in accessible housing in Scotland. I believe that Blackwood still leads the way in that innovation. The Blackwood standard is something that all housing associations should aspire to.
Shona Robison and I visited the stroke and thrombectomy team at Ninewells hospital a couple of years ago, with the Stroke Association. We saw at first hand how AI technology enables that extraordinary thrombectomy treatment. We also saw how the innovative use of workforce can be employed in its delivery.
For the record, a thrombectomy is the mechanical removal of a clot of blood from the blood vessel connecting to the brain. The Stroke Association has told me that 153 people in Scotland had a thrombectomy in 2023, which is just one in seven of those eligible. It is clear that thrombectomy needs to be normalised in Scotland’s stroke pathway, and innovation is critical to its delivery. It is great that the national procurement process for the development of an AI tool for assisting stroke clinicians to perform thrombectomies has begun.
I take this opportunity to highlight the work of Professor Iris Grunwald, who won Innovate UK’s women in innovation award in 2023. Professor Grunwald’s achievements include developing the first AI solution for image interpretation in acute stroke and bringing the first mobile stroke unit ambulance to the UK.
I want to take a moment to talk about something that is very personal to me. In October 2022, my father had a very serious stroke. I take the opportunity to thank Professor Grunwald and her team—personally and on behalf of my family—for saving not only my dad’s life but his quality of life. My dad celebrated his 89th birthday last month and is loving life. [Applause.] I hope that the minister is able to say something in her closing speech about the on-going work to ensure that more people who have a stroke can have the positive outcome that my dad experienced.
The final issue that I want to touch on is the huge potential of robotics to improve many aspects of health and social care provision in Scotland. Robotics can be central to transformative technology and the establishment of practical ways to bring technology into our hospitals, care homes and care at home. The expansion of NHS Tayside’s robotic surgical service, which is being used in a range of disciplines, is benefiting patients in Dundee and across our region.
I highlight the work of the National Robotarium at Heriot-Watt University, which is the UK’s centre for robotics and artificial intelligence and is in my colleague Gordon MacDonald’s constituency. I am pleased that the cabinet secretary and other members have already mentioned that.
It is clear that there are significant health and economic benefits to the innovations that I, and colleagues from across the chamber, have set out. Crucially, those innovations are having an enormous positive impact on the lives of the people of Dundee and those across Scotland. To continue to realise the benefits of innovation, we must continue to invest in our hugely talented research institutions, in social care and, ultimately, in the future of our healthcare system.
16:26
Often, before I write my speeches, I like to have a discussion with people around me just to see what they think about the topic. I am very lucky to have a friend who works in research, development and innovation in the NHS: it has been helpful to get some links from her.
Overall, there was a perception among people whom I spoke to that healthcare innovation is a bit of a luxury item, that it is way off in the future and that they would only ever see it in the likes of “Star Trek”. However, the opposite is true, and many great advances in healthcare technology are happening in Scotland right now.
Take the NHS Grampian’s GEMINI—Grampian’s evaluation of Mia in an innovative national breast screening initiative—project, which is a perfect example of such an advance. It was developed with the University of Aberdeen and Cairn Technology. It is changing how we detect breast cancer by using artificial intelligence to improve screening accuracy. Its AI tool—Mia—has helped radiologists to detect 10.4 per cent more cancers than standard screenings, while reducing their workload by 36 per cent. That is not some futuristic idea—it is a real working example of how technology is improving patient outcomes today and reducing the burden on our NHS workforce, thereby freeing it up to focus more on patient care. It is exactly the kind of technology that ensures efficiency without compromising on quality by allowing healthcare professionals to dedicate more time to patients than to processes.
The accelerated national innovation adoption pathway is making sure that, when research-backed advancements emerge, they do not get stuck in trials for years, but are adopted by our NHS fast. That is making healthcare safer, faster and more effective overall.
Although such advances are transforming many areas of healthcare, we also have to ask who is benefiting from them most. If innovation is to work for everyone, we need to make sure that it is reaching those who have historically been unserved—for example, in women’s healthcare.
A few nights ago, I chaired the cross-party group on heart and circulatory diseases, and we focused on women’s health. Let us be honest: we all already know the problem, and we do not need more reports telling us that women are more likely to be misdiagnosed when they have had a heart attack, or that menopause and menstrual health are still not treated as the serious medical issues they are.
This is personal for me. My mother died of heart disease when she was only 49 years old. That was 25 years ago, but women are still saying that they do not feel that they are listened to when it comes to their health. Perhaps this is where empowering patients with innovative systems to monitor and track their own health can help—not just in helping with physical health but by ensuring that women feel that they are being heard.
On women’s health, cervical cancer representatives came to speak with us today about how women are not able to get their cervical cancer surgery on time.
It was ovarian cancer.
I apologise—we spoke to people from Target Ovarian Cancer.
We have also had people come to talk to us about how women are struggling to get their mastectomy operations done. When it comes to women’s health, especially in the AI and technology fields, how can we ensure that women get the same level of treatment as men?
I will come on to that later in my speech. That is why I chose this specific topic. I will get to it after a couple more paragraphs.
Technology can now track menstrual cycles, which is flagging early signs of conditions such as endometriosis and polycystic ovary syndrome. We are already spotting heart disease and cancer earlier than we were previously. Remote monitoring services, such as the connect me programme, allow women to track their blood pressure and symptoms from home, thereby cutting down on unnecessary appointments and ensuring that intervention happens sooner, not later.
This is where I come on to the solution that I spoke about. Technology alone will not solve everything; rather, it has to be embedded in a system that actively includes women in its design. Women’s symptoms do not always fit the textbook definitions for common conditions, which has real-world consequences, from delayed diagnosis to treatments that do not fully meet women’s needs. We must ensure that innovation is developed with women in mind from the start—they must not be an afterthought. That means increasing their representation in clinical trials, ensuring that female-specific conditions receive the attention that they deserve and integrating women-focused research into every stage of healthcare innovation.
Let us not forget the economic case. Investment in innovation is not just about better health outcomes. It is also about future proofing the NHS workforce by reducing the strain on hospitals and freeing up staff to focus on complex cases. Innovation helps to make our healthcare system more sustainable overall.
Scotland is already advancing rapidly in health innovation. Now, while pushing forward, we must ensure that advancements reach the people who need them most. If I have a specific ask, it is that women benefit from being included from the very start, because when we design healthcare solutions for everyone, we will build a healthier and stronger Scotland for all.
16:32
It has been a really interesting and insightful debate. There has been a degree of unity across the Parliament this afternoon on the opportunity for Scotland to harness its great strengths in healthcare—not just to advance our country’s performance, but to make a global contribution to the condition of mankind. As a country, we can all aspire to achievement of that.
We have already achieved so much, but we could do so much more by harnessing the unique opportunity that the national health service gives us—internationally, it is a unique model—to rapidly achieve triple-helix effectiveness. Other countries have done so in the past, and we could learn from what other countries are achieving, particularly in creating national champions who can drive forward rapid advancement in healthcare technology.
Just last year, I was walking through Liverpool and saw the statue of Brian Epstein, the fifth Beatle, and I thought about what that represented. The Beatles were a great cultural achievement for the UK, but inadvertently, they gave birth to one of the greatest healthcare inventions of all time. What links the Beatles to the computed tomography scanner is EMI, which ran not only the EMI Records label but a massive medical technology research company as part of the industry that it developed.
Working in concert with the NHS through the 1970s, Godfrey Hounsfield, who ran EMI’s laboratories, used proceeds from the Beatles’ record sales, along with a Department of Health and Social Security grant, to develop what was then known as the EMI scanner. He went on to win a Nobel prize. Not many people realise that the Beatles are indirectly responsible for his winning a Nobel prize for a global medical innovation that has saved millions of lives.
The development of CT scanners for the world is a great medical achievement, but the catch is that, despite Britain and Scotland having such great technologies, inventors, universities and creative outpourings—often because working-class people have been able to access education and improvement in a way that has not been achieved in other countries—we seem not to have a knack for turning them into industrial benefit for our society and our country. To return to my point about EMI, I note that that company has since been broken up. It is now owned by American and German companies, and most of the CT scanners in the world are made by American and German companies, so Britain does not benefit from that technology.
Similarly, diagnostic ultrasound was developed in Glasgow. In 2014, I was at a dinner to celebrate the inductees to the Scottish Engineering hall of fame. The late Tom Brown was being inducted. He had been working in Glasgow for Kelvin and Hughes Ltd, mainly in industrial radiography, and had teamed up with colleagues who were clinicians to develop the first diagnostic ultrasound machine. In his acceptance speech, he made the point that, although
“It wasn’t an easy birth, nor one that was recognised at the time for the impact it would have on diagnostic medicine in general, and mothers and babies in particular ... it was the ‘little acorn’ out of which would grow the great oak”
of that global advancement. However, he said,
“it was the engineers who made it happen”,
and
“As usual the medics tried to claim more credit than their due share”
for the invention, and that,
“through our seeming national incompetence at exploiting our own inventions, we lost out to the Americans and”
Japanese,
“and ultrasound machines are now only made abroad and imported back”
into Scotland.
We see that happening with Optos, which was another fantastic innovation company, based in Dunfermline, that was sold to Nikon in 2015. Douglas Anderson—who started that amazing company, which produced ultra-wide-field retinal imaging systems—made a great invention, but why could we not scale it in Scotland? As many members mentioned in their speeches, we have a real problem with taking companies that have fantastic potential, and keeping them anchored and owned in Scotland, and achieving benefits in concert with the national health service. I earlier mentioned Touch Bionics, which was a spin-out from the NHS that was sold to an Icelandic company in 2016.
Many members have touched on the opportunities to harness technology across our national healthcare system, and not just in hospitals. On the critical point that time is the currency of healthcare, Mr FitzPatrick told a touching story about his father’s experience of having a stroke. I have heard from constituents about similar situations, in which not getting people to hospital in time and not getting rapid emergency treatment has often led to lifelong disabilities when conditions were not dealt with quickly.
Time is of the essence: ultimately, that is what we are talking about when it comes to technology. Equipping our clinicians—the people on the front line of our NHS—to act more rapidly, more accurately and more effectively to treat our population will, I hope, get better outcomes for everyone and add to our national prosperity.
That carries over from acute hospitals into the home setting. Hospital at home has been mentioned, as have housing associations. We need to ensure that such adaptations are carried through to the primary care system.
Many GPs say that they are overwhelmed. They would love to harness new technologies and to work with their community links workers. They would love to have a sophisticated interface for their patients, but they have queues out the door and are dealing with clinics every day—there is no head space to implement innovations. The cabinet secretary needs to think about how he can support our primary care practitioners to develop and deploy technologies that are industry standards elsewhere in the world. We have heard about other parts of the UK where use of those technologies can be achieved.
As I always do, I am enjoying Paul Sweeney’s speech. Do we need to build confidence among our patient base, particularly in primary care, about use of technology? Would that be an advantage for the practitioners, as well?
I will give you another minute, Mr Sweeney.
Thank you, Deputy Presiding Officer.
The point that Dr Gulhane made earlier about the quadruple helix and the idea of buy-in from the population is critical to achieving those outcomes. The population is up for it. During the pandemic, there was a lot of doubt about whether the population would go for lockdowns or participate in mass vaccination programmes. In fact, there were huge levels of co-operation. When people see the public health benefits of such initiatives, there is wide buy-in: we could do a lot more to encourage people to buy in.
People do not want to be advised, “Unless you think that you’re literally going to die, do not come to A and E—go and see your GP.” We need a more sophisticated way of dealing with people who present at the NHS. Often, people are not getting the right access at the right time and, as members have mentioned, that means that they have worse outcomes.
I also think that we need to look at productivity, which is at the heart of it all. There is a huge opportunity for primary research, but if we are to incorporate that in the system of improvement in the NHS, we need to empower staff to deliver advancements on the ground. That is why our amendment encourages the Government to do more.
I call Brian Whittle to close for the Scottish Conservatives. We have a bit of time in hand.
16:40
It is with an unusual degree of enthusiasm, excitement and hope that I close this debate on behalf of the Scottish Conservatives. I should note at the outset that we will support the Government motion and, indeed, the Labour amendment.
The potential exists for the debate to have a really positive outcome and to move things forward in a positive way. Debates about health and social care seem to be dominated by waiting times, missed Scottish Government targets, shortages of consultants, nurses and midwives, and record investment or the lack thereof. In the political maelstrom of blaming one another, we seldom seem to get the opportunity to take a step back and offer sustainable and effective solutions. In other words, we do not seem to get the space to work the problem.
This debate has, in the main, given us that opportunity. I am very grateful to the cabinet secretary for using Government debating time to address innovation and technology in the health and social care service and for his pragmatic approach to the motion, none of which we disagree with. I am not sure that such collaboration will take off, but I think that it is the way forward.
We have heard a great deal about innovation. As I listened to Kevin Stewart extolling the virtues of the innovative technology that comes from his constituency, I could not help noticing that Joe FitzPatrick was sitting behind him. It was inevitable that Mr FitzPatrick would speak in the debate, because Dundee has always been a great hub for such innovation.
Key to this debate is the issue of how we ensure not only that early-stage innovation is tested properly but that it is adapted and adopted timeously, rather than—as Paul Sweeney mentioned—being snapped up and developed by foreign agencies, with the result that we do not benefit from it.
Roz McCall mentioned Mr Blackwood’s comment that the lack of strong national leadership was one of the problems. I hope that this afternoon’s debate signals a change in that respect. Today, the Parliament has an opportunity to instruct the Scottish Government to move more quickly on that element.
Mr Sweeney mentioned Covid. One of the things that came out of the pandemic was an ability to rapidly adopt technology when we absolutely need it. Somehow or other, that seems to have fallen away.
In my view, the problem that we are trying to solve here is one of time. Our healthcare professionals do not have the time to deliver the healthcare that they are trained to provide and which they are passionate about. That only leads to frustration and pressure on our healthcare professionals, which, in turn, can affect our ability to retain staff.
Brian Whittle makes an important point about time. One thing that surgeons have told us is that national treatment centres might not be the panacea. The issue is not necessarily the facilities; it is more to do with their efficient utilisation. When it comes to how we treat operating theatres, perhaps we should think about Formula 1 pit stops. Maybe we should specialise theatres so that they can roll patients through. That would involve their doing only one procedure, being highly tuned in and effectively utilising the assets that we already have. That is the core of the issue, and we need to look at that more—[Interruption.]
I heard the cabinet secretary muttering, “That is coming.”
When it comes to how we adopt technology, the issue is how effective that model can be. We need to create more time for healthcare professionals to spend on delivering healthcare. For that to happen, they need to spend less time dealing with administration and red tape. With basic AI, we could rationalise the back-office functions of the 14 health boards in one centre. That might be a bit contentious, but it is definitely something that we need to do.
We are not talking here about saving money in the health service; we are talking about being able to redeploy money much more effectively. Imagine if the cabinet secretary had that money and the ability to use it in pay negotiations with our health professionals, and picture how much easier his job would be.
What if we could speed up scanning and screening or even evaluate patient need before those tests are required? I seem to come across potential advances in technology every day that would do just that. Last Tuesday, my friend and colleague Alexander Stewart hosted an event for brain tumour awareness month at which a technology company presented its development of a blood test that takes just 15 minutes to get a response, which can, in turn, help practitioners to decide whether an MRI scan is needed. That is against the current situation, in which everyone eventually has to be sent for a costly MRI. It would save time and money, not to mention giving the patient peace of mind or, at least, an earlier diagnosis.
There are literally hundreds of innovations with the potential to deliver effective and time-saving solutions, many of them invented and developed in Scotland’s academic institutions or in our life science and technology businesses.
The problem always comes from the ability to adopt and integrate that technology, much of which is bought and taken for development overseas in the early stages. If Alexander Graham Bell had gone to NHS Scotland procurement with a view to introducing the telephone we would still be waiting on the results of the consultation to decide whether we should buy a second handset.
The reality is that we need a basic architecture that allows primary and secondary care, pharmacies, social care and the third sector to integrate and collaborate nationally.
Will the member take an intervention?
If I have time, I will happily take another intervention.
I thank the member for indulging me in a second intervention. He makes an interesting point about silos and about harnessing the technology that Scotland is good at. For example, we have one of the biggest fintech clusters in the world. We know how advanced financial services applications are and how easy it is to access banking services by phone, but there is no such development in the healthcare system. Could we tap into some of the existing centres of excellence that the member mentioned? There is work in Dundee on the gamification of technology as well as on fintech. Could we look at more and deeper collaboration on that?
I thank the member for the intervention because I was just about to mention him. He brought up the subject of Estonia, which is the gold standard in this area because the Estonians started from scratch and had to build their technology from the base up.
Will the member accept an intervention?
If I have time. This is a good debate.
I will be brief. Does Brian Whittle realise that, by quoting developments in Estonia, he has just made the case for Scotland to be an independent country?
I do not think that we are starting from scratch. We have an NHS, but we need to do two things that have come out of this debate, which I urge the Government to consider. There is no halfway house here. We have to get things right at foundation level to allow the on-going, fundamental and transformative change needed in our healthcare system. We need a universal platform that has basic architecture to host all the fantastic software that we have discussed today and gives us the ability to share successful trials and evolve as the technology evolves. So much of our tech fails because it becomes obsolete, and that cannot be allowed to happen.
Just as important, we need a commitment to the adoption and innovation of tech on the front line, and not just by those who are early adopters. That is the number 1 reason why tech fails. We spoke about the quadruple helix and buy-in from the public, but staff buy-in is the most important thing. It will have to happen eventually so that healthcare does not collapse, so why not commit to it now? I welcome the way in which the cabinet secretary has communicated and discussed this subject with me, so perhaps we can actually have some real progress.
16:49
I have enjoyed this debate. There was quite a lot of consensus on the importance of innovation to the future of health and social care services in Scotland. I paid particular attention to what we heard from the Conservative Party, because we are sympathetic to its amendment, in that we believe that we have to go further and faster and that there is a lot to learn from other Administrations and other countries. We are leading in some areas, but other countries are leading in other areas, and we should get to the pace that they are going at and learn from them as well. I am not quite sure that the Conservative spokesperson reflected the tone of his amendment in his opening speech, but we will support the amendment.
I point out to Brian Whittle that Alexander Graham Bell was forced to emigrate to Canada in 1870. The SNP was not in power in 1870—I think that it was the Liberals or the Tories, but it was certainly not the SNP. I know all about him and he is close to my heart because he taught in Elgin twice before he came up with the invention of the telephone and achieved other great things.
Scotland has a great pedigree in medical and health-related innovations. Examples include chloroform; the hypodermic syringe; penicillin; Dolly, the first cloned sheep; the first application of the ultrasound scanner; and beta blockers—the list goes on and on. I could fill my whole speech talking about Scotland’s innovations in the healthcare and social care space over many years.
Scotland punches way above its weight when it comes to innovation, and not just recently, but throughout history. The issue is not so much that we do not have innovators or people doing amazing things. The issue is that, in the NHS, we have a culture of managers saying no, not allowing innovation to occur, and making clinicians come up with management plans rather than doing it themselves.
I do not recognise the picture that the member paints. Of course there are challenges and more barriers to be broken down. We have to be faster and go further, as many other countries are doing. However, an independent report that was published in September 2024 made exactly the same points about NHS England, so the situation is not unique to Scotland.
The pace of innovation is very fast at the moment, so we have a lot to do to keep up with it. However, Karen Adam and others spoke about the innovations that are taking place in NHS Grampian with the use of AI in breast cancer screening. In the news this week, we have heard every hour about more innovations in this space. Today, I noticed a post from Edinburgh Innovations, about a team of 20 data scientists and clinical researchers from the Universities of Edinburgh and Dundee. They are using CT and MRI brain scans from across the Scottish population, representing 1.6 million images, with the aim of building a digital healthcare tool that radiologists can use when scanning for other conditions to determine a person’s dementia risk and diagnose early stages of related diseases such as Alzheimer’s. That is happening here and now. There have been a lot of references to the inability to use data in Scotland, but that is a real example, which was announced today, of what is happening using Scottish data that is available, and what that team is doing is very innovative.
I am grateful to the minister for giving way again. I cannot disagree with the minister’s enthusiasm for innovation. The issue is how we collaborate on and share innovation, and how that sits in a basic architecture that will allow more and more innovation to be shared across the whole of the NHS.
That is what ANIA is about—in his opening remarks, the cabinet secretary mentioned that initiative to accelerate innovation in the NHS. It is also why we are developing an innovation strategy that will involve introducing innovations to public services and the public sector.
Last night, I spoke to 200 members of Technology Scotland who were gathered in the Parliament’s garden lobby. They were mainly from the critical technologies sectors—the semiconductor, quantum photonics and sensing sectors. The debate is therefore timely, with many members reflecting on the roles that those technologies can play and how they are being used. They do not just underpin industry or exports; they are also helping to transform the world around us and our society, and there is no better example of that than the transformation of our health services.
AI, robotics, 3D printing, virtual reality, augmented reality and nanotechnologies are transforming and will further transform our NHS and health and care in Scotland and around the world. Those technologies will provide faster and better diagnosis and deal with admin tasks to free up staff for other priorities. The list of benefits from deploying innovations in our NHS goes on and on: new cures for life-threatening diseases; easier to access services no matter where patients live in Scotland; cuts to waiting lists and waiting times; cost savings and more efficiencies; and people living longer and better lives. Many innovations are already being deployed in the NHS and the social care sector. In the years to come, the experience of our health and social care services will be very different from the experience today. There will be better outcomes for patients and people, and more lives saved.
As innovation minister, I am delighted to have the opportunity to participate in and close a debate in which the cabinet secretary announced two of the latest remarkable innovations to improve health outcomes for patients. Scotland’s triple-helix approach to collaboration between the NHS, industry and academia means faster adoption of those life-changing, research-driven innovations.
Our ambition for Scotland is that we are recognised globally as a destination of choice for health science. At the same time, we can improve patient and clinical experiences and outcomes. Today’s debate has provided many examples of how that is happening in Scotland as we speak.
We should also celebrate our world-class life sciences sector. A great part of my job is being able to go round many of the life sciences companies in Scotland. I have scratched the surface, as, with more than 700, there are so many of them. I am learning first hand about the incredible life sciences work that is coming out of this country. It is one of Scotland’s success stories. As we can see today, by addressing some of the most pressing health challenges, improving lives and driving economic growth in Scotland, that work is making a huge difference to our country.
From groundbreaking research in biotech and pharmaceuticals to advanced manufacturing and precision medicine, companies and universities in Scotland are at the forefront of global progress in this critical field. All of them are playing a pivotal role in transforming our public services, creating high-quality jobs and providing higher wages, which bolsters our economy. The life sciences sector is identified as one of the four key growth sectors in the Government’s innovation strategy.
Since its inception in 2020, the Scottish National Investment Bank has invested £27 million in life sciences businesses. I will give a few quick highlights—or maybe just a couple, because I have not got a lot of time.
EnteroBiotix is a manufacturing centre in Bellshill that has secured not only £6 million of funding from the bank but inward investment from the United States. The company’s work is making breakthroughs in gut health medicines and aims to deliver less invasive treatments for patients.
Another innovation and home-grown company in Scotland is Stirling-based iGii. The bank has invested £4 million in iGii to develop a cost-effective and highly scalable means of producing a novel 3D graphene-like structure that has been marketed for use as a biosensor in point-of-care diagnostic devices, opening up the possibility of quicker responses and removing the requirement to send tests to laboratories for processing.
I will take one more intervention.
I appreciate the minister giving way. There are many good examples, and he has highlighted a couple, but the key fundamental structural problem is that we do that good primary research, make the early-stage investment and scale Scottish companies up, but they get to a value of £20 million to £30 million and then they are usually acquired by a large foreign multinational. How do we try to anchor more of those firms in Scotland so that they can get to FTSE 250 and FTSE 100 levels, building more headquarters in Scotland for those big companies?
We have debated that before. How we encourage Scottish companies to scale up is important. A lot of effort is under way to attract more investment capital into the country.
I do not really like getting personal in speeches in Parliament, but I think that I have a duty to do so in this instance. On Sunday, I was out on my bike, cycling through the sunshine in the Moray countryside. I mention that in a debate on innovation in the NHS and healthcare because I was thinking about 10 months ago, when I was lying in a hospital bed, getting emergency open-heart surgery; I also had sepsis. Once I came to, I lay there—as the Scottish Government’s minister for innovation—thinking about all the innovation around me that had just saved my life. From the crane that lifted me so that I could get off my bed to the electronic zimmer machine that I used once I had a bit of strength, those things were there because someone had innovated and created them. Every time that I had a side-effect after the operation, I would mention it to the doctors and nurses, who would say, “We have a special drug for that.” I would get the drug and it would solve the problem. I was constantly taken away for assessments with lots of fancy machines and fancy procedures. Those are all innovations that saved my life, and they have saved lots of people’s lives. Joe FitzPatrick, for example, mentioned the care that his father received.
Those innovations are deployed here and now in Scotland’s NHS, and they are saving lives. Many more innovations are coming into the NHS. We have the building blocks for faster adoption of innovations: we have the companies, the ingenuity, the invention, the company entrepreneurs, the academic side and the research side. All those ingredients together will give us a much better NHS and better outcomes for patients in the years ahead.
I urge the chamber to support the Government’s motion.
That concludes the debate on adoption of innovation in health and social care.
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