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Highlands and Islands Labour MSPs, David Stewart and Rhoda Grant, are backing calls for improved end-of-life and palliative care as new research shows that by 2040, 95% of people who die in Scotland may need additional support in their care.

Charity Marie Curie Scotland says another 60,000 people are projected to be dying with a terminal condition by 2040 – with an increase in people dying in the community rather than hospital – and has urged end of life care to be made a priority for the Scottish Government with a new national strategy.  This is being backed by Scottish Labour.

Mr Stewart and Mrs Grant have previously called for end of life care to be at the top of the political agenda as home care services for the dying in Scotland are patchy at best. Around 10,295 people die in the Highlands and Islands each year and of these 7,720 have palliative care need. Marie Curie, in an opinion poll of Scots, highlighted that 61% would prefer to die at home.

Mr Stewart, who is also Labour’s Shadow Public Health Minister, held his cross-party member’s debate on the ‘Right to Full Care to Die at Home’ in the Scottish Parliament last year.

The debate was prompted by a plea from Shetland GP Susan Bowie that there should be an automatic right for people to have full care at home day or night for their last few days of life, so that then can have their wish fulfilled by being able to die at home with suitable palliative care.

Mr Stewart stressed that parents currently have the right to have their child born at home and the national health service provides midwives, but we do not have the right to carers to enable us to die at home.

“A new national strategy is desperately needed,” said Mr Stewart.

“What we have learnt from the pandemic is that end-of-life care is extremely important to families and carers as they struggle with lockdown restrictions and limits to hospital and care home visiting.

“It would be a huge relief to many GPs across Scotland that when someone says they want to die at home they know for sure they can get the compassionate care to back up the palliative care that is provided.”

Mrs Grant added: “A national strategy will help ensure that those living with and dying from terminal illness will get the support they need to live as comfortably as they can with the time they have left.

“It is not so much about dying at home it is more about living at home. When days are few they are precious. There is a greater need to live them to the full, to savour and appreciate things around you. That is much better to do at home than in an institution.”

Dr Bowie said: “I am incredibly grateful to the Scottish Parliament for discussing this, and for the cross-party support. Indeed, when days are few they are precious.

“As a Highlands and Islands GP I want to be able to care for my patients at home in their last few days. But that doesn’t always happen as my patient may have wished, because we don’t have the necessary care at home, or nurses.

“At the moment we can be born at home, even though we can’t decide that. Our parents can, and the midwives have to help, as it’s the law. You have a right to have a baby at home, no matter the risk, and the state must provide a midwife.

“But there are no such rights for death.

“There is much talk about people having the choice to die at home, in palliative care strategies, both national and local. However, when it comes to death 60% of folk in Scotland want to be able to die in their own beds, with their loved ones in attendance.

“If, however, home care or district nurses decide they don’t have the means to support it, it forces people ‘at the last’ to be taken off to care centres or hospitals against their wishes, if the relatives are unable to manage entirely on their own.

“Sometimes relatives caring for a dying person at home just need a few nights help to care, or even just a few hours, or just help with the dignity of personal care. Help to make their loved one comfortable. Homecare don’t have to provide that help. It’s up to the Integration Joint Boards, and whilst they don’t have to provide, then many won’t. It’s all wrong and the only way we can sort this is legislation, so that councils and Health Boards will make it happen.”

https://www.mariecurie.org.uk/media/press-releases/end-of-life-care-must-be-a-priority-for-incoming-scottish-government/288561

Highlands and Islands Labour MSP, Rhoda Grant, has appealed to the First Minister to put help in place for marine tourism businesses who have received no financial assistance to mitigate the effects of the ongoing Covid-19 restrictions.

During First Minister’s Questions yesterday, Mrs Grant said “The First Minister is aware that businesses have received lifeline assistance based on their rateable value.

“However there are maritime businesses that do not have rateable values, but do have berthing dues and rental payments, commitments on a similar scale to their land based equivalent.

“They have received no help. They may qualify for discretionary local authority funding but this is inadequate to meet the charges they face and tiny in comparison with land based businesses. 

“Will she look at this again and provide support that will keep them in business?”

The First Minister responded to Mrs Grant that she would ask the Finance Minister, Kate Forbes, to look into it.

Commenting afterwards Rhoda Grant said “I have contacted the Finance Minister about this previously and I have put questions directly to the Cabinet Secretary for Rural Economy and Tourism, Fergus Ewing, and to the Deputy First Minister, John Swinney.

“To date, it’s fallen on deaf ears and they don’t appear to have grasped the difficulty being experienced by marine tourism businesses. The marine based businesses who have contacted me do not have a rateable value as their businesses are based on boats rather than in bricks and mortar. Most of the funding on offer however, is based on the rateable value of the business and so excludes these businesses from applying.”

Mrs Grant concluded “These businesses are facing the same real financial difficulties as land based businesses and are crying out for help. I am however, on the back of the First Minister’s response to my question today, contacting the Finance Minister again, to urge her to put help in place for these businesses now.

“They have been left in the lurch for months and I hope the First Minister’s intervention will now mean that these business owners can receive the help they so desperately need to continue to operate.”

Highlands and Islands Labour MSP, Rhoda Grant, asked a Scottish Parliament committee if it could examine whether obstetric and paediatric support could be put in place at Caithness General to stop most pregnant woman travelling to Raigmore hospital to give birth.

Mrs Grant’s statement was read out at the public petitions committee today which considered the petition to review maternity models in remote and rural areas.

The petition, lodged by Maria Aiken on behalf of Caithness Health Action Team, called on “the Scottish Parliament to urge the Scottish Government to ask all relevant health boards to review their maternity model to ensure that it meets the needs of remote and rural communities”.

Mrs Grant said:

“A total of 90% of Caithness women currently give birth in Raigmore hospital, over 100 miles away in Inverness and really that needs to be addressed. There has never been a risk assessment on emergency transfers or indeed on the journeys south that pregnant women face, sometimes in appalling weather conditions.

“A focus group feedback on maternity services in November 2019 found the issue of road, and possible ambulance transfer, was a huge concern that “could not be overemphasised”.

“There was an overriding opinion that many women were requesting an induction or an elective section in order that they could plan their journey and not have the stress and anxiety of undertaking the journey in an unplanned way whilst in labour. Transferring women in labour by air to Raigmore and also transferring medical experts into Caithness by air also have their problems which seem insurmountable at the moment.

“The CHAT health campaigners in Caithness, after many years of raising the concerns of parents and their families, are now asking that Obstetrics support the Community Midwife Unit based at Caithness General to provide a 21st century experience for maternity services in the far north.  This would need to have the equivalent Paediatric support, something that appears never to have been considered.

“I ask that the committee examine whether Obstetric and Paediatric support could be put in place at Caithness General and, at the very least, that a risk assessment of emergency transfers takes place.”

The committee, at a previous sitting, had unanimously agreed to get back to the Scottish Government to ask what progress had been made on several initiatives which were looking at solutions for rural areas.

However, today the committee’s MSPs thanked campaigners for bringing the petition forward, but decided to close the petition, saying that the Scottish Government had moved to identify a number work streams to tackle the issues raised.

Although, it was also agreed that the issues were not going to go away and would continue to be highlighted and discussed in the future.

More information on the petition:

http://www.parliament.scot/GettingInvolved/Petitions/reviewmaternitymodels

Media release issued today by Tremor Society:

The Scottish Parliament cannot address a petition urging for the use of a new, life-changing treatment, transcranial Magnetic Resonance Guided Focused Ultrasound – more commonly referred to as MRgFUS – for the treatment of medication refractory Essential Tremor within NHS Scotland.

The Public Petitions Committee has been considering the petition, which was first tabled in July 2019 and during multiple meetings since. The most recent of these meetings in December heard evidence from a renowned Professor Neurosurgeon from Imperial College London, and the committee were impressed by the benefits of the therapy. As a result, the Committee requested written evidence from the Cabinet Secretary for Health and Sport, Jeane Freeman OBE MSP, on whether the treatment can be cleared for use in Scotland.

The Committee was due to discuss this again on the 10^th of February but the Cabinet Secretary for Health and Sport failed to respond in time, resulting in the issue being dropped from the meeting agenda.

Mary Ramsay, chair of the Scottish Tremor Society said, “I have spent 21 years raising awareness of the impact of Essential Tremor and a lifetime living with the condition myself. I learned six years ago about MRgFUS as an effective treatment for this condition from the National Tremor Foundation in England. Since that moment, I have tirelessly petitioned the Scottish Government to make this treatment available to Scottish patients. I am deeply frustrated that the Cabinet Secretary for Health and Sport has failed to respond to our parliamentary petition. One hour of her attention could mean a lifetime of change for many thousands of Scottish people living with a condition that could be treated more effectively, safely and cheaply.”

She continued, “The COVID-19 response must be taking up most of the Cabinet Secretary’s attention right now and we all want to see Scotland recover from COVID-19 and build NHS Scotland back better. Surely MRgFUS could build an opportunity for recovery for Scottish Essential Tremor patients alongside these plans. If the Cabinet Secretary does not respond to the Scottish Parliamentary Petitions Committee before the election, we will have to start the process all over again. I just wish the Cabinet Secretary, or the First Minster would talk to me about my experiences throughout 64 years of living with the condition, I know in my heart it can be better treated.”

More than 4,000 people in Scotland live with Essential Tremor, and it is estimated to be up to ten times more common than Parkinson’s Disease[1]. A progressive and often debilitating disease that is relatively unknown, Essential Tremor frequently leaves patients isolated, embarrassed, and often frustrated at the lack of awareness and understanding of the disease.

Highland and Islands Labour MSP, Rhoda Grant, who supports Mary Ramsay’s campaign,  said, “To hear that we are further delayed in our efforts to offer potentially life-changing treatment is incredibly disappointing. Many Essential Tremor patients in Scotland will be extremely disheartened by this news, particularly when this treatment is already being offered in England. While I understand the challenges that NHS Scotland faces in the midst of this global pandemic, I urge the Cabinet Secretary for Health and Sport to deliberate this matter and support those suffering from Essential Tremor in Scotland.”

About Essential Tremor

Essential Tremor is a neurological disorder which affects an estimated one million people in the UK,[2] and can affect any age group, with a prevalence of around 5% of patients being children.[3] It is characterised by an uncontrollable shake or tremble in parts of the body (arms, head, eyelids, lips and other muscles), and is a progressive disease that has hereditary links. Generally, tremor is caused by a problem in the deep parts of the brain that control movements. Everyday tasks such as personal care, writing, using technology, eating, or simply getting dressed etc., can be impossible for people with severe Essential Tremor.

 About Magnetic Resonance-guided Focused Ultrasound (MRgFUS)

Magnetic resonance-guided focused ultrasound (MRgFUS) technology uses MRI imaging to guide high powered, focused ultrasound to a very small point. At that point, molecules are vibrated extremely quickly, which creates intense local heat. That heat can destroy tissue. MRgFUS allows clinicians to target a very specific focal point – with very little heating produced in front of and behind that point, so only the targeted tissue is affected.

About the Scottish Tremor Society

The Scottish Tremor Society is an affiliate of the UK wide National Tremor Foundation and is dedicated to helping people in Scotland with Tremors.

We hope to provide a supportive and caring environment and aim to help everyone no matter how young or old with a Tremor.

[1] National Tremor Foundation. About Tremor. Available at: https://tremor.org.uk/what-is-tremor. Last accessed: February 2021.

[2] Imperial NHS. 2016. Available at: https://www.imperial.nhs.uk/about-us/news/trust-first-in-the-uk-to-use-non-invasive-ultrasound-for-brain-surgery. Last accessed: February 2021.

[3] National Tremor Foundation. Essential Tremor in Children. Available at: https://tremor.org.uk/essential-tremor-in-children. Last accessed: February 2021.

The Scottish Government’s Communities and Local Government Secretary has been urged to investigate ‘flawed’ Boundary Commission proposals for the Highlands.

Highlands and Islands Labour MSP, Rhoda Grant, put Aileen Campbell on the spot today asking if she had discussed with Highland Council proposals to cut councillor representation in some of the local authority’s most remote and rural locations.

At the Scottish Parliament’s Portfolio Questions, Mrs Grant said: “Parity in island council areas has been set at 1 councillor for every 800 people. Yet in Highland the parity level has been set at 1 to 2,800.

“This will result in fewer councillors, covering huge geographical areas and islands, creating a substantial democratic deficit.

“Can I ask what the Cabinet Secretary is going to do and should do to ensure that people in these remote rural communities are properly represented?”

Ms Campbell said that her colleague, MSP Graeme Dey, had written to the council and was engaging with the council on the issue and councils were being encouraged to engage with the Commission and articulate any concerns. However, she added that if Mrs Grant wanted to alert the Scottish Government to certain issues, or if things could be done differently, then Mrs Grant was to let them know.

After the session, Mrs Grant explained that she had already written to Local Government Minister Kevin Stewart outlining the local authority’s arguments.

Highland Council had rejected the Local Government Boundary Commission’s proposals outright with the local authority saying it was “deeply unhappy”.

“There are contradictions in the plan. For instance, Skye would see a reduction from four councillors to three and this does not make sense when compared to the proposals for island wards elsewhere in Scotland,” she added.

“On the other hand, in Fort William and Ardnamurchan, the proposals are rightly to retain four councillors because roads infrastructure and travel distances require more councillors. Yet in Sutherland and Wester Ross and in Caithness, the plans are to reduce the number of councillors.

“That makes no sense to me, as I can testify that the roads and the travelling time are no different for those areas and they should be assessed in the same way as Fort William and Ardnamurchan.”

Highland Council wants an early meeting with Mr Stewart to put its case.

• The council feels the changes proposed by the Boundary Commission fail to recognise the specific Highland context, particularly in relation to parity, sparsity, rurality and deprivation and, if implemented, would result in a significant democratic deficit and in a way that is at odds with the purpose of the boundary review which was meant to be specifically focused on reflecting the requirements of the Islands (Scotland) Act. Parity on the islands has been set at 1 councillor for every 800 electors and so these councils will get additional councillors and enhanced democratic representation. In Highland the parity level has been set at 1 to 2,800 electors across the entire area, whether island, rural or urban. This will result in fewer Councillors, creating a substantial democratic deficit in Highland. It is clear that these proposals take little account of remote and rural areas. It says the Commission’s proposals are “fundamentally flawed”

CLARITY is being sought over the schedule of coronavirus vaccinations on Mull.

MSP Rhoda Grant said patients in their 80s remain anxious for information on when they will be called.

Several contacted the MSP last month saying fears of a slow vaccine roll out was causing alarm across the island.

They said they had been told the vaccine would not arrive on the island until the beginning of February, by which time, over-80s elsewhere should have had their jabs in line with the Scottish Government’s February 5 target.

Mrs Grant said: “I raised their concerns in Parliament with the First Minister a fortnight ago and she said she was going to look into it but she hasn’t yet given me a reply.

“I further raised it at a meeting on Friday (29th Jan) with NHS Highland who said they are on it and will meet their timeframe to have all over 80’s vaccinated by the 5th (this Friday).

“But people living on Mull are feeling the roll out there is being handled in a very furtive manner when it should be fully transparent. They just want to know what is happening and where.”

Mrs Grant sent a follow-up email to NHS Highland’s chief executive Pam Dudek this morning (Monday 1st Feb) asking if she can provide those specifics.

Mrs Grant’s email said: “Constituents are getting in touch complaining the roll out on Mull is furtive when it should be transparent. They just want to know what is happening and when. They need some reassurance.

“I would therefore be grateful if you could confirm that vaccinating of the over 80s is underway in the Ross area and Iona, and that the over 80s in Tobermory and North Mull will be vaccinated next week, followed by Salen and Craignure. I would appreciate an early reply.”

Highlands and Islands Labour MSP Rhoda Grant says communities will have to wait to see what concrete plans the Scottish Government has to tackle their concerns about a predicted second wave of tourists descending on the region this summer and autumn.

In a reply to a Parliamentary Question Mrs Grant lodged, Rural Economy and Tourism Secretary, Fergus Ewing, was keeping any proposals close to his chest, despite telling Mrs Grant “an announcement will be made ahead of the 2021 season outlining steps taken.”

“You would think these plans are state secrets!” commented Mrs Grant.

“I can see that many people and families will be looking at staying in the UK this year, much like last year, especially if everyone has managed to be vaccinated by July and August.

“It’s predicted that accommodation will be in short supply, especially in areas such as those around the NC500. What I would hate to see is dirty camping, litter left by the roadside and irresponsible parking and I am sure that Government ministers do not want that as much as anyone else.

“But what proposals are in the offing with Easter not far off and people looking hopefully to the summer? Whatever restrictions are in place by then, the country needs to be prepared and we can’t let it drift on as it did last year.

“However, Mr Ewing’s response that its Visitor Management Strategy ‘will not resolve all the issues’ has set alarm bells ringing that local communities, councils and parks authorities will have the burden of responsibility for enforcement after suffering the stresses, strains and funding gaps left by the pandemic.”

Mrs Grant stresses that she welcomes tourism because it represents up to 43% of employment in areas such as the Cairngorms National Park compared with 8% in Scotland overall. While tourism also boosts communities in remote, rural areas, expanding the economy and allowing smaller businesses to thrive.

However, the MSP would like to see what is in the Scottish Government’s plans to develop tourism infrastructure and to promote education to cope with problems on the ground.

Mrs Grant is concerned if campsites remain closed, and hopes campsite owners can be better advised on safety measures to keep customers safe while also keeping campervans and campers off unregulated sites and unacceptable camping spots.

She received an answer to a Parliamentary Question in October last year where Mr Ewing, said that a multi-agency group was due to meet in November to look at solutions and make recommendations to Ministers but then nothing more was heard.

Question S5W-34700: Rhoda Grant, Highlands and Islands, Scottish Labour, Date Lodged: 21/01/2021

To ask the Scottish Government, further to the answer to question S5W-32106 by Fergus Ewing on 26 October 2020, whether the public agencies group reported back in November 2020 and, if so, what actions are being taken by the cabinet secretary regarding (a) camping, (b) pressure on rural communities and (c) the environment, particularly in the Highlands and Islands.

Answered by Fergus Ewing (29/01/2021):

The group has made positive progress. A Visitor Management Strategy for the 2021 season has been agreed and focuses on 3 areas: Education and Marketing, Investment and Infrastructure, and Prevention, Regulation & Reassurance.

An announcement will be made ahead of the 2021 season outlining steps taken.

It should be noted though that although some progress has been made by the Scottish Government and its partners, this will not resolve all the issues. This will require an ongoing partnership approach from relevant authorities and communities. Littering, roadside dumping and antisocial behaviour should continue to be tackled through enforcement. The ultimate responsibility for adequate service provision also remains the responsibility of local and national park authorities.

Current Status: Answered by Fergus Ewing on 29/01/2021

 

Highlands and Islands Labour MSP, Rhoda Grant, is “exasperated” by a reply from the Scottish Government’s Health Secretary, Jeane Freeman, on problems with people accessing the pick-up of Covid home testing kits.

Mrs Grant wrote to Ms Freeman after Skye resident and self-employed carpenter Daniel Barratt, from Ord, found no courier service came to pick up his home test, and he then had difficulty accessing grants to self-isolate.

Mr Barratt contacted Mrs Grant over the festive break detailing his conversations with the Covid home testing helpline and with those running Track and Trace and operating crisis funding. Since then another Skye constituent has contacted the MSP with a similar experience on a home testing kit not be picked up.

Ms Freeman says that NHS Highland is supporting courier collections for home test kits.

However, the Health Secretary added: “It appears that there may have been some initial problems with staff on the helpline not being aware of the correct procedure. This has been raised with DHSC as a training issue.”

The Department of Health and Social Care (DHSC) is the run by the UK Government and the majority of the tests administered in Scotland are through the UK Government’s testing network through its UK portal.

“What is exasperating about the Health Secretary’s reply is that, yes she has raised it with the UK Government department which is good news, but then we are left hanging,” said Mrs Grant.

“Surely, she must know if that training issue has been picked up and remedied? If not, then we really need to have some joined up thinking here.”

Mrs Grant is still waiting on a response from NHS Highland about the operation of its courier service which is supposed to fill the gaps left by the lack of Royal Mail priority boxes* in remote and rural areas of the Highlands.

“Maybe that will shed more light,” added Mrs Grant.

Just before Christmas Ms Freeman issued a letter to all MSPs heralding the fact that Scottish Government and UK Government officials were working closely together and had improved the home test kit provision for rural areas.

“The experience of constituents means I remain unconvinced that the Scottish and UK Governments are sorting out the home testing system to benefit those in more remote areas, many of whom would not be able to go to a testing centre many miles away.

“With the rapid spread of a new variant, testing and track and trace are vital to protect local communities.”

*Priority mail boxes – the Royal Mail pick up home testing tests for laboratory testing from these boxes in more urban areas. People can check the availability by using their postcode.

https://www.royalmail.com/priority-postboxes

 

 

 

 

 

 

 

Highlands and Islands Labour MSP, Rhoda Grant, asked the Deputy First Minister, John Swinney, if the Scottish Government will remove ringfencing from all Covid support funding and allow local authorities to deal with the differing needs of their own areas.

The MSP put her question to Mr Swinney after today’s (26/01/2021) virtual Ministerial Statement on Covid-19.

Mrs Grant said “After Covid business support funds are announced there is a delay while the Scottish Government issue the criteria for each fund to Councils. This builds in delays and, because these monies are ringfenced, also makes it difficult for Councils to meet the specific need in their own area. While there is discretionary funding available this is small in comparison. Will he consider removing the ringfence from all Covid business support funding and allow Councils to deal with the differing needs of their own communities?”

In response, the Deputy First Minister said he understands the difficulty here but “… the government is often encouraged to put in place specific funds for specific sectors to provide assurance to individual sectors that there is financial support available to them. He continued “There is a need to reflect both the general levels of business support and the specific funds that are available for individual sectors to try to make sure we are meeting the needs of everybody in these circumstances.

The Minister continued “We move at pace with local authorities to agree the eligibility criteria to ensure we can distribute money as quickly as possible and that is very much the thinking that goes into the approach behind the various schemes that we have in place for local authority distribution.”

Rhoda Grant said afterwards “Local authorities know their areas and needs better than central government. I am receiving calls and e-mails from business owners who are fighting for their survival complaining that they aren’t eligible for funding for a variety of different reasons.

“Having put these concerns to Highland Council, it then transpired that the hands of local authorities are tied as they are waiting for information from the Scottish Government on the eligibility criteria for many of the funding streams and this is having a knock-on delay in getting funding out to the businesses who so desperately need it.

Mrs Grant continued “It makes sense to me to have the ringfencing removed and I was happy to back Highland Council’s call on this. I am disappointed by the Scottish Government’s inflexibility here and would dispute the Minister’s statement that they move at pace to agree the criteria with local authorities. The constituents who have been contacting me would dispute this too, they are the people at the coalface who are telling me of the precarious situation their businesses are in.

She concluded “It is a dire situation and a little bit more leeway from the government could have allowed a lot of business owners to sleep a bit sounder in their beds, instead, their fear for their staff and their businesses rumbles on.”

Highlands and Islands Labour MSP, Rhoda Grant, has contacted the Association of British Insurers after being made aware of what she describes as ‘a deeply unsavoury situation’ whereby a commercial landlord has been contacted by his insurance broker regarding his premises being unoccupied due to the Covid-19 restrictions in place.

Typically, most insurance policies only provide unoccupied property cover for a limited period, usually 30 to 60 days. During the first national lockdown last year most insurers granted extensions to these periods, however the MSP has been advised that many insurers are not providing such extensions this time around and are asking to be notified of premises becoming unoccupied.

The directive from government from the start of the outbreak last March has been, and continues to be, that people should work from home where possible to limit the spread of the virus.

Mrs Grant said “The broker in question advised my constituent that, now that we are in a further lockdown, it may once again be necessary for the landlord or the tenants to vacate the commercial premises or change how they are occupied.

“My constituent has been told this could have implications for his insurance as most policies only provide unoccupied property cover for a limited period, typically 30 to 60 days and he has been told to make sure he understands his insurance policy and the requirements therein with regards to changes that are made due to Covid restrictions. He has been told that if there are substantive changes to the pattern of occupancy, he should let the broker know.

She continued “It is deeply unsavoury, in my opinion, that insurance companies or brokers would seek to make capital out of this public health crisis and I have contacted the Association of British Insurers to see if they are aware of this situation and if so, if they are taking steps to stop this distasteful practice from taking place.

“Business owners are facing unprecedented challenging times as it is without having this added burden placed upon them and I would hope this would be nipped in the bud before owners are penalised in this way through no fault of their own.”