Labour’s new shadow health secretary on tackling HAIs and rejecting the SNP’s minimum pricing policy
Jackie Baillie is a constituency MSP through and through. More so than most, her politics have been shaped by her experiences at a local level – many of her anecdotes are proudly pitted with references to constituents and local campaigns, and while she has previously served in former First Ministers’ Donald Dewar and Henry McLeish’s ministerial teams, it is her dogged campaigning with the families of those who died or were affected by the C difficile outbreak at her local Vale of Leven hospital for which she is perhaps best known. And it is precisely this local experience and knowledge that she brings to her new role as shadow health secretary, she says, and will help inform Labour’s health policies going forward.
It is little surprise then that Healthcare Associated Infections, which Baillie terms “the biggest challenge facing the NHS”, are an early priority. However, while C diff is an issue that she has become personally involved in – Baillie says she now counts members of the C Diff Justice Group as friends and she was reportedly holding back tears when she read out extracts from a letter written by a relative of an elderly woman struck down by C diff to Parliament – she recognises that it extends beyond the boundaries of her Dumbarton constituency as the recent outbreak and fatalities at Ninewells Hospital in Dundee sadly illustrates.
Baillie challenges Health Secretary Nicola Sturgeon to “get a grip” of the issue, calling the SNP Government’s handling of the matter “scattergun”.
“I think what the Government has done is a plethora of initiatives in response to usually the demands of the family, or the publication of something or press report or whatever. It has not been strategic, it has been scattergun.
It is not actually joined together so what you have is them saying, ‘let’s have 250 steam cleaners’ because it is the SNP conference. Six months later there is another SNP conference so we’ve got more cleaners. Where is the strategy that says from beginning to end, here is what works?” She calls on the Government to implement Labour’s 15-point plan to tackle HAI, which was drawn up by Professor Hugh Pennington, and challenges Sturgeon to be “more adventurous”, describing the Scottish Government’s HEAT target to achieve a reduction of C diff in Scotland of 30 per cent by 2011 “desperately unambitious”, pointing to measures south of the border that have seen C difficile rates driven down by 40 per cent in one year.
“I think she should be hammering this in hospitals,” says Baillie of Sturgeon. “If you listen to someone like Hugh Pennington, this just isn’t rocket science. It is basic stuff. If you put that in place and make sure you signal to the NHS that this matters and you want reports about it then implementation needs to be on her agenda in a way that it currently isn’t.” What would she have done differently in Sturgeon’s position?
“I would have made sure that we identified precisely what was the nature of the problem, precisely that nature of the solution and made it simple, backed it with resources and made sure we had not just cleanliness champions, important though they are, but actually made the senior charge nurse the one responsible for overseeing all issues within the ward, including cleaning. But most importantly, I would have put in a system that actually monitored implementation along the ground, not just in a tick-box way but actually watched it.” However, she welcomes the newly created Healthcare Environment Inspectorate as a step in the right direction and says she is hopeful that the current inquiry into the deaths at the Vale of Leven, chaired by Lord MacLean, will not only give us a clear idea of what went wrong, but what systems needs to be put in place and what lessons need to be learned so they can be applied to other hospitals.
“The issue for me is why from the Vale of Leven when the Cabinet Secretary clearly said that the whole of the NHS will learn lessons from this, and promised that clearly, why are we, two years later, still finding the same problems and none of them have been resolved. Now that is not true across the country, there is some very good work going on, but there are pockets where C diff is going the wrong way rather than the right way.” While Baillie has only held the health brief for a short period, her early influence on Labour’s health policies is again evident in the party’s decision to reject the SNP’s minimum pricing policy for alcohol, on the eve before the Government published its Bill, no less. The move was a bitter blow to the SNP, as while the Scottish Conservatives and Liberal Democrats have maintained a steady opposition to minimum pricing, parroting objections voiced by business groups and questioning the legality of the legislation, under Baillie’s predecessor Cathy Jamieson, Labour had kept its options open and so was considered the Government’s best hope of getting the legislation through Parliament.
Baillie, however, made up her own mind on the policy long ago, writing on her website that more should be done to enforce existing legislation “instead of bringing in new measures, such as minimum pricing,” and it appears her party – with the exception of the independently-minded Malcolm Chisholm MSP who has given the policy his public backing – have listened.
However, Baillie is keen to stress that while Labour is rejecting the SNP’s policy on minimum pricing, it is not denying the scale of the problem Scotland faces in tackling alcohol misuse, nor that price may have a role to play. But nevertheless there is still, Baillie argues, “too much dubiety” over the SNP’s policy, adding, “we don’t think it actually does what it says on the tin.” “There is confusion about who this is meant to target,” she says. “Now the Government will quite rightly say, look at all these people with severe alcohol problems, look at their health issues, but actually, minimum pricing set at 40p is not going to make a substantial difference to them. So there are people who are not as price sensitive as we would like to think they are. Public health professionals would say the minimum should be 60p. We need a debate about what that level should be to ensure that actually, if we are going to bring something like this in that it is properly targeted. Now we don’t think that debate has happened to any great degree and the Government is very reticent about telling us what that minimum price would be.” If then the SNP came out with a figure of 60p rather than the mooted 40p, would it make her party more inclined to support it?
“It would remove one of the considerations but it wouldn’t necessarily deal with the fundamental flaw I see in minimum pricing, which is that the money goes into the pockets of the supermarkets,” she says, adding, “… I just think it is a missed opportunity to actually put the money into education or treatment programmes, which are thin on the ground, or enforcement of licensing conditions and activities, which again, doesn’t seem to happen as much as it should.” Like with the Calman Commission, which was set up to debate constitutional change for Scotland untainted by the SNP’s ideal of independence, Labour has decided the best way forward is to establish its own commission, chaired by Emeritus Professor of Education Sally Brown, which will look at a range of measures for tackling alcohol abuse as an alternative to minimum pricing.
“Price is still very much on the table,” says Baillie. “We are not saying price has no role to play, quite the opposite, we think price does have a role to play. But what we want to do is look at alternatives to minimum unit pricing.” And yet scores of public health professionals have lined up to voice their support for this particular pricing mechanism – the UK’s four Chief Medical Officers, the British Medical Association, Royal College of Nursing, Royal College of Physicians, Faculty of Public Health et al – so how did they take the news that Labour is effectively vetoing the policy?
While she says she accepts and regrets that the initial reaction among health professionals will be disappointment, she hopes they will take comfort in the fact that she does accept the underlying analysis of the scale of the problem, the link between price and consumption and that price and availability are key drivers in reducing consumption. Moreover, she says she hopes they will recognise that through the commission they are trying to put in place a serious mechanism to deal with the complex problem of how to address Scotland’s relationship with alcohol.
“I think the commission is charged with coming up with some of those answers for us, recognising that the alcohol debate is still very much a live thing and I hope that they will come and engage with us in taking that debate forward…It is that agenda that I want us to all move forward together on rather than polarising the debate in a genuine search for what some of the solutions could be. Scotland deserves nothing less than that kind of serious consideration instead of that polarisation of positions that is about playing politics.” Baillie and Sturgeon have already engaged in several heated sparring sessions in the chamber and media since her appointment, but party politics aside, what does she make of her opposite number?
“I think Nicola is a very polished and accomplished politician, without a shadow of a doubt. I respect her ability in the chamber, I respect her ability as the cabinet secretary.
I would never ever underestimate her. But I recognise that there are things that I think need to be improved within the NHS and I will bring them to the chamber, to the public’s attention and I will do my best to help in the process of creating the very best NHS that we can have in Scotland.” Where something is wrong she will challenge it, she says, but equally, she says she will be supportive where there is good work going on.
“But my job is to hold the Government to account,” she says, “and I intend to do that.”