 The final item of business is a member's business debate on motion 8.317, in the name of Fiona Hyslop, on the future of St Michael's hospital in Lillithgo, West Lothian. This debate will be concluded without any questions being put, and I would ask those members who would wish to speak in the debate to please press the request of speak buttons. I call on Fiona Hyslop to open the debate around such minutes, please, Mrs Hyslop. Thank you, Presiding Officer, and to all members cross-party who signed my motion, allowing me to bring this important debate to the chamber. I would also like to thank my constituents and the friends of St Michael's hospital for their work on this campaign, some of whom are in the public gallery this evening. St Michael's is a community hospital providing end-of-life care respite and step-down intermediary care, as well as supporting patients waiting for care packages or placement in a care home. Situated in Lillithgo, in the north of the county, it supports patients from all over West Lothian. St Michael's hospital is the only NHS facility of its type in the north of West Lothian. The land for the hospital was owned by St Michael's Church and gifted to the health authorities at no cost in 1854 on the stipulated condition that it would remain a hospital facility and garden for the people. Indeed, I understand the then Conservative Secretary of State, Michael Forsyth, MP confirmed to David Steele, not our former Presiding Officer, but his father, the Minister of St Michael's, at the time, that the land would revert with the buildings in it if the land ceased to be used for the purpose that it was given back to the Kirk Session. In August 2021, West Lothian Health and Social Care Partnership, IGB, took the decision to close St Michael's temporarily using emergency powers under pressure of short-term staff shortages across the NHS. A decision was taken to move patients and staff to Tippithill community hospital in Armadale, allowing staff to be reassigned to St John's hospital in Livingston. It remains closed. In June 2022, a report to the West Lothian Intuition Joint Board contained two recommendations that St Michael's should remain closed or a public consultation be held with all relevant parties to review future bed space requirements at St Michael's. If the minister is told that there were a few patients previously, that is because the IGB did not refer them. Organised by the Friends of St Michael's, West Lothian's Health and Social Care Partnership held a public information meeting in February this year on the future of the hospital. Hundreds of people attended the standing room-only public meeting in the Kirk Hall, and the health and care management were left in no doubt of the importance of St Michael's hospital to the community. Many of those who attended the public meeting had relatives cared for there. The IGB then launched a review of bed capacity consultation, citing moves for care at home, which is due to report next month. Minister, the same IGB has since announced that it wants to outsource care at home and six care of the elderly residences in the future. Taken together, that points to an IGB that wants to own no community properties for elderly care and exists simply to contract out home care services. That is not on. We need the public provision of the quality of care and certainty of a home for current and existing older people in our county and community hospital care when they need it. I implore the minister to look at what whistles in the IGB are doing carefully. Stealth tactics over a number of years are removing public facilities. We know that their finances mean that they have to make savings, but we also know that they hold significant reserves. With such drastic action planned, now is the time to allow them to release reserves to support care for our elderly population. When I raised the need for step-down care and facilities like St Michael's—I specified St Michael's—with the First Minister when he was health secretary in October 2021 in questions on his winter planning and social care statement, he agreed to stress the need for community-based elderly nursing care and rest-pite in the north of the county as a priority with local partners. My constituency of Llynydd is the largest in Scotland by population. West Lothian as a whole has a growing and an aging population. Over the next 25 years, it is forecast to have the fastest growth in population of pensionable age in Scotland, with an increase of 44 per cent, twice the Scottish average. There are also no hospices in West Lothian, meaning that without St Michael's families in West Lothian who require end-of-life palliative care to support the loved one, we will have to travel almost an hour to St Columbus and Granton in the north of Edinburgh or to the Marie Curie hospice in Edinburgh south. The IGB has previously used statistics under reporting the scale of population growth in neighbouring Winchborough and with the high price of property in Edinburgh and major population growth in Queensfrey and Curt Liston, surely joint provision for elderly cler at St Michael's with the west of Edinburgh would make sense. There is a clear moral and needs argument to keep the site for health purposes but possibly a legal argument if the health board thinks that they will sell lucrative land for housing and that it might revert to church ownership. The friends of St Michael's are a dedicated and committed group of volunteers and I thank them for their work and their support and care over the years for the patients and their families. They were a lifeline to the families of those staying at St Michael's, providing emotional support to many. They also provided financial aid and help to families who needed that extra help. They paid for taxis and other public transport to make sure that patients got to see their loved ones when they were at their most vulnerable. As the local MSP for Llythgo and on behalf of all the patients and families who benefited from care at St Michael's in the past and hopefully in the future, I thank them. We know that there are continuing challenges in securing and resourcing staffing for any expansion of care at home and we recognise that senior managers at Wessels in health and social care partnership have been clear that no decision has been taken about St Michael's and have made commitments to maintain the fabric of the hospital pending their review. However, I reiterate my call to the partnership to take a strategic view in favour of using the physical, social and community assets of St Michael's for the benefit of the growing population in the north of the county. It is clear that there will be an on-going need for a health facility providing end-of-life and step-down and intermediary care and potentially new support services to match the increasing home-based care for a rapidly growing elderly population in the north of Wessels in. The strong spirit and solidarity of local people who support the retention of the hospital exists because of the extraordinary nature in which St Michael's hospital and the friends of St Michael's have cared for their loved ones and their families. St Michael's hospital must be retained to benefit the communities and the families who depend on it. I welcome the chance to speak in this debate today about the future of St Michael's hospital in Llythgo. I thank Fiona Hyslop for bringing the issue to the chamber today. I believe that local health services are a vital part of our local communities. As we know, St Michael's hospital has been serving the community for many years. However, the current situation demands that we take a hard look at the hospital's viability and its role in meeting the healthcare needs of the community. St Michael's was first shut in August 2021 in response to acute staffing pressures created by Covid-19 and is a clear indication that the hospital was struggling to provide the level of care that was needed. Importantly, it was a temporary closure and it was used by emergency powers. We have a growing population in West Lothian that is well in excess of that of Dundee. As one of the highest proportions of older populations, West Lothian needs a healthcare system that can meet the needs of the community now and in the future. As Ms Hyslop said, West Lothian has the fastest growing population of a pensionable age, with an increase of 44 per cent projected twice the Scottish average. I would also like to put on record my support around the concerns with data that is being used around the population growth across West Lothian. The importance of this hospital to the local community cannot be overemphasised. I would also like to draw parallels with what is happening elsewhere in the NHS Lothian boundary with the editing hospital in East Lothian, which remains closed for very similar issues. That is not just an isolated incident for West Lothian. Supporting, developing and protecting our workforce is vital. To ensure that that happens, there will need to be an active talent management and succession planning across NHS Lothian in addition to recruitment and retention initiatives. That is key to keeping our local services in the communities open and thriving. Although I acknowledge the campaign to maintain the hospital and the health services at St Michael's, we must take a view that considers the future needs for patients and families in the area. The West Lothian Health and Social Care Partnerships consultation on the current closure of St Michael's hospital and its community bed review was an important step in understanding what direction needs to be taken. When I visited St Michael's last year, it was clear that the building was not in a good state of repair and would need a significant investment to restore it to what would be expected of the standards that are required for modern healthcare. However, the Scottish Government funding decisions have resulted in the West Lothian IGB needing to save an eye-watering £17 million. Therefore, any decision to close St Michael's hospital must be accompanied by a clear plan to ensure that the healthcare needs of the community are met in a way that is sustainable, effective and equitable. Unfortunately, there is a funding shortfall in NHS Lothian relative to other health boards or the National Resource Allocation Committee, NRAC. In the financial year 2022-23, that equates to approximately £14 million, which is a huge challenge alone. I would also like to emphasise that, over the past decade, that equates to more than £100 million. If we are to continue services in the community across the Lothian region, that must be rectified, in particular when we reference the changes in population specifically in West Lothian. In conclusion, although the history of St Michael's hospital is important, we must prioritise the needs of the community and ensure that we have a healthcare system that can meet the needs in the future. I urge my fellow members to work together to find a sustainable and effective solution that meets the healthcare needs of the people of West Lothian. I thank my colleague Fiona Hyslop for securing this member's debate. I should also point out that my wife is a district nurse in West Lothian. As Fiona Hyslop outlines, St Michael's is the only hospital facility of its kind in that part of West Lothian. If it was to permanently close patients and their families, we would be forced to use other sites such as Tippett Hill and Armadale, which are one of the two respite and end-of-life centres here in Edinburgh at St Columba's Hospice to the north of the city and the Marie Curie Hospice in my constituency of Edinburgh-Pentlands. I visited the hospice at Fairmail Head on a number of occasions, and I recognise the dedication that the staff have to provide compassionate end-of-life care, but they only have 20 in-patient beds, which are already increasing pressure without that proposed closure in West Lothian. The friends of St Michael's hospital group have been unwavering in its support for the families of its patients, both in terms of emotional support and financial assistance, and as Fiona Hyslop highlighted, she has paid for many family member's taxis from different parts of West Lothian to the hospital. Something I am not certain other hospitals would be in a position to offer, particularly if the journey was into Edinburgh, which is obviously more costly. This is not just about the financial costs but the time taken to travel and the ease of travelling, especially at peak times, given the congestion on the A71 into Edinburgh or indeed on the city bypass. It is especially difficult for those without a car and who are reliant on public transport, given the recent cuts in bus services across West Lothian. By closing the facility and forcing patients to other facilities such as Marie Curie or St Columba's hospices, you are immediately creating a huge, stumbling block in terms of the patient's most basic needs, spending time with her family and friends. How do those family and friends, especially the elderly and vulnerable, get to the hospital to visit their loved ones, given the transport issues that I mentioned previously? That proposed permanent closure is at a time that West Lothian has a growing older population, therefore the need for access to healthcare facilities will only increase Hospital sites such as St Michael's will be in demand from uses a step down facility to relieve delayed discharge, to providing respite and end of life care. Not to mention the fact that if you are diverting those patients elsewhere, indeed out of West Lothian, you are not only reducing the availability of local healthcare but the jobs that are required to offer a fully functioning service. Of the suggestion that West Lothian patients could be moved to the city hospitals, well, Edinburgh's population grew by 10 per cent in the 10 years to 2021 to 526,000 and is expected to grow by another 26,000 people by 2028. Edinburgh's 75s and overs is also projected to see a 25 per cent increase in the period to 2028. Presiding Officer, I believe that this closure of St Michael's would be a retrograde state and it should be paused until we understand the impact of the national care service bill which is proceeding through this Parliament. Stripping services at this point I believe would be reckless. Fiona Hyslop has raised this issue before and I know will continue to raise this issue both here in Parliament with NHS Lothian and other stakeholders until a positive outcome for both the community hospital and those that need to access its facilities now and in the future is secured. I thank Fiona Hyslop for bringing this motion to the chamber today to discuss the important issue. In January I wrote to the chief executive of NHS Lothian Scotland expressing the concern of my constituents where they were worried about the lack of end-of-life care at the nearest hospitals St John's. I also addressed the lack of GP surgeries in the area and that the possible closure of St Michael's would be catastrophic if no alternative palliative and respite care is available. They were also concerned that this may lead to nurses retiring earlier adding to the overall pressure on the NHS. The original purpose of St Michael's hospital was to provide a service for the local communities thanks to the friends of St Michael's groups amazing dedication and commitment. I know that for so many of my constituents St Michael's hospital is not only vital for providing hospital and crucial end-of-life care but also acts as a community hub supporting families with loved ones being cared for at the hospital. The SMP have been in power for the last 16 years yet the state of health and social care sector has deteriorated due to the chronic underfunding and mismanagement. Local government and the integrated joint board IGB in West Lothian have been starved of resources and have been left between a rock and a hard place. St Michael's hospital is just one example of the current crisis in health and social care in West Lothian. Many of you may have been aware of the public meeting last evening about the privatisation of care homes in West Lothian where more than 200 local residents turned up. Residents were there to express their concern for the future of social care in West Lothian and the local residents they rely so heavily on it. I attended the meeting on behalf of my Lothian Scottish Labour colleagues and there was a clear frustration and anger toward the insufficient resources and funding for health and social care. This has happened due to cuts made by the Scottish Government that are putting councils under pressure. It is important that all Lothian MSPs meet together now to discuss how we can get extra resources and funding allocated to health and social care in West Lothian, Lothians and how we can move forward and tackle this on-going crisis. A cross-party approach to tackling this crisis is essential. Once again, I thank my colleague Fiona Hyslop for bringing attention to this issue. I look forward to meeting with my Lothian colleagues soon to deal with this crisis in health and social care in West Lothian. I now call on Minister Marie Todd to respond to the debate around seven minutes. First, I thank Fiona Hyslop for bringing this debate to Parliament today. I am very grateful for her commitment to champion the role of St Michael's hospital. I am also grateful to the friends of St Michael's hospital and similar groups across the country who work so hard to support those who benefit from community hospitals. St Michael's hospital, as others have said, was originally gifted by St Michael's Church in the 19th century for the wider benefit of the community, and that is a principle that still endures today. Caring for individuals, whether they are our own loved ones or members of our wider community, is a fundamental shared responsibility of us all, both personally and as a wider society. I am committed to ensuring that we do this with the utmost care, dignity and respect for those who need it. I want to pay tribute to and place on record my thanks to all those individuals and teams who make that happen right across the country, from our unpaid carers, social care staff, allied health professionals and clinicians. We are all indebted to the teams who provide care right across our health and social care system. We all know that the best bed for us to be in is our own bed, and where that is not possible, being close to home, is extremely important for the individual and their family. Ensuring that people are cared for in the right place at the right time is absolutely at the heart of everything that we do. Community hospitals play a vital part in that. They provide care closer to people's homes, which is personalised, holistic and patient-centred. Our community hospitals, including St Michael's, can provide a wide range of services, including non-acute and patient services, rehabilitation services and palliative care. They form a crucial element in facilitating service integration locally, and they function as an integrator of services. That is a local for the development of a single point of access to services. Palliative and end-of-life care spans a wide range of professionals and sectors, with clinical and social care delivered in acute hospitals, community hospitals, hospices, care homes and people's own homes. The Scottish Government committed to ensuring that everyone who needs it can access seamless, timely and high-quality palliative care. We are developing a new strategy to achieve the very highest standards of care right up to the end of life, and we will develop a strategy that reflects what matters to people, experiencing serious illness, dying and bereavement. We are reviewing the information and evidence that we have about people's experiences of palliative and end-of-life care and bereavement in order to inform our strategy going forward. That will contribute to a holistic, integrated and multidisciplinary approach that will ensure access to palliative and end-of-life care wherever and whenever it is needed and which has the person and their families and carers at the centre. As we look to ensure that our services reflect the changing needs of patients and wider society, we must harness the advancements in technology. Home health monitoring, community alarms and near me, we are constantly looking to develop clinical and care pathways to prevent people from being admitted to hospital. For example, our hospital at home programme is a really innovative approach to providing hospital-level care for patients in the comfort of their own home. We know that it assists with the recovery of patients as well as alleviating much-needed pressure on acute sites, emergency departments and the ambulance service. Hospital at home currently provides levels of virtual capacity matching that of St John's hospital in West Lothian. I am pleased that we are continuing to fund the expansion of the programme by providing health improvement Scotland with a further £3.6 million in this financial year to support more than 150 additional virtual beds. Innovations linked to the advance of technology such as hospital at home enable health and social care partnerships to be more creative and pragmatic when designing the future service provision. Designing of those services must always put the patient at the centre working with them and for them to provide the best level of care to suit their needs. However, it is really important that decisions on how services are delivered are made at a local level, in consultation with those who use the services to ensure that local needs are met in the best way. I am aware that the consultation regarding St Michael's is on-going and at this point I do not want to influence the outcome of that consultation in any way. My officials will continue to engage with the West Lothian health and social care partnership as the consultation progresses and stand ready to support where appropriate. More generally, we will also continue to work with partners and with people with lived experience to make sure that our social care services work for everyone. On the point that was raised around the population levels expanding and growing, I am absolutely comfortable with my officials reaching into the HSCP and making sure that they are using the most up-to-date and relevant data on population levels as part of their strategic planning, if that would be helpful. On the issues that were raised about funding, the door is always open for NHS boards to discuss funding with the Scottish Government health officials. Enrack, as raised by Sue Weber, is always contentious. The point around local authority funding raised by Fausal Chyder is that the real-terms increase of £376 million or 3 per cent to local government supply. West Lothian is getting £405 million to find fund local services, which equates to £17.5 million to support day services. I am not sure whether the minister is aware, but West Lothian Council received 8.9 per cent of an uplift and increase in this financial year. Secondly, I understand the city of Aberdeen. I was not aware, but that is a very, very good point to make at this juncture. Funding is undoubtedly challenging. I share the concern that IGPs and HSPs have. As a Government minister, we have to balance finite resources and make tough decisions, but, undoubtedly, there is an open door policy with the Scottish Government where concerns need to be raised. I would like to conclude today where I began. The cornerstone of our health and social care system is the people who work tirelessly day in and day out to support individuals. I am grateful to them all. I am grateful to our communities, like that of the Friends and St Michael's group, for their dedication to providing care to individuals and to their families.