 The final item of business today is the member's business debate on motion number 13354 in the name of Lewis MacDonald on Stonehaven Dialysis Unit. This debate will be concluded without any questions being put. I would be grateful if those members who wish to speak in the debate could press the request to speak buttons now. I call on Lewis MacDonald to open the debate. Seven minutes, please, Mr MacDonald. Thank you very much, Presiding Officer. I am delighted to have the opportunity today to celebrate the efforts of local people in raising hundreds of thousands of pounds for a dialysis unit at Concardin community hospital in Stonehaven. I would like to thank members from across the chamber who have signed my motion to that effect and to welcome those campaigners from the area who are in the gallery today. Dialysis, as members will know, is a vital service for those with kidney failure. It involves removing the patient's blood, cleaning it 10 times over to make it safe and putting it back. Patients undergo dialysis for at least four hours at a time, at least three times a week. Those who are no longer well enough to cope with a transplant will require this treatment for the rest of their lives. It is therefore a radical procedure and it is tough on patients. One patient told me that after dialysis he felt as if he had run a marathon. This is daily treatment that saves lives, but it is important to remember that people feel worse after the treatment than they did before. The staff at Aberdeen Royal Infermery's Dialysis Unit work very hard every day and provide dialysis to upwards of 120 patients several times each week. Patients who travel into the city for treatment would really like to be treated closer to home, and that is why they have campaigned to have local units established across Grampian. There are local units now in Elgin, Banff, Peterhead and Ibaruri, as well as for patients in Orkney and Shetland who would otherwise have to come for dialysis to Aberdeen. There is no local unit for the south of the region, the historic county of Concardinshire. That means that patients have to be brought into the city every day by a single patient transport ambulance, collecting patients everywhere from Cove Bay on the edge of the city to Sincerus in the mountains. The patient transport has to start with the person furthest away and wait at the hospital for the person whose treatment takes the longest. Given the distances, that makes for very long days for all concerned. One woman described getting up before dawn every morning to get into Aberdeen for four and a half hours of treatment, then getting home hours later feeling dog-tired with much of the day already gone. Her quality of life would be greatly improved if there was a local alternative, and that is what this campaign is all about. Fundraisers in Stonehaven have been inspired by the example of Inverruri, where local people helped to raise the money to pay for a local dialysis unit a few years ago. That example is very relevant to this evening's debate. In the case of Concardinshire, Stonehaven Rotary Club alone has raised many thousands of pounds, and the social calendar in the area has been greatly enlivened as a result. Once again, the campaign has been anchored by the Grampian Kidney Patients Association, which has also provided the necessary bridge between fundraising in the community and decision-making in the NHS. The vice-chair of the association is Dr Ann Humphrey, who has been responsible for the care of many renal patients in Grampian over the years, including, indeed, my father, Roddie MacDonald, a way back in the 1990s. Ann Humphrey is in the gallery today. The Grampian Kidney Patients Association continues to be among the most active in the country, and I have no doubt that that reflects Ann Humphrey's personal commitment over the years. Also here is local kidney patient Angus Simpson, who first asked me to highlight the campaign in the Scottish Parliament. Angus worked as a baker offshore, when he was an active member of United Union speaking up for his fellow workers. Nowadays, he is equally committed to campaigning and speaking up for his fellow patients. Of course, a patient who is fit enough to travel to Holyrood today is likely to be able to manage his or her own condition and to help to develop a new model of self-directed care at a satellite unit like Stonehaven. Not every kidney patient who lives south of the city will be able to do that, as the most acute cases will still need to attend ARI in order to have dialysis with full medical support nearby. For non-acute patients who need safe access to dialysis, with a minimum of fuss, the provision of a local service will make a huge difference to their daily lives. Something like 10 per cent of those who currently attend ARI will be able to have dialysis at nearer to home instead. That will, of course, help to take pressure off the unit at Aberdeen and, thereby, benefit all those who attend the dialysis unit that they are at present. The support of NHS Grampian for this initiative has been vitally important. If that is true up to now, it will be even more true as the project enters its next phase. NHS Grampian has recognised this project as a strategic priority, and that recognition has enabled much else to follow. It is in line with the provision of dialysis in satellite units across the region, and, of course, it is in line with the developing model of self-directed care. NHS Grampian has provided the site for the new unit at Concardin community hospital, which is one of the newer hospitals in the region and which is readily accessible from all parts of the Concardinshire area. Now that campaigners have raised the bulk of the funding that is needed to meet the capital costs of the new unit, they are understandably impatient to move on to the next phase. They would like to have a timetable for construction and commissioning, and, of course, they would like the unit to be up and running as soon as possible. NHS Grampian clearly is keen to make progress, and they have already taken professional advice on what needs to happen next. They are committed to meeting the future revenue costs of the service, and that is critical to the project going forward. Clearly, some additional funding is still required in order to allow them to complete the business case. I hope that ministers will support the NHS locally as they seek to bridge the remaining funding gap. The British Kidney Association is willing to help, potentially with a substantial grant, but that support is, as always, conditional on the bulk of the necessary funding being already in place. Building on the fantastic work of local fund research, which continues to this day, money is still coming in, I believe, every weekend from one direction or another, and that is fantastic. However, in order for the case to be completed, clearly there is more that needs to be done. I hope that ministers will do whatever they can do to help NHS Grampian to move that forward and thereby to help patients in the Stonehaven area to obtain access to a local dialysis service. On that basis, thanking and congratulating again all those who have made this possible, I look forward to the successful conclusion of this campaign at the earliest possible date, with continued support from all concerned. We now turn to the open debate speeches of four minutes, please, and I call Nigel Dawn to be followed by Nannette Milne. As always, I would like to start by congratulating Lewis MacDonald on bringing this debate before the chamber. However, I would also like to thank him most sincerely for that very interesting speech, which I think actually covered off the subject so comprehensively that he's not left me very much to add, but that's actually fine, because clarity and simplicity are always the order of the day here. I start, however, by registering that I first heard about this wonderful fundraising exercise when at the Feing marting market in Stonehaven shortly after I was elected as the local MSP to New Banderers, of course. I was required to pay some money to toss some balls at some old plates, which I was supposed to smash. I remember that quite distinctly, because I failed to hit any of them at all. Never mind, I smashed them. I didn't cost them anything, and undoubtedly I made my contribution. However, I think that that would be symptomatic of some of the things that have been done by fundraisers, but also, of course, right across the area and much more significant things. The figure that I have is 553,000 at the moment. You don't raise that kind of money from that kind of activity alone, and they are seriously to be congratulated for that effort over a sustained period of time. As Mr MacDonald points out, the proposal is to have a hemodialysis unit at the King Gardenshire community hospital in Stonehaven. I notice, as he has, that it is the only area in Grampon that does not have that kind of local renal unit, and clearly it will fulfil a need. I would like to just express one note of concern here. That is simply—I was reminded of this in Audit Committee only this morning—that the capital costs estimated at £800,000. I have no doubt that that is the best estimate that people can come up with, but I do sound a word of caution that it is only when you have actually finally designed it, got it seriously costed by quantity surveyors, and then you have actually got quotes in front of you that you know what the real cost is, even likely to be. Given that there is probably no underground work here, that should be the final answer, but let's just be sanguine about quoting capital costs until we have gone through that process properly. I note, as, again, Lewis McDonald has commented, that a design team has been appointed by NHS Grampion. Clearly, they are committed to it. Clearly, they are committed to finding the four and a half whole-time equivalent nurses who will staff it, probably by directly transferring folk from ARI where they won't now be needed. We do seem to have buy-in from NHS Grampion. I will also be interested to hear the comments from the minister. I would also just like to make one other observation. As I do as the constituent CMSP, of course, cross-border, I note that a facility in Stonehaven will clearly be of value to people within Aberdeenshire or the historic King Gardenshire, but given the proximity to the rail line, I do just wonder whether this might actually be a very useful facility for those from the Montrose area, clearly outside Grampion, but only just. Therefore, I think I just want to make the point that we may just want to be a little bit cleverer than sometimes about whether people cross borders in order to make use of facilities and it would be a great pity if that point was missed. I mention that in the passing. I don't think that it will be missed because I am very conscious that the maternity facility in Montrose is used by folk from King Gardenshire on exactly the same kind of basis, so I suspect that people are wise up to this, but we just need to make sure that once the facility is there, it is used as well as it can be. In closing, Presiding Officer, can I commend all those involved, the Stonehaven Rosary Club, the Cranprion Kidney Patient Association in particular, for doing that very difficult negotiation process, which again, Mr MacDonald pointed out, has been done. It would have been very easy for this to become just too difficult and plainly it hasn't been. On that basis, I commend everybody involved. Thank you again, Lewis, for bringing the debate. Many thanks. I now call on Nanette Mellon to be followed by Dr Richard Simpson. I would also like to begin by congratulating Lewis MacDonald on securing this debate and for bringing the campaign for a new renal dialysis unit in Stonehaven to the attention of Parliament. I confess that I was not aware of this campaign until I read the motion, but even though Stonehaven is within my region and quite close to home, so hopefully any local publicity that Mr MacDonald can get from this debate will help to increase the general public's awareness of it and assist the fundraisers in achieving their goal. In-stage renal failure is a very trying condition to live with, the only long-term cure being transplantation and the only way of treating it being regular dialysis, which usually has to be undertaken at least two or three times a week, and which lasts around four or six hours, with a far that hour or so before and after, for preparation and recovery. This is a huge chunk out of people's lives. Bad enough if one lives close to a major renal unit such as those in our cities, but if one lives at a distance, then travel time, of course, has to be added. Stonehaven lies in the south of the area covered by an HS Grampian, where there are currently no dialysis facilities, with the nearest unit being an Aberdeen royal infirmary, some 15 miles from Stonehaven, and obviously further for people living south of that. At the present time, we're told there are around 25 patients in the south of Grampian area who could benefit from a Stonehaven-based unit. As the motion states, the cost of setting up a new unit in Concardin community hospital is around £800,000, and the fundraising campaign has a target of £150,000 over and above a bequest of £250,000 already received to cover the capital costs, with staffing and running costs to be met by the health board. Thanks to the stalwart efforts of several local organisations and other fundraisers, I'm told the end is in sight, and the Newstonehaven dialysis unit will soon be a functioning reality. Soon after I became an MSP, I became involved with an almost identical campaign to set up a satellite dialysis unit in Inverruri, mentioned by Lewis MacDonald, which is about the same distance north of Aberdeen as Stonehaven is to the south. I apologise that the Presiding Officer is digressing slightly from the terms of the motion, but in that area, a charity called Gordon renal dialysis was set up to fund the capital costs, and I was happy to help that organisation in a very small way by helping to highlight their work and by reinforcing that efforts to persuade the health board to take on responsibility for the staffing and running of the unit, which, from memory, wasn't on the cards at the time when that charity was initially set up. The unit, which was purpose built, was opened at Inverruri cottage hospital in 2006, with running costs shouldered by the health board, and the first patients were treated there soon after, allowing the charity to wind up in 2008. I know that many patients in the north of Aberdeenshire have had a better quality of life since being spared the time-consuming journey to Aberdeen two or three times a week and the hassle of trying to find parking spaces close to a really busy acute general hospital. The consultant clinics held monthly in the unit so that patients can be reviewed locally as well. Moreover, it also provides an outpatient service for a venopuncture and for intravenous iron administration for local peritneal dialysis and low clearance patients. I have visited the Inverruri unit and spoken to patients who have benefited from it, and there is no doubt that they appreciate their local facility. Not only is it more accessible for patients, but the atmosphere in the unit has much calmer than can be achieved in a bushland major centre. I had the greatest admiration and respect for all the fundraisers who put so much effort into achieving the satellite unit in Inverruri, not least their dogged determination to press ahead without the health boards decision to take it over. I feel exactly the same about all those who are working towards a new unit in Stonehaven, even though their task has perhaps been made easier by the success of the earlier unit, which no doubt has influenced the health boards decision to staff and run it. I congratulate every single one of them on their efforts and look forward to hearing when the unit is up and running, and hopefully to seeing it in action. Deputy Presiding Officer, I have my congratulations to Lewis MacDonald for this motion and I have joined him in congratulating all those who have been involved in the fundraising effort, including Angus Simpson and other Simpsons, so I am glad to see the Simpsons featuring here. There are two aspects that I want to cover. One is the question of haemodialysis, and in fact dialysis in all its forms currently in Scotland. The other is the whole question of community support and the relationship between voluntary and statutory organisations in this sort of issue. The situation is that there are some 250,000 patients across Europe on dialysis, and the figure is going up by 46 per cent annually. In Scotland, we currently have 35 haemodialysis units, 25 of which are now satellite units. This is important because if you go back a period of time, you will find that the units were all centralised on places such as Aberdeen Royal, and they were not in satellite units of the type that we have heard today in Burruri and now to be Stonehaven. The addition of satellite units is really critical, and it is part of what the Kerr report talked about very strongly. It is where it is safe to do so, and it is helpful to patients. Services should be devolved to as close to them as possible. Haemodialysis is an absolutely classic example of that. When we obtained the haemodialysis unit in my own area at Royal Labot, that was a very useful step forward and saved patients from travelling into Glasgow, so having 25 of those satellite units out of the 35 in Scotland today is really important. There were only 16 from 10 years ago, I understand. In addition, 11 of the 35 units also provide home dialysis, and that is an area that is growing and is becoming safer. There are also 15 peritoneal dialysis units in Scotland. This is an area of particular interest to me, as I was actually the first doctor in Scotland to apply peritoneal dialysis in 1967. It was a very little known technique. I regret to say that it was not successful for the patient at that time, but the patient and my consultant were both very keen that we should try this novel technique at the time. Peritoneal dialysis is an alternative when haemodialysis cannot work. In relation to something that was said, I think, by Nigel Donner and alluded to by Lewis MacDonald, 31 of those units provide holidays and visitor dialysis. That is also important, because dialysis tends to tie you to your unit, so the knowledge on our website that you can go to another area and get the dialysis is important. That is underpinned by another thing in Scotland, which is that the kidney patients in Scotland are the only group at the present time, as far as I know, who have total access to their laboratory results. That was very evident when the Glasgow IT system collapsed, as you remember. It was down for two days, and we discussed that in this Parliament. The only group who were totally safe during that time were the kidney dialysis patients, because they knew their results and they could tell their consultants exactly what those results were. There is excellent work going on Scotland. There are a couple of clinical trials. One is being co-ordinated by Dundee. In Dundee, there is a 2.2 million European-wide study on new techniques to underpin the vascular access related to hemodialysis, which is a very important study. There is another four-year trial on 2,000 patients about tackling the issue of iron, which is also important. We have good research in Scotland, as we always do. I will finish on the other aspect of this note. That is the question of voluntary support. For me, it is essential that there be agreement with the health board beforehand, because raising the capital is one thing and raising the continuing costs is another. Communities should agree with the health board on that development, but that voluntary and statutory partnership is exactly what is contained in the documents by Sir John Elvidge called The Enabling State, which I have commended in other debates to this Parliament. I believe and fact a way forward, because it gives ownership to the community, it gives a feeling of co-operation and partnership with the statutory body, and that is very good for Scottish society as a whole. I thank Lewis MacDonald for bringing this to the attention of Parliament and to the contribution from other members. It is, of course, clearly close to my heart. As constituents of mine, I would obviously prefer to travel south to Stonehaven rather than into ARI, but, of course, I speak here as a Government minister. I also welcome to the gallery those from Stonehaven. Their fundraising efforts have been absolutely marvellous from Stonehaven Folk Club's Cabaret Night, Stonehaven Rotarians, as Lewis MacDonald mentioned, the July Music Festival in Mineral Well Park, the Harbour Festival, the large sum from the Gammie family beer festival, Christmas lights from the residents in Malcolm's Way and the sea commence cadets to name a few. I have probably missed somebody out or some groups out and I apologise for that. As others have said, patients requiring dialysis treatment have to go through continuous life-saving treatment, sometimes for several years, which inevitably means some disruption to everyday life. Firstly, I want to make clear that the Scottish Government is committed to ensuring that people with renal conditions are able to access the best possible care and support and benefit from healthcare services that are safe, effective and put the patient at the centre of their care. We are absolutely committed to ensuring that patients requiring renal dialysis in Scotland are able to access those facilities as close to home as possible, but because of the highly specialised nature of dialysis, people often have to travel a fair distance to their nearest renal unit. It is well established in research that renal patients do better when they receive treatment nearer to home, with the support of family being on hand, with less travel time and where set routines for mealtimes, for example, are easier to keep. An example of how we are seeking to ensure continuous improvement in this area and reduce journey times for patients in more remote areas is a pilot programme, which is under way, where two dialysis chairs have been provided by NHS Gator Glasgow and Clyde in Campbelltown to provide a dialysis service to patients in the Argyll and Bute area. The two-year pilot, which began in August 2015, will be evaluated after one year to analyse its progress and whether such a model of care might be workable in other parts of the country. The pilot was co-funded by local fundraising, and I look forward to seeing the results of the pilot to ensure that any learning can be passed to other NHS boards. We know that, in December 2013, there were nine adult and one paediatric renal units in Scotland with 25 dialysis units—the number, of course, increasing, as Dr Simpson said. The fundraising that has been done by the groups that I mentioned is testament to the great work that can be done locally, along with health services, to ensure that services are delivered locally to patients. Indeed, NHS Grampian is committed to establishing a satellite renal dialysis unit in Cincardin and meeting the staff, running and equipping costs, therefore meeting any difference between the cost and the final fundraising total. As has been said, a design team has been appointed to work with the local community and the board to agree a cost for the facility, after which a commitment to the timetable for the establishment of the service can be given, which I am sure is great news for the 25 patients in the Stonehaven area who travel to Aberdeen on a regular basis for treatment. Of course, for some people, although not all, dialysis is a precursor to the requirement for a kidney transplant. In 2013, we published a donation and transplant plan for Scotland 2013 to 2020, which sets out the ways in which we hope to improve donation and transplantation in Scotland. We want Scotland to be among the best-performing countries in the world for donation and transplantation. The plan sets out the priority areas of work that we need to tackle over the period up to 2020 to enable us to reach that goal. The Scottish Government is delighted to be working with Kidney Research UK to deliver a three-year peer educator programme, specifically designed to raise awareness of kidney disease and the need for organ donation, particularly in the BAME communities in Scotland. I am looking forward to attending an event that they have organised in Glasgow next month to learn more about the important work. In regard to services for renal patients, the Scottish Government has, since 2010, funded the renal patient view service. The service enables patients to view their latest test results, as Dr Simpson said, and diagnostic information online from anywhere in the world and to share it with anyone they want. Information comes directly from existing records, for example hospital and GP records, and may be entered directly or via other apps. Securing messaging functionality is also included. The system provides a vital service to renal patients, allowing them to communicate with their clinician to discuss their test results and on-going management of their condition. The system can also be developed for other conditions, and the Scottish Government is currently working with clinicians and third sector organisations to develop the system for other long-term conditions. I am also looking forward to visiting the renal unit at the Edinburgh Royal Infirmary on 4 November to see the vital work that is carried out there, and, importantly, to meet some patients who attend the hospital on a regular basis to receive their care. I commend the excellent fundraising work that has been done in the Stone Haven area. I look forward to hearing the progress, as members will probably hear in our regular meetings with NHS Grampian and the local community, to hear about how plans proceed for the dialysis service at Crenard and community hospital, which, of course, will be very welcome. Many thanks, minister. That concludes Lewis MacDonald's debate on Stone Haven Dialysis unit, and I now close this meeting of Parliament.