There needs to be a partnership between people who access social care services and those who provide them, say Shelley Gray and Ian Welsh

Last month we brought together more than 250 people for the Health and Social Care Academy Citizens Wellbeing Assembly. The Assembly heard from Cabinet Secretary Shona Robison, hot on the heels of her announcement at the NHS Scotland annual event that she wants to have a national conversation on the future of health and social care. At the same time the Cabinet Secretary also launched “Our Voice”, an initiative designed to strengthen all our voices in health and social care, and make sure words lead to action and improvement.

There is no doubting the appetite for change in Scotland, and for that change to be shaped not only by politicians and civil servants, but by us all. We all recognise what the Cabinet Secretary told the Assembly; doing more of the same will not address the challenges we face. We have had at least a decade of policy seeking to drive fundamental change in health and social care and, while we have seen some shifts, that change is not happening fast enough, widely enough or radically enough.

the Assembly offered some insight into how we might move from conversation about change, to creating change together, so that the way we address our health and wellbeing is transformed.

Participants were very clear that the discussion needs to be about “wellbeing”, rather than about “health and social care”. As Oliver Escobar, Co-Director of What Works Scotland, said, this is not simply about how we design services, but rather about asking the big questions about what kind of society we want.

The debate echoed, too, the messages of the Enabling State from Carnegie UK Trust which foresees a new relationship between the state and citizens; one in which rights, community empowerment and peer-to-peer support are key. All of this is reinforced by our own work on self-management, peer support and enabling communities to own, find and develop their own assets for supporting wellbeing.

The Assembly also reflected on the challenge of having mature discussion about complex issues without debates becoming polarised or politicised. Participants demonstrated their willingness to engage in discussions about tough decisions (for example, a majority voting that the health budget should not continue to be “protected” at the expense of other areas such as social care), and frustration with political debates dominated by waiting time targets to the exclusion of wider issues. Underlying all the discussion was a sense that change requires a substantial shift in culture, and particularly in the balance of power. Initiatives such as “Our Voice” will only succeed if there is equal partnership between all of us, including between people who access services and those who provide them. That shift is happening, not least through recent efforts towards self management, self-directed support and co-production, but is far from the prevailing culture throughout health and social care. People still describe feeling that they do not have parity of esteem alongside health and social care professionals. They highlight, too, the need for people to have the resources to enable them to participate. These are usually modest and may include access to information, communication support, independent advocacy, accessible transport or cover for caring responsibilities. At a Scotland-wide level, too, there must be continued investment in programmes designed to enable shifts in culture and practice, for example initiatives like the Alliance’s People Powered Health and Wellbeing Programme, designed to embed co-production across health and social care.

Lastly, the Citizens Wellbeing Assembly was clear that, while we need to build on what is already good, we also need to embrace truly transformative change and this requires a collective approach. The Alliance established the Health and Social Care Academy precisely to support the radical thinking that the Cabinet Secretary has called for, and to enable this to be driven by all those with a stake in our wellbeing by thinking, talking and acting together. As the National Conversation develops, we look forward to continuing to create these opportunities and helping turn words into real change that emerges from, and makes a difference to, lives and communities across Scotland.

• Shelley Gray is Director of Policy and Ian Welsh Chief Executive at the Health and Social Care Academy run by the Health and Social Care Alliance Scotland. It seeks to amplify the voice of lived experience to drive transformative change. The Citizens Assembly will contribute to the national conversation on the future of health and social care, along with its “My Wellbeing, My Future” creative competition, which runs to 17 July.

academy.alliance-scotland.org.uk/

www.alliance-scotland.org.uk

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JOB losses on Scotland’s railways could now top 100, far more than the “dozens” previously expected, a union fears.

The Rail, Maritime and Transport union (RMT) described the cuts by the new ScotRail-Network Rail partnership as “stealth” reductions.

Voluntary redundancies are being sought by the closer-working alliance between train operator and track owner to cut costs and end duplication.

The RMT, its biggest union, revealed it had been told by ScotRail of plans to reduce the number of fitters (a type of engineer) by 80.

However, the union said it expected some cleaners to go too.

The news comes a month after The Scotsman revealed dozens of jobs were due to be shed by the alliance, which employs 7,000 staff.

There are also expected to be reductions among control room staff and management.

RMT general secretary Mick Cash has now warned ScotRail it would ballot members for industrial action if more than 80 posts were lost, or the firm reneged on its “no compulsory redundancies” policy.

The policy also covers Network Rail workers as part of a two-deal pay deal until the end of next year.

ScotRail has stressed no one will be forced to leave, and said it had pledged to recruit up to 100 extra train drivers. That is part of the settlement of a pay dispute with drivers, to make Sundays part of the working week rather than rely on staff working voluntary overtime.

ScotRail said a joint working party would be set up with the unions “to discuss how we ensure Sunday becomes part of the working week”.

Mr Cash said: “ScotRail confirmed their intentions to reduce the headcount by means of introducing a voluntary leavers scheme.

“The union’s executive committee is of the view the introduction of a scheme is in fact a reduction in staffing numbers by stealth.

“The company has indicated they are looking for 80 fitters to leave the business. It is likely the figure will go beyond the 80 fitters as this does not include cleaning grade members.

“A ‘no compulsory agreement’ currently exists between the RMT and ScotRail. Therefore, should the company renege on this agreement or indeed the reduction in staffing numbers goes beyond the 80 jobs through voluntary redundancy, then the RMT will immediately go into dispute with ScotRail and I will commence a ballot for industrial action.”

ScotRail said it could not give the number of redundancies until it knew how many staff had applied to leave.

A spokesman said: “We have a no compulsory redundancy policy in place, so everyone who wants a job will have a job.

“In fact, we recently announced we will be recruiting up to 100 extra train drivers to allow us to run a modern, seven- day railway that can grow and develop in the future.

“We have opened up a voluntary leavers scheme so people who wish to leave the business can do so.

“This is a matter of choice for our employees. Nobody will be leaving us who doesn’t want to.”

CALLS have been made for improvements to care for stroke victims after many Scottish hospitals fell short of expected standards.

The Scottish Stroke Care Audit revealed that a string of key targets were missed last year, with only 80 per cent of patients treated in a specialist stroke unit within one day of admission against a 90 per cent target.

The annual report, which was published yesterday, found that 20 hospitals across Scotland failed to achieve the standard set by the Scottish Government.

Just 43 per cent of patients were treated using the drug thrombolysis within one hour of hospital admission, against a target of 80 per cent.

The proportion of patients undergoing carotid endarterectomy, an operation to clear a narrowing of blood vessels in the neck, within 14 days of a stroke also fell to 38 per cent, against an 80 per cent target.

Important standards were also missed on the provision of aspirin and swallow screens, which help people to ingest food and fluids safely.

Campaigners said there was still a long way to go until patients could be assured of receiving the best possible care.

Andrea Cail, director for Scotland of the Stroke Association said: “These standards are tough and they are meant to challenge stroke teams to ensure continuous improvements in treatment and care.

“However, we are concerned to see that a number of hospitals in Scotland are still failing to meet the standard set for some of the vital elements of care as outlined in the stroke care 
bundle.”

She called for more patients to have a scan within four hours of arriving in hospital, to ensure the right treatment is provided.

Ms Cail added: “Stroke remains a key health issue for the people of Scotland and the Scottish NHS. It is the third commonest cause of death in Scotland and the most common cause of severe physical disability amongst Scottish adults and we have to continuously seek to improve how we manage this condition. The pressure that hospitals are facing isn’t likely to go away. Despite the reduction in the number of strokes in Scotland over the last 10 years, type 2 diabetes and obesity are on the increase and we have an ageing population – all of these are risk factors for stroke.”

The figures show there is “a real problem” with stroke care in Scotland, warned Labour health spokesperson Jenny Marra.

She said: “Not only has the performance gone backwards this year, the target has been missed by a staggering ten per cent. The health secretary should be looking at these figures and asking why key targets have been missed by such large 
margins.”

NHS Scotland clinical director Professor Jason Leitch said: “This year’s Scottish Stroke Care Audit continues to show that stroke care is consistently improving year on year with every health board making improvements in delivering the ‘stroke care bundle’ – a group of specific interventions which can significantly improve patient outcome.”

Our message for the government: stop the bus, we want to get on with a pass, writes Jan Savage

People who have learning disabilities are losing their bus pass and becoming increasingly isolated due to gaps in the National Concessionary Travel Scheme.

Enable Scotland launched its #stopthebus campaign in May to call on Scottish Government to make a difference for people with learning disabilities in Scotland. As it stands, disabled people who receive the lower rate of DLA have not qualified for a bus pass since the Scheme was nationalised in 2006.

However, many people only found this out when they went to renew their travel card some years after this decision was made. This impacts on many people who have learning disabilities who rely on their bus pass to access transport. The National Bus Travel Concession Scheme provides more than financial support. It facilitates the accessibility of bus travel and the independence of people with learning disabilities. Having a bus pass removes the psychological barriers to independent travel; reduces the anxiety of having the correct change for a bus fare and increases confidence to make journeys independently.

For many people with learning disabilities, it is a lifeline – a bus pass to independent living. The Scottish Government’s current ten-year strategy to improve the quality of life for people with learning disabilities, the Keys to Life, states: “In order for people with learning disabilities to be truly independent, it is important that transport is accessible, affordable and available.” Concessionary travel is fundamental to delivering both affordable and accessible transport. Enable Scotland members such as Jacqueline Bonar told us how difficult the situation is just now. Jacqueline said: “I don’t travel anywhere new alone now. I have difficulty with numbers and money so I would panic if there were any disruptions on the journey and I had to change buses.

“Beforehand I knew I could go on any bus with my travel pass but now I would panic about how much it would cost and if I would have enough money. If I had my pass, I could get the bus into town when I want and I wouldn’t have to rely on my mum to pay me onto the bus. It would be my card to use when I wanted.”

We identified #stopthebus as a campaigning priority through our regular contact with members, who were increasingly telling us that many of them were losing entitlement to their bus pass when they came to renew, and were ending up with no way to travel independently.

Many of our members live in areas where buses are the only means of public transport, and without access to that service they are faced with social isolation. The Scottish Government has an opportunity here to make a real difference to the lives of people who have learning disabilities. We ask that they extend the eligibility criteria for the concessionary travel scheme to include those with the lower component of Disability Living Allowance. We are also asking the Scottish Government to refine the process for people with learning disabilities accessing the scheme via the non benefit-related route specifically designed for those who have mental health problems and learning disabilities. It is clear from our research that this route is not being consistently followed and people are losing out for no reason other than a lack of clarity. Since the launch in May, these messages seem to have been moving in the right direction, if you’ll pardon any pun. MSPs were quick to voice their support when the Enable Scotland campaign bus reached Holyrood on 23 June as part of Learning Disability Week.

MSPs have met our campaigners, and it is encouraging that Minister for Transport and Islands, Derek Mackay wants to discuss our concerns. We need to keep telling politicians at every opportunity what damage is being done to people’s lives without these cards. They really are a lifeline. Write to your MSP through our campaign and help make this vital change to the lives of people with learning disabilities.

• Jan Savage is Director of Campaigns and Social Affairs, Enable Scotland See www.enable.org.uk/stopthebus

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A new environmental charity aiming to bring back species such as wolves, bison, lynx and even humpback whales to Britain has been launched.

Rewilding Britain, inspired by the success of campaigner George Monbiot’s book “Feral: Rewilding the Land, Sea and Human Life” hopes to establish at least three core areas of “rewilded” land by 2030, covering 100,000 hectares or more each.

It wants at least one of these rewilded areas to connect both land and sea from mountaintops to coastal water.

The charity has been founded with the support of key organisations such as the Forestry Commission, John Muir Trust, Friends of the Earth and the Cairngorms National Park.

It argues that almost all land in Britain is managed and that even in conservation areas natural processes are “arrested”.

While acknowledging the work of projects such as the Carrifran Wildwood in Dumfries and Galloway, Wild Ennerdale in Cumbria and Trees for Life, it says their efforts are generally disjointed, isolated and on a fairly small scale.

The project also aims to stimulate eco-tourism which is already worth £1.4 billion to the Scottish economy.

Mr Monbiot said Britain needed to catch up with the rest of Europe in reintroducing rare species.

“The changes we’re calling for would be considered unexceptional almost anywhere else in Europe, where in many countries populations of beavers, boar, lynx and wolves are already recovering rapidly.

“So far, the public appetite for change here has had few outlets. We want to change that, and to restore the living world and our relationship with it.”

Stuart Brooks, chief executive of the Pitlochry-based John Muir Trust, said the vast scale of the Scottish Highlands could offer an ideal location for one of the core areas.

“Nature reserves with fences around them where you go in and ‘see nature’ do a disservice to Scotland. We have the land to establish something on a much bigger scale.

“This is not a threat to landowners. It is not beyond reason three or four landowners could get together and establish an area across some of their sporting estates. The same could be said for local authorities and NGOs.”

Mr Brooks said the introduction of a species such as wolves would take time.

“The trust is supportive of reintroducing species but there are lots of issues to consider first including the impact on other land users. You can’t introduce a species knowing it doesn’t have wide public support.

“The term ‘rewilding’ is new but the idea is embedded in much of what we do.

“We’re on a journey here and Rewilding Britain is the next step in a process which has seen the reintroduction of species such as the beaver and white-tailed sea eagle.”

Dairy Crest saw sales of its butter and spreads brands fall in the first three months of its year, but said strong demand for Cathedral City had helped keep trading on track.

The group, which is selling it dairy arm to Germany’s Muller for £80 million, said sales of Clover and Country Life had fallen in the 12 weeks to the end of June in line with the wider butter and spreads market.

However, the firm added that sales of its flagship Cathedral City cheese brand had “another strong quarter, during which it has continued to grow sales and market share”.

Muller, which announced its deal in November, will acquire four dairy sites and 72 depots from Dairy Crest, as well as the flavoured milk brand Frijj.

Dairy Crest said the deal had already been approved by its shareholders and was being looked at by the Competition & Markets Authority. It added it expected to complete this sale before the end of the year.

Doctors are warning that allergies could be missed in children because many healthcare professionals are relying solely on blood or skin-prick tests.

Dr Kate Grimshaw, a specialist paediatric dietitian at Southampton Children’s Hospital, warned that not all allergies could be detected purely by measuring levels of a protein in the blood – immunoglobulin E (IgE) – which is linked to allergic reactions.

Her advice follows new research into cow’s milk allergy, published online by the medical journal Allergy, which found that for every UK child who had a cow’s milk reaction due to IgE in their blood, there was a child who suffered a reaction who 
did not.

Dr Grimshaw, who was involved in the European Union- funded project known as Euro-Prevall, said: “We know that sometimes if a child is seen for a possible food allergic reaction – to any food, not just milk – but tests show there is no measurable IgE, then a possible food reaction may be ruled out when in fact the child may be reacting to the food, just not via IgE.

“This research will hopefully highlight to GPs and non-allergy specialists that just because an IgE test is negative, the child may in fact be reacting to a food and further investigations should be carried out.”

Food allergy reactions are split into two groups – IgE-mediated, which cause a range of immediate symptoms such as skin rashes, vomiting, respiratory issues and, in some cases, potentially life-threatening reactions, and non-IgE mediated.

Non-IgE mediated reactions occur around four to 28 hours after an incident and may cause stomach complaints such as diarrhoea or constipation, among other problems.

The study, which saw more than 9,000 babies from nine European countries followed up until the age of two, found that 1.3 per cent of UK children reacted to milk within two hours – the highest rate of all the countries involved – but only just under half (45 per cent) had IgE at a “high” level.

Professor Graham Roberts, a consultant in paediatric allergy and respiratory medicine at Southampton Children’s Hospital and principal investigator for the UK study, said: “Our study shows that a significant number of children can be reacting to a food despite having a negative IgE test.

“The take-away message for any non-allergy specialist is that if the patient’s history is convincing, then further investigations should be made if the IgE tests are negative, to ensure the child isn’t actually reacting to a food.”

The research, funded in the UK by the Food Standards Agency, was part of a project called Prevalence of Infant Food Allergy (Pifa), which assessed the development of food allergies in children in Hampshire in the first two years of life.

Dr Grimshaw and Prof Roberts now plan to reassess all 1,140 children who participated in that research at school age to discover what happens to allergies that started in early childhood, and find out which older children develop allergies and asthma.

DAVID Cameron was fuming over the SNP group of 56 blocking changes to hunting in England. It was clear that the Prime Minister thought that Scottish MPs should not be voting at all on an issue that only affects England and Wales.

But the huge irony was that Mr Cameron’s own proposals for English votes for English laws (Evel) would not prevent the SNP exercising a veto again, given the right circumstances in the future over foxhunting south of the Border.

The Evel proposals simply provide English MPs with a wrecking power over legislation they do not like if a UK government some time in the future requires MPs from Scotland to form a majority.

What is on the table is an English grand committee stage and then a double majority of English MPs and UK MPs in a final third reading in the House of Commons.

The double majority is a double-edged sword. It means that English MPs can stop something but so can all UK MPs. What this row over foxhunting has done is raise suspicions that the Tory leadership may be persuaded to go with a version of Evel that is even worse than currently proposed.

If Mr Cameron really does not want Scottish MPs to vote on matters like hunting which only affect England and Wales then he would have to bring in a change which would actually block them from taking part in anyway. This would really mean that there were two classes of MP in Westminster as is being claimed by critics of the current Evel proposals.

The row has worked for both the English and Scottish nationalists.

Mr Cameron can point to the need for a stronger English voice in parliament while the SNP have undoubtedly seen Evel as the means for driving a wedge into the Union.

We pride ourselves on the care we provide, writes Lucy Hyde

THE reputation of Leuchie House relies on the people who work there. People from all over Scotland and further afield who book for caring respite breaks are doing so because of the attitude of staff who pride themselves on making each break an unforgettable experience for guests and their families.

We recently received a wonderful letter from two first-time guests, a husband and wife, who wrote: “I have never experienced an organisation or company whose normal standard showed so much attention to detail and who listened and heard what the person wanted and needed. Every member of staff we encountered during our stay went the extra mile to make us both comfortable and relaxed and confident that we were getting the best of care.”

Last year, Leuchie House provided 6,279 days of respite. These are desperately needed breaks from the rigours of living with long-term degenerative conditions such as multiple sclerosis, stroke, motor neurone disease, Parkinson’s, cerebral palsy and Huntington’s.

Leuchie is not like other care providers, though. It is as far from a purpose-built medical establishment as you could imagine. Set in a beautiful 18th-century country house in the rolling countryside of coastal East Lothian, the fully accessible house and grounds offers expert nursing care in a non-clinical environment.

Modelled on quality country house hotels and with the backing of some of Scotland’s top tourism destinations, Leuchie offers a full holiday experience as well as expert medical care. Guests are offered a full programme of trips, activities and outings, as well as on-site physiotherapy and a range of complementary therapies.

The emphasis is very much on the social side of the breaks and for many of the guests, this is crucial as their options for socialising may have been reduced as their condition progresses, leaving them increasingly isolated.

For recruitment purposes, this leaves Leuchie in a field on its own. The independent charity is held up as a true example of the Scottish Government’s agenda on the integration of health and social care. But this dual role calls for exceptional staff – which is why we go out of our way to recruit people like Lorena Brown.

Lorena first came to Leuchie on a six-week work placement in 2009 from her Napier University nurse training. She came back in 2010 for management training before graduating the same year and returning as a care assistant before she started working as a registered nurse.

After working her way up to her current role as charge nurse and acting clinical nurse manager, Lorena has now come full-circle as she prepares to mentor students from Napier University at Leuchie.

She said: “I would love it if any of my students chose to come and work at Leuchie House. It’s so different to working on a ward. One of the main reasons I love working here is that you get to build up a rapport with the guests, especially the ones who come back again and again.

“There is time to get to know them and you see what a difference their break at Leuchie makes to them. Many of our guests can’t get out at all when they’re at home, but we are able to take them on trips when they’re here, which is great for us as well as seeing how much they enjoy it – it is so rewarding.

“The staff here are all great too. It’s a perfect place for students to come as there’s so much to learn because we have guests with so many different conditions.”

These are challenging times for any business in terms of recruitment, but for some third-sector organisations, and particularly, perhaps, those in the healthcare sector, there are additional obstacles to overcome before we can get high-quality staff in the door. Recruitment is tough across the nursing sector at the moment, but Leuchie has so much to offer both new and experienced nurses. Not only is it innovative in terms of the integration of health and social care, it is an area that will grow significantly as the population ages.

But it is a demonstration of the ethos and atmosphere of Leuchie that as soon as people are through the door, they immediately realise what makes us different.

The guest is at the centre of everything we do and, while job descriptions and roles are clear-cut, we are one big team which really knows how to welcome a new face.

• Lucy Hyde is HR manager at Leuchie House, www.leuchiehouse.org.uk

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EVENTS, birthdays and anniversaries on July 15.

St Swithin’s Day.

AD862: When St Swithin, Saxon Bishop of Winchester, died, he asked to be buried outside where rain could fall on his grave. Some 108 years later on the same day, when devoted monks decided to move the body from the “vile and unworthy grave”, a sudden deluge drenched the funeral party and it rained for nearly seven weeks.

1099: Jerusalem was captured by the Crusaders.

1207: King John of England expelled Canterbury monks for supporting the Archbishop of Canterbury.

1381: John Ball, a leader of the Peasants’ Revolt, was hung, drawn and quartered in the presence of Richard II.

1799: The Rosetta Stone was found in the Egyptian village of Rosetta by French Captain Pierre-François Bouchard.

1815: Napoleon surrendered to Captain Frederick Maitland of HMS Bellerophon following his earlier defeat at Waterloo.

1864: A troop train loaded with Confederate soldiers collided with a coal train near Shohola, Pennsylvania during the American Civil War, killing 65 and injuring 109 of 955 aboard.

1869: Margarine was patented in France by Hippolyte Mège-Mouriés of Paris.

1889: National Portrait Gallery for Scotland opened in Edinburgh by the Marquess of Lothian.

1912: National Insurance or social payment, devised by Lloyd George, began.

1916: William Boeing founded his aircraft company, Pacific Aero Products, in Seattle, Washington.

1927: Bobby Jones scored 285 at St Andrews to win the Open Championship.

1933: Wiley Post took off from New York for first solo round-the-world-flight - the journey of more than 15,000 miles took seven days, 18 hours, 49 minutes.

1937: The concentration camp at Buchenwald was opened.

1939: Clara Adams became the first woman to complete a round-the-world flight.

1958: South Africa resumed full membership in United Nations.

1963: Paul McCartney was fined £17 for speeding.

1965: US Mariner-4 sent back the first close-up pictures of Mars.

1978: Jack Nicklaus scored 281 at St Andrews to win the Open Championship.

1983: Linda Ronstadt made her Broadway debut as Mabel in The Pirates of Penzance.

1989: Police searched for £1 million cash that disappeared from Heathrow Airport.

1994: Hundreds of thousands of Hutu fled to Zaire – now the Democratic Republic of the Congo – to escape genocide in Rwanda.

2002: Anti-Terrorism Court of Pakistan handed down the death sentence to British-born Ahmed Omar Saeed Sheikh and life terms to three others suspected of murdering Wall Street Journal reporter Daniel Pearl.

2007: In the largest compensation deal of its kind, the Roman Catholic Church in Los Angeles said it would pay a total of $660 million to the 500 alleged victims of sexual abuse by 221 priests and other church staff dating back to the 1940s.

2009: Harry Potter and the Half Blood Prince, the sixth film in the Harry Potter series, was released.

2014: Israel announced it had voted to accept a ceasefire proposal by Egypt. Hamas rejected it, saying they had not been consulted.

BIRTHDAYS

Celia Imrie, actress, 63; Carmen Callil, founder of Virago Press, 77; Derek Griffiths, actor, 69; Trevor Horn CBE, songwriter, 66; Irène Jacob, French film actress, 49; Ann Jellicoe, playwright and theatre director, 88; David Miliband, former Labour minister, 50; Brigitte Nielsen, actress, 52; Linda Ronstadt, rock singer, 69; Arianna Huffington, founder of news website The Huffington Post, 65; Forest Whitaker, actor, 54; Diane Kruger, actress, 39; Jill Halfpenny, actress, 40; Peter Odemwingie, footballer, 34; Clive Cussler, novelist and marine archaeologist, 84; Sheikh Mohammed bin Rashid Al Maktoum, president of United Arab Emirates and racehorse owner, 66.

ANNIVERSARIES

Births: 1573 Inigo Jones, architect; 1606 Rembrandt Harmenszoon van Rijn, artist; 1858 Emmeline Pankhurst, suffragette; 1865 Lord Northcliffe, newspaper proprietor and pioneer of mass circulation journalism; 1911 Baron Shackleton, geographer and politician; 1914 Gavin Maxwell, author of Ring of Bright Water; 1919 Iris Murdoch, author; 1929 Larry Lamb, newspaper editor.

Deaths: 1767 Michael Bruce, Scottish poet; 1883 Charles Sherwood Stratton, known as General Tom Thumb, 40in tall; 1976 Paul Gallico, novelist (The Snow Goose and The Poseidon Adventure); 1989 Laurie Cunningham, footballer; 1990 Margaret Lockwood, actress; 1997 Gianni Versace, fashion designer (murdered); 1999 Earl of Dalhousie, governor-general of Rhodesia and Nyasaland; 2011 Googie Withers, actress; 2012 Celeste Holm, actress.

Individual police officers must not be “scapegoated” by an inquiry into the fatal tragedy which saw two Scots left in their crashed car for days after the accident was reported.

Labour and the Liberal Democrats have raised fears after justice secretary Michael Matheson ruled out a “systemic” problem with police call-handling – before an inquiry into the tragedy has reported.

John Yuill and Lamara Bell were found inside the crashed car last Wednesday by the side of the M9 motorway near Stirling, three days after it had been reported. Ms Bell was still alive but died after three days in hospital. Mr Yuill was dead when the couple were found.

Lib Dem leader Willie Rennie said rank-and-file officers must be able to “participate fully” in a review of call-handling by Her Majesty’s Inspectorate of Constabulary in Scotland (HMICS), without fear of repercussions.

Mr Rennie said: “The fact the HMICS review has been ordered by the justice secretary is welcome but by appearing to rule out systemic problems, Michael Matheson seems to have pre-judged the outcome. I am alarmed that the justice secretary and chief constable are already claiming it was an individual’s fault and that the wider system was blameless.

“There should be no scapegoating of any officer so we need the inquiry to be free to come to its own conclusions.”

The tragedy has already been put down to human error after it was revealed a senior officer had taken down details of the accident, but they were not then fed into the system.

But Scottish Police Federation chair Calum Steel yesterday criticised the justice secretary, saying it was “remarkably dangerous” to pre-judge the outcome of an inquiry before it has taken place.

Mr Rennie, who has been contacted by serving officers and civilian staff regarding difficulties in police control rooms, warned the minister that officers must have confidence that they can speak freely.

Labour’s acting leader Iain Gray has written to the First Minister and said the tragedy was the latest in a “long line of failings” on the part of Police Scotland after rows over stop and search and armed policing.

Mr Gray welcomed the inquiry, but also raised concerns the justice secretary appeared to give the call-handling process “a clean bill of health before the inquiry has reported”.

He said: “We may never know whether Lamara Bell or John Yuill would have survived. But we do know that both deserved better.”

A Scottish Government spokesperson said; “Work is underway to ensure a tragic incident like this cannot happen again.

“While we were informed the initial Police Scotland internal review did not suggest any systemic failure, it is precisely to ensure this was the case that the Cabinet Secretary for Justice has directed Her Majesty’s Inspectorate of Constabulary in Scotland to carry out a full review of all call handling and processes within Police Scotland’s Contact, Command and Control centres.”

NOT everyone gets the treatment they need, says Richard Meade.

Why do some people with a terminal illness other than cancer miss out on palliative care? If you have one or a combination of the most prevalent terminal illnesses, such as heart failure, chronic obstructive pulmonary disease (COPD) or dementia, shockingly, you may not get the care and support you need. In Scotland, around 40,000 of the 54,700 people who die each year need palliative care.

Palliative care is often recommended for people living with a terminal illness. It can include pain and symptom management, as well as physical, emotional and spiritual support. Although this issue is complex, we think there are two reasons why people who have a condition other than cancer miss out. Firstly, there is a lack of understanding amongst some healthcare professionals and the public about what palliative care can do, who it can benefit and when it should be introduced. This can be because some disease courses are hard to predict, so it is difficult to know when the person has become terminally ill, and some diseases aren’t always considered to be terminal.

Secondly, professionals do not receive enough training to be able to recognise when someone needs palliative care or when someone is dying. There is an overwhelming need to make palliative care everyone’s business.

Palliative care can be, and is, delivered by a wide range of professionals across a range of settings. This includes geriatricians, cardiologists, and GPs, not just palliative care professionals.

In the report Triggers for Palliative Care and its accompanying implications for Scotland report, released on 23 June, Marie Curie has highlighted a number of barriers people living with a terminal illness face in receiving palliative care and how we might address some of these challenges.

To help healthcare professionals, patients and their carers to recognise the signs, we have highlighted a series of “triggers”, which can indicate that a palliative care approach might be needed. These triggers can include the patient having complex or persistent problems with a symptom, such as continuous pain or breathlessness, high levels of hospital use and especially unplanned admissions, more than one condition to manage, weight loss or a change in eating habits, or new clinical interventions such as ventilator support, and for some conditions, such as Motor Neurone Disease, palliative care may be needed at the point of diagnosis.

There are also a range of screening tools that healthcare professionals could use to help identify patients needing palliative care. Ensuring that all healthcare professionals working with a terminal illness have training so that they can identify these triggers, and can feel confident to talk to their patients about end of life as well as help deliver palliative care, can help ensure that more people get the support and care they need without placing a huge and perhaps unnecessary demand on specialist palliative care professionals.

The number of people dying in Scotland is due to increase by 13% over the next 25 years so we need to act now or this problem will get much worse. Marie Curie fully supports the Scottish Government’s commitment to publishing a new strategic framework for action for palliative and end-of-life care in 2015. This is an opportunity to set out an ambitious plan to ensure that everyone living with a terminal illness gets the care they need. We believe that the framework should include a clear commitment to ensure that everyone with a palliative care need has access to it by 2020, regardless of condition.

We also make a number of other recommendations in our report, which include required palliative care training and support for everyone working with people with a terminal illness and supporting better understanding between palliative care specialists and disease-specific specialists to improve care pathways.

Shona Robison MSP, Cabinet Secretary for Health, Wellbeing and Sport, stated that palliative care would be an “early priority” for the new integrated health boards. We hope they look to tackle the palliative care needs in their areas as they now develop their board strategies for the coming three years. The next six months presents us with the best opportunity to shape palliative care in Scotland for the rest of the decade. We must all work to get this right for our family, friends and ourselves when the time comes.      

• Richard Meade is Marie Curie Head of Policy & Public Affairs, Scotland. Visit mariecurie.org.uk/change

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CONTROVERSIAL plans to create a system of English votes for English laws (Evel) will be defended by ministers today in a tense debate overshadowed by rows and claims the Government is a “shambles”.

Commons Leader Chris Grayling had hoped to force through major changes to how the Commons scrutinises new laws to ensure an English, or English and Welsh, veto on measures which do not apply in Scotland.

But following an emergency Commons debate last week, coordinated opposition from Labour and the SNP and significant unease on his own benches, Mr Grayling offered a two stage debate which will not finish until at least September.

Today’s first debate will be overshadowed by fox hunting after an SNP pledge to vote against Government moves to water down the hunting ban in England and Wales forced the Tories to shelve their plans.

MPs had been due to vote on hunting immediately before the Evel debate but the SNP decision to break its normal rule of not taking part in issues which do not effect Scotland ensured almost certain defeat.

Cancelling the debate yesterday led to chaotic scenes in the Commons as Mr Grayling announced the U-turn in a point of order hours after the news was reported in the media - only to have Speaker John Bercow force the Commons Leader into a 20 minutes question and answer session with MPs on the change.

It provoked Pete Wishart, the SNP’s spokesman on Commons business, to tell Mr Grayling: “What an utter and absolute shambles.

“We need these (Evel) plans to be withdrawn from the House, absolutely and totally, they are a complete and utter mess. What you have to bring back is a proper approach to dealing with this, which is a piece of legislation.”

Ahead of the debate, Mr Grayling has published a tweaked version of his Evel proposals, clarifying rules that will allow all MPs to continue voting on the Budget and other financial matters.

Under the plans, a new Commons stage will be introduced for laws passing through Parliament when English, or English and Welsh, MPs will be asked to accept or veto legislation only affecting their constituents before it passes to third reading.

There will be a separate committee stage for English, or English and Welsh, MPs for Bills not affecting Scotland and Northern Ireland, meaning legislation can be amended without the consent of all MPs in the Commons, although there will be further opportunities to overturn any changes.

The Speaker will be responsible for declaring which legislation is English, or English and Welsh, only.

Secondary legislation - such as that which would have implemented the change to fox hunting rules - would still be voted on by all MPs under the current version of the plans.

Travel search engine Skyscanner has launched a joint venture with Yahoo to try and crack the vast Japanese market.

The Edinburgh-based technology firm, which earlier this year became Scotland’s first $1 billion (£650 million) internet business, will hold a 51 per cent stake in the venture with Yahoo Japan owning the remaining 49 per cent.

Japan is the third largest travel market in the world, with bookings this year estimated to rise to some $71bn.

The firms said that the establishment of Skyscanner Japan provided both partners “an opportunity to accelerate their growth in this important market and offers millions of consumers comprehensive travel options for free”.

Gareth Williams, co-founder and chief executive of Skyscanner, said: “Skyscanner Japan is a start-up backed by a leading global travel search engine and the biggest search engine in the world’s third biggest travel market.

“This is great news for travel in Japan and worldwide. Skyscanner offers the most comprehensive range of travel options to travellers globally, and we strongly believe in making our sites as locally relevant as possible.”

Gen Miyazawa, head of media company at Yahoo Japan Corporation, added: “This joint venture gives us a thrilling opportunity to launch a travel service in Japan, together with Skyscanner, a leading global travel search company. Yahoo Japan, as a problem-solving engine, will enhance the travel search experience for Japanese consumers through its search service, powered by Skyscanner.

“What’s more, we hope to meet the demand of an increasing number of inbound travellers to Japan, and improve their satisfaction, through the widely recognised Skyscanner service.”

Two early actions will be the setting up of a Tokyo office and the hiring of a chief executive for the venture.

SCOTLAND’S Year of Homecoming in 2014 was worth £136 million of additional revenue to the nation’s economy and encouraged more than 326,000 visitors from other countries to make a visit, new figures show.

There were 4.6 million attendances at more than 1000 events and 1,336 net full time equivalent jobs generated by visits associated with Homecoming 2014 - which was a series of events designed to attract people of Scottish ancestry to come to Scotland.

VisitScotland said events associated with the Year of Homecoming “extended the benefits brought to Scotland” alongside the Ryder Cup and the Commonwealth Games in 2014 that were hosted at Gleneagles and Glasgow respectively.

Tourism minister Fergus Ewing, welcoming the findings, said “Scotland welcomed the world in 2014 and this report shows the substantial impact that Homecoming 2014 had on the Scottish economy.

“The Homecoming celebrations were used to showcase Scotland on the international stage as a dynamic and creative nation.

“This was achieved through a year-long programme of over 1000 events designed to welcome visitors from around the world in a celebration of the very best of Scotland’s food and drink, our assets as a country of natural beauty as well as our rich creativity and cultural heritage.”

UNEMPLOYMENT in Scotland fell by 15,000, to 152,000 in the period March to May 2015 with the jobless rate now standing at 5.5 per cent new figures showed.

However, unemployment for the UK as a whole increased for the first time in more than two years as the numbers out of work went up by 15,000 to 1.85 million in the three months to May, the Office for National Statistics (ONS) said.

Employment in Scotland increased by 1,000 over the three month period, and increased by 40,000 over the year, to stand at 2,616,000.

Scotland’s minister for youth and women’s employment Annabelle Ewing welcomed the findings, which also showed a six-year low in youth unemployment – which fell 20,000 over the year.

She said: “These figures show a growing economy and falling unemployment – both extremely encouraging indicators and signs that the economic picture in Scotland is continuing to improve.

“Indeed, Scotland was the only country of the UK where unemployment actually fell over the quarter.

“The 20,000 fall over the year in youth unemployment also means 20,000 more young people are now benefitting from the rewards and opportunities of work – something we are determined to improve on even further.”

Almost 100,000 Scottish patients were forced to travel outside their local area for hospital treatment last year, official figures today show.

The numbers have been growing steadily in recent years and 2015 represents a new high prompting opposition fears about the strain on the NHS.

Patients often travel outside their local areas in order to meet waiting time targets if particular speciality areas are under pressure in their own health board.

In 2014, 99,791 people were admitted to hospitals outside their local health board area, according to the figures obtained by Liberal Democrat health spokesman Jim Hume. This compares with 642,000 who are treated within their own area, suggesting about one in eight are forced to travel.

Theere have been year on year increases since 2011

“There may be good medical reasons for treating patients outside their local health board,” Mr Hume said.

“But these figures are stark, and suggest that services are under real pressure. Almost 100,000 people were admitted to hospitals for treatment outwith their local area.

“What this could mean is patients and their families facing longer and more expensive journeys and extra stress at what may already be a difficult time.

“We know that bed blocking remains a problem in many areas and we have seen the number of beds for older patients fall on the SNP’s watch. We need to understand why so many patients are being asked to travel outside their health board for treatment. Ministers need to ensure that doctors and nurses are getting the support they require to give patients the treatment they need as close to home as possible.”

FANDUEL, the Scottish-founded sports entertainment business, yesterday said it had closed a bumper $275 million (£176m) funding round backed by big-name US investors including Google Capital and Time Warner.

The move, which is thought to have put a value of well over $1 billion on the company, underlines the remarkable rise of the business since it was founded just over five years ago by a group of entrepreneurs and graduates.

The oversubscribed financing round, which was led by US venture capital giant KKR, brings the total capital raised by the company to $363m and will be used to accelerate its growth.

FanDuel charges players to compete in fantasy leagues across the NFL, NBA, NHL and other US sports.

A number of NFL and NBA team owners also participated in the funding round along with previous investors including Edinburgh-based Pentech Ventures.

The financing will be used to grow customer numbers across the US and Canada, develop new products and strengthen its management team. FanDuel said its paid active user numbers in the US have risen by 300 per cent in the last year and that it now has more than a million paying users.

Nigel Eccles, a former group business development manager at Johnston Press in Edinburgh who co-founded the company, said: “Having partners like KKR, Google Capital and Time Warner/Turner Sports invest in FanDuel underscores the way this company is transforming the sports entertainment industry.

“This roster of investors, with expertise across finance, technology, advertising and sports entertainment, is committed to the growth and success of FanDuel as a game-changer for the sports industry.”

Eccles is chief executive of the firm and his wife Lesley, who he met in 1995 when they were students at St Andrews University, is executive vice-president. Originally known as Hubdub, the start-up was supported by the School of Informatics at Edinburgh University.

Ted Oberwager of KKR, said FanDuel was poised to become the “top sports entertainment platform for fans around the world”.

“We are thrilled to support FanDuel’s next phase of growth given the company’s leading position in the daily fantasy market, model operating principles, highly efficient customer acquisition capabilities, and visionary management team,” he said.

FanDuel has become the second Scottish tech business of late to be valued at more than $1bn following Edinburgh-based travel search firm SkyScanner which was named as Scotland’s first internet company to achieve such a price tag last year.

FanDue employs some 225 staff in Edinburgh and the US and has said it sees the potential for its headcount to double as it looks to recruit more software engineers.

Last month the company secured 8,450sq ft of space on the fifth floor of the new 2 West Regent Street building in Glasgow for new offices.

In May it had recruited 40 staff from gaming company Zynga in the US. That move has seen it set up a new Orlando office, adding to existing US operations in New York and Los Angeles, where the staff from Zynga will be based.

Eccles has previously talked about his ambitions for an initial public offering of the company.

Industry estimates suggest the market for online fantasy sports games in the US could top $14bn by 2020. One in three men over the age of 15 is said to play some form of fantasy sports online in the US.

DURING last year’s independence referendum campaign, the BBC came under relentless, often intolerable, pressure from those in favour of a Yes vote.

The corporation was held up as a model of cynical partiality and accused of deceiving voters by many, including former First Minister Alex Salmond, who wished to see the break-up of the United Kingdom. On a number of occasions, pro-independence campaigners gathered in their thousands outside the BBC’s Scottish headquarters to demand the dismissal of journalists they believed had transgressed. It seemed, at times, that the national broadcaster had become little more than a whipping boy.

We have never subscribed to the view that the BBC acted inappropriately during the long and frequently testy referendum debate. Yes, journalists demanded answers to difficult questions and challenged blithe assertions, but this represented nothing more than the corporation’s staff carrying out their duties. It is in the interests of all for politicians to be held to account and we believe the BBC played its part in doing so with distinction.

News that an advisory board to the BBC Trust has urged the broadcaster to carry out a review of how it covers “controversial political issues” affecting Scotland will, doubtless, be seized upon by some as evidence that a problem exists.

That advisers have warned of public concerns about impartiality and the quality of analysis when it comes to coverage of Scottish public life will surely further encourage the perception that all is not as it should be in the corporation’s newsroom.

Bill Matthews, chair of Audience Council Scotland, the body which advises the trust, says that while the corporation continues to produce “high quality independent journalism” from Scotland, its network coverage is “inadequate” and was seen as having adopted an “Anglified” perspective” when reporting, to the rest of the UK, on the referendum.

Of course, it is legitimate for anyone to raise concerns: the BBC must be impartial. It is also legitimate – even necessary – for any large organisation to continually review its procedures. There will frequently be room for improvement.

So, we welcome the call for review of the BBC’s reporting of Scottish issues. Scotland’s political landscape has changed and – while it should not be expected to fall into line with any new political consensus – the corporation may benefit from closer examination of the way it delivers news from Scotland.

But this cannot become an opportunity for those with vested interests to apply undue pressure to the corporation. Our national broadcaster must always be free to ask difficult questions of those in power, no matter who they are or what policies they espouse.

Why we should keep boldly going…

IT’S a photograph that causes the jaw to drop. For decades, we have known of the existence of Pluto, sitting on the outer edge of our solar system. Now, thanks to the brilliance of Nasa scientists, we can gaze upon it, picking out a remarkable degree of detail.

The New Horizons spacecraft yesterday sped past the planet at 14km a second, capturing an image that stands testament to the brilliance of human endeavour. Pluto orbits the Sun more than three billion miles away from Earth. It’s difficult to put that into perspective: but we can all agree that it’s a very long way, indeed.

From time to time, space exploration is dismissed as an expensive indulgence. Why, ask some naysayers, should gargantuan sums of money be spent exploring the solar system and beyond when there are so many problems to address here on Earth? But we were exhilarated by the image of Pluto captured by New Horizons. It speaks of the best of scientific progress, of the importance of ambition and the questing mind.

Space exploration has, in the past, led to innovations – from improved firefighting equipment to memory foam to freeze-dried food – that we now take for granted. Who knows what new scientific discoveries might result as mankind continues to explore billions of miles into space?

But let’s not feel obliged to find a practical justification for this latest giant leap. It is, we feel, enough to explore space because it is there; the satisfaction of our curiosity and the testing of our ingenuity are reasons enough for us to keep searching, to travel further, to see far beyond our horizons.

ONLY one in four learner drivers are taught by driving instructors, according to a survey published today.

The poll found most people preparing to sit their driving test mainly relied on family and friends to teach them.

The most common reason given by novices for not paying for lessons was they were too expensive, with costs averaging £22.50 an hour.

The survey of 2,178 drivers who had passed their test in the last two years showed only 26 per cent had been taught predominantly by a driving instructor.

Discount website vouchercloud, which commissioned the research, said: “Initially, all respondents were asked ‘Who did you do take the majority of your driving lessons with?’

“Almost half of respondents - 46 per cent - stated ‘a family member’ had taught them, with remaining respondents admitting the majority of their lessons had been with either ‘a friend’ (28 per cent) or a ‘qualified driving instructor’ (26 per cent).

If the poll is representative of learner drivers across the UK, the move away from driving instructors does not appear to have affected pass rates.

The latest figures show 46.5 per cent passed their tests between January and March - a rate which has remained virtually unchanged for at least eight years.

Vouchercloud managing director Matthew Wood said: “When you realise those who turn to their family and friends can save so much money, it’s actually a wonder that more people aren’t just using instructors for a few lessons before taking their test.

“That saving of over £600 could go towards the cost of a first car, an insurance policy or even treating yourself and those who have helped you to pass your test.”

However, that angered the Driving Instructors Association, the UK’s largest professional association for driver trainers.

Chief executive Carly Brookfield described the comments as “astonishing” and “irresponsible”.

She said: “This may promote the idea that it’s a good idea to cut the costs of learning to drive because so many other people are already doing it.

“According to the latest [UK] Department for Transport analysis, the statistics for people killed and seriously injured on the roads are up again, with newly qualified drivers being over represented.

“One of the reasons could very well be poor driver training - people short-cutting on learning to drive by using unqualified, inexperienced and inexpert friends and family to ‘teach’ them to save costs.

“What they save on not learning to drive properly, they pay out in terms of accident and repair costs, vehicle maintenance, insurance costs or, sadly, injury or loss of life.”

Motoring groups also underlined the importance of professional instruction.

RAC Foundation director Steve Gooding said: “[UK] Government research has shown two main things deter young people from driving: the cost of lessons and the cost of insurance.

“Therefore it is no surprise the number of approved driving instructors in Britain has declined steadily, with about 41,500 currently on the books.

“But when young people are budgeting for the cost of learning to drive, they should not under value the benefit of getting professional instruction on how to drive safely.”

Edmund King, president of the Automobile Association, which has its own driving school, said: “Private practice helps learners get vital on-road experience so they can pass their test and go on to be safe and confident drivers.

“But it isn’t always easy to teach someone to drive, especially as private cars do not have dual-controls or a professional and patient instructor in the passenger seat.”

A spokesman for the Institute of Advanced Motorists said: “Inexperience, lack of adequate driving skills, risk taking, poor judgement and decision-making are all factors in the higher crash rates for new drivers.

“Learning with a professional instructor, backed up with practice with a parent, can give learners valuable experience.”