Healthy debate at Holyrood

Sat in for an excellent debate at Holyrood today. Excellent, Brian? Were there ructions? There were not. Was there excitable rhetoric? Equally, no.

Was there, then, a demand for the Minister to resign? To the contrary. The Labour committee convener said that he and the SNP minister were "on the same page".

To lodge a caveat, my colleagues and I in the wicked media are sometimes too easily inclined to conflate excellence and news-worthiness. It is part of our charm.

This debate will not make headlines, I suspect. But it was decidedly note-worthy for all that. In a sense, it was Parliament at its best.

The topic was access to medicines. This is a particularly difficult problem.

Human instinct says: all patients should have access to all medicines, in all circumstances, in all cases, if they believe said drug might do them good or prolong their life or even just give them hope.

Then along comes hard-nosed governance. Can we sanction every treatment in all circumstances? Even when the evidence of gain is minimal and the cost is overwhelming?

So, without stating it over bluntly, without confronting the question too vigorously, policy involves compromise. Some patients get treatment - if there is a discernible prospect of a return.

It is a grim calculus. How many days of prolonged life can be expected in return for what degree of investment?

Today at Holyrood, Parliament confronted that compromise as MSPs debated suggestions for improving the allocation of medicine, for removing the harder edges.

And it was Holyrood at its best because the issue first surfaced through a plea to the petitions committee. It was then transferred to the health committee for rigorous scrutiny.

Search for action

Today MSPs discussed the proposals from the Health Committee: a day after the Health Secretary Alex Neil had come forward with a response to those published plans in the shape of proposed reforms which should enhance access to drugs for those who need them.

From popular pressure to political examination to governmental action. If you can produce a better definition of the democratic decision process, I would welcome your guidance.

The debate was opened with a thoughtful, compassionate speech by the health committee convener, Labour's Duncan McNeil.

He admitted himself that his contribution was rather weighed down by alphabet soup, the endless acronyms which blight public life.

But his theme was common humanity. Let us not just tinker, he said. Let us not just change structures. Let us make things better, measurably better, for patients.

At the same time - and crucially - it was by no means an unmediated plea for endless resources, regardless of demands elsewhere.

No "give 'em the money, Barney" speech, easy but futile. Rather it was a modulated suggestion for reform, a plea for more detail from the minister.

Intelligent contributions

Alex Neil, in his turn, spoke well.

But, instead of the oratory with which he frequently delights colleagues and infuriates opponents, his tone and his approach matched that of Duncan McNeil. A common search for action.

There were several other intelligent contributions as Parliament caught the mood. Each aware of the need for change. Each aware of the pressures upon budgets. Each award of the pressure of time.

If a week is a long time in politics, imagine how much, much longer it is when you are waiting for life-enhancing medication.