Chamber and committees

I was really pleased to have a recent round-table meeting with audiology experts, and I think that you have received a letter updating you on the significant work that is under way to ensure that we have a comprehensive audiology service across Scotland. Tayside is an excellent example—

That sort of thing will certainly be addressed through sectoral bargaining. As people will appreciate, it is not for me to sit here and set wages for the sector. Bringing the workers, trade unions and providers together is the most important way of ensuring better wages and more certainty for people in the sector, which can often have a high turnover of staff.

Yes, we can certainly look at that. We want to see more people coming through the sector. One of the things that I have seen reflected in previous reports is that, because the workforce in Scotland is more qualified, people value the ability to work in Scotland and to go through the processes that we have here to deliver that very high-quality care. It is really important that we have people who are qualified but who also have a real passion to work in the care sector.

Audiology services are working well there, and I think that, in time, we will be able to roll out that experience across the country.

There is often a stigma around seeking help for hearing loss or getting a hearing aid. That should be no different from going to the dentist or the optician. It should simply be part of what people do, and the preventative step of going for a hearing check is really important.

On community services, we are funding the Royal National Institute for Deaf People’s “Near You” programme in various places across Scotland, where volunteers support hearing checks in the community. I went to see some of those recently. It is a simple test, and we could all do it online right now if we wanted to. It helps people who think that something may not be quite right with their hearing and who want to check that. If you do not get your hearing checked, that could have implications for other parts of your life. For example, hearing loss is a contributory factor in dementia, which is something that I have seen in my own family. It is important to think about hearing and how we can maintain healthy hearing throughout our lives. Therefore, if we have any issues, it is important to have them checked.

I appreciate your experience around dementia. I also have experience of that in my family, so I am personally committed to making sure that we make improvements. I was very grateful for the recent opportunity to meet representatives from Alzheimer Scotland’s lived and living experience groups, who were clear about what they would like to see and about their ambitions and priorities. I am listening carefully to those voices to make sure that we get this right. They reflected that Scotland has been a leader in Europe and across the world in the work that has been done on Alzheimer’s and dementia. We need to keep up that pace, because other countries are now moving ahead.

The next stage of the delivery plan will look at brain health and improvements to post-diagnostic support, on which we have made great progress, although there is still a lot more to do. That support must be available to everybody, and we are making some progress on that. There are also issues around transitions within care. When someone’s condition worsens or gets more complicated, transitions should be made in the best possible way for people.

Work is under way on women’s health as it relates to dementia, to understand how that affects women more or in different ways than it does men.

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Work is continuing in relation to hospice care, too. Recently, I was happy to meet Children’s Hospices Across Scotland. I looked at the CHAS facilities that are available at Robin house and at the developments that it is making to improve the conditions in that centre. When I visited, I was struck by the care that was being provided not just in the hospice but out in the community. That speaks to the community aspect of care.

At the reception that CHAS held recently, people spoke powerfully about the fact that more young people are now able to die in the safety, comfort and warmth of their own homes, rather than in a clinical hospital location. That was really important to those families. In the hospice sector, there is a lot of talk about how to make that real for people. Whenever possible, people should have the death that they wish and that they choose, and the hospice sector is a huge part of that. I have a massive amount of respect for what those in the sector are doing, and we will work closely with them.

I thank the committee for inviting me today; it is lovely to see you all.

I very much support the campaign that Unison has embarked on regarding visas for care workers. Care workers are a crucial part of the care system, they are valued and they are important. However, the rhetoric from the United Kingdom Government on the issue has caused significant damage to the visa system and our ability to recruit in the sector. I understand that, in 2023, 108,000 people came to the UK on a care worker visa but that the most recent figures show that that has fallen to just 1,400. That is a huge reduction in the number of available workers in a sector that very much needs them. It is hugely damaging, particularly in more rural and remote areas, where it is challenging to recruit people. Yes, we need to ensure that we are recruiting and training people from Scotland, but we also need those other workers to come and supplement the work that is being done.

The displaced workers scheme, which we reopened on 31 July, has been able to bring in additional people who would otherwise have lost their ability to work in the UK. I know, having spoken to some of those displaced workers and listened to their stories, how much they valued the opportunity to come here to work, to serve and to do their bit. They really value that caring role, and we are very glad to have them.

There are.

That is an important question, particularly for those who work in social care and for those who receive it. It cannot be people on the lowest possible wages who deliver that service, because people will not get the devotion and care that they need and that they would get from a well-paid and engaged workforce.

I have seen that change over the years. In the distant past, when I was a councillor, we moved significantly from getting the cheapest contract to looking at best value in the broadest sense and what value we were getting for the service. That has been a journey. We are not quite where we should be yet, but we are certainly moving in that direction.

An important part of that is the move towards sectoral bargaining. Progress has been made on that—things have been moving quite quickly—and there is hope that we have almost reached the final stages. Officials will be meeting providers and trade unions next week to discuss that. Sectoral bargaining can make a difference by providing real benefits to the 110,000 workers in the sector in Scotland. Those workers already receive the real living wage—which is a significant step—but improvements can be made for them over time. Sectoral bargaining is a huge part of that picture.

Absolutely. The work that the Red Cross is doing is really interesting: the pilot is making sure that people’s houses are ready for them to go into. If you live on your own and are coming to the end of your hospital care, you do not want to go back to a cold, empty and dark house; you want to go home to a house that is warm, that has food in the fridge and that is ready for you, because that makes the transition all the easier.

The great opportunity from the reforms that we are embarking on is that we will make pockets of good practice common practice by ensuring that more people know about the good bits of work that are going on, sometimes in isolation. Instead of a small organisation having to go around the 32 local authorities to let them know about the work that it is doing, we will have a better way of organising that to ensure that people who have conditions such as Huntington’s are able to get equity across Scotland, rather than there being really good services in some places but poor services elsewhere.

That is more in Ms Todd’s area than in mine.