Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, November 23, 2021

Official Report 934KB pdf

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Topical Question Time

The next item of business is topical question time. In order to get in as many members as possible, I would prefer short and succinct questions, and answers to match.

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National Health Service (Support)

To ask the Scottish Government what support it is giving to NHS boards that are under pressure. (S6T-00301)

As members will be aware, the health and care system is under extreme pressure due to the pandemic, and all health boards are experiencing significant issues, including workforce challenges and high levels of delayed discharge.

As members will know, we have invested an additional £300 million in a package of measures to support health and social care services over the course of the winter. Over and above that, and to maximise capacity during winter, we have invested £10 million in two new specialist programmes that aim to provide alternatives to admission and to ensure that our processes are right to ensure timely discharge.

I pay tribute to everyone who is working on the front line in our NHS. I was hoping that we might get more about the measures that the Government is taking to give immediate practical support to the health boards, our front-line NHS staff and care staff.

The winter plans should be about practical support, not press releases. How many people are waiting for a care package in order to be discharged from hospital, and what is the longest time that people have been waiting to be discharged?

Forgive me. I do not know the exact figures off the top of my head, but I will get them to Stephen Kerr. He is right to focus on delayed discharge. As I think he knows, it is not just about press releases; we are taking practical action with £300 million of investment. The practical action involves, for example, recruiting 1,000 band 2 to band 4 staff, who will help with the people who are waiting for care at home. We hope to fund interim care home placements, so that individuals for whom discharge is clinically safe will be discharged.

I meet health boards regularly; I have meetings this afternoon and tomorrow afternoon with the health boards that have the highest numbers of delayed discharges. I promise Stephen Kerr that such practical action is what, I hope, is making the difference. Although figures are nowhere near where we would like them to be, such action is maybe why we have, for the past three weeks, seen improvements in accident and emergency departments’ performance.

With the greatest of respect to the cabinet secretary, I say that the numbers should be at the front of his mind, because he is absolutely right to identify the issue as being a critical challenge that our NHS is facing. The fact that he does not know the numbers is deeply disappointing.

For weeks, the Government has been talking about the approaching crisis; we are listening now to the product of Scottish National Party neglect of our NHS and care system. It seems as though the cabinet secretary is asleep at the wheel, and he needs to get a grip.

Yesterday, the Royal College of Physicians and Surgeons of Glasgow offered the cabinet secretary realistic solutions to workforce planning. Its president, Professor Jackie Taylor, said:

“It’s no secret that Covid-19 has placed unrelenting pressures on an already fractured healthcare system. However, these challenges existed long before the pandemic—staff shortages and excessive workloads are nothing new. The workforce is in crisis and the urgency in the need to address this cannot be overstated.”

Does the cabinet secretary disagree with Professor Taylor?

I have a good relationship with Professor Taylor, and I look forward to meeting her again. I will continue to engage with the royal colleges.

I do not disagree that there were challenges pre-pandemic. It would be absurd or foolish to suggest—the First Minister, the Government and I have never suggested it—that there were not issues pre-pandemic. I suspect that it would be equally absurd for anybody to suggest that the biggest shock that our NHS has faced in its 73-year history does not have a bearing on the outcome that we are seeing today.

Stephen Kerr asked me for a specific figure. I know that there are 1,500 standard delays, but he asked me for a specific figure for people who are waiting to be assessed for a care home package. I will get the exact figure to him; if he wants the numbers broken down by health board, I will do my best to give him that detailed information, as well.

However, I do not accept his characterisation of the action that the Government is taking on the NHS. Under this Government, we have the highest staffing numbers in the history of the NHS, nine years of consecutive growth, record investment, and the highest-ever single pay deal for NHS staff, who are the best-paid NHS staff in any part of the United Kingdom. Of course, I want the statistics to be higher, and we are working hard on that, but we still have the best performing A and E service, which has been the case for six years in a row.

I understand that various schemes have been put in place to provide support to NHS staff, who are working incredibly hard in the face of the pressure that has been caused by the pandemic. Does the cabinet secretary agree with NHS Lanarkshire staff that Covid is still with us, and that the best thing that we can all do to support our healthcare workers and protect the NHS is get vaccinated?

Yes, I agree with that whole-heartedly. I pay tribute to NHS staff across the country for their incredible efforts during the pandemic, which have been nothing short of Herculean.

Collette Stevenson is absolutely right that the best thing that we can do to help and to protect our NHS is to get vaccinated. We know what protection the vaccine offers. We should also rigorously follow the baseline mitigation measures; that is, people should wear face coverings in appropriate settings—unless they are exempt from doing so—test themselves regularly and practise good hygiene.

All those measures can help us to get Covid more under control. As we know, the numbers of infections that we are dealing with are currently far too high. Taking all those measures can help to alleviate the pressure on, and help those who are working courageously and tirelessly in, our NHS.

Last week, I asked the cabinet secretary about cancellation of surgery, in particularly cancer surgery, as NHS boards struggle under immense pressure. He pointed to the challenges of the pandemic, but we know that waiting lists have been growing for years. Elective surgery is also a concern and people are struggling in pain for long periods. What is he doing to support NHS boards to enable surgery to recommence? We want practical measures to be taken, such as increasing bed capacity. We also want the recommendations of the royal colleges to be listened to.

Of course we will listen to the royal colleges.

On cancer performance, it is worth saying that, for the quarter ending June 2021, 97.9 per cent of cancer patients started treatment within 31 days of the decision to treat. The 31-day target was met, but we know that it is more challenging to meet the 62-day target. Consequently, a lot of our investment goes into diagnostics.

I am pleased that the Government has invested in three early cancer diagnostic centres in health boards around the country. We will evaluate the centres; if they are going well and give us the results that we expect, we will consider rolling them out further.

In terms of more practical support, I have already referenced the fact that we are recruiting more staff to the NHS and will continue to do so.

We have immediate pressures, but Paul O’Kane is right to mention that they are also long-term recovery pressures, and that is why we have a recovery plan that is backed by £1 billion of investment.

I have concerns about the booster vaccination roll-out in NHS Lanarkshire. Reportedly, there are nearly 5,000 housebound people in the health board area who are waiting for their boosters. I have been contacted by constituents who are housebound but have not been registered as such and have been given appointments at vaccination centres that they cannot possibly attend. Will the cabinet secretary look into the matter, and at whether further support can be provided to NHS Lanarkshire to help it to work through the backlog?

Yes—I will, of course, look at any information and details that Gillian Mackay can provide about particular constituents.

I will address the general issue that she mentioned. Yesterday, I spoke to the chief executive and the chair of NHS Lanarkshire. We went into a fair bit of detail on the autumn-winter vaccination programme. They referred to the fact that the board is looking to increase the number of doses that will be administered during the festive period.

If there are specific constituency cases that the member wishes me to look at, I will, of course, do that.

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Covid-19 (School Closures)

To ask the Scottish Government how many schools are currently shut due to staff shortages resulting from Covid-19 cases. (S6T-00296)

We receive daily management information from local authorities that provides their intelligence on which schools in their area are closed or at risk of closure due to Covid reasons. For example, last week, local authorities informed us of a total of four schools across Scotland that were closed at some stage. As of yesterday, the reporting indicated that one school was closed. However, the management information does not include a detailed breakdown of the reasons for a school closure, and the responsibility for such decisions sits with local authorities.

We know that all parts of the system have been stretched as they have responded to the pressures of the pandemic. We have already committed £240 million to supporting local authorities to recruit additional teachers and staff, and deploy more support to their schools, children and families. The investment has supported the appointment of an additional 2,200 teachers and more than 500 support staff in schools across Scotland.

The cabinet secretary has confirmed that 2,200 new teachers have been recruited, but we are also in a period of teacher shortages, with cases rising as the normal winter illness rates are about to hit. That is causing schools to close year groups, and worse. How will the Scottish Government mitigate the number of absent teachers?

We appreciate that there are operational challenges for many schools as they continue to deal with the challenges that Covid presents. Obviously, those are discussed at the Covid-19 education recovery group every time that it meets. The Government takes that very seriously.

Schools can decide to close a year group, for example, if that is, in their eyes, the right response to the operational challenges that they face. I should point out that the figures on new positive cases among pupils show that just under 50 per cent of schools have no cases reported between primary 1 and 7 and secondary 1 and 4, and 17 per cent of schools have only one case, for example. Very few schools have a multitude of cases, or what might be classed as an outbreak.

We look seriously at what needs to be done to support teachers. I discussed some of the national issues in my original answer. We keep closely up to date with local authorities and trade unions and, if anything more can be done, we are happy to do it.

For more than a year, we in Scottish Labour have been highlighting the need for proper ventilation in schools, but the Scottish Government still does not know how many classrooms failed the inspection. This winter, children are again being advised to wear coats and gloves while windows are open. What will the Scottish Government do to improve the environment in pupils’ classrooms, which are also places of work for teachers, classroom assistants and others?

The member will be aware that, in the early days of the pandemic, the Scottish Government provided £90 million to support schools with a variety of issues, including ventilation. That was followed by another £10 million to support schools and to ensure that all local authorities undertook monitoring of the teaching areas in their schools. That work is being completed, and local authorities are then responsible for dealing with any maintenance issues that have come to light. I stress that, in the main, the issues that have come to light have been quite minor.

Of course, we keep in close contact with local authorities to ensure that work has been undertaken and continues to be undertaken where necessary. Natural ventilation will play an important part in that, and it is not the Scottish Government that has decided that; it is very much based on considering the expert advice on ventilation. We will continue to keep a close eye on the issue and to support schools with the on-going monitoring that will be needed during the winter months.

I share Martin Whitfield’s concerns about the impact, albeit temporary, of recent classroom closures. I note the return of home-based learning at Ross high school in Tranent and for nine classes at Preston Tower primary school in East Lothian. Pupils in S4, S5 and S6 are set to sit crucial exams next year. Despite the heroic efforts of teachers, Scotland’s young people have already had their learning negatively affected by lockdowns. Will the minister commit to tackling on-going teacher shortages? What will the Government do to support councils to assist schools such as Ross high, which might be subject to disruption or class closure due to Covid and the Scottish National Party’s teacher shortages?

In my original answer, I referred to the additional 2,200 teachers and 500 support staff for which the Scottish Government is providing financial support to local authorities. That will be paying dividends across the country. We absolutely recognise that there will still be challenges with pupil and teacher absences, which is exactly why, before the summer, the Scottish Qualifications Authority announced modifications to the national qualifications for 2022 and why it has investigated, and continues to investigate, the modifications that might have to be put in place if there was significantly more disruption than we saw last year, although we are not at that stage.

Clearly, those discussions do not just happen within the SQA or within Government; they happen with our stakeholders to ensure that they—young people in particular, but also parents and teachers—are part of the process of ensuring that young people are reassured that they will have a credible qualifications process next year, and that the Government and the SQA will support them through that.