Chamber and committees

Windygoul is a great example.

You will be aware that, in the previous parliamentary session, this committee, as well as the Equalities, Human Rights and Civil Justice Committee, looked at the issue of neurodiversity and that there was discussion about the proposed learning disabilities, autism and neurodivergence bill. Various summits were held, too. Where is neurodiversity in the Government’s priorities? I want to hear your thoughts on what comes next. We all get lots of casework on the issue, so what can we tell constituents in that regard?

Yes, I do. I want to raise an experience in East Lothian on the back of the points that have been made about staffing and recruitment. Working with Enable Scotland, we held a round-table event to discuss the issue. Enable was offering a wage of £17 or £18 an hour to some workers in an effort to attract people to East Lothian, and it recruited a certain number, but not a huge amount. There is about a 20 per cent capacity gap.

We struggle to recruit people in the more remote parts of East Lothian. For me, the recruitment issue is not only about how we recruit but about how we recruit in both remote and urban areas. I am talking about areas that are only 15 miles from Edinburgh. We are even struggling to recruit in North Berwick and Dunbar.

Will you say a bit more about that specific challenge? We can talk about recruitment, but the strategy must cover all parts of Scotland; it cannot just focus on the areas where we think action is needed. That is a really important point for me to get across.

I will pick up on the point that Rachel Cackett made, and then I will talk about staffing.

Rachel, I think that you are right. I spoke to colleagues from Penumbra about a month ago, and they talked about commissioning and the difference for the viability of their business that having a two or three-year contract made—it was chalk and cheese. That is an important point, which they asked me to stress. I agree with Rachel Cackett’s point on that.

My first question is probably for Jill Laspa. You have all spoken about staffing issues and we all know that there are demographic challenges not just in the here and now but for the next 10, 15 or 20 years, so whatever we do has to work in the years ahead. There are procurement issues connected to demographic pressures, in which I know that there is a role for local authorities because I spent 15 years as a councillor and council leader. How much assessment has been done at COSLA level and how much does that feed into the process and into what everyone else does? Can you say something about the demographic challenges that you are seeing and how those impact on staffing requirements? How can we have a workforce plan to deal with that? I will open the question up, but I would like to hear from COSLA first.

I saw you nodding your head, Donald. Scottish Care made a few recommendations, one of which is to have a validated true-cost-of-care framework. One recommendation that stuck out for me is to have a fully funded fair work and workforce strategy for social care. You are right that that should be fully funded, but it has to meet the challenges of the next 10, 15 or 20 years. Can you say a little more about the importance of those issues?

Yes. Paul Johnston mentioned prevention, which is mentioned in all the submissions. What are the benefits of the subnational approach in relation to prevention? You touched on that in relation to where we go with the prevention agenda.

My question is for Kenny Stewart. Your submission made several points. One of them, which you also mentioned in your opening remarks, relates to achieving a meaningful shift towards prevention. We have heard about prevention throughout our evidence sessions today, but will you say a bit more about how you see that happening? I suppose it is about having a more systemic approach, because this is not just a health issue. The question is where health fits into that, because—as we heard this morning in the earlier evidence sessions—the issue is much more systemic.

Sorry for interjecting, but my second question was going to be about local procurement and commissioning. Maybe you can take that question as well when you are answering the first one, because that is almost the same—I would be asking the same thing.

What is the most appropriate way to access mental health triage, initially? Some people are referred, for example. I am not just talking about CAMHS; the issue is much broader than that. What are the key points on triage? Someone might seek help from their GP or from you. What is the most efficient way to access triage?

Thank you for your submission, Caroline. On the back of yesterday’s announcement, I would like to ask about the impact of subnational planning. You have been moving towards regionalisation. In your submission, you said:

“This collaborative work demonstrates that working at scale enables better use of resources, improved consistency, greater overall system impact and better value for the public purse.”

Could you say a bit more about that? You mentioned that the planned care funding requirement has dropped from £61 million to £52.4 million and that planned activity has increased from 31,000 procedures to 39,000 procedures. If we move to having only two health boards, what lessons can we draw from the subnational planning work? For me, that is the key question.