Chamber and committees

I need to defer that and come back to you in writing. I do not currently have that information, but I will ensure that that is part of the correspondence that comes back.

Thank you, convener. First, I want to express my appreciation for the opportunity to be here. As you said, it is my first time both in this room and appearing before the committee. I am very grateful for the work that the committee does in raising areas of concern and interest that the public have brought forward. I appreciate the opportunity to respond to some of those. Given the potential number of petitions that we are discussing and the time that we have available, I will attempt to be as pithy as possible in my responses.

As you have set out, convener, there can be gaps between policy and delivery. Where that is in evidence, it is normally due to capacity or demand-level constraints. There can be variation in delivery between health boards for geographical or demographic reasons, which members will understand. However, that said, I obviously want to narrow the gaps between demand and capacity and ensure that the patient experience is as positive as possible in what are sometimes very difficult circumstances, such as—as you set out, convener—a mental health crisis or other issues that are going on in people’s lives. That is what I am endeavouring to deliver, in concert with the 14 territorial health boards and the national boards, to ensure that we maximise improvements in patient experience.

I understand that flexibility on such services is already offered, and it is up to NHS Highland to ensure that they are delivered. I am not sure whether that is an on-going process or whether it will happen before the winter, but I will ensure that Mr Ewing is updated on NHS Highland’s latest position.

Our colleague Emma Roddick has brought great attention to Ehlers-Danlos syndrome and to the work of the petitioner to ensure that the matter is brought to the attention of the Parliament and that there is greater public awareness of the effects of some rare conditions and diseases.

As you acknowledge, convener, we have perhaps not had information across our desks about some of these conditions before. In those cases, we have to find a balance with regard to demand—the level of need for treatment—and the ability to deliver the treatment safely. The clinician who is delivering the treatment must be able to do that at a level at which they continue to be safe to practice. That is always a balancing act.

Territorial boards have different levels of demand for treatment for these conditions, so local decision making is important, because the boards need to make decisions with regard to local priorities—for example, if they have higher levels of Ehlers-Danlos syndrome or other conditions that they need to prioritise and invest in treatment for.

I recognise that travelling for treatment can be extremely challenging. I am originally from the Northern Isles—from Orkney—and I recognise that travelling for healthcare can be challenging, but it is also an expected part of living in some communities. We need to ensure that the boundaries between health boards are blurred so that, where a specialist service is being delivered, it can be provided on a national basis, co-ordinated through National Services Scotland. Our rare disease action plan focuses on that, to ensure that we have better co-ordination of where services are delivered for some rarer conditions.

Ms Baillie and I talked about those points in the most recent of our one-to-one discussions, which I offer to Opposition health and social care spokespeople regularly. Discussions at that level allow me to share my vision and the Scottish Government’s intention with colleagues and to hear their concerns and examples of where things are not working.

I expect NHS Greater Glasgow and Clyde’s use of the Golden Jubilee hospital to increase. New management is in place at NHS Greater Glasgow and Clyde, as it is on an interim basis at the Golden Jubilee. As I said in response to the convener and to others, I expect, and we are seeing, greater co-operation between health boards to ensure that capacity is being optimised across their boundaries.

I recognise the point that Ms Baillie made about cancer waiting times in Glasgow compared with those in Lanarkshire. Can there be greater co-operation there, in relation to either how Lanarkshire has been able to meet its targets when other boards are struggling to do so, or whether the level of delivery in one health board area allows it to pick up some of the challenge that other boards face? That is exactly the type of work that is under way.

That work is under way now, so I expect that situation to start improving as of now.

In my response to Mr Ewing, I set out that there is a service available in Tayside and I will discuss with the petitioner whether that service is sufficient for her. It was certainly helpful for my constituent and his need. On whether more can be done, I am clearly happy to consider that with NSS, as I have already committed to do, in response to Mr Ewing.

Douglas McLaren advises that the committee meets quarterly, but I am happy to provide a more detailed answer on its productivity, as you put it. I am happy to furnish that response.

I point Ms Baillie to the community link worker network, which seeks to move provision upstream, although I recognise the challenges that there are with that in some parts of the country.

I know that there is a petition from the deep-end practice network that calls for an expansion of the community link worker network. The CLW programme is under national review. Community link workers try to ensure that people, in a trusted place—the GP surgery—can be signposted to other services through which the root cause of the issue that they are presenting with can be addressed. Often, that support relates to housing, income maximisation, education and other elements of public service. It is also about the need to increase the opportunities that are available through social prescribing to address people’s mental health issues, which is in the population health framework.

The community link worker network is there to do that, and it is where we seek to move things upstream. The likes of the family nurse partnership is similarly about ensuring that we are supporting people much earlier in the journey than we are at the moment, where we treat the acute situation.

Agenda for change staff have protected time for developing skills and for training. We are asking our staff to go the extra mile in order to get through the Covid-related backlog. I am incredibly grateful to them for that, and recognise that we can see activity levels increasing and waiting times reducing. In July, we delivered the highest number of operations in the NHS in Scotland since February 2020.

Clearly, a shift in delivery has resulted from the investment that has been put in and the endeavours of staff, as well as the optimisation of capacity to ensure that we maximise the ability of the service to deliver. However, I recognise that, where we are asking staff to go further, that is putting stress and strain on them when they are already in a stressful situation, and is putting at risk their ability to undertake continuous training and upskilling. That is why the agenda for change contracts include protected learning time, which I expect boards to honour.