Chamber and committees

You have made a really good point about the engagement process. That is why I am asking these questions. In the evidence that we received from students, they talked about having that breadth and being given opportunities to demonstrate their skills and achievements at school. There seems to be a huge amount of trust in the teachers, which is really positive.

Do you have any comments with regard to young people with additional support needs? An issue that came through quite strongly in that respect was the need for flexibility in the system to allow them to demonstrate their skills and experience. I know that Professor Louise Hayward will be leading the expert group, which will also include people from the curriculum and assessment board. However, does that representation reflect the current situation, given that around 30 per cent of our students have additional support needs? How do you think they can be included or helped to demonstrate their skills in a new system?

Professor Stobart, you made the point about the fact that there can be corruption as far as assessment—[Inaudible.]—so I just wanted to check that you are satisfied that Scotland’s approach—[Inaudible.]—fair and robust in that standards were checked across teachers’ approaches in schools and departments, across local authorities and nationally. I want to check that that is a good indicator and that, if we are going in that direction, you have confidence that—

Orders not to attempt cardiopulmonary resuscitation—often called DNRs, or do not resuscitate orders—have been in the news. That has created fear, because there is a feeling that some use has not been consensual. I have looked into this, I know that families instinctively want to save their loved ones and want them to have as long a life as possible, but DNRs can also prevent harm and distress. A lot of people do not understand how distressing resuscitation procedures can be. Are we looking at the public message about people having kind, compassionate and comfortable deaths, rather focusing on the use of DNRs, which involves a fear factor? What are we doing to improve that?

Thank you, minister; and thank you to Marion, too. There is not much at all in what you said that I could disagree with.

We know that the women’s health plan is not all encompassing. I am thinking of conditions such as menopause, hyperthyroidism and even endometriosis, which I have suffered from. The number 1 point that we must address is that women are dismissed and disbelieved, as we have seen with the mesh situation.

When I was suffering from endometriosis, it took more than 10 years to get a diagnosis, as has also been the case for so many others. The disease was really severe and I have had several operations. I have a daughter and, like every parent, the last thing that I want is for her to go through the same thing. She is getting to the age at which she might be affected.

Great training is provided in medical school, but how do we propose to change the deeply embedded attitudes to women who present with health issues? A lot of the time, the attitude comes from the top. It is not just male doctors or consultants who are the issue; females can be just as bad. In my experience, the same dismissal of and disbelief in what we say has been apparent in relation to not only women’s health issues, but to our children’s health issues. How will we tackle that?

I accept that we have been doing things on that. When taking evidence, the committee has often heard about how health professionals’ focus tends to be on the targets that they are measured on. How do we ensure that prevention and inequality are suitably prioritised? The health professionals said that those matters end up being pushed to the side because they have other numbers that they need to hit. We all know about what is measured.

There have been recent announcements about priorities relating to place and wellbeing and about preventative and proactive care being based in communities. That might involve 20-minute neighbourhoods, where people have different services to hand.

You spoke about shining a light on pre-existing health inequalities and their drivers. The Christie commission report has been around for quite a long time now—it has a big anniversary this year. What progress has there been with regard to the findings of Christie?

It was good to hear from Dr Buist about Tayside, where the NHS is working together with local authorities to roll out the enhanced community model, which relates especially to older people at home. However, my question is for Annie Gunner Logan and perhaps John Mooney. Integration joint boards have done quite a bit of work on preventing admission to hospital and ensuring that people are discharged as quickly as possible, which fits with the Tayside model. What are your views on how helpful that can be? How much of that model do we need to incorporate in future?

That is great. I am a councillor on South Lanarkshire Council, so I was delighted to hear the positive comments about the collaborative work on education that the council has been doing.

What Tricia Meldrum said is interesting. There was comment about the pandemic leading to the delivery of the Christie recommendations “at scale”. What lessons can be learned from that in terms of policy approaches?