Chamber and committees

Are the witnesses concerned about workforce morale and wellbeing and the impact on retention? Mary Ross-Davie talked about focusing on both recruitment and retention. Do you feel that, just now, there is too much of a focus on recruitment and not enough on retention?

When a woman is pregnant or has recently given birth, she will be in contact with a range of health professionals, which potentially creates a lot of opportunities to identify whether she is struggling. Are the witnesses confident that staff have the training to take up those opportunities? For example, are primary care teams, in particular, equipped to identify perinatal mental health issues?

What role could health visitors and midwives play in prevention and in proactively identifying people who are at risk of developing perinatal mental health problems? Do they have the training that they need in that respect? Perhaps we can hear from Cat Berry first.

Are the witnesses satisfied that sufficient long-term workforce planning is taking place to ensure that Scotland has the perinatal mental health workforce that it needs? Perhaps I can start with Mary Ross-Davie.

As the First Minister outlined in her statement, continued home working will be a vital tool in our efforts to suppress the virus. I am sure that we have all read comments online from workers who are concerned at the expectation that they be back in the office. What support will be offered to employees who were working from home earlier in the pandemic but who now feel under pressure and are being required to come into work by their employers?

No. It is recognised by both of the proposed CPGs that specific work needs to be done in each area. We could spend years discussing the work that is needed in both of the spheres relating to those conditions, which is why the decision has been taken in this session that they should have their own dedicated cross-party groups.

The purpose of the cross-party group on stroke is to provide oversight, encouragement and support in the implementation of a progressive stroke service in all health boards, based on the recommendations of the new stroke action plan, which will be published next year. Increased political awareness of the scale and impact of stroke and the benefits that implementation of a progressive stroke service will make, as well as increased political awareness of stroke as a national clinical priority, will help to ensure that stroke is treated as a clinical priority in all health boards.

Stroke is the third most common cause of death in Scotland. In addition, it can be a very disabling event for those people who survive their stroke. It accounts for about 7 per cent of the health spend. The ethos of the CPG will be about focusing all meetings on the current stroke improvement work. The CPG will be part of forming the conditions in which those stroke improvements can take place. It will contribute to and support the opportunity for the significant change promised by the commitments in the 2019-20 programme for government and the subsequent good work to date.

Although there are currently no external members listed for the group, apart from the secretariat, we will invite a range of other organisations to join shortly, and we will update Parliament on that once we have done so. That will include third sector charities, regulatory bodies and other health and social care organisations. Individuals will also be invited to join the group, including clinicians and those with lived experience of stroke. Those names will be provided to Parliament as soon as possible, so that the web page can be updated.

We are aware that a similar group existed previously as part of the cross-party group on heart disease and stroke. As the Government treats the two conditions separately, with their own action plans, we believe that it is better to separate into two CPGs so that both conditions can receive the attention that they require. Where appropriate, we will seek to work with the proposed cross-party group on heart disease. Given that our proposed group’s aim is to scrutinise the upcoming stroke improvement work, I do not envisage there being a huge amount of crossover.

Yes.

I welcome the opportunity to speak in the debate and will focus my remarks on how we can help public health to recover from the pandemic. The omicron variant is a painful reminder that we are not out of the woods yet and that Covid-19 is still a very real threat. The Greens have been clear that we need to take a precautionary approach and ensure that a range of mitigation and health protections are in place, including a robust test and trace system, asymptomatic testing and PCR testing for international travellers.

It is indisputable that the pandemic has put severe and serious pressures on all areas of health and social care. Once again, I thank all those who have worked so hard during the pandemic.

Before the pandemic, Scotland was known for its poor public health. The “sick man of Europe” moniker has been hard to shake off. As I have said before, in this session, I would like the Parliament to be the public health Parliament. We need a renewed focus on improving people’s standard of living and tackling non-communicable diseases. We should be building on people’s increased awareness of their health, which has arisen from the pandemic.

We know that inequality is a main driver of poor health and, as we have heard, the current rise in the cost of living has put a real squeeze on incomes. Everyone has the right to an adequate income to live on, and the Greens have long supported a universal basic income. At the Health, Social Care and Sport Committee, we heard from Professor Sir Harry Burns and others about the positive impact that such a policy could have on health and wellbeing. Although our preference would be for a UBI, I am pleased to see that work on a minimum income guarantee is under way. I look forward to monitoring progress on that.

During the earlier part of the pandemic, we saw that emissions fell significantly along certain routes as we took fewer car journeys. Many of those routes are seeing a return to normal and those living, working and playing along them are again being subjected to a high level of pollution. As part of our recovery and to improve health, we need to tackle environmental harm such as air pollution, as well as health-harming products.

We know that more people have been drinking at home during the pandemic and that that is contributing to more alcohol-related deaths, which increased by 17 per cent in 2020. We need to address the ubiquity of alcohol. Given that we are constantly told of the health benefits of sport—and rightly so—why do we allow alcohol brands to sponsor sporting events? That seems counterproductive to say the least, particularly when combined with the fact that more people are engaging with sport at home, where we know that more drinking has been taking place. That also has impacts on children in households.

I have expressed my support for the uprating of minimum unit pricing. The policy was bold when it was introduced, but in order for it to continue to have an impact, we must ensure that it keeps up with inflation. I would also like to see mandatory unit calorie and ingredient labelling as well as prominent health warnings on alcohol products, so that people can be better informed about what they are consuming. We put calorie and ingredient labels on food and other drinks and we need to ensure that alcohol is not the exception to the rule.

Turning to mental health, we know the impact that the pandemic has had on mental wellbeing. The Greens are clear that everyone should have access to the support and treatment that are right for them, whether that be medication, counselling, social prescribing or in-patient treatment. We want treatment options to be diversified, particularly in the community. People should be able to access services through their GP surgery, for example. We also need to make better use of social prescribing. Clinicians’ time to engage with social prescribing was limited before the pandemic and, as we know, health services are under more pressure than ever. The provision of social prescribing can also be patchy.

Alongside an expansion in provision, I would like it to be made easier for clinicians and other professionals to signpost patients to resources and for patients to self-refer. I hope that community mental health link workers will play an important part in that.

While we deal with the on-going impact of the pandemic, it is never too early to set out our positive vision for Scotland. Now is the time to implement bold and radical policies to improve Scotland’s public health now and for generations to come.

My thoughts are with everyone who has been affected by infection outbreaks at the Queen Elizabeth university hospital and with anyone who has lost a loved one. I cannot imagine the pain that has been experienced by the families of people who have caught infections in a place where they were supposed to be safe and cared for.

Those people deserve answers, which is why it is right that a public inquiry has been established and is under way. It is, of course, essential that we do not wait for the findings of the inquiry to be published and that action is taken now to prevent further infection outbreaks. As we have heard, Healthcare Improvement Scotland is carrying out a wider review of Aspergillus infections at Queen Elizabeth university hospital, and the board is implementing the recommendations of the independent review, the oversight board report and the independent case note review. That essential work must continue at pace, and I am sure that we will all monitor progress closely.

It is important that any findings and decisions are communicated on an on-going basis to patients, families and staff. I would be grateful if the cabinet secretary would confirm that people are being kept up to date.

The independent review found that

“Patients, staff and visitors who are vulnerable due to immuno-suppression, or who are in proximity to patients with certain highly infectious communicable diseases, have been exposed to risk that could have been lower if the correct design, build and commissioning had taken place.”

It is of deep concern that we cannot seem to get the basics right when constructing new, state-of-the-art hospitals in Scotland. We have seen that at both the Queen Elizabeth university hospital and the Royal hospital for children and young people in Edinburgh. I sincerely hope that the public inquiry will clearly set out the steps that we need to take to avoid such failures in the future.

There has been a devastating human cost behind those failures, and we have a responsibility, when debating these sensitive matters, to get the tone right. We risk causing more harm than good if we are not careful about the language that we use. Senior clinicians at NHS Greater Glasgow and Clyde have raised concerns about the way in which the issues have been portrayed. They feel that their integrity is being questioned and that that is undermining patients’ confidence in them and the services that they provide.

As I said, those who are responsible for failures must be held to account, but the attacks on clinicians will not help us to do that. I am concerned about damaged patient trust and lower staff morale at a time when people are under severe stress. We need to establish what has gone wrong and how it can be prevented in the future, while also rebuilding trust between clinicians and patients, whose faith in services will understandably have been shaken.

Practical steps are being taken to improve patient safety, but we cannot ignore the emotional toll, so mental health support must be made available to patients, families and staff who have been affected. [Interruption.] I would welcome any comments from the cabinet secretary about what support is being provided.