Chamber and committees

What work is being, or should be, undertaken to ensure that information sharing can take place between the wider primary care team, the multidisciplinary team, the acute sector and social care so that we have all the records in the right place at the right time? What problems have there been in joining up all those records?

Good morning. What do you consider to be the biggest gaps in our workforce data?

Good morning, panel. I wonder whether Christopher Wroath could give us an update on the development of the national digital platform and a flavour of the work that is being done on it.

I put on the record our thanks to all who participated in the citizens assembly.

One of the key weaknesses in participatory democracy is the lack of information about what will happen after the process, and there can be unclear assurances about how recommendations will be implemented. It is particularly important to retain the trust and enthusiasm of young people. Will the minister outline how we can ensure that people who participate in assemblies and other processes are clear about how their recommendations will be taken forward?

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?

I welcome the First Minister’s emphasis on testing and the addition of lateral flow device tests to the vaccination certification scheme. What is the Scottish Government doing to widen the range of venues and settings where packs of lateral flow device tests are available, to make it easier for more people to test themselves? Do we have a sufficient supply of tests to cope with any resulting surge in demand?

Sadly, alcohol-related deaths in Scotland rose by 17 per cent in 2020, to 1,190. Those devastating figures emphasise the point that action must be taken and that a range of methods, including minimum unit pricing, should be implemented to tackle harmful alcohol consumption.

I know that the Government plans to consult on the marketing of alcohol. Will the First Minister consider implementing other measures, such as mandating nutrition and health information on alcohol labels and placing a social responsibility levy on alcohol retailers?

The pandemic has been an extremely difficult time for all those who are learning and working in the NHS, and I, too, express my sincere thanks to them for their efforts.

We know that the NHS workforce was under pressure before Covid and that the pandemic has intensified that pressure, and it is vital that every avenue is explored in efforts to ensure that our NHS has the staffing levels that it needs. However, it is also important that any decisions are made with a view to the long-term impact.

In its statement about today’s debate, the BMA said about the Conservative motion:

“Simply taking steps such as these without a proper, strategic long-term plan for our whole workforce could potentially be counterproductive.”

Right now, we have staff shortages in the NHS, and the staff who are in post have experienced huge increases in their workload. That means that the number of clinicians who are available to engage in teaching and training is reduced. Any move to increase medical student places must take account of that, or we risk piling even more pressure on existing staff and creating bigger class sizes with fewer teachers, which, as the BMA has warned, could affect the learning experience.

In the wake of the pandemic, proper workforce planning will be essential if we are to secure the sustainability of the NHS, but that must be long-term strategic planning that anticipates how the decisions that we make now will affect the workforce in future generations. The BMA has also warned that, if the Conservatives are proposing that we lift the cap on Scottish students without increasing student numbers overall,

“there are issues around how that is done fairly and appropriately.”

Increasing student numbers is, of course, an important part of long-term workforce planning, but we must also look to the short term. We need to retain the staff who are in place now, but that will become increasingly difficult while the pressures on the NHS continue to increase. Staff are exhausted. They are worn down and burned out. Mental health support will play a key role in supporting the workforce, and I have heard positive feedback about the national wellbeing hub, although it is only part of the picture.

Fundamentally, we need to improve working conditions for staff and ensure that they feel valued and that their contribution is recognised. I have been dismayed by some of the questions that have been asked in Parliament about why GPs are “not seeing patients” or when GP practices can “reopen”. GP practices are open and GPs are seeing patients. General practices in Scotland deal with more than half a million appointments every week. There are, of course, on-going issues with waits for appointments, and I do not want to minimise the distress that that is causing to patients. People are waiting for far too long, which is unacceptable, but that is due to the immense pressure that is being placed on GP services and it is not because their doors are shut to the public. We do GPs a disservice by pretending otherwise, and that will certainly not help retention.

I turn to widening access. I welcome the Scottish Government’s commitment to doubling the number of widening access places to help to create a more diverse medical workforce. The NHS needs to reflect the diversity of Scotland, and there is evidence that a diverse workforce can improve the quality of care. Widening access is essential from a social justice perspective, but it also has numerous benefits for the NHS and patient care.

We know that students from the poorest 40 per cent of neighbourhoods are less likely to study medicine, or the other professional courses such as law, veterinary medicine and architecture. People who are care experienced, young carers and asylum seekers might also be less likely to study medicine. That means that we are missing out a significant pool of people who could go on to become excellent clinicians. That is to our and the health service’s detriment, and it needs to change.

I have one more question, which is on social work. Social workers have maybe been the only front-line workers whom we have not discussed. Like many other services, social work has come under increased pressure during the pandemic, but we hear very little about the impact that it is having on social workers. Does the minister have a sense of the wellbeing levels in the profession and how they might be impacting on retention? We know that the average working life for a social worker is around seven years.

The mental health benefits of social prescribing are well known. Does the minister have a sense of the impact of the pandemic on social prescribing? As pressure has increased on primary care, do healthcare staff have reduced time to engage with social prescribing?