Chamber and committees

As a millennial, I think that we may be in danger of oversimplification in this line of questioning—if you teach everyone how to cook pasta, it will all be fine. Multiple factors are involved. We have already covered some of them, such as income, background, disability, health condition and all sorts of other things. As someone who has polycystic ovary syndrome, I have an insulin resistance and therefore need to look at an entirely different diet from that of someone else of my age and socioeconomic background. In your work, how do we address those multiple factors to make sure that everybody has the information that is relevant to them? Obviously, there is a vast array of advice and information on social media and so on, some of which is not particularly useful for an awful lot of people. How do we make sure that that information comes from reputable sources that are backed up by science and experts?

I have one more brief question. What is being done, or what needs to be done, to support young players so that they are able to raise issues when they see them? I have no doubt that the complaints that we have heard about are the tip of the iceberg and that there are probably young players who have heard things but not raised them because of various factors. What is being done to ensure that young players’ voices are heard and that they are able make complaints, which might often be against adults, when they hear things that are inappropriate?

I have a follow-up question to David Torrance’s last question. Does that in essence mean that there is no way in which to enforce divergence for the different nations of the United Kingdom if goods that have been made in another country can be sold in, for example, Scotland against decisions that have been made here for public health reasons?

There are many issues with vapes, including in relation to flavours and advertising, that we should be tackling, and I hope that the cabinet secretary would support that.

As well as being an issue for public health, vapes are an issue for the environment. That is covered in today’s Daily Record, which is running a campaign on the issue. Would the cabinet secretary support a ban on single-use vapes?

To ask the Scottish Government what work is under way to assess the impact of vapes on public health. (S6O-01802)

That commitment has never disappeared from our work in government. [Interruption.] The difference between the Greens and Labour is that we are in government, working as hard as we can to push for uplifts, of which there have been several in the past year. [Interruption.] While Labour continues to shout from the sidelines, we will continue to do the work in government.

As well as hearing about pay, I regularly hear about working conditions in meetings with unions and NHS workers. Some of the issues and pressures are health board and, sometimes, hospital specific; others indicate wider issues.

Many in the chamber will be aware of a story that broke in NHS Forth Valley in my region, where one nurse was left to support 37 patients on their own. The scale of that is, I hope, an extreme example.

The implementation of safe staffing legislation is essential to ensure patient and staff wellbeing. The cabinet secretary has previously set out to Parliament steps that were under way and I ask that whichever minister sums up gives an update on the situation.

To boost retention and ease pressure, recruitment is, as I said, essential. We need to allow staff the time to take breaks, to go home on time and to ensure that they do not have to take on extra shifts when they are already tired.

I hope that the UK Government will listen to the suggestion that I put to the cabinet secretary last week on fast tracking visas for international workers coming to the Scottish NHS. That could allow faster access and provide a more attractive option to those workers who were put off by Brexit.

Work in the Health, Social Care and Sport Committee has highlighted that people do not understand all the pathways that are available to them. We have to be explicit with patients as to what treatment options are available. Changing the way that people view their healthcare is not always a quick process, but we need to advertise all the different routes well.

At the moment, it is essential that the diversity of urgent care in particular is well understood. I hope that we can collectively support services such as GP out-of-hours services, which are staffed by passionate people who often have other commitments, too. With the strain that we are seeing across the health service, there is a real danger that we will rely on a dedicated few or risk seeing the service eroded.

I hope that in the future we can also see more digital offerings from NHS 24. Not everyone is comfortable speaking on the phone, and some cannot. Some people find waiting in long queues on the phone difficult—for example, if they have multiple caring responsibilities. A chat function might be more suitable for some, and I hope that that can be explored.

In the medium term, the treatment backlog that has resulted from the pandemic will continue to need to be addressed, even after the peak of winter pressure. Across the chamber, we are all aware that three health boards have taken the decision to pause elective surgeries, and I hope that that can be for as short a time as possible.

Many people have also seen their conditions progress more quickly because of restrictions and not being able to access services that had to be shut for public health reasons. We need to make sure that those who have had their operations or treatments postponed are well informed.

I hope that the capacity that has been brought in by national treatment centres can also help with waiting lists. I am always grateful for information from the cabinet secretary on progress and the details of that.

For the long term, we also have to consider what services will look like in the future and to plan for that now. There is a danger that, in the midst of increased pressure, we recruit to plug gaps without forward thought. Patients want to have more services delivered locally. We have seen a move towards that through the development of the hospital at home programme, and statistics show that more people want to die at home. Given our ageing population, that means that more palliative and end-of-life care is delivered in people’s homes instead of in hospital. That presents its own challenges for the primary care and social care workforces, where district nurses, social care workers and GPs are often on the front line. The need for recruitment across the health service now is clear, and we need to ensure that the mix is the right fit for what we would like to see from healthcare.

We should be making the move towards preventative health spending and keeping people well from the outset. That is not to say that all ill-health can be prevented—that would be too simplistic a viewpoint—but preventative spend saves time in hospital and saves costs at the acute end. I say to Mr Mason that it does pay for itself eventually. Preventative spend should also cover mental and physical health and be appropriate for whatever impairment or health condition a person already has. I recently met some amazing school nurses in Falkirk who are carrying out preventative work. I encourage everyone to speak to school nurses in their area.

I will end, as others have, by thanking all those across health and social care who have worked relentlessly, not just this winter but over the past number of years, to ensure that those who need care can get it.

Before Christmas recess, we all noted in the chamber the strain that could be brought on the NHS over winter. Sadly, we are now seeing the reality of that played out in our hospitals across the country.

We need to tackle the current issues and ensure that we build in future resilience. We must plan services by anticipating demographic change. In addition, we must do the work now on preventative care and public health, to help people avoid becoming sick in the first place and to stay as well as possible if they have a health condition.

In the current period, the on-going work on recruitment and retention needs to gather pace to ensure that services are fully staffed and that patients are seen in a timely manner.

Some of that is undoubtedly about pay and I am pleased to see the progress that the cabinet secretary has made with unions. I hope that talks can be resolved in a way that is acceptable to all.

I had the absolute privilege of visiting some school nurses in Falkirk a few weeks ago, and it was incredible to see the amount of preventative work that they do. They are hugely passionate and innovative in what they do. In rural and remote areas, their preventative work on health could be extremely important. Given the potential impacts of certain practitioners on keeping people well—resulting in fewer attendances at acute settings, which is important—and given some of the distances involved in remote and rural areas, what planning is under way to ensure that we have a diverse mix of recruitment and that we do not lose sight of really important healthcare professionals, such as school nurses?

I think that the cabinet secretary shares my view that we should be trying to deliver services as locally as possible. He mentioned the Lawson memorial hospital in Golspie. I have family members who have had stints in that hospital. It is a brilliant facility, but the building is not the newest building in the world. How can we ensure that such buildings can keep up with the pace of the technology that is being delivered in some of our bigger hospitals in the central belt, where appropriate, and how can we make sure that they continue to be fit for service?

We have an ageing population. We heard during our national care service visit to Dumfries and Galloway that a higher number of people are retiring there, which increases pressures on certain areas of services. What work is under way to ensure that, with regard to the workforce, we take account of that potential change of demographic, and particularly the potential skewing due to people retiring to certain remote and rural locations?