Chamber and committees

I appreciate that. Some of this is absolutely about resource but, as you referenced earlier, it is also about culture, which does not always need pounds behind it. What is being done by COSLA to improve the culture in which people work?

I appreciate the work that is being done at joint ministerial working group level and all that sort of thing, but what work is being done at COSLA level to make sure that good terms and conditions exist? One thing that is being looked at in the creation of the national care service is making terms and conditions consistent across the country. What is being done in relation to the services that are delivered by local authorities to ensure that terms and conditions and working conditions are consistent across the country? Also, what is being done where services are contracted out by councils? The variations are wild, in some places.

In its written submission, the Faculty of Advocates raises concerns about use of the word “sufficient” in relation to carers’ breaks. How can that wording be strengthened? Does the faculty have a view on what mechanism would be most appropriate to determine what qualifies as “sufficient”?

Good morning. What are your views on how we can ensure that carers are consulted on whether the breaks that they receive are sufficient, and should a mechanism to support that be included in the bill?

To ask the Scottish Government what steps it is taking to support the workforce skills that are needed to pursue a transition towards a fossil fuel-free future. (S6O-01466)

A recent report by Scottish Renewables found that more than 27,000 people in Scotland are directly employed in Scotland’s renewables sector. With fossil fuel supplies likely to be impacted this winter, the need to accelerate the transition to a green future has never been greater.

Will the minister outline what steps the Scottish Government is taking to ensure that the green jobs workforce academy and similar programmes are boosting skills and employment across Scotland, including in my Central Scotland region?

I welcome the decision to put human rights into the terms of reference. I appreciate that the inquiry is independent but, given the public interest in any outcomes of the inquiry, how will the Scottish Government ensure that the conclusions of the inquiry, including any interim conclusions if appropriate, are in accessible formats in order to provide all families who have lost a loved one with the answers that they deserve?

Will the minister outline what will be put in place as a result of the strategy for those people who have made multiple attempts to take their lives, many of whom have complex trauma? How can we ensure that each of those crisis periods is taken seriously and treated without stigma?

This will, once again, be one of the most difficult winters in the history of our NHS. We have a workforce that is already tired, rising Covid-related admissions and a backlog of delayed and more complex treatment. We also face a battle to reduce A and E waiting times.

As always, some health boards are doing better than others. In my region, NHS Forth Valley is continually at the top of the table for long waiting times. We must understand better why that is the case. We also need to support a sustained incremental improvement in waiting times rather than what we are seeing at the moment: bad statistics one week, a marked improvement the following week, and then the cycle repeating itself. That does not deliver for patients, and I am greatly concerned about the pressure that clinical teams are being put under to achieve lower waiting times when they are already stretched and tired.

Keeping people out of acute settings in the first place should always be the primary goal. At the start of this week, I attended a Marie Curie round-table discussion, in which I heard about the experiences of unpaid carers and the organisations that support them. We discussed the current issues that face those who care for loved ones at home.

An issue that was raised was access to NHS 24 for people with a terminal diagnosis. Carers and patients often look for guidance on whether the issue that they currently have needs acute care. However, because of the wait to be triaged, they often end up phoning for an ambulance or taking their loved one to A and E.

I believe that some health boards, as part of anticipatory care planning, provide specific pathways for those with a terminal diagnosis to get the information that they need. Given the number of people who want to die at home, I hope that the cabinet secretary will look into that issue as one way to prevent people from ending up at A and E unnecessarily.

I have previously raised the issue of the staffing of out-of-hours GP services. That hugely valuable service diverts people away from A and E and provides timely care. We must make that service an attractive option for GPs to work in.

In its briefing, the Royal College of General Practitioners highlighted its belief that people are unaware of how to effectively navigate health and social care services. Many things have changed over the pandemic. Some services are not delivered in the same way, and pathways might have changed. I hope that, especially over winter, effort can be put into ensuring that patients know where and when they can access the most appropriate care. For example, the pharmacy first model will be able to help with minor ailments over the winter, which will potentially reduce the impact on GPs.

We should acknowledge those in different parts of community care who are working extremely hard to ensure that their patients remain well. District nurses are doing home visits, changing bandages and monitoring people’s conditions; school nurses are dealing with a vast range of issues across multiple schools; and health visitors are providing advice and guidance for new parents. They are all contributing to the system, as are the brilliant allied health professionals and support staff, without whom the NHS simply would not work.

We need to ensure that staff can take their breaks, that they have time for peer support, and that they can access wellbeing measures that help to relieve the physical and mental toll that they experience.

Pay is a very important issue. However, having spoken to nurses from the RCN outside the Parliament building before the recess, I know that their working conditions and their terms and conditions are really important issues, too. I will continue to work with RCN members on that.

This winter, we must reduce waiting times as far as possible without putting more undue pressure on a tired workforce, and we must ensure that all avenues for access to care are well advertised and communicated.

David Torrance said it first, to be fair to him.