Chamber and committees

Is there a particular instance that springs to mind that might illustrate that point for us?

Yes.

I want to touch on some points that are made in the written submissions about potential waste in the healthcare system. The most valuable commodity in the national health service is time, but Community Pharmacy Scotland reports in its submission that

“Community pharmacists did not have read and write access ... to the patient ... record”

so they had to email or write to GPs with details of any changes. That antiquated process is taking up pharmacists’ time, and CPS says that it creates a “risk” in that patients might seek “further treatment” before their records are updated.

That is just one example. Other blockages came to light last winter that could be remedied with the support of technology. On the point about obvious waste in the system—CPS’s view is just one that has been highlighted—do you find other examples of difficulties that would benefit from parliamentary support?

That leads on quite well to my other question on the issue. I have heard, particularly from GPs in Glasgow, that people are so busy firefighting in their clinics day to day that their practices simply do not have enough time to consider innovations or improvements. That is a real frustration, because they know that digital solutions could help to alleviate some of the pressures that are facing primary care. The written submissions refer to digital care technologies such as NHS Near Me. Do any of you have views on how we can create a space not just to deploy technology, but to allow people to be trained and the technology to be embedded, particularly in primary care settings? I see that David Gibson has put up his hand.

You mentioned NHS Fife and the example in NHS Lanarkshire. When there are examples of good outputs being achieved and clear evidence that they reflect good performance, how does the system or the span of control at the Scottish level capture that and normalise it across the health board territories? There is quite a cluttered landscape—shall we say?—of management structures.

A number of the written submissions question how data from previous years has been used to evaluate the impact of winter planning and identify gaps and opportunities for improvement. It is clear that there are multiple concerns regarding last year’s plan alone.

One of the recommendations in the submission from Public Health Scotland and the Scottish directors of public health group is to

“Stop things that have not worked and not introduce anything that has not been evaluated in a robust way”.

Ahead of this year’s plan, has the Scottish Government undertaken any assessment of what has and has not worked well in previous winter plans? Can you highlight some examples?

I thank the witnesses for coming today. Submissions in response to our call for input to our inquiry cited a disproportionate focus on secondary care in the most recent winter plan and claimed that it undermined the Government’s intention to support a whole-system approach. Indeed, health expenditure across the UK is similar to that of other Organisation for Economic Co-operation and Development countries in total, but differs in that most of the spend is allocated to hospital care as opposed to preventative care or community-based settings. It could be argued that the disproportionate expenditure on secondary care is a year-round structural imbalance that exacerbates vulnerabilities, particularly in the acute hospitals.

Do the witnesses agree with the views expressed in written evidence that primary care was not prioritised in the winter plan in the way that it should have been? Perhaps you could pick up on the point that John-Paul Loughrey made about GPs in deep-end practices?

Another thought occurred to me based on my experience of visiting India, which is that they have extremely intensive road safety signage—in some cases, it is quite witty, such as: “You might get ahead but don’t lose your head.” We found the signs quite amusing, and they certainly caught your attention—that is the important thing. You could not go 100m without seeing some sort of sign that would indicate the road safety risks. It might be worth looking at other jurisdictions where they have much more intensive signage to do with issues around road safety than we do. Perhaps it might be worth considering a short-term measure to intensify the road safety signage on the A9.

I agree with colleagues’ recommendations so far. I add that, in practice, the feasibility of the roll-out would depend largely on local authorities leading the logistics. It might be useful to get an understanding from COSLA about how ready the school estate is to adapt to such a change, should it be introduced, what sort of capital changes might be required and what existing contracts might need to be changed. It would also be useful to get an understanding of the opportunity for things such as developing community food networks, using the school as the anchor for a community food network and building resilience around the good food nation concept, which was recently passed into statute by this Parliament.

Rather than simply seeing the issue as a potential liability, I think that it presents us with huge opportunities. Trying to socialise those ideas with COSLA and local authorities would be helpful at this stage, if the committee thinks that there is potential in them.

I have some familiarity with the petition and, obviously, the community of Milton. I agree with all the suggested actions and the sentiments that have been expressed today. There are youth organisations in Glasgow that have demonstrated a positive track record of benefiting their communities. For example, St Paul’s Youth Forum in Blackhill, which has achieved significant improvements relating to youth violent behaviour in that community. We might be able to learn from and scale that model in communities where there is a persistent issue with gratuitous youth violence.

The lack of enforcement and lack of engagement with the issue by the police is a deep concern, because it only emboldens the action that the convener has described, which is completely demoralising for a community that already feels alienated.