Chamber and committees

I will pick up on some of the modelling that has been done in the productivity paper that you prepared, Professor Ulph.

The number of people in the NHS workforce in Scotland would make it the fourth largest city in Scotland. I think that the head count sits at 181,000 people, so it is the biggest employer in Scotland by a considerable distance. That clearly has an effect on national performance in terms of productivity. Do you have any thoughts on whether we can improve our analysis of the productivity of the NHS workforce in informing national policy?

Sorry—it looked as though you wanted to comment.

The recruitment crisis in social care is another major issue that has been fed back strongly to the committee. The programme for government included a commitment to a pay rise to £12 per hour for social care staff. If the Government had acted when calls for the rise to £12 per hour were made three years ago, that increased level would now be worth almost £14 per hour, after inflation. Does the cabinet secretary think that that is sufficient to address the scale of the recruitment and retention issues in social care, bearing in mind the opportunity cost of not acting?

I want to pick up on the work of the COVID-19 Recovery Committee on its inquiry into dentistry services in Scotland. A number of stakeholders are concerned about those. For example, the British Dental Association said that

“uncertainty remains around whether”

the Scottish Government’s reform proposals will be enough to

“halt the exodus of dentists from NHS services”.

In my own experience, my recent check-up was cancelled for the first time ever because the permanent dentist had left the practice and it was relying on locums to cover appointments.

What is the Scottish Government doing to implement the recommendations of the COVID-19 Recovery Committee’s inquiry into NHS dental services, particularly on consideration of costing service model options?

Okay. That is disappointing.

I thank the cabinet secretary for that response. The Royal College of Nursing strongly fed back the point that nurses in training felt that they were not able to continue with their studies because of the financial costs. Having an employee status at the outset under an apprenticeship-led model would offer a way of remedying that.

Another major issue that has been fed back is the abolition of non-residential care charges. That was raised very strongly by stakeholders. Non-residential care charges are still in place, with the cost in Glasgow almost doubling. There was no mention of care charges in the programme for government, despite the strain of the cost of living crisis and its impact on some very vulnerable people. Is ending non-residential care charges still a priority for the Scottish Government, or is that not on the radar at the moment?

We have had a lot of correspondence from members of the public as a result of our call for feedback on the state of the national health and social care system and mental health in Scotland, particularly on waiting times for child and adolescent mental health services. Waiting times data for the most recent quarter shows that 73.8 per cent of children and young people were seen by CAMHS within 18 weeks. That figure is lower than that for the previous quarter, and it falls short of the Scottish Government’s target of 90 per cent of people being seen within 18 weeks. I understand that the delivery plan for the mental health strategy will look at when boards can reach the waiting times standard, but will that plan be accompanied by funding so that health boards can build the required capacity to meet that target effectively?

Could you tell us a bit more about the mechanisms that you are looking to deploy to ensure greater consistency and reduce variation? What specific operational changes do you propose to make?

I recognise that you cannot commit to specific funding at this stage, given that it is not necessarily in your gift alone as the cabinet secretary, but there is the broader objective of allocating at least 10 per cent of expenditure to mental health, as set out in your party’s manifesto and the Bute house agreement. Is the end of the current parliamentary session still the target? Will there be a commitment to that 10 per cent target, or will there be a proposed cut in real terms to the mental health budget?

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.