The Official Report is a written record of public meetings of the Parliament and committees.
All Official Reports of meetings in the Debating Chamber of the Scottish Parliament.
All Official Reports of public meetings of committees.
Displaying 1466 contributions
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
What about my point about the cost of regulating a PA being half that of regulating a doctor?
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
In order to regulate, it is necessary to have very tight definitions of what it is that the profession is doing. There are very tight definitions around nursing and expanded roles and around what doctors do. Given the scope of practice of AAs and PAs, 69 per cent of respondents to a BMA survey said that they were concerned that their role had been expanded more than it should have been. An example that I have heard of is the medical registrar bleep being held by a PA. The holding of that role is one of the most senior positions in a hospital. What is the scope of practice for a PA when it comes to the complaints procedure and the regulation process?
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
We have seen a significant reduction in mental health across our country. We have also seen significant increases in waiting times for child and adolescent mental health services; the longest wait in Glasgow was 37 weeks to be seen. The reduction in budget will surely impact and harm mental health.
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
I am not sure whether I need to declare my interest again, but I shall do so. I am a practising NHS GP.
I have met the Association of Anaesthetists, the British Medical Association and the General Medical Council Scotland on multiple occasions to discuss physician associates and anaesthesia associates; I have a number of concerns about their roles. There is a really important point to be made when it comes to regulation: we cannot regulate a body if we do not know what people’s roles are and what the scope of their practice is. “Supervision level” has not been defined. Is supervision on a one-to-one basis, a two-to-one basis or a three-to-one basis? The numbers could go on. In her questioning, Emma Harper spoke of the tightly defined role of an anaesthesia associate in the US.
Let us consider two issues. First, the fit and healthy patients whom Emma Harper spoke about are exactly the type of patients whom our junior doctors are required to deal with during their training. When junior doctors start their training, they cannot start by treating really complicated patients; they need to start by anaesthetising—obviously, with supervision—fit and healthy patients. That is really important. Therefore, there are impediments to training and, potentially, other issues.
I have also heard of—
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
Cabinet secretary, we were speaking about the national care service and you said that there is £1 billion in the social care budget. How much of that budget line relates to the NCS and how much relates to adult social care funding?
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
Can we talk about money? The cost of regulating a PA will be half the cost of regulating a doctor, and the Government is putting in money to subsidise the regulation process. Is that fair?
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
In stating your top three priorities, you spoke about NHS recovery, which you mentioned in your opening statement as well. You feel that you have put a budget for that in place. Therefore, at next year’s budget time, should we expect to see significant reductions in improvement in accident and emergency waiting times and significant improvements in waiting times for procedures?
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
I will take an intervention once I have made these points.
I have also heard of anaesthesia associates anaesthetising children. I am also concerned about how anaesthesia consultants know how to supervise and what their level of cover is when something goes wrong. They have never been trained in supervising anaesthesia associates.
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
No—my argument is about the role of regulation. Of course, regulation is important and it must occur, but we cannot regulate what we cannot define. Scope of practice is a very important part of that regulation, as is supervision level. With regard to scope of practice, we know that there has been an expansion in what our PAs and AAs have been asked to do. I know of general practices that run almost entirely on the work of allied health professionals, which saves the practice money, but potentially provides a two-tier system and service to patients in remote and rural areas, where they will not, in the main, see doctors. With the expansion of that PA role also—
Health, Social Care and Sport Committee
Meeting date: 16 January 2024
Dr Sandesh Gulhane
I declare an interest as a practising NHS general practitioner. Good morning, cabinet secretary, and thank you for coming today.