Chamber and committees

I certainly will—scrutiny is the job of all of us so that we get this right.

I wonder if I can just scrutinise the benefits and the understanding of them among the respondents to the consultation. We have heard that the Government’s analysis acknowledges that a large number of criticisms were made in the consultation process, in all formats of submission. Two of the principal reasons that were given were the complexity of the issues and the lack of detail in the proposals. Does the minister accept that people are struggling to engage and to understand the benefits that we have just talked about? I know that the minister has committed to further engagement work, but it is clear that people want to see that detail and to continue that conversation.

Good morning, minister. In evidence to the Public Audit Committee, the Auditor General said:

“We know that the social care workforce has been under immense pressure during the pandemic”.

You spoke about that in your opening statement. The Auditor General went on to say:

“indeed, that was the case even before the pandemic ... The Scottish Government now needs to take action to improve working conditions for this vitally important workforce, otherwise it will not be able to deliver its ambitions”

in the longer term

“for social care.”—[Official Report, Public Audit Committee, 3 March 2022; c 3.]

The Audit Scotland briefing outlines what those pressures and challenges are, and it is clear that there is an immediate need to resolve some of them.

I am also interested in the exacerbation of those issues by the cost of living crisis. It is very clear that many of these workers—who are very often women and lower-paid workers—are struggling to make ends meet and to be able to do their job because of the rising costs of getting to work between their shifts on public transport or in their car. What is your assessment of what needs to be done immediately to deal with some of that?

Audit Scotland is particularly concerned about, or interested in, the learning that can be taken from previous public sector reform. Its analysis highlights that the expected benefits are often not clearly defined and that, even where they are defined, they are not always delivered, particularly in the short term. Are you confident that the benefits have been defined and can be delivered?

I, too, send my condolences to anyone who has lost a baby—these cases are indeed tragedies.

The Government is right to make it clear that there is no link to neonatal Covid or to the Covid-19 vaccine, but Dr Sarah Stock, who co-led the Covid-19 in pregnancy Scotland study, has said that further research is required to understand the effects of Covid-19 in pregnancy, because it can cause complications such as early birth. She has also said that the wider impacts of Covid-19 on the NHS workforce and services need to be looked at.

Can the minister confirm that the inquiry will examine those issues? When does she anticipate updating the Parliament further on the matter?

Like colleagues, I begin by thanking Emma Roddick for bringing the motion and the debate to the chamber. I also thank Jamie Greene for his contribution as co-convener of the LGBT+ cross-party group and both colleagues for the work that they do on that group; indeed, I thank all other colleagues who are members of or who support that group. I think that it does vitally important work in our Parliament in representing the important issues for LGBT+ people across Scotland—and none is more important than the issue that we are debating this evening.

I also thank SHAAP for its work with Glasgow Caledonian University on the report. If I may, Presiding Officer, I would like to plug an event that is coming up in the Parliament in June. I am delighted to be hosting SHAAP and Glasgow Caledonian University to mark pride month, which will give us all an opportunity to hear more about their work and to engage more fully in it. I would welcome all colleagues to that event.

As we have heard already, many communities in Scotland suffer from health inequalities when it comes to the overconsumption of alcohol, and Scotland’s LGBT+ community is among them. Evidence shows that although alcohol-free spaces for LGBT+ people are highly valued where they exist, alcohol still plays a central role in most LGBT+ safe spaces. We have heard from colleagues about their own experience of that, and I would echo much of what has been said. It is so important that our towns and cities have a gay scene and areas where there are bars, cafes and other places that are safe spaces for LGBT+ people. However, those spaces are often based around a drinking culture and alcohol, and that can be very challenging for some people. We need to widen out those safe spaces and ensure that many of them are as safe as they can be.

I point to what Jamie Greene said about the challenges that we know exist around access to sports for LGBT+ people. Historically, many people have not engaged in sports and find it difficult to do so. We know that LEAP Sports Scotland and others are doing a huge job of work to try to make sport more accessible and to ensure that people are welcomed.

The SHAAP research points to challenges for LGBT+ people in accessing alcohol support services as a result of misconceptions that are embedded in those services regarding the sexuality or gender identity of their service users. Indeed, very often how people’s sexuality or gender identity influences wider relationships with alcohol is misunderstood.

We have made great strides in Scotland when it comes to protecting the rights of LGBT+ people and amplifying voices, but it is clear that we still have a lot of work to do. The threat and reality of discrimination can have a devastating impact on wellbeing and can contribute to the reality that LGBT+ people are particularly vulnerable to experiencing poor mental health. Colleagues—particularly Pam Duncan-Glancy—have spoken about LGBT Youth Scotland, evidencing some of their recent work in that regard.

Testimonies have shown that mainstream health services are not always inclusive. Members of the LGBT+ community are not just more likely to struggle with mental health issues and alcohol misuse, but less likely to receive the support that they need when they are facing those struggles. Glasgow Caledonian University’s report displays the LGBT+ community’s concerns that alcohol services are often intimidating and oriented towards white, straight men, and that support groups are not gay friendly. We all have a right to support and it is vital that that right is accessible to everyone across all communities, especially marginalised groups such as LGBT+ people.

We must commit to the provision of additional alcohol-free spaces in the LGBT community and more widely. We must provide spaces where people can express themselves and unite, free from alcohol, if that is what they choose to do. That is a key step towards improving things for people who are isolated and providing social support, and I think that it is particularly important for people who are under 18. I think that we would all want to try and engage with LGBT Youth Scotland and others to look at those issues, in particular.

Once again, I thank Emma Roddick for bringing this timely debate and urge all colleagues to attend the event with SHAAP in June.

The £10 million fund was announced in September of last year, but there was no spending until the beginning of this financial year. Why was that and what is the long-term strategy for funding this crucial work?

I heard the cabinet secretary’s initial answer to David Torrance’s question on workforce pressures, and his answer about Brexit. When the Auditor General for Scotland gave evidence to the committee, he spoke about historic problems with staffing. He said:

“We know, and have previously reported, that the NHS has, historically, struggled to achieve all its staffing ambitions.”—[Official Report, Health, Social Care and Sport Committee, 19 April 2022; c 3.]

Will the cabinet secretary acknowledge that there has been something of a historic failure to deliver a workforce plan, and that there were failures in meeting staffing targets before the pandemic?

I do not think that anyone would deny that the pandemic has exacerbated the pressures. I was just pointing to the fact that the Audit Scotland report says that there was no financial sustainability prior to it. The committee will be keen to hear an update on the progress of the boards to which I referred when we get to the financial year end.

I will ask more broadly about the increase in funding. The Scottish Government committed to a £2.5 billion increase in funding for health and social care over the parliamentary session. However, the medium-term framework for health and social care has not yet been updated. In the absence of any medium-term financial framework, how can the cabinet secretary be confident that the additional funds that were committed will be allocated and used effectively? When will the updated medium-term financial framework be published?

I will continue in that vein. We have seen evidence in the Audit Scotland report that data and planning have not been adequate. That answer suggests that we have to do a lot more to understand and profile where we are.

I return to the cabinet secretary with a question about nursing places and vacancies. There are 6,674.4 whole-time equivalent nursing and midwifery vacancies in the NHS, and we have heard some of the cabinet secretary’s reasons for the challenges in that. Will he also accept that the reduction in the number of nursing training places—a decision that was taken by his predecessor—has exacerbated those challenges?

I am trying to ask you a question and get the answer.