Chamber and committees

I thank the panel for their helpful introductory remarks, which touched on a number of key themes including in particular the pressures that are being experienced in our NHS, the pressure on staff and the staffing challenges that we face.

I am keen to get a sense of what you think about the Government’s recovery plan. There have been a variety of responses to its publication. For example, Dr Lewis Morrison of the BMA has said that it is at best “only a start”, and I have heard the RCN highlight the point that has just been made about the pressure on staff and whether the plan does enough to address staff burn-out and stress. Dr Robertson, will you tell us what confidence you have that the recovery plan will deliver the required transformation?

I would not disagree with much of what has been said about the real pressure on staff.

I am interested in our immediate crises, and particularly in the onset of winter and winter pressures across the piece. Obviously, there is long-term workforce planning, but there is clearly an immediate need, particularly in acute settings, when it comes to how we physically keep the show on the road. We are seeing a lot of pressures at the moment, and we are not even at peak winter yet when it comes to admissions and use of service.

I am therefore keen to understand what is needed and what can be done to increase resources and staffing right now, and what would make most difference. I appreciate that that is not easy to answer, but I am keen to get a sense of that, possibly again from Dr Sue Robertson or the RCN, although I can ask everyone, I suppose.

The cabinet secretary says that there will be additional ambulance staff on the ground by April 2022 and that, of the 443 staff who will be recruited this year, only 148 will be new additional staff, with the rest being recruited to cover staff turnover. Does the cabinet secretary intend the British Army to support ambulance services all the way through until April 2022? Where will the military personnel be deployed, and when will members be made aware of that?

Between 2016-17 and 2019-20, more than 11,000 ambulances were sent out with a single crew member, which is an increase of nearly 39 per cent. When the First Minister was health secretary, she said that she would take action to eliminate rostered single manning and that ambulances

“should be double crewed, with at least one crew member being a paramedic unless in exceptional circumstances”.—[Written Answers, 27 July 2007; S3W-2125.]

In the midst of the crisis in our Ambulance Service, will the First Minister tell Parliament how many ambulances have been single crewed since the start of the pandemic and why her Government has failed to eliminate the practice as she pledged to do 13 years ago?

I thank Miles Briggs for bringing the debate to the chamber. As other speakers have done, I congratulate the SCVO on this significant milestone in the delivery of community jobs Scotland.

I recognise the immense contribution that the SCVO makes to society in Scotland, supporting our voluntary sector to flourish and working in communities across Scotland with people from all backgrounds. We must also recognise the immense challenges that have been placed on the sector, and on all other sectors, by Covid-19. However, we also want to celebrate the way in which the voluntary sector in Scotland has risen to the challenge of supporting the most vulnerable people and, more widely, our cities, towns and villages in this time of crisis.

I wanted to speak in this debate because, prior to my election to Parliament, I had the great pleasure of working for over a decade in the voluntary sector. After leaving university, in 2010, I landed my first job at Volunteer Centre East Dunbartonshire, based in Kirkintilloch, as a development officer. Part of my role was supporting people to get back into work through volunteering and getting involved in community projects. In my first year in the role, community jobs Scotland was created, and I was able to directly support people into the new roles that were created across the voluntary sector.

I met people whose confidence had been shattered, who felt that they did not have a pathway to work and who felt that there were just too many barriers for them to get a job. They were people who, as the motion describes, had caring responsibilities, were care-experienced young people, held criminal convictions, were leaving the armed forces early or were living with disability. Community jobs Scotland offered a new avenue for people and a new sense of hope that they could gain the experience and skills that they needed to enter employment, and not through unpaid or tokenistic work but through a meaningful paid role for a fixed period, with the support that they needed for the role and to move beyond that and into longer-term employment.

Voluntary sector partners such as Citizens Advice Scotland, carers organisations and advocacy services provided roles that gave a strong standard of skills development and training. Perhaps most importantly, those partners met people where they were: they took time to get to know them as individuals and to know their needs, and they developed strong support within teams in their organisations.

Later in my career, while working for Enable Scotland, I managed a number of community jobs Scotland roles and was able to give the same support, having learned so much all those years before in East Dunbartonshire.

When writing this speech, I was reflecting on one person in particular, who started in an admin role with Enable through community jobs Scotland and went on to become an integral part of our membership and events team, eventually running large member events and conferences. That person left Enable and went on to work full time in other roles across the voluntary sector and continues in full-time employment today. I hope that that demonstrates the real impact of community jobs Scotland. I know other members have spoken in similar terms about their experience.

As has been said and as the SCVO outlined clearly in its briefing, we should be a little concerned that community jobs Scotland will come to an end as funding transfers to local authorities. We would certainly want to see the bridging that Miles Briggs outlined in terms of the relationship between the SCVO and local authorities. In the words of the SCVO, CJS is a successful

“national ... programme which supports young”

people

“into employment”.

It seems counterintuitive to remove it at exactly the point that furlough ends, particularly when we have seen the examples of young people being able to access the right support at the right time and finding that pathway into work, as I said at the start of my remarks.

We have much to do to rebuild from the pandemic. Our priority must be to support existing and new avenues to employment for everyone who needs them, particularly the most vulnerable. We should not forget the key role that our voluntary sector has played and must continue to play.

Certainly.

Rachael Hamilton and Jackie Baillie made the point that the promise to recruit 800 new GPs is nothing new and has not yet been delivered.

We point again to the Government’s thin recovery plan and ask where the detail is to support retention and increase capacity to ensure a sustainable future for primary care in Scotland, with the wellbeing of patients and staff at its heart.

In closing for Scottish Labour, I echo the comments of colleagues across the chamber, and pay tribute to the GPs who are working in our NHS across Scotland. In particular, I recognise their dedication throughout the pandemic, their support of colleagues in acute care and the help that they provided to administer the vaccination programme, most notably to the oldest and most vulnerable in our communities.

We should also take a moment to pay tribute to all those who support GP practices, including the practice managers, practice nurses, healthcare assistants and admin staff. Those teams working together and knowing their communities makes a real difference to the health and wellbeing of us all.

In the debate, we have heard about some of the frustrations and worries that patients have experienced, particularly when they have been unable—or have felt unable—to access face-to-face appointments. In her opening remarks, Jackie Baillie referred to the frequent confusion in communications about whether GPs are open. Carol Mochan said that some of her constituents feel that they should stay away from their GP and the NHS.

From Sandesh Gulhane’s first-hand experience, we heard about the capacity that is required in order to support GP practices, and the current pressures on all parts of the system. We have to recognise that, for many elderly patients and patients with a learning disability, or perhaps due to communication or language barriers, digital is not always accessible or appropriate. Virtual GP appointments should not be the default position. Patients and clinicians must have the option to have face-to-face appointments when it is safe to do so.

Of course, we acknowledge that technology has its role to play, but we need to consider, along with clinicians, the appropriateness of when digital appointments are offered. In her contribution, Gillian Mackay spoke about Asthma UK and the British Lung Foundation, which have pointed out the importance of ensuring that diagnostic GP appointments, such as those for people who have lung condition symptoms, take place in person as soon as possible, to allow a holistic view to be taken of what is going on in that person’s life. Therefore, we call on the Government to make clear what more can be done to support GPs to see more patients face to face.

I highlight the issues that were raised by Alex Cole-Hamilton, and previously by Willie Rennie, around physical distancing, particularly in smaller and more rural practices, where space in waiting rooms is a concern, and the possible need for improved ventilation.

My point, and the point that was made by other members, is that we need to look at the package of measures that can be put in place. For example, in smaller practices, we need to look at where people are waiting, where it is acceptable to wait and what ventilation is put in place. We need to consider how we can increase capacity by doing a variety of things.

It is clear that GPs and their teams are stressed and undervalued, and we must recognise that. We have heard about the survey by the Royal College of General Practitioners, which reported that 57 per cent of GPs who have been working during Covid-19 said that it has negatively impacted their mental health, and 58 per cent of respondents to its annual tracking survey reported that they are so stressed that they cannot cope at least once a month.

Many are leaving front-line practice altogether: they are leaving a job that they love, because they just cannot do it anymore. However, we know that, as with other crises in our NHS, those challenges existed before the pandemic and have been exacerbated by it. Indeed, the Royal College of General Practitioners, the BMA and others have pointed out that the on-going crisis in GP recruitment has been around for some time; that has been referenced today by colleagues.

Good morning, minister. I will follow up on that point. We all understand the importance of better understanding the information on and patterns of instances of people overdosing and being treated in or attending hospital. On reporting, I am keen to understand what we can do to get more data. For example, hospital admissions information does not cover accident and emergency attendances, nor does it cover cases in which people are treated by the Scottish Ambulance Service. How can we get more data on where people are treated, and how can we make sure that we follow them up?

I agree with much of what the minister said, certainly on the need for local connections and accountability and the need to improve the status of those services. It will be interesting to see people’s views during the consultation.

I want to ask about alcohol and drug partnership reporting in the here and now. The Government previously committed to providing information from ADPs on spending by integration joint boards. That happened in 2016-17 and 2017-18; I think that 2018 was the last time that we had those figures.

That was going to be a baseline for future reporting, but there has been no further information since then. As part of the intelligence to enable us to understand what is working on a local level and where spend is going, it would be helpful to have such information. Will the minister say something about that? What other intelligence can we garner from ADPs that will help us to map some of this area and meet the MAT standards?