Chamber and committees

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.

Prior to the summer recess, we had quite a consensual debate on many of these issues, certainly on medication-assisted treatment standards and the need for strong and timely implementation of them—April 2022 has been set as the target. I am keen to hear a progress update from the minister. Also, how will that progress be reported? I think that the minister made a commitment to report to the Parliament six-monthly on MAT standards. Could you address those points, please?

Alcohol and drug partnerships play a very localised role with regard to their relationship with their integration joint boards and delivery. I note that, in the consultation on the national care service, there has been discussion about whether ADPs should form part of a more national service delivery approach or whether they should remain more local. I am therefore keen to hear your views on that issue and the question of where they can be used most effectively.

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?

In their manifesto, the Scottish Greens committed to £15 an hour for care workers. Are they still committed to that position, given that they are now in government, and will they support Labour’s amendment today?

A common thread has run through our debate. As colleagues have already done, I thank all our hard-working NHS and social care staff for all that they have done and will continue doing. They have worked hard on the front line, caring for us all and for the sickest people in Scotland and keeping services going in unimaginable circumstances. We owe them our deep gratitude.

As we have heard, warm words of thanks are not enough. Words will not solve the crisis in A and E, whereby people are waiting an average of six hours for an ambulance. Praise from ministers will not address the more than 600,000 people waiting for treatment or diagnosis. Applause does not make a £15 per hour wage for key workers a reality.

A Government motion and a thin recovery plan that fails to recognise the scale of the crisis are cold comfort to those who know what is happening on the ground: the doctors, nurses, healthcare assistants and support staff who, as we have heard today, use words such as “exhausted”, “undervalued” and “burnt out” to describe their day-to-day experience.

I know that ministers and SNP members are quick to retort that these are unprecedented times. Of course they are. The cabinet secretary continually cites the pandemic as he seeks to justify the serious and imminent challenges that have been referred to today. However, he refuses to acknowledge not only what we in Parliament are saying but what professionals, patients and carers are telling him: that the crisis has been growing since before the pandemic and has been exacerbated by it.

My colleague Jackie Baillie spoke about the stress that is experienced by people on waiting lists. There were 400,000 people languishing on waiting lists before Covid-19. As Craig Hoy said, BMA Scotland has been warning about workforce pressures in the healthcare sector since before the pandemic. Ambulance turnarounds were taking longer before the pandemic, with 17,926 turnarounds taking more than an hour, which is a shocking increase of 634.4 per cent since 2014. How can the Government be taken seriously when it talks about the planned recovery but refuses to admit that the crisis has been unfolding on its watch for 14 years?

The cabinet secretary has recently been fond of saying in his answers to members’ questions on these issues that he does not have a magic wand, but he clings to his plan as if that might be a magic wand. That plan has been described as “only a best start” by Dr Lewis Morrison, the chair of BMA Scotland, and further described as “unrealistic” and having a number of “worrying gaps”. The RCN has said that there is little detail in the plan on how issues such as staff burnout can be addressed and has warned that nurses have felt undervalued and underresourced for far too long. Sue Webber and others have said that it is time for the Government to show how it will support and retain exhausted staff in the system.

I turn to social care. Scottish Labour first advocated a national care service in 2011. As my colleague Jackie Baillie likes to remind the Government, we welcome all converts, however late. We have always been clear, as we heard from Willie Rennie and others today, that any such service must be about culture and not solely focused on structure. A national care service must be about those who live in our communities and who need access to the right care in the right place at the right time. Clare Adamson was right to speak about rebuilding our communities better.

The service must ensure that older people are supported holistically as they live for longer in our communities and must ensure that care homes adhere to rigorous standards and are held to account for those in order to drive up quality and improve the training and retention of staff. It must ensure that people who have learning disabilities can live their lives with choice and control and do not simply face false choices from ever diminishing budgets.

People want to have a seat at the table where decisions are made. Carers want to have a voice at the table and those who use social care want a meaningful say in the decisions that impact them. If the Government insists on driving an agenda that is about drawing power towards the centre and does not recognise the importance of local decision making, in which people who use services have a say, this will simply be upheaval and structural change with little real change on the ground.

The people of Scotland cannot wait five years for the Scottish Government to work out its big vision for a national care service. Action can be taken now, and action is needed now. There are practical steps, which Jackie Baillie alluded to, that will make an immediate difference to the lives of people who are in receipt of social care and those who support them. Those steps include restarting respite services and creating a plan around that; ending non-residential care charges; pausing commissioning; and addressing the poverty pay in the sector, which we have heard about, by supporting a pay rise to at least £15 an hour for social care staff. I welcome Gillian Mackay’s support for that and the fact that she has held true to the Green manifesto. I hope that she will influence her colleagues in ministerial office.

Our social care workers deserve more than warm words. As my colleague Carol Mochan pointed out, they must be valued. In its motion, the Government speaks of fair work, but it has failed to deliver. One in five workers are on insecure or temporary contracts and 15 per cent of staff work unpaid overtime. Once again, we on the Labour benches call on the Government to give care workers the pay rise that they deserve and show that they are valued.

It is clear that, after 14 years in power, the SNP Government has mismanaged the NHS, and we are facing a serious crisis before we even get to the crisis that winter will bring.