Chamber and committees

Certainly, Presiding Officer.

The Government is letting down health and social care staff. If it is serious about the challenges that Scotland faces, it must show that it values every single member of staff in the NHS and create a plan to match.

The First Minister says that the work of test and protect is vital and hugely appreciated, but, two months since I first raised with her concerns about test and protect staff feeling stressed and overwhelmed, whistleblowers now describe staff as being burnt out. Test and protect is stretched to breaking point, with reports of contract tracers being told to make only two calls before closing a case, in order to get through the volume of calls. Staff have also reported not feeling listened to when scripts change.

In previous answers, the First Minister also referred to the overall number of cases being closed. However, the figures for the week ending 29 August show that only 60.5 per cent of contact tracing was completed within 72 hours. That is 13,330 contacts taking more than 72 hours to be traced from the time cases were recorded on the system. Will the First Minister clarify the position on that point and say what she is doing to fix test and protect and to support our hard-working staff?

With dental practices across Scotland currently operating at restricted capacity in line with Covid restrictions, there have been worrying reports that although NHS patients are having to wait months to see a dentist, those who can afford to go private are being seen within days. Is the minister not concerned about risking the development of a two-tier dental system in Scotland? What steps will be taken to ensure that NHS patients who cannot afford private dental care still receive the timely treatment that they need and to which they are entitled?

I am keen to hear more about early cancer diagnostic centres, which have already been alluded to. We know about the delays in setting them up. They add a lot of value through early diagnosis and opening up new pathways for people who do not have clear-cut symptoms, and there is a sense that we could utilise them in every health board area. I am keen to understand from the cabinet secretary what the plans are to roll out centres further and what the timescales for that are.

We are having a discussion at the moment about our long-term future planning, and I think that a lot of our work for many years to come will be dominated by workforce planning issues and ensuring that we get the recovery right. Will you say something about the imminent challenges of the winter? We are about to embark on a difficult winter period in the NHS. I note that the national workforce strategy will be published in December, but by then we will be into the winter pressures, and a lot of the recommendations will take time to flow through.

Will you comment on the pressures on staffing in the winter? The question relates not just to the NHS, but also to social care, because it is important to be able to discharge people from hospital more quickly and to have care packages in place. I am keen to understand the cabinet secretary’s thinking on that.

The pandemic has undoubtedly exacerbated health inequalities. We have all seen quantitative and qualitative data that shows that. I also think that public health has never been so in focus for people in Scotland and so sharply understood in our homes on a daily basis.

Cabinet secretary, with regard to the learning from the pandemic, what key interventions do you envisage as we look ahead and move beyond Covid into recovery? For example, do you support the suggestion in the paper on non-communicable diseases that was published yesterday by the British Heart Foundation and nine other charities that there should be quick interventions on issues such as the advertising of e-cigarettes, the monitoring of sugar content in foods and better planning of smoking cessation and obesity services?

I draw members’ attention to my entry in the members’ register of interests, as I am a councillor on East Renfrewshire Council.

As we meet this morning, we know that Covid cases have been increasing throughout the summer, and that there have been a number of very seriously concerning situations across our hospitals, with code black status being, or almost being, reached.

I would like to hear the cabinet secretary’s view on the capacity that we have to deal with the current surge, and any future surge, in cases. We know that there are concerns, for example, around staffing levels and staff fatigue. I know that we will come to those issues later in the meeting, but first I want to get a sense of where we are in the pandemic now, in terms of capacity and our preparedness for the future.

I thank the cabinet secretary for that answer. On what he said about recovery of services, a number of health board areas and hospitals have made the decision to cancel operations and surgeries, and there is concern about how long it will take to recover the previous position. Professor Caroline Hiscox, in NHS Grampian, has said that it will take “years” to recover the position in which people are able to get diagnosed and treated and get the operations that they require.

As I indicated in my earlier comments, I want to move on to talk about workforce pressures. Given what we know about those pressures and the number of people who, whether they are doctors or nurses, are considering leaving the medical profession, what is the cabinet secretary’s view on what could, essentially, become a perfect storm? Staffing levels are reducing, and a long period of time is required to recover to a position in which we are able to treat people in as normal a way as we would expect and that everyone in Scotland would want.

I take the opportunity to thank our GPs and acknowledge the importance placed on high-quality care in general practice when GPs have time to nurture and maintain relationships of trust with patients.

According to a recent British Medical Association survey, one third of GPs are considering taking early retirement. In relation to the Government’s remobilisation plan, Dr Lewis Morrison, the chair of BMA Scotland, has said that the plan contains “worrying gaps”, including the “crucial omission” of any plan to retain current NHS staff.

The plan states that there will be 800 new GPs by 2026 or 2028, depending on which paragraph you read. Will the cabinet secretary clarify that target and outline what action will be taken during the current crisis to retain GPs and ensure that there is sufficient capacity for people to see their doctor?

Dr John Thomson, vice-president for Scotland of the Royal College of Emergency Medicine, said in July:

“the Emergency Medicine workforce in Scotland is not adequately staffed to deliver the highest quality patient care. This has led to an increase in intense pressures on the existing workforce and is very likely to be a contributing factor to the continued deterioration in performance.”

He went on to say that

“before the pandemic, the increase in demand put ... pressure on staff”,

and it was a

“struggle to meet the four-hour”

target.

Given that A and E pressures in summer are resembling those in mid-winter, given that the NHS recovery plan has been met with scepticism by the British Medical Association and the Royal College of Nursing, and given that we have the worst waiting times since records began when this Government took office, is it time that the cabinet secretary stopped denying that there is a crisis, acknowledged that the crisis is on his Government’s watch and started listening to the serious and real concerns of the people who know best, that is, the doctors, nurses and workers on the front line?