Chamber and committees

I have one question for Alison White. I noticed that you said that co-design should come before the legislation, not after it. My question relates to what you said about your concern that further integration could make adult social care a delayed-discharges service. Could you go into more detail as to how that might happen?

Dr Williams, the NCS risks taking power away from local decision makers. What impact do you expect that to have?

The convener of the Finance and Public Administration Committee, Kenneth Gibson, said that, with the bill, it seems that the Government is

“using a sledgehammer to crack a nut.”—[Official Report, Finance and Public Administration Committee, 25 October 2022; c 24.]

Will you comment on that, please?

The Finance and Public Administration Committee had serious concerns about the financial memorandum that accompanies the bill. What is your view of that?

I thank Carol Mochan for securing parliamentary time to mark allied health professions day 2022 after the debate was delayed last month. It is great to see people in the gallery today. I hope that my colleague Ms Mochan will get them hot cups of tea for braving the weather to get here.

This is an opportunity for MSPs to not just thank allied health professionals for the work that they do and their commitment, compassion and dedication during the pandemic but to reflect on the contribution that AHPs can make to the delivery of healthcare and public health more generally.

AHPs make up the third-largest workforce in NHS Scotland—it employs just under 13,000 AHPs. Their impact on their patients’ health and wellbeing cannot be overstated. A multidisciplinary team that spans a range of allied professions can have a huge bearing on the quality of life of the new mother who needs postnatal physiotherapy following the birth of her baby, the victim of a car accident who needs a prosthetic leg and lifelong care, the young child who is struggling to talk and would benefit from the intervention of a speech therapist, and the sufferers of neurological conditions such as Parkinson’s disease.

As a fellow of the Chartered Institute of Personnel and Development, I feel qualified to say that there are, unfortunately, high vacancy rates in the allied health professions. The vacancy rate has almost doubled in the space of four years, from 4.4 per cent in March 2018 to 8.2 per cent in March 2022. The number of vacant AHP posts has increased by 43 per cent in a single year. The new mother who needs a physiotherapist to help her postpartum recovery has to wait weeks to be seen.

In NHS Grampian, the wait for routine pelvic dysfunction physiotherapy is around 24 weeks. Many women seek private treatment because NHS waiting lists are simply too long. As we seek to address the gender-related health gap, that risks further entrenching inequalities.

I have challenged the Cabinet Secretary for Health and Social Care many times on the Scottish National Party’s plans for NHS recruitment and retention. NHS workforce planning is a massive issue that the SNP has managed to get spectacularly wrong.

We know that the coming months are expected to be extremely challenging for Scotland’s NHS. The Scottish Conservatives believe that we would utilise AHPs to their maximum potential in workforce planning. The diverse skills and expertise of the allied health professions can add a huge amount of value to primary and secondary care, but we need to ensure that supply is commensurate with demand and that the NHS is able to keep the AHPs who come through the pipeline.

Against the background of potential strike action by NHS staff over the coming months, it is especially important to understand the pressure that they are working under. They are tired and overstretched, and their voices must be heard.

Huge parts of the bill will be implemented through secondary legislation, which will mean much less parliamentary scrutiny. Can you comment on the appropriateness of that use of secondary legislation?

If you do not have a product, how can you scrutinise it?

There are benefits to centralisation, but there are also benefits to keeping things local. The Faculty of Advocates was represented on the previous panel of witnesses, and its written submission says:

“There is clearly a risk that the quality of services previously provided effectively on a local model is diluted when provision is attempted on a larger, national, scale.”

Is the nub of your concern that the move to centralisation means that control, power and funding will go to the centre, at the expense of quality local services?

I do; I have a question for Eddie Fraser. SOLACE has said:

“there is very little detail or consideration of the significant implications for local authorities, not only in respect of workforce, but also in respect of council assets and liabilities”.

Do you agree with that assessment? Do you want to put on the record the effect that the bill will have on local government workforce, assets and liabilities?

I have two questions, one for Jennifer Paton and the other for Isla Davie.

The picture that I have in my head is of being asked to comment on or scrutinise an aeroplane that is being built as it is flying through the air, which is obviously very difficult. In its written submission, the Law Society of Scotland has been very critical of the lack of detail in the draft legislation and the fact that it makes it really hard to scrutinise the bill. Therefore, I wonder, Jennifer, if you can expand on the view in the Law Society’s submission that

“It is not clear what safeguards are in place to ensure that co-design is meaningful, effective and timely and that Scottish Ministers are appropriately held to account by Parliament for the design and implementation of the National Care Service.”