Chamber and committees

Over the festive period, NHS Grampian made an extraordinary plea on social media for exhausted NHS staff to come in on their days off. Dr Iain Kennedy—who is chairman of the British Medical Association Scotland, as members will know—said that that intervention should

“close any debate that the NHS is broken”.

The issue of how strapped for staff NHS Grampian is has been well publicised. Does the cabinet secretary think that that will happen more often? Is it acceptable for that to become the norm?

Since June last year, I have repeatedly tried to ask the Scottish Government when a women’s health champion will be appointed. The Minister for Public Health, Women’s Health and Sport and even the First Minister have deployed every delaying tactic in the book, and the can is just being kicked down the road. The petition on the services in Caithness and Sutherland underscores why a women’s health champion is so important to Scotland. Why is a women’s health champion not a priority for the Scottish Government? Can you say today when an appointment will be made?

Hello, and thank you, cabinet secretary. I acknowledge that you do not want to provide the budget allocation for NHS 24 until this afternoon’s statement, although I am disappointed to hear that. I raised NHS 24 capacity with you in October, and, at the time, you emphasised the additional recruitment that will take place to support that crucial service. Can you at least indicate this morning, cabinet secretary, how many new NHS 24 staff have been put in place since you made that pledge in October and how many you intend to recruit over the coming weeks?

Thank you.

Cabinet secretary, the total maintenance backlog bill across Scotland’s 14 health boards has, shockingly, reached more than £1.5 billion. What budgetary provision is in place to cover that bill? Why is the 2021 commitment to invest £10 billion over the next decade to replace and refurbish health infrastructure not mentioned in the 2022 programme for government or in the 2023-24 budget?

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.]

With members of your party and the finance committee raising concerns about the spending in relation to the bill, how can you possibly justify the costs? I thought that it was £1.3 billion, but you actually said this morning that it is £1.4 billion, and that is not including terms and conditions of employment and benefits. Some even say that the bill is an open cheque book.

Minister, I welcome the fact that you have said that you are being open and transparent. The adult social care independent review that was published yesterday does not mention your desire to improve maternity benefits for social care staff. If it is so important to you, why has it not been mentioned, and why has it not been costed? Is it on top of the £1.3 billion estimate for the NCS?

I ask this question wearing three hats: as a member of the committee; as a representative of a largely rural area; and as a fellow of the Chartered Institute of Personnel and Development with experience of legislation such as the Transfer of Undertakings (Protection of Employment) Regulations—TUPE.

Have you considered the cost of harmonising the terms and conditions? I accept your saying that not all the 74,000 employees will transition under TUPE, but a large chunk of them could. Even increasing mileage rates from 45p a mile to 65p a mile—that figure was given to us by some witnesses—will cost millions of pounds, not to mention harmonising sickness and pension benefits, which will go into the billions. Are you really serious about wanting to transition to a central service—referring to what you said in your opening remarks—or are the proposals a power grab, plain and simple, to centralise services with a view to taking budgets away from local councils?

I want to press you on that point, minister. We have heard that one of the current staffing issues is that social carers cannot be recruited, partly because of the 45p mileage rate. Carers are looking for mileage rates equivalent to 65p. The difference between 45p and 65p might seem small to you, minister, but to many carers that could make the difference between surviving in a job and not surviving. Harmonising the mileage rates would cost millions of pounds. You might say, “We are not going to do it and we are not going to think about it” and talk about TUPE legislation and all that sort of thing, but just thinking in terms of fairness, if someone is working and doing the same job as someone else and they are on 45p per mile and the other person is on 65p per mile, that could lead to employee relations issues and industrial unrest. Do you have any comment on that?

I have just one key question, which is for Mark Hazelwood. The SPPC has said that the bill’s principles do not take into account people who still need care but who have no hope or expectation of a cure. If the issue is not addressed, what consequences will that, in your opinion, have for those patients?