Chamber and committees

So you do not expect the number to increase, and you hope that it will decrease. I will move on to my second question, because we have been asked by the convener to be quick.

You describe the issues that rural practices face because of bad weather, and the Braemar practice is a good example of that. You talked about high winds, flooding and heavy snow in the winter. When it comes to moving a GP practice to 2C status and the cost model of sourcing and supplying the practice with locums, that can work in-hours, but it cannot work out of hours, so you have rural practices that are cut off and isolated during the winter months. What are the cost implications of that, and what are the considerations of leaving those remote areas without any form of GP support?

I have three questions, the first of which is for Caroline Lamb. You said that you always expect a high turnover of staff. As a fellow of the Chartered Institute of Personnel and Development, I know that, with regard to the percentage of voluntary staff turnover, there are what are called red-zone levels, and it looks as if the NHS is in the red zone, with staff turnover being too high.

Last month, it was reported that doctors in NHS Grampian had used whistleblowing procedures to raise very serious concerns about conditions and staffing levels, with one doctor saying that, tragically, that

“There have been avoidable deaths”

as a result of the situation. What action is the Scottish Government taking with NHS Grampian to address staff shortages urgently, especially as winter approaches?

You have not really answered my question about your confidence levels and where on the scale you might be in that respect. Are you confident or are you concerned?

Thank you. The committee will take that away.

I am here to represent my constituent Maggie Reid, who has worked tirelessly over the past year to advocate for her sister. This is an emotional petition, and it deals with an issue that is of critical importance. I pay tribute to those two extraordinary women, and I hope that I can do justice to their voices.

Maggie’s sister was diagnosed with postpartum psychosis after she had a baby girl, and she was initially treated at the mother and baby unit in the central belt, which was a long way for her to travel from the north-east. However, the treatment was successful and her condition improved. Unfortunately, she had a relapse and she could not be admitted to an MBU because her baby was too old and, instead, she was sectioned at the Carseview centre in NHS Tayside. Maggie shared with me that her sister was frightened, confused and very scared. It was a truly traumatic experience, and she was also separated from her baby at that time.

For many mothers with mental ill health, the 12-month mark is a precipice where the nature of support changes or falls away, but it should not be that way. As you have pointed out, convener, the Scottish Government committed to look at the parameters for perinatal mental health support two years ago, when the Health, Social Care and Sport Committee recommended that mental health support should not be restricted to the one-year period following the birth of a child. Since then, however, it feels like the Scottish Government has been dragging its feet. Recently, I went to the newly constructed maternity hospital in Aberdeen, and I found that there are no plans for any mother and baby units there. That issue needs to be considered now, while that hospital is being constructed. If it is not, we could just build in delays.

No health authority in the north-east is any closer to establishing a mother and baby unit, and research conducted by the Maternal Mental Health Alliance shows that women outside the central belt are missing out on the highest standard of specialist perinatal mental health services, as perinatal mental health services are concentrated in NHS Lothian and NHS Greater Glasgow and Clyde.

I thank the Citizen Participation and Public Petitions Committee for its consideration of PE2017, and I urge the committee to use all the available levers to ensure that women such as Maggie’s sister have the access to the treatment and support that they need. The issue must be addressed with urgency, so that no other women experience the trauma that Maggie’s sister has experienced.

You have talked about the importance of clinical centres for attracting and developing specialist skills, and you have highlighted that service redesign and enhanced national and regional working are also very important.

There is a concern that “redesign” is a euphemism for a drive to centralisation. Large portions of the population in the north-east, for example, are concerned that they are being disadvantaged as they are having to travel long distances. There are huge issues in the north-east with buses not turning up, which means that many people have to take taxis to travel long distances, such as from Montrose to Perth or to Ninewells hospital. That takes a day and it is very expensive to travel by taxi. How can you make sure that people in rural areas are not disadvantaged by any redesign?

Cabinet secretary, you mentioned the Baird family hospital and ANCHOR centre. Thank you for doing so—I am glad that they are at the top of your mind—but alarming concerns have been raised about delays as a result of issues with the water and ventilation systems, of which you are aware. I would like to hear your thoughts on how we make sure that lessons have been learned from ventilation and water systems in other hospitals, and on what you can do to oversee the matter to prevent any issues from arising at those two centres in the future.

Good morning, cabinet secretary and officials.

The chief executive of NHS Grampian told the committee that her health board will still be in deficit by 2028, which means that, like many health boards, it will have to make very difficult decisions in order to plug the hole. What action is the Scottish Government taking to support health boards’ financial sustainability in the short-to-medium term?

Thank you.

I have a short follow-up question. I understand the need for that delicate balance. However, there are two major issues here. First, with the new redesign and the drive to have centres of excellence, people are having to travel long distances. It is not just a question of time—in many cases, people are very poorly.

Secondly, as our Green colleagues will tell us, there is an additional carbon footprint when people have to travel by car—if they are lucky enough to have one—or take extra bus journeys. It could be a day’s travel there and back for treatment. As well as the issue of the pain and upset for patients, there is the additional carbon that is used.