Chamber and committees

The Lowit unit in the Royal Aberdeen children’s hospital provided day care and out-patient support to children and young people with autism spectrum disorders, but it closed almost a decade ago. Families in the north-east are crying out for dedicated post-diagnostic support such as that given by the Lowit unit. What action is Scottish Government taking with health boards and local authorities to ensure that such support is in place?

But, cabinet secretary, do you think that it is acceptable that a local community has to take recruitment into its own hands to find a GP?

There is a big difference between 800 and 2,000. The BMA says that we need to recruit 2,000 GPs in Scotland. Do you dispute that figure?

Cancer waiting times are at their worst level, with 8,000 people waiting for treatment. CAMHS and accident and emergency waiting times are way off your target. One-year waits for outpatients are on-going. Agency staff costs have quadrupled due to the high NHS turnover. There is a new variant of Covid; and you have brought forward the flu vaccination programme. Can we expect the worst winter for the NHS this year?

In relation to workforce planning, this is not rocket science. You do not have to wait to find out whether someone is retiring; if there were Scotland-wide workforce planning, you would be able to understand the flows, see when people would be retiring and therefore know at the front end how many people you had to recruit.

The launch of the national centre for rural and remote health and social care is now months overdue, and the workforce recruitment strategy has been kicked down the road until 2024. It is good that you actually recognise that workforce planning is required, but the fact is that we are kicking the recruitment strategy into next year.

My follow-up question is about GP recruitment in rural areas. That seems to be a major issue, and rural healthcare is in crisis. Things are so bad that—we brought this issue up at committee last week—the community of Braemar is trying to headhunt its own GP, because the local practice has struggled to recruit a suitable candidate. Residents had to take action into their own hands and do their own recruitment.

In Aberdeenshire alone, five practices are now managed by the Aberdeen health and social care partnership and that figure is about to increase to six. The wheels are definitely off the bus in the north-east in terms of the provision of healthcare by rural GP practices.

I have two questions on that. First, why has not the Scottish National Party done more to address this crisis in primary care and GPs and to make rural Scotland more attractive to health professionals? Secondly, does the Scottish Government intend to look at the 2018 GP contract in the context of rural practices?

I have three questions for the cabinet secretary. The chair of the British Medical Association has said that Scotland needs 2,000 general practitioners, yet you are struggling to find 800. How will you deliver the primary services that patients deserve?

I, too, thank Liz Smith for securing the time for this evening’s debate.

Earlier this year, I was involved in the fight to save Bucksburn swimming pool after Sport Aberdeen’s devastating decision to close it. That decision, which was a result of funding cuts by Aberdeen City Council, was taken without consultation and without equality impact assessments. At the time, Bucksburn was the only swimming pool in the city with a shallow-stair entry for people with disabilities. Only now, months after the axe came down, are we likely to see a full formal consultation on the closure, because of legal challenges prepared by the Govan Law Centre and the Grampian Community Law Centre. The surrounding community rallied around that beloved facility, and I pay tribute to those involved in the campaign to save the pool, such as Kirsty Fraser and Genevieve Wheeler-Melvin, and their incredible efforts to keep the pool open, as well as to Dr Mark Brown, president of Bucksburn Amateur Swimming Club.

Too many people in decision-making positions forget or are oblivious to the benefits of public swimming pools. The reality is that councils look at facilities such as Bucksburn through the lens of balance sheets and financial liabilities. However, a mental health nurse I met at a save Bucksburn swimming pool demo told me that she swears by swimming as a help to her patients; another woman told me that she has a rare kidney disease and that the water makes swimming a weight-bearing exercise for her; and there was a man with two replacement knees who found walking difficult and therefore needed the pool to exercise and build up his strength. The pool also provided the opportunity for children to learn essential life skills to keep them safe in water. Indeed, hundreds of children were learning to swim at Bucksburn pool before it closed.

There is also a wider story to tell about the state and provision of council-funded leisure facilities elsewhere in my region—and I would note that no Labour or Scottish National Party members from the region are here this evening. In Dundee, a storied saga of ineptitude and dither has led to the city’s flagship Olympia swimming pool closing for two years, only nine years after opening. Meanwhile, Dundee City Council is spending more than £100 million replacing two schools—Braeview academy and Craigie high school—that have swimming pool facilities, but there are no plans for a swimming pool at the new East End community campus.

In March 2023, the UK Government announced a £63 million fund for struggling swimming pools. The Scottish Government received Barnett consequentials as a result of that, yet we are still in the dark about how that money has been allocated. I hope that Maggie Chapman, who has spoken so passionately about Bucksburn swimming pool, can influence her SNP colleagues to spend the money that they have received from the UK Government to save it.

The social, emotional and health-related value of our swimming pools cannot be ignored, and I urge the Scottish Government to step up to save them.

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?