Chamber and committees

Scotland has only 13 health boards, but many more local authorities. There is a small cohort of healthcare providers. What can the Scottish Government do now to be more forceful and to ensure that best practice, such as in Grampian, is not just spoken about but is consistently implemented across the country?

Minister, you have mentioned a number of times the importance of listening to the voices of those with lived experience. As we heard from Paul O’Kane, the suicide prevention action plan from 2018 was reviewed back in March. The plan stated:

“Our vision is supported by our key strategic aims of a Scotland where ... people at risk of suicide feel able to ask for help, and have access to skilled staff and well-coordinated support”.

I have been contacted by a friend who knew two ladies who, tragically, both committed suicide very recently and who had cried out for help many times. Both were looking for access to rehabilitation services. One woman was told that she could not be helped because she was not on benefits and “looked amazing”. She took a paracetamol overdose when drunk, and she died four days later sober. I am emotional—I am sorry. Her other friend lost her job of 33 years. She was in the system and well known, and she was desperate for help. She hanged herself and left her young family behind. They were both able to ask for help, but it was denied. That is the harsh reality of what is happening again and again in our communities.

What is the Scottish Government doing now to help these people? Those suicides could have been prevented. Today, I want to make sure that we acknowledge that their lives mattered. I want those in decision-making positions to be able to do something about that.

The level of local service being X in one place and non-existent in another is relevant to the earlier discussion about mental health.

Is economic modelling under way to cost the proposals? I am looking at a chart that shows the number of care homes in Scotland. There are 1,069, 63 per cent of which are privately owned and 23 per cent of which are run by the voluntary or not-for-profit sector. That means that the balance—142 care homes—is under local authority control. I apologise for giving a lot of numbers. In relation to the economics of funding something or the reforms that might happen, what economic modelling is taking place?

Thank you, convener. In the question on the theme of delayed discharges, I should have declared that I am a City of Edinburgh Council councillor. I apologise.

I hope that my question will follow on nicely from those of Stephanie Callaghan and Carol Mochan.

I want to ask you about health inequalities across Scotland, minister. You mentioned the established and successful CAMH service in Grampian but, in Lothian, it is quite a different story for the many young people who are trying to access services. The counselling is being rolled out quite differently across local authorities—some are lagging behind or doing very little. As taxpayers, we want to ensure that every single penny is spent well and reflects the intended purpose of the investment. What actions are you taking to address those inequalities in the delivery of mental health services across the country?

I understand the rationale for the interim care facilities, but surely they are just going to result in more of the most vulnerable people making multiple moves over a short period of time from one facility to the next. What will happen if there is no care package in the community after the six weeks? If the community care issues could be solved in six weeks, why has that not happened already? This is all the stuff that is going round in my brain. Also, delayed discharge is not new. If anything, during Covid, we had some rapid discharges from hospitals into care facilities and we are now looking back and being a little bit reticent about those decisions.

I am trying to figure out what will happen if, after the six weeks, nothing is in place in the community. Also, how many people are currently in what are classed as interim care facilities? Where is that data recorded? Are they still classified as delayed discharges? I ask those questions so that we can get a sense of how things are progressing.

You spoke to us about the importance of the 20-minute neighbourhood, which involves easy access to things within walking distance. You made the statement that centralising services far away is not helpful. You have also mentioned, and are aware of, the importance of good-quality end-of-life palliative care close to the heart of communities. Will the Government therefore encourage health boards to do everything that they can to preserve and expand the services that are in local communities?

On a specific local issue, my colleague Craig Hoy and I were at the “Hands around the Edington” rally on Sunday. Right now, that issue is a very serious one for the community in North Berwick. We have already said that care should be within communities. Will you now reach out to NHS Lothian and urgently reverse the closure of the in-patient palliative beds at the Edington hospital?

If someone needed support right now, there are gaps. How would they get access to treatment? As you have said, there has been a rise in the number of alcohol-related deaths. That leads me to believe that there are perhaps more people out there with an issue with alcohol who are seeking support and help right now. That is a more specific issue.

I will buck the trend, convener, as my question is for Andrew Buist of the BMA, although it relates to A and E.

How does the BMA respond to claims by the Royal College of Emergency Medicine that demand in A and E is now partly attributable to reduced access to GPs and primary care?

Okay—I will try. I had a long question, but I will make this as succinct as possible. Given the challenges and restrictions, how feasible is it to provide nurses who work in the acute sector with the opportunity for flexible working, with a view to improving their wellbeing and retaining those members of staff?