Chamber and committees

It might be best if Leigh Johnston answers this question, because it is about the clinical prioritisation framework.

Leigh, you mentioned that you were not getting a clear sense of whether patients were correctly prioritised. Indeed, while patients wait—sometimes for up to two years—their symptoms can get significantly worse, so the question is whether they are progressing to the higher priority level. Do you get a sense that, when people lose hope that they might ever get seen, they take themselves off the NHS list? Are we measuring the people who go off to private providers to have their treatments?

Welcome to the meeting, Mr Boyle. It is nice to see you face to face.

It has been eight months since the Scottish Government published its NHS recovery plan. What is your assessment of the progress, if any, that has been made since then? As you have rightly stated and as we all understand, there is no quick fix, but we now have an opportunity to reform the system instead of recovering to pre-pandemic levels. However, given that the statistics that are coming out of the NHS with regard to accident and emergency, cancer, delayed discharges and diagnostics are all bleak, do you think that the Government’s plan is working?

It is concerning that an unusual number of hepatitis cases have been detected in young children across Scotland’s central belt. Although I appreciate that Public Health Scotland and the UK Health Security Agency are investigating the matter at pace, what urgent steps is the Scottish Government taking, in addition to the measures that the minister has mentioned, to trace the outbreak and to raise public awareness, particularly among parents and guardians, of hepatitis symptoms so that those who are susceptible to it are better protected and able to receive life-saving treatment far more quickly?

When the clerks report back to us, would it be possible for them to tell us the reasons why substitutions took place? Even if we knew whether the reasons were health, Covid or constituency related, that would allow us to get a sense of where the challenges lie. I understand that that might not be possible, for personal reasons.

Yes, thank you. It is uncanny timing that I am here as a substitute.

I reiterate what Mr Doris said; I think that having continuity and consistency of substitutes is key. Having such consistency on the Standards, Procedures and Public Appointments Committee is particularly relevant. Although giving some committees more flexibility than others might have to be scoped out, I have certainly found it helpful to have consistency, and I hope that the committee has also found it helpful to have a consistent substitute here.

This week saw the publication of another deeply troubling set of cancer statistics. They reveal that fewer than 80 per cent of urgent referrals are being treated within the two-month target, which is shamefully short of the target set by the Scottish National Party Government, and it cannot use the pandemic as justification for that. The target has now not been met for almost a decade and this is the worst performance since 2008. For all the time that the target remains unmet, patients and their families are left in limbo. What steps will the First Minister urgently take to recover 10 years of missed targets?

I am pleased that the Scottish National Party Government, despite having described our plan for Covid recovery, “Back to Normality: A Blueprint for Living with Covid” as “reckless”, has accepted, in its updated strategic framework, a large number of our recommendations.

Chief among them is the ending of mass testing in Scotland and its replacement with a programme of representative sampling. Although that is a welcome development while we learn to live with Covid, it means that 7,000 test and protect employees might have their contracts terminated early. Given the acute and unrelenting staff shortages across Scotland’s NHS, what assessment has the cabinet secretary made of the possibility of redeploying those workers to other parts of our health service?

The cabinet secretary mentioned that model 4 was a bridge to model 6, but that in itself could take up to two years to establish. As the cabinet secretary will know, and as we have heard already today, getting to model 4 will require substantial investment in both recruitment and the existing workforce.

Given the existing and long-standing recruitment and retention issues in the health boards, what immediate steps will the cabinet secretary take to ensure that the workforce is in place in time? Importantly, can the cabinet secretary confirm that the two years for the establishment of model 4 is the very limit of the time that it will take and not a target?

I want to follow up Evelyn Tweed’s point about the role of the receptionist. Some of the papers talk about gatekeepers, but they are also called signposts or gateways. I realise that that is all about positive versus negative language, but the point is that the people accessing these MDTs still have to contact a particular individual, and that is often still the bottleneck that causes the frustration. How might we overcome that?

I have one more question. What assessment have you and your team made of provision of GP out-of-hours services during the pandemic?