Chamber and committees

Thank you—that was very helpful. You mentioned that one of the challenges is with local collection, due to a lack of investment specifically with regard to local authorities. Is enough work being undertaken to understand those issues? Investment is a big issue, but what other hurdles and gaps might exist when it comes to data collection? What is it that creates the variance?

Our NHS is under pressure like never before, and it is increasingly clear that the SNP has no positive ideas for how to turn things around. All that it offers the people of Scotland, and our hard-working NHS staff, is more excuses.

The SNP does not want to admit that removing the cap on funded places for key NHS roles is the right thing to do. The current crisis in the Scottish NHS is, in large part, down to the lack of GPs, doctors, nurses and paramedics—and the list goes on. The problem stems from Nicola Sturgeon’s decision a decade ago, when she was health secretary, to cut the number of funded training places at Scottish universities. When this Scottish Parliament first sat in 1999, more than 60 per cent of medical places were filled by Scotland-domiciled students. That figure has dropped by around 10 per cent as a result of the decisions that have been taken in this chamber.

We cannot continue with a policy that is holding back our NHS. After having 14 years in which to sort things out, the SNP has failed. We know that the applicants are still there and are still applying, that Scottish universities are filling their funding places and could fill more with suitably qualified young Scottish people, and that the widening access places could and would be maintained. It would, therefore, surely be worth giving that suggestion more than a cursory glance.

As Paul McLennan outlined, there is a wide and diverse range of new training places, which conflicts with the cabinet secretary’s statement about the threat of a lack of training places for graduates of our medical and nursing schools. Would it not be a more desirable problem to have too many graduates, rather than the workforce crisis that we currently face? Surely our universities are better placed to meet and plan for the longer-term workforce needs.

At the Health, Social Care and Sport Committee earlier this month, the vice-president of the Royal College of Emergency Medicine stated that the training scheme had nationally determined numbers and was six years out of date, and that one in five consultants was considering early retirement and one in two was seeking to reduce their hours. He went on to say that, right now, we have one A and E consultant for every 6,500 patients, when it should be one for every 4,000; we are 130 whole-time-equivalent emergency medicine consultants short; and GPs are already facing unprecedented demand. Andrew Buist from the BMA translated those figures to say that, right now, there are 250 whole-time-equivalent GP vacancies in Scotland.

We cannot keep on letting the problems get worse. The SNP’s incremental increases in funding for places simply do not meet the scale of the challenge that we face. I urge members on all sides of the chamber to ask themselves whether we are doing enough to protect and future proof our NHS.

We cannot keep on doing the same thing and hoping that the staffing shortages will sort themselves out. We need a bold new approach. Is the SNP Government ready to admit that it has got it wrong? For a nationalist Government, which claims to care about Scotland, to be overseeing a system in which we are turning away bright young Scots who want to be the nurses, doctors and paramedics of the future is nothing short of shameful. By keeping the funding cap in place, we are selling Scotland short. We have the talent—let us do something about it and support the motion from Dr Gulhane today.

November is pancreatic cancer awareness month and tomorrow is pancreatic cancer awareness day. I welcome the opportunity to speak in the debate and to show my support. It is a fantastic chance for the pancreatic cancer community to come together to raise awareness and funds, and to remember loved ones who have, sadly, died of the disease.

Raising awareness is key, because two thirds of people in the United Kingdom cannot name a single symptom of pancreatic cancer. Even more worrying is that around half of pancreatic cancer patients will visit their general practitioner three times because of their symptoms before being referred to hospital.

Pancreatic cancer is the deadliest common cancer in Scotland. Only one in four of those who are diagnosed with it survives beyond a year. In the UK, 10,000 people are diagnosed each year, yet pancreatic cancer receives only 2 per cent of national cancer research funding, despite being the fifth-highest killing cancer.

Scotland is leading the way in pancreatic cancer innovation. For example, Precision-Panc is a major research programme that is being developed and run at the Beatson West of Scotland Cancer Centre in Glasgow. It collaborates with world leaders from the University of Glasgow, the Cancer Research UK institutes at the Beatson and in Cambridge and Manchester, the Institute of Cancer Research in London, the University of Oxford and the national health service.

My life before Parliament allowed me unparalleled access to the surgical treatment of this deadly cancer. I worked alongside upper gastrointestinal surgical consultants from across the country, including Ross Carter who was mentioned by Clare Adamson. I know from experience the complex nature of the surgery that is needed to treat pancreatic cancer. The specialist surgeons are dedicated and are committed to adopting innovation to reduce surgical operating time even by the slightest margins, and to seeking new ways to reduce surgical risk and post-operative complications. They work collaboratively across the NHS to do all that they can to increase their patients’ survival.

However, the outcomes following the potentially lifesaving surgery are still a long way from being acceptable. If a patient is diagnosed in time for surgery, the?five-year survival rate increases to around 30 per cent. We must diagnose people far earlier, so that they will live longer and experience better quality of life.

For anyone who receives a diagnosis of pancreatic cancer, as my friend’s mother has, life stops—albeit briefly—and family and friends must respond quickly. My friend Mike had to return from Australia: the only saving grace was that he was able to return to see his mum, which would not have been possible a year ago.

A diagnosis of pancreatic cancer affects every aspect of life and brings emotional, financial, and practical problems that can last long after treatment ends. If anyone who is in that position is listening to the debate today, I take the opportunity to direct them to the practical, emotional and financial support that is offered by Macmillan Cancer Support. Anyone can, as a first step, call their telephone helpline on 0808 808 00 00, or go to the Macmillan website for help.

I thank Clare Adamson for bringing the debate to Parliament, and for helping to raise awareness of pancreatic cancer.

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.

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?

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?

Yes, it is. Thank you, convener. My colleague mentioned the fact that sport is perceived as costly, but, often, that cost is related to access to facilities, which is associated with charges payable to local authorities. What can you do to ensure that the costs to the clubs and participants are reduced and that local authorities keep rents as low as possible?