Chamber and committees

John Scott made a range of recommendations in his report, and we accepted all the key ones. Implementing some of them will require changes to primary legislation and I hope that we can aim to introduce primary legislation during the current parliamentary session to give effect to some of the measures that will be needed to do that.

Good morning, convener. Public Health Scotland continues to monitor Covid-19 levels and is testing for the new variants. That is largely being carried out through people who have been admitted into our hospitals, who might present with symptoms, and that is being used to inform our approach to how we continue to manage Covid-19.

Members will be aware that the decision was made a number of months ago, in line with other parts of the United Kingdom and countries globally, to manage Covid-19 in the way that we would manage any other seasonal infection. That continues to be our approach, but we are monitoring very closely any changes to the pattern and rates of infections. That will inform any further decisions that we make about any changes to our approach that we might have to make.

We will also continue to keep in place a range of testing arrangements for individuals who are being discharged from hospital into social care settings, for example. We have taken a slightly different approach on that from some parts of the UK in order to maintain a level of vigilance. That means that a level of testing is still taking place for vulnerable categories of patients, particularly if they are going to be transferred into social care settings.

We are engaged with the chief medical officer, who is engaged with the other CMOs across the UK, and work is being taken forward through the genome sequencing process, which is, obviously, operating at international level. I do not know the full clinical details around that, but work is being carried out to test the impact of the existing vaccination programme against the new variant.

I also understand that vaccine producers are monitoring whether they have to make any amendments to their existing vaccines, but all that work to monitor the on-going situation is being taken forward across the UK and globally. At this stage, we are still waiting for those reports to come back, but there is a level of vigilance in place to ensure that our decisions are made on an informed evidence base.

Our social care staff are critical in supporting and sustaining our health and social care systems, which are interlinked and are key to each other. The social care setting has traditionally been undervalued, which has been reflected in the rate of pay within social care compared to that in healthcare.

We have taken forward a programme of work to make social care a more attractive working environment and to reflect the value of our social care staff, which has resulted in an increase in their pay. Pay has been increased to £12 an hour over the past two years. We have already taken it up to £10.90, and the pay increase in the sector will be equivalent to more than 14 per cent in two years.

The objective behind that is to make care a more attractive profession and to support the retention of social care staff to make the sector more resilient. The principal objective is to try to get more people into care and to support and encourage those working there to remain there in future by providing them with better pay.

Any form of industrial action is hugely disruptive to our NHS, not only to staff and to the management process but to patients. To see that, we only have to look at England, where there has been repeated industrial action and where I believe that more than 7.5 million patients are on waiting lists and that almost a million procedures and appointments have been cancelled as a result. That is the immediate impact, and there will be a cumulative impact caused by backlogs in the system.

The system and staff are already under enormous pressure and adding persistent industrial action to that demoralises staff even further and makes them feel undervalued, bringing all the challenges that go with that. My deal with the junior doctors involved acknowledging and recognising the real challenges that they face because of pay erosion, and we managed to negotiate an agreement with them to avoid industrial action.

My big concern with industrial action is that it is not only disruptive to patients but demoralises people who work in the system even further, which has consequent challenges, and puts people off working in the NHS as a result of the disruption and difficulties.

There is a monetary cost to settling those matters. However, we would create even bigger challenges for ourselves if we did not try to address the issues. The challenges that we would have faced from industrial action would have been even greater—they would have been worse—than dealing with the financial challenges arising from the pay settlement.

I know the 218 service from my time in the justice portfolio. It is not funded under the health portfolio; if I recall correctly, it is funded directly through the community justice programme. I know that the Cabinet Secretary for Justice and Home Affairs has been engaged on that matter. I think that the issue was raised in Parliament and that she said that she would engage on it. That was in relation to community justice funding that was having an impact.

Christine McLaughlin can say a bit more about that.

CAMHS have expanded enormously over a number of years, but demand for them has also increased significantly. I recognise the concerns that Paul Sweeney has raised about children’s and families’ unnecessary waits to access some of those services. The intention behind our delivery plan is to ensure that there is a much more consistent approach to how services are delivered across the country. Members will be aware that some boards are performing better than others on service delivery, but there is a need to achieve greater consistency.

I cannot give a commitment on the funding aspect at this stage because we are going into the budget round for next year and we will need to see what the budget settlement is. However, we need to continue to expand and develop our CAMHS as a priority. I know that the Minister for Social Care, Mental Wellbeing and Sport, Maree Todd, spends a lot of time trying to ensure that we are taking the right approach to getting greater consistency of service delivery across the country, because variation of service provision is one of the biggest challenges that we face around CAMHS. The objective behind the delivery plan is to ensure that there is greater consistency of approach.

It is still a priority for us, but it is a challenging area of policy to take forward in the existing financial climate. Our options for making more progress on it are limited, largely because of the financial consequences and our not being in a budgetary position where we could actually advance it. It is still a priority and we will progress it should finances become available to allow us to do so, but at present we do not have the financial provision to be able to take it forward.

The plan was to have 10 NTCs across the country, and we are moving towards phase 2 of that work. The work is being considered in our capital programme, which is being reviewed because of the cuts to our capital budget, and is primarily focused on elective procedures—predominantly around orthopaedics, ophthalmology, endoscopies in some cases, and so on—rather than acute care. Caroline Lamb can say whether anything has been considered around cancer care with NTCs—I do not know off the top of my head.

It is difficult to assess the number of people who have long Covid. Some of the patients whom I have met who are experiencing long Covid have seen a detrimental impact on their employment. In some cases, they have had to give up their employment because they are no longer able to continue with the job that they were in. Others have been able to adapt their working environment so that they can accommodate their issues with long Covid, and others still have been able to continue with their employment.

The situation is therefore variable, and, at this stage, I could not give you a figure for the economic impact of long Covid and we have not carried out an assessment to enable us to do so. Again, it will have an impact on individuals in different ways and it will depend upon employers being prepared, as they should be, to make reasonable adaptations for employees who have a long-term condition so that they can continue with their employment. It is important that employers do that while it is necessary.