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Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
We will get on to data and evidence shortly.
One of the clear recommendations of the report that we are discussing concerns the fact that there is a great inequality in the impact of mental ill health. In one of the evidence sessions, we considered the impact on the minority ethnic community and other marginalised groups. Will taking money out of the mental health services budget not also have a disproportionately unequal impact on the communities that are most marginalised and probably most dependent on mental health services?
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
I will finish up by asking a little bit more about the funding situation, but I have another question before I get to that. You mentioned that many mental health issues are not, at the end of it, directly your responsibility as the director general of health and social care, but are a function of inequality in society, of economic and social deprivation, and of a lack of access to services. Will you tell us a bit more about what the Government can do, or is doing, to take a more whole-system approach to the matter?
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
That is the community wealth building model, is it not?
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
Can you give us reassurance that that is not just a passing fad and that it will be part of the approach to health and social care?
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
When I see a figure of 10 per cent being set out as a goal in Government policy, I do not see that as just being about amounts; I see it as also being about proportions.
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
I will finish with a fairly straightforward, I think, question. The COSLA and Scottish Government mental health strategy was published after the Accounts Commission and Audit Scotland reports came out, and the committee is very interested to know when you will publish a progress report on where you are with the commitments in the delivery plan and, in particular, when you will report back on the workforce action plan. Again, for the avoidance of doubt, we have been told by a number of witnesses that there is—to quote their expression—a “workforce crisis”. When is there likely to be a progress report?
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
A particular occupational group that we have not yet spoken about explicitly is community link workers. When Christiana Melam from the National Association of Link Workers gave evidence to the committee on 16 November, she basically said that link workers feel quite undervalued in the system, and cited their not even being listed as a group to be consulted in relation to statutory guidance for the Health and Care (Staffing) (Scotland) Act 2019. Caroline, what is your view on the role of community link workers?
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
I do not know whether you were sitting watching that 16 November evidence session with a cheque book in your hand, because the rise in funding for community link workers was announced at the same time as we were taking evidence on that issue.
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
Can I just clarify something for the record? We spoke at the beginning of the meeting about the £29.9 million cut, which would have an effect on primary care services and community link workers as part of that whole network. Are those community link worker positions protected from the likely cuts that are coming down the track?
Public Audit Committee
Meeting date: 14 December 2023
Richard Leonard
I will take us back to one of the fundamentals that we have discussed a few times this morning. Do you believe that NHS boards are on track to meet the target of 10 per cent of all front-line spending being on mental health services?