Chamber and committees

As a member of the committee, I welcome the opportunity to highlight and focus on our report. It has been interesting to hear others’ contributions.

The report highlights that primary health is vital in ensuring people are seen by the most relevant professional for their needs and is crucial in relieving pressure on secondary care, particularly when our NHS is under the greatest pressure that it has experienced in its 74-year lifetime as we emerge and recover from the pandemic.

We looked at a wide variety of areas in our report on alternative pathways to primary care. I thank the witnesses, clerks and my colleagues for their input. We heard about community link workers; ALISS, which is an online local digital system for signposting and supporting people; the role of digital health and care; single electronic patient records; third sector involvement; and a lot more besides. I will focus on social prescribing and recruitment.

Social prescribing was not a widely used term during the previous session of Parliament, but more and more people now understand what that is and what its benefits are. In our report, the committee welcomed the increased uptake of social prescribing during the pandemic and the positive lived experience that those who have used it told us about. The evidence that we heard shows that social prescribing is effective in targeting the causes of health inequalities and that it can vastly improve mental health and wellbeing. We have heard others highlight that during the debate.

However, the committee took evidence that patients who used social prescribing during Covid recovery are now reverting to contacting their GP in the first instance, even though on-going use of social prescribing could offer better outcomes.

We heard how cost is a critical barrier to people accessing social prescribing pathways, particularly in areas of multiple deprivation. One point that came up is that there is no single national lead on social prescribing because responsibility for it is shared between two Scottish Government ministerial portfolios. I ask the minister to provide an update on the Government’s work to simplify the national approach to social prescribing and to better align ministerial portfolios so that there can be leadership and accountability on social prescribing in alternative pathways to primary care.

I turn to recruitment. The committee heard evidence to suggest that sustainable long-term workforce planning will be a critical prerequisite for encouraging greater use of alternative pathways to primary care in the future. Evidence that was submitted to us suggests that that must include consideration of how roles and skills requirements are likely to change as a result of advances in technology and the on-going evolution of services and their delivery.

I agree with Alison Keir of the Allied Health Professionals Federation Scotland and others who have indicated that it is really important not to look at workforce planning around team members but to understand it from the point of view of population-health need. We must plan the workforce from that perspective rather than say that we need X physiotherapists, occupational therapists, dieticians and so on.

I welcome the Cabinet Secretary for Health and Social Care’s launch of a new GP recruitment campaign this June, as part of the Scottish Government’s commitment to increase the number of GPs in Scotland by 2027. By highlighting the flexible, supportive and collaborative environment that is available here, the campaign seeks to encourage GPs from the rest of the UK to relocate to Scotland. That campaign is in addition to the Scottish graduate entry to medicine programme—ScotGEM—which allows graduates with healthcare and science degrees to train to be GPs with a particular focus on rural medicine. Dumfries and Galloway is part of the programme, and feedback from that areas ScotGEM lead is extremely positive.

Scotland is struggling to recruit in social care and nursing. A fall in the size of the working-age population and the ending of free movement of people as a result of Brexit have contributed to those challenges. Although the Scottish Government’s steps are welcome, recruitment and retention of the workforce across multidisciplinary teams will be crucial to our success in promoting greater use of alternative pathways to primary care. That will be a particular interest of mine as we scrutinise the National Care Service (Scotland) Bill. The committee’s report recommended that the Scottish Government provide an update on its work to assist health boards in developing an integrated approach to workforce planning and overcoming recruitment challenges.

The report also describes strengthening people’s understanding of the role of medical receptionists, who are critical in signposting folk to get the support that they need. I welcome the Scottish Government’s right care, right place campaign, which aims to increase that understanding. I am sure that lots of work has gone into creating the campaign, but my concern is that it mibbe isnae reaching the public as effectively as it could. Perhaps it needs a relaunch and for its messages to be shared again. I will use my social media accounts to share them and I encourage colleagues to do the same with theirs.

There is loads to read in the report, which was published in June. Securing parliamentary time to debate our committee reports is crucial. I encourage all members to read the report and to share its contents, because it has a lot of worthwhile material in it.

Some of what the member is saying is interesting, and some of it is in the report. However, it seems as if what he is proposing is not what the report was about. Could he provide some clarity about the part of the report that he is referring to?

It is interesting to listen to everyone. It is my understanding that this is a framework bill to create a more integrated service. It includes fair work, human rights and improvements in the quality and equity of services. I have the recommendations of the Feeley report in front of me. The report lays out the case for the creation of a national care service. Recommendation 20 is:

“The National Care Service’s driving focus should be improvements in the consistency, quality and equity of care and support experienced by service users, their families and carers, and improvements in the conditions of employment, training and development of the workforce.”

There is a lot even in that single recommendation. It is my understanding that this is about people with lived experience and about people who need care in order to prevent hospital admission. It is not just about dealing with delayed discharge; it is not a delayed-discharge bill. I am trying to get my head around how we support co-production, co-creation and innovation.

The framework bill is supposed to set out what further statutory instruments will come afterwards. Those will come from people—whether they are service users, service providers, NHS leads or others—working together. I would be interested to hear comments about Derek Feeley’s recommendation number 20 on the case for the national care service. Nick Morris has his hand up.

I have a quick question about the national care service charter that is part of the bill. Sections 11 and 12 mention the creation of a national care service charter that is “publicly available” and they state that the charter should be monitored and reviewed after five years.

I am interested in your thoughts about inclusion of the charter, specifically as it relates to the human rights-based approach and to supporting people—especially people who receive care. This is about embedding support for people with lived experience, as I understand it. Can you please tell us your thoughts on that?

I have questions about the workforce and fair work. Section 1 of the bill says that

“the National Care Service is to be an exemplar in its approach to fair work for the people who work for it and on its behalf, ensuring that they are recognised and valued for the critically important work that they do.”

In the previous evidence session, Nick Morris said that a national care service should allow for greater awareness of the work that social care staff and social workers do.

Can you comment on the fair work principles in the bill and say whether anything still needs to be added? Are there any gaps?

I will pick up on what Nick Morris said about the national health service, which was created 70-plus years ago but is obviously still a work in progress, given the changes that we see happening in it. I take on board what you are saying about the creation of a national care service needing to be done with consideration. We need to do it carefully and make sure that we get the legislation right.

However, that brings me back to the beginning. This is a framework bill and there will probably be amendments after our stage 1 report, but I am interested in how we make sure that we bring everybody along with us. It is great that we are singing the praises of social workers and that we can use this to value their work. That could be done using national approaches to skills development, education and things like that, as well. I am interested in your thoughts on that.

I am interested in any legislation on feed additives that is introduced, and I will continue to be so because I think that it is really important that we know what we are consuming. We hear about novel foods and what is happening in other countries in relation to trade, and I know from my research that there are issues around hormones and other chemicals that are being added to products that might end up in our food supply chain. We also had an informal discussion with Food Standards Scotland last week. I just want to put on the record that this is an important issue and we should pay attention to it.

As a former clinical educator, I like the national pathways model of skills development and the ability to look at how we measure the quality of care that is delivered so that we can ensure that it is the same whether the person is in Stranraer or Stornoway. I am interested in your thoughts on establishing recognised national career pathways so that we can focus on recruitment and retention and ensure that the career development process helps us to focus on valuing the staff and the care that they are providing. Can you give us your thoughts on that?

I would support any ways in which we can innovate and move forward. We need a canny approach—we need to ensure that the research is evidence based. That is how we should take things forward.

I will, in one wee second.

The UK Government’s own impact assessment on the bill makes it clear that the market for precision-bred products

“ultimately depends on prevailing consumer attitudes to products which contain genetically engineered material”

and that the

“public’s acceptance of GE and similar products remains an area of uncertainty.”

I will take a wee briefie intervention from Edward Mountain.