Chamber and committees

I am thinking about the principles of fair work, employment and supporting people into career pathways and routes in a way that supports them as well as the people for whom they are providing care. How do we ensure, in the text of the bill, that those principles can be applied across the whole of Scotland?

I know that it is still early days, but I am thinking about, say, compensation for travel, support for education and aspects of employment—for example, whether someone is employed by one care provider or another. Those issues arise when we get down to the detail of how we support people to be carers, whether in a care home or through care at home. Does the bill have enough detail on that?

Thank you.

I have a final quick wee question. You said that it is obvious that the charter should contain the principles that are laid out. I quite like seeing them laid out right there in the bill. It is almost like a seamless transition from saying, “Okay, we talk about the principles and here is what the national care service is going to do”, to saying, “Now, here is what the charter will incorporate.” Is it reasonable to have the charter laid out in this framework bill, as we have just discussed?

The bill talks about the charter being reviewed every five years. Is that enough time, or should the period be longer? Indeed, should it be shorter?

I mean before the bill was published. Did COSLA engage with the Government before the bill was published?

Okay.

I am keen to pursue the matter of centralisation. To me, it is about creating standards. We just had a care home close in Dumfries and Galloway, and during the pandemic NHS teams had to go into a couple of care homes because there were issues related to infection control. It is about knowledge, skills and taking a standardised approach; for example, staff not wearing personal protective equipment unless they are engaging in patient care. For me, a standardised approach is about fair wages and the level of skills for a certain band in the local authority. No matter where a person is in Scotland, there should be a standardised approach for development of knowledge and skills. Is not that part of what would be centralised, with local delivery then being based on the standards that are set across the whole of Scotland?

At my recent surgery in Summerhill, in Dumfries, I heard concerns from local residents about what they believe to be increased levels of antisocial behaviour in that area. We know that engagement and education are the best ways to prevent crime and antisocial behaviour in the first place, so I have called for a multi-agency meeting with the police, the housing authority and the community safety team to address constituents’ concerns.

How is the Scottish Government supporting the police and the community safety team? Can the cabinet secretary urge them to engage with me and with the local residents on those matters?

I have a direct border question. Under the common travel area, Scotland, like Ireland, will retain freedom of movement across the British isles and Ireland. That means that people, such as my constituents who live on one side of the border but work on the other, will continue to be able to do so and will be able to move freely between Scotland and England. Can the cabinet secretary confirm that that will be the case? Can he indicate whether he expects the UK Government to try to mess with the CTA arrangements, which predate the European Union?

Here we are again, with another politically opportunistic motion from the Labour Party that is politicising our health service in Scotland. Contrary to the motion, the health secretary and the team are focused on ensuring that Scotland’s NHS is as well equipped as possible to tackle the huge challenges that we face.

I know that there are challenges in taking care of people, the processes and pathways, the prevention of acute admissions and the work in primary care. The work that my former colleagues undertake every day is complex, and the systems are challenging. For 30 years before becoming a member of Parliament, I was in the NHS in Scotland and England and a nurse in the USA, so I think that I know a wee bit about what is going on in our national health service. Sometimes, when I read such motions, I wonder if the Opposition ken diddly qua qua about what is actually going on.

I know that, over the past two years, the NHS has suffered the biggest shock in its 74 years of existence. I thank all the people who work in the NHS for their work, care, compassion and commitment, and for what they do every day. The Scottish Government’s recovery plan, which is backed by more than £1 billion of investment, sets out plans for health and care over the next five years, so it is not just for this winter. The plan will support in-patient, day case and out-patient activity, as well as implementation of sustainable improvements and new models of care through investing in a network of national treatment centres. That will increase capacity for additional specialties, including diagnostics, general surgery, orthopaedics and ophthalmology.

The plan also supports the mental health and wellbeing of the health and care workforce, which we have heard so much about in the past couple of years. We should get right behind looking at ways to support people using digital opportunities such as NHS Near Me.

It is crucial that we help to equip the NHS for the winter pressures, but we need to think beyond the winter as well.

On specific A and E challenges, I hear what is being said. In common with other health services across the UK and globally, Scottish A and E departments are working under significant pressure, and the pandemic continues to affect services. Mind that word “Covid”? We need to remember the impact that the Covid pandemic has had, and is still having, on our national health service.

The Scottish Government is taking action to improve A and E waiting times, and the £50 million urgent and unscheduled care collaborative will help to implement a range of measures to drive down those waiting times. The work includes offering alternatives to hospital, such as the hospital at home service; directing people to urgent care settings; and scheduling urgent appointments to avoid long waits in A and E departments. I know about the long waits in A and E. I hear about them directly from former colleagues and from folk working 12-hour shifts. It is hugely challenging.

In August, Scotland’s core A and E departments performed 8.1 percentage points better than England’s and 10.3 percentage points better than Wales’s. During that period, A and E waiting times in Labour-controlled Wales were worse than they were in Scotland, so I wonder whether Jackie Baillie or any other Labour member, when closing the debate, can clarify whether they are also calling on the Welsh Labour health secretary to resign. Labour’s performance in Wales does not inspire confidence that Labour would do any better here in Scotland.

I am conscious of the time, but I note what Gillian Martin said about potential solutions, and I welcome the steps that the Scottish Government is taking to support our NHS. I want the health secretary to listen to clinicians directly so that he can hear their ideas and suggestions for improving systems. We need to get right behind our NHS workforce and support staff in any way that we can in the future.

To ask the Scottish Government whether it will provide an update on the provision of community policing, including community safety patrols, in the South Scotland region. (S6O-01455)