Chamber and committees

It is welcome to hear the update that the cabinet secretary is working really well with the A77 action group. Will she clarify that, although overnight closures of the roads are extremely frustrating, they are necessary to ensure the maintenance of critical infrastructure routes such as the A77? Will she highlight how the A77 has been improved in recent years as a result of action taken by the Scottish National Party?

I have been working with a family in Wigtownshire who are in the same position as many others, in that a contact order was given by a sheriff for a father to have contact with his son months ago, but that order is still not being complied with. The minister will know that I have corresponded with her on the issue, but will she agree to meet me to explore whether a change could be made to the law that would compel a party to comply with a court order in a Scottish family court as in criminal cases?

I thank Neil Gray for highlighting that. I know that it is a complicated issue, and that the interchanges between various health boards and pathways are complex.

I welcome the report, and I thank the committee members, clerks and the people who gave evidence. I also commend all the health and social care staff for their compassion and commitment to the people in their care, and I look forward to the Government’s response.

As a member of the Health, Social Care and Sport Committee, and as a representative of rural Dumfries and Galloway, I am pleased to speak in the debate about our inquiry into healthcare in remote and rural areas. I remind members that I am a registered nurse and that I was a clinical educator for remote and rural NHS Dumfries and Galloway.

Our inquiry focused on many issues that relate to the challenges of providing healthcare in remote and rural areas. Members of the committee visited the Isle of Skye, for example, and we took online evidence, including from persons in my South Scotland region—people who were aligned with the Galloway community hospital action group, and a former GP who was also the previous chief medical officer of the Galloway community hospital in Stranraer.

I cannot cover everything in the report in the six minutes that I have—maybe I have more than six minutes now, Presiding Officer—but I welcome the fact that the committee convener covered lots of information from the inquiry, including the GMS contract flexibility needs. I will highlight some of the key issues that came out of the inquiry. The committee made recommendations on education and training, recruitment and retention, how services are designed and delivered, primary care and multidisciplinary team working, and the importance of the third sector.

As we have heard, one prevalent and prominent issue was the lack of housing. That is a challenge not only for full-time workers but for people who are assigned a placement in remote and rural areas as part of their training. As I said, that has been highlighted by many. Dumfries and Galloway Council and Scottish Borders Council recently declared housing emergencies, and that certainly impacts on the ability of the health boards in both areas, and of both councils, to recruit and retain a health and care workforce.

However, I know people who work in NHS D and G and live south of the border—who, for example, commute from Carlisle to Dumfries. One team member told me that they chose to travel to Scotland from England because the pay is better, the patient to staff ratio is better and the NHS service performs better. I can say that as a person who lives near the border and has had people give me such testimony about why they choose to live in England but work in NHS Dumfries and Galloway.

I highlight the success of the unique Scottish graduate entry medicine programme, about which I made an intervention earlier. ScotGEM is a four-year graduate medicine programme that trains healthcare professionals with a primary degree in health or science to work as generalists in the NHS in Scotland.

I was a member of the Health and Sport Committee in the last parliamentary session, when the then cabinet secretary Jeane Freeman took forward the legislation that allowed ScotGEM to proceed. The programme has a specific focus on rural practice, and we know that GP training, recruitment and retention are not just a Scottish problem but a global problem. Closer to us, Ireland is experiencing the same reduction in GP numbers in its remote western places. ScotGEM has proved to be very successful for NHS Dumfries and Galloway. I am a member of the British-Irish Parliamentary Assembly, and, in BIPA debates, I have cited ScotGEM as a model that could be replicated in Ireland. That has been welcomed and people have been positive when they have heard me speak about it.

Will the cabinet secretary comment on the success of the ScotGEM programme? Does he have figures for GP retention in rural areas once ScotGEM GPs graduate? We need to talk up some of the good-news stories.

As Colin Smyth knows, we have worked on that matter together with the minister, so I am aware of what was highlighted in the independent review with regard to having a midwife-led unit. There have been real recruitment challenges, which we have highlighted. It is an on-going issue that we are working with the minister to address, and I welcome that work.

I am conscious of the time. During the informal evidence session in the inquiry, the committee heard about issues to do with cancer pathways, including the fact that people in Stranraer and Wigtownshire have to go to Edinburgh for radiography, for example, although Glasgow is closer. D and G’s cancer pathway is linked with the south-east cancer network, which sends people to Edinburgh for radiotherapy, for instance, for part of their treatment. We have been asking for patients to be given a choice. Some people might choose to go to Edinburgh if they have family support there, but others might choose to go somewhere closer to home. The issue has been on-going for more than 20 years, and people have been campaigning about it. It will be interesting to see whether any progress can be made, including looking at the optimal place for people to receive services and offering people a choice as the bottom line.

To ask the Scottish Government what support it provides to people who are going through family court proceedings. (S6O-04105)

That is a challenge. As we have discussed, I know about Stranraer and maternity issues, but we need to focus on safety. That is a primary concern for me when we think about the best place for care to be delivered.

I am aware that there have been challenges in other parts of Scotland. I highlighted the successes in my area, south of the central belt, which I am more familiar with. I am interested in the success of the ScotGEM programme, which is why I am asking the cabinet secretary to give us some figures for that.

We have just heard that expectant mothers who live in Stranraer and Wigtownshire are required to make a 150-mile round trip to deliver their babies in Dumfries. We have heard horror stories of mothers birthing at the side of the A75. The situation causes a huge amount of stress and anxiety for mothers and their families. This is not dissimilar to what is happening in other areas of Scotland, and I am sure that we will hear about that from Douglas Ross in a wee minute. The report also highlighted the issue.

I thank the minister Jenni Minto and Maree Todd, in her previous ministerial role, for their engagement with me on these matters. That continued engagement includes our meeting just last week. Again, it is about highlighting what we are hearing on the ground and what could be done differently. As a registered nurse and as someone who used to teach midwives about safety, assessment and all the associated matters, I am acutely aware of this issue. I reiterate that I would like to see the situation addressed so that people who live in rural Scotland can deliver their babies as close to home as is clinically safe and possible.

There is nothing to add. I recognise that Scots is spoken in a variety of ways and in different dialects in different parts of Scotland. I urge colleagues to support the amendments in the group.

I engaged with the Scots language community when we discussed amendments to propose. There has been no direct discussion with ADES and teachers, but I have engaged with members of the Scots language community, who I believe are experts in Scots.

I encourage members to support amendments 69, 71 and 74.

Amendment 69 agreed to.