Chamber and committees

The words “co-design” and “co-production” are often used interchangeably but, in this case, we are pursuing co-design. Just yesterday, I had a conversation with an elected member who used “co-production” and “co-design” as if they were interchangeable. I am interested to hear about what the co-design process really is and how distinct it is from co-production.

I will pick up on some of the issues about engaging with COSLA and the unions. We took evidence from the Scottish Partnership for Palliative Care and heard that

“The national care service is a real opportunity to be part of improving people’s experiences of living with serious illness, and of dying and bereavement.”—[Official Report, Health, Social Care and Sport Committee, 13 December 2022; c 5.]

Age Scotland said that the Scottish Government has made it clear that there is a commitment to involving people with lived experience.

I would be interested in hearing about engagement with unions. I read a statement from Unison that said that

“the bill leaves profiteering at the heart of care”

and I know that there are concerns about employment and pensions. In contrast with the position of the Health and Social Care Alliance Scotland, the Scottish Partnership for Palliative Care and Age Scotland, who all welcome the bill, others have concerns and may feel that they need to have a voice. Can you speak about that, minister?

I have one final question on this wee section. Things such as the regional forums will help to identify the differences that you described, such as differences in pay. As a former nurse educator, I am interested in support for career pathways and career progression, and I think that a national standard approach would give more weight to career pathways for social workers and carers. Will the forums and the plans for regional approaches help to determine that a standardised approach to education will be part of the national aspect?

We need people to be empowered to understand that they will be part of the co-design process and that the bill is a framework that we will build on. Is that what we are asking people to believe and trust—that they will be part of the co-design?

When you made your opening statement, minister, you talked about the fact that you are a Highland MSP. The Highlands is a rural area. I am an MSP for South Scotland, which is also rural. There are complexities in designing impactful changes, so I am glad to hear about the processes that will be undertaken, especially those that will look at services.

In Dumfries and Galloway, there are no council-run care homes, but in the Borders, for instance, there is a mix of private and council-run care homes. Is that going to affect the work that is taken forward? Will that look at the fact that individual areas have specific needs?

In its report on the bill, which I have in front of me, COSLA made a positive statement. It said that it recognised that a national care service in some form

“could provide national leadership on matters such as workforce planning, training, terms and conditions, national standards, ethical procurement, registration, inspection, and improvement.”

However, COSLA had concerns, and it asked for the bill to be amended. That means that you will need to work with COSLA and with the relevant representatives, as you have indicated. I just wanted to clarify that.

Jeff Ace talked about a Scotland-wide approach, with combined or joint services. Do you mean combined human resources as part of joint work and integration, or combined financial services? Is that something that could work for NHS Dumfries and Galloway, which is a small board, or does there need to be a Scotland-wide approach, as well?

I have a quick question for Jeff Ace about international recruitment. You have been quite successful in recruiting nurses. Not only a warm welcome, orientation and training are required; a wider holistic approach is required. Is housing a challenge in recruiting folk to remote or rural areas such as Dumfries and Galloway? If so, what can be done about that?

The recovery plan is a five-year plan; coming out of Covid is not an overnight fix. It will take time, and I know that as a nurse myself.

I am interested in the cancer diagnostics centres. One was created in Ayrshire and Arran, one in Fife and one in Dumfries and Galloway. Prevention and early diagnostics are happening in NHS Dumfries and Galloway, where there is a trial of self-sampling for cervical cancer diagnosis. Would Mr Ace like to comment on that?

You have said that it is about a holistic approach. As I read the papers, I saw information about continuing feelings of being let down, of prolonged and continued anxiety and of disappointment, because the expectations were already low and they were not being met. It seems that there is also conveyance of lack of empathy for their experiences. It is almost like there needs to be a Maggie’s centre equivalent for people who have had mesh injuries. It is quite difficult to read some of what has been presented. How would you describe the holistic approach? I know that psychologists and clinical nurse specialists are involved. How would you see progress being taken forward based on feedback from surveys about people’s experiences?