Chamber and committees

On a point of order, Presiding Officer. My app would not connect. I would have voted yes.

I thank the cabinet secretary for early sight of his statement. Having read the statement, my overriding feeling is: what a breakthrough. Who would have thought that investing in preventative health and digital solutions would benefit the NHS and the health of our nation? Rarely have so many statements of the blindingly obvious been contained in a single Scottish Government publication.

In my first debate, on 7 June 2016, I championed preventative spend and investment in digital solutions. The then Cabinet Secretary for Health and Sport, Shona Robison, said:

“I am committed to taking forward our health and social care agenda in the context of public sector improvement and against the four pillars of public sector reform in our response to the Christie report”,

those being

“prevention; integration at a local level; workforce development; and a focus on performance, with outcomes-based targets.”—[Official Report, 7 June 2016; c 9.]

Scotland’s poor health record and low healthy life expectancy are no secret. In fact, the solutions have been in front of us for decades.

How will the cabinet secretary quantify preventative spent and measure success? Considering that the documents have apparently taken years to come together, when does he expect the changes in them to be achieved?

Finally, the much-trumpeted digital front door, commonly known as the NHS app and first announced in 2021, is expected to be providing limited services to dermatology patients in Lanarkshire by the end of the year. When does the cabinet secretary expect it to be able to do for patients in Scotland what it can already do for all the patients in the rest of the United Kingdom?

The report by the Scottish Fiscal Commission highlights the wider effects of public health on our fiscal forecasts. It inevitably has profound effects on the wider economy, not least around workforce productivity. As the minister knows, improved productivity is vital to addressing our anaemic economic growth figures. Does he agree that there is an economic imperative as well as a health imperative to take greater action to improve public health? How does he intend to ensure that improving the health of Scotland’s workforce is embedded in Scottish Government policy?

I will, briefly.

In relation to workforce planning, I feel that we are stuck in a time loop. It seems as if, for all the time that I have been in the Parliament, and as Monica Lennon pointed out, we have been asking for some kind of credible workforce plan—and by credible, I mean one that actually addresses the need.

Back in 2018, the then Cabinet Secretary for Health and Sport, Jeane Freeman, decided that the Scottish Government would train an extra 800 GPs over a 10-year period, to address a shortfall of 860 in the number of GPs—the mathematicians among us may already see the flaw in that plan. However, as Audit Scotland pointed out, by the time those 800 new GPs are trained, some of the existing workforce will have retired—who could have foreseen that?—leaving an estimated deficit of 664 GPs in 2027.

Of course, the situation has got progressively worse than that: the Scottish Government is very keen to count the number of GPs, as opposed to the full-time equivalent number, which paints a really different picture of primary care.

The same applies to our stretched nursing and midwifery departments. “Burnout” is a word that is used increasingly often, as more and more of our NHS staff are either retiring early or off sick with stress. The Scottish Government often puffs out its chest and tells us about the record investment in the NHS and the record numbers of nurses, doctors, midwives and consultants. However, when we challenge that with the reality of record waiting lists and vacancy numbers, and continually growing ill health, we suddenly hear the words “Westminster”, “Brexit” and “pandemic”—anything other than “SNP responsibility”.

Both positions cannot be true, and the truth is that the Scottish Government’s response is akin to trying to fill the proverbial bucket with holes in it. Staff retention should be tackled first: recognising the issues that our GPs and nursing staff face, and creating an environment that encourages them to stay and, crucially, encourages more people to take up those positions. That is an approach that I have pushed ever since I arrived in the Parliament.

Incidentally, something that the Scottish Government could do right now is reintroduce nursing and midwifery apprenticeships as an alternative route into the profession. More than 40 per cent of midwifery students are over the age of 30 and have probably had to give up another career to pursue that one. We should be making it easier for them to access it.

Will the cabinet secretary give way?

To ask the Scottish Government what assessment it has made of any economic implications of the Scottish Fiscal Commission’s latest forecasts and the potential impact of rising public health costs on businesses across Scotland. (S6O-04775)

I appreciate that.

That brings me to the way to tackle the pressures that have been put on our healthcare system and, specifically, our GPs and nurses. There are two elements to dealing with the pressure on hospitals and GP surgeries: increasing the head count and, crucially, reducing need. However, all I have ever heard the Scottish Government talk about is increasing the head count and the fact that we have record numbers of staff per head of population.

There are reasons for that need. Scotland’s rurality is one of them, but the poor health of our nation is the huge elephant in the room. As a result of ill health, we have high levels of economically inactive people, and there has been an alarming rise in poor mental health. If we focus only on increasing the head count, we will forever need to increase the head count. Preventative health has been the poor relation in that equation.

The deployment of a technology-agnostic interoperable solution is absolutely essential if we are serious about bringing our NHS into the 21st century. Apparently, the Minister for Social Care, Mental Wellbeing and Sport and her team did not understand the term “technology-agnostic interoperable solution”, so they decided to google the meaning of it—it appears that that is how the Scottish Government now decides policy—and were confused by the answer. Therefore, I thought that I would google the term. Here is what I got:

“A technology-agnostic interoperable solution is one that can work with various technologies and systems, allowing for flexibility and integration without being tied to a specific vendor or platform. This approach promotes interoperability, scalability and future-proofing, enabling businesses to adapt to evolving needs without being constrained by a single technology or vendor.”

If I was cynical, I would suggest that the minister was trying to avoid scrutiny.

The SNP Government is not a serious Government. It has no idea how to deal with the issues that we are debating today, and while it remains in office, the health of our nation and the support that our NHS needs will continue to slide.

I am grateful to the cabinet secretary for giving way. I know that he wants to deploy technology in the way that it can be, but the reality is that it is not happening. I had a look at the app that is being deployed in South Lanarkshire, and all that can be accessed is dermatology. We are miles behind. What is preventing the Scottish Government from adopting technology in the first place?

I appreciate the cabinet secretary giving way, because I have a genuine question. When my daughter qualified as a midwife, there were 10 times as many applications as there were places. Now, midwifery places at universities are going through the clearing house. Does that cause the Government any concern?