Meeting of the Parliament (Hybrid)

Meeting date: Wednesday, June 23, 2021

Official Report 1117KB pdf

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Urgent Question

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Royal College of Nursing Scotland (Trade Dispute)

To ask the Scottish Government what its response is to the formal notification by RCN Scotland that it is in trade dispute with the Government over pay.

Clearly, the notification—[Inaudible.]—but I look forward to continuing to engage with it. We have engaged in the pay negotiations through the staff-side representative and collective union group STAC, the Scottish Terms and Conditions Committee. That process has been in place—[Inaudible.] In May, the clear majority of unions, including Unison Scotland, the Royal College of Midwives and many others, which represent a clear majority of national health service staff, reported that they accepted the 2021-22 pay deal. We have therefore moved to deliver the pay increase, with uplifted back pay, as soon as possible. The 4 per cent increase stands in stark contrast to the paltry 1 per cent that is on the table from the United Kingdom Government for nurses in England.

I met—[Inaudible.] Clearly, I would be happy to meet them again on these matters—

I am sorry, cabinet secretary, but we have a point of order from Jackie Baillie.

I did not ask for a point of order.

I am sorry. I thought that it was from Jackie Baillie, but it is from Alex Cole-Hamilton.

On a point of order, Presiding Officer. Unsurprisingly, as this is an urgent question, there is a lot of interest in the answers from the Government. Given the connection issues with which the cabinet secretary is struggling, I wonder whether another member of the Government might be prepared to answer the question.

I note the point of order. I will ask the cabinet secretary to turn off his video so that we have audio only. We will try again and see if that works better. Perhaps the cabinet secretary could start again with his answer to Jackie Baillie’s initial question.

Yes, I am happy to do so. I can see and hear everybody, so I apologise if the connection problem is at my end. Please interrupt me if the connection does not get better. If it is helpful, I have a back-up device, which I am happy to set up quickly and use.

In answer to Jackie Baillie’s question, the notification from the RCN is, of course, disappointing. I look forward to continuing to engage with the RCN. We have engaged in pay negotiations through the STAC process, which has been in place since 2005. In May, the clear majority of unions on STAC, which represent a clear majority of NHS staff, reported that they—[Inaudible.]

—Scotland, the Royal College of Midwives, among others. Therefore, we have moved to deliver that increase in pay, with uplifted back pay, as soon as possible. That 4 per cent increase in pay stands in stark contrast to the paltry 1 per cent from the UK Government that is on the table for nurses in England. I met the RCN and the rest of STAC on 14 June, and I would be happy to meet them again to discuss those matters. At the STAC meeting, we discussed the fact that the 4 per cent increase was the biggest uplift for NHS Scotland staff in at least 20 years and that it will continue to ensure that our nurses are the best paid in the UK.

Jackie Baillie, I hope that there was enough of that answer to help you in asking your supplementary questions.

There was, Presiding Officer.

It is fair to say that this is the first time in the history of RCN Scotland that it has notified the Government of a trade dispute. However, it is about so much more than pay. Nursing staff have been warning for years that unsustainable vacancy levels, increasing workload demands and the risk that those pose for patient care and safety need to be addressed. The vacancy rate is up, and 30 per cent of vacant posts have been vacant for more than three months. After months of working on the Covid front line, nursing staff are now exhausted and many are considering leaving the profession, which will make staff shortages worse. Given the scale of the backlog challenge that the NHS faces, why has the Government allowed the relationship with the nursing workforce to deteriorate to that level?

Unsurprisingly, I do not agree with Jackie Baillie’s characterisation, but the RCN’s action is unprecedented and I will look to engage and reach out to the organisation. In my first few days in the role, I wrote to the RCN and, as I mentioned in my previous answer, I followed that up with a meeting with the RCN and other trade unions, in which pay and other matters were discussed. I will reach out again to the RCN to have a discussion and bilateral talks.

However, this Government has an exceptional record, and these are the most unprecedented of times. The record pay rise that we have implemented, which is the single largest pay rise for NHS staff in a single year, comes on top of the £500 thank you payment. The number of qualified nurses and midwives in Scotland is at a record high, having gone up by 12.8 per cent to more than 46,000. We have 8.5 qualified nurses and midwives per 1,000 people, compared to 5.9 per 1,000 in England.

However, I do not seek to minimise the points that Jackie Baillie raises. We know that there are still challenges, and that is why I am absolutely committed to ensuring that we continue to invest in, for example, the mental wellbeing hub, which will help the resilience of our workforce. There are issues that still need to be discussed, and I am happy to get back around the table with the RCN.

I repeat that this is the first time in its history that RCN Scotland has taken such action; it is unprecedented. What wider action will the cabinet secretary take to deal with the workforce pressures? What action will he take to recruit and retain the required nursing staff? The RCN claims that, despite attempts to engage with the new cabinet secretary, its requests for a meeting have been ignored. Will the cabinet secretary commit to an urgent meeting with RCN Scotland to hear its concerns and find a solution before the matter escalates even further?

I reiterate that I have engaged with the RCN; within my first few days in the post, I wrote to the RCN in response to its letter to my predecessor. I met the RCN about 10 days ago as part of a wider group of meetings with all the trade unions. Of course, I am more than happy to meet the RCN, and I will look to do that and get that process under way.

On the broader issues, which I think Jackie Baillie raises fairly reasonably, we will look to engage with not just the RCN but our other trade unions around the mental wellbeing of our staff. We know that the past 15 months have probably been the hardest and most difficult for most of our NHS staff in their entire careers. That is why we are putting in place a comprehensive package of wellbeing support that includes the national wellbeing hub, the national wellbeing helpline, psychological interventions and therapies, coaching for wellbeing, digital apps and workforce specialist services for regulated staff including nurses.

Jackie Baillie will know about our plans for a national recovery plan. A lot of our implementation of important wellbeing measures will be part of that plan, which I am happy to engage with Jackie Baillie on.

The latest workforce statistics show that there are more than 4,400 nursing vacancies in Scotland and that a fifth of the workforce is over the age of 55. We urgently need to improve recruitment and retention of nurses if we are to maintain safe levels of care. Does the cabinet secretary recognise that pay and conditions will be essential to ensuring that the NHS has the nursing workforce that it needs and to the implementation of the Health and Care (Staffing) (Scotland) Act 2019, which has been delayed due to the pandemic?

Yes. I think that Gillian Mackay makes reasonable points. That is why we have implemented the single largest pay rise in the history of devolution for NHS staff, and it is also why we gave our NHS staff a £500 thank you payment in recognition of what a challenging 15 to 16 months it has been.

Gillian Mackay is right that both recruitment and retention are important. I am pleased with the Government’s record of recruiting qualified nurses and midwives—the figure is at a record high—but where there are still challenges, I am more than happy to engage, and will engage, with the RCN. Many of the issues that Gillian Mackay and Jackie Baillie have raised will be part of our recovery plan, which we have committed to producing in the first 100 days.

All too often, nurses have had to bear the brunt of the pandemic, and many have had absolutely no respite, between cancelled leave and overtime. The sustained high-intensity workload has resulted, and will result, in significant mental health repercussions. There can be no NHS recovery without a committed and motivated nursing workforce. Nurses are pivotal, and the Government must make it clear that they are valued and will be listened to and supported at all times, not just in the run-up to an election. When it comes to the mental wellbeing of our nurses, what package of support will be offered to them alongside a much-needed pay uplift?

I probably answered that in my answer to Jackie Baillie, but Alex Cole-Hamilton is right—there must be a comprehensive package of wellbeing support, and I am pleased that there is one. It includes the national wellbeing hub, the national wellbeing helpline, psychological interventions and therapies for staff, and coaching for wellbeing. Digital apps are available for the workforce, too, and there is a workforce specialist service for regulated staff, including nurses. If Alex Cole-Hamilton wishes to have even more detail about some of those interventions, I am more than happy for him to write to me and I will, of course, respond in due course.

We take our commitment to our workforce exceptionally seriously. That is why we have implemented the single largest pay rise in the history of devolution for our NHS Scotland staff.

Thank you, cabinet secretary. That concludes the urgent question.

15:38 Meeting suspended.