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Chamber and committees

Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 22 November 2024
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Displaying 937 contributions

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Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 21 May 2024

Neil Gray

As Ms Harper will be aware, there are particular challenges around those in island communities being able to get to the mainland to access services. That means that they often need to travel by plane, which is incredibly costly and requires quite a bit of logistical planning. Ms Harper asked a direct question on whether we would review the situation for people in other rural areas, such as Dumfries and Galloway—the area Ms Harper represents—and the Borders. I am always happy to keep the arrangements under review.

I am cognisant of the financial challenges that are being faced by patients at the moment amid the UK cost crisis and, when it comes to being able to provide any extra funding, Ms Harper will understand the financial fragility that we are living with in government. I am always happy to continue to consider the situation. If Ms Harper has individual examples of where things have proved to be problematic I would be happy to hear about that, in order for us to have an informed review.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 21 May 2024

Neil Gray

Mr Gulhane will be aware of the Scottish Government’s reaching 100 per cent—R100—programme that invests in broadband and supplements digital connectivity as an area of UK Government responsibility. The roll-out is going well and rural communities are being connected in a way that they would not have been had it not been for the Scottish Government’s investment. Work is also being done on mobile connectivity by some of the service providers.

I am racking the back of my former economy briefing brain, but I would be happy to ensure that colleagues in the economy portfolio furnish Mr Gulhane with more information on some of the work that is being done with service providers in rural and island communities to improve the availability of mobile internet connectivity. He is absolutely right that making sure that those areas are able to access digital services is critical, especially when that innovation will be most needed by and will be most appropriate for some of the rural areas.

Health, Social Care and Sport Committee

Subordinate Legislation

Meeting date: 21 May 2024

Neil Gray

I appreciate the opportunity to speak to the two Scottish statutory instruments relating to the regulation of independent healthcare in Scotland.

First, the inspections regulations will allow any suitably trained inspector who is authorised by Healthcare Improvement Scotland to inspect medical records. Currently, the regulations state that Healthcare Improvement Scotland can draw on medical practitioners, registered nurses, pharmacists, and registered dentists to inspect medical records during an inspection. That change will enable Healthcare Improvement Scotland to be more flexible in its approach to conducting independent healthcare service inspections.

The second SSI is the modification order, which has three distinct purposes. First, it will widen the definition of an independent clinic, so that Healthcare Improvement Scotland will regulate clinics where services are provided by pharmacists and pharmacy technicians. That will not include pharmacies that are already regulated by the General Pharmaceutical Council or services that are provided under NHS contracts.

Secondly, the order will amend the definition of “independent medical agency”. That provision will now include services that are provided by dental practitioners, registered nurses, registered midwives, dental care professionals, pharmacists and pharmacy technicians. The updated definition will also regulate wholly online services that are based in Scotland. I believe that to be a particularly urgent and important change.

The final purpose of the modification order is to enable Healthcare Improvement Scotland to cancel the registration of independent healthcare services that fail to pay their continuation fees. The inability of HIS to remove services from its register means that, at present, services that repeatedly fail to pay their fees can continue to operate in Scotland. Making that change is likely to have a positive impact on the willingness of providers to pay the fees that they owe and the provision is intended to be used as a last resort.

We have engaged with stakeholders and the wider public throughout the development of the modification order and our public consultation received support for the changes.

The SSIs that are being considered today will ensure that HIS continues to have the power to effectively regulate independent healthcare providers in this growing sector.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 21 May 2024

Neil Gray

There are frameworks in place around the integration of health and social care that should allow for some of those discussions to take place. Where there is an understanding on the part of IJBs and health and social care partnerships that there are particular workforce challenges in the communities that they are looking to serve, those discussions can start there and spread to other forums. However, of course, where we have that convening power or, indeed, where we can provide that guidance, we will continue to do so. There are good examples of some of that work being done already, and we need to build on those and try to provide that advice on a wider basis.

Health, Social Care and Sport Committee

Subordinate Legislation

Meeting date: 21 May 2024

Neil Gray

I am happy to share that with the committee.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 21 May 2024

Neil Gray

To answer some of your other questions and bring it back into one answer, for the strategies and plans to be effective, stakeholders have to be consulted on them. In order for us to have an effective and sustainable health service and if we are to have a workforce strategy that means anything, the workforce and trade union representatives must be consulted and must be part of the discussion. They will absolutely be part of the discussion.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 21 May 2024

Neil Gray

I do not think that there is a particular issue in respect of ensuring that we have greater cyberresilience in remote and rural areas. Having grown up in an island community, I know that when a system fails, physically going to a clinic or hospital service is more challenging, because of travel time, transport connections and so on but, from a cyberresilience perspective, I do not think that rural or island communities are any more likely to be targeted by criminal gangs, such as the one that targeted Dumfries and Galloway, than other communities would be.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 21 May 2024

Neil Gray

I could not say for certain, but the work is on-going.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 21 May 2024

Neil Gray

Obviously, local health boards and integration joint boards are responsible for their own delivery, and we have clear expectations that they will ensure that services continue to be sustained and delivered. We work closely with them, particularly on the workforce. We have instituted the areas of work that Stephen Lea-Ross and Paula Speirs have already set out, but there are others, such as the ScotGEM—Scottish graduate entry medicine—programme for rural general practitioners, that ensure that we continue to support new entry into rural and island areas.

We have the highest fill rate in the UK for the priority foundation areas, which is a good thing when it comes to filling the vacancies in rural and island areas, The fact that we are competing well against the rest of the UK is a good thing and shows that the work that we are doing with IJBs and health boards is coming to fruition. Obviously, challenges remain, and issues are clearly outstanding in certain areas, but the progress is there. The work that Stephen and Paula have already set out will, I hope, continue to support local areas in developing their workforce strategies.

Health, Social Care and Sport Committee

Healthcare in Remote and Rural Areas

Meeting date: 21 May 2024

Neil Gray

I will bring in Stephen Lea-Ross, as I am not as familiar with that issue, although I am familiar with the incredible work that NHS Education for Scotland does and, in particular, the way in which it is helping to inform some of the initiatives that we have already spoken about, such as ScotGEM and the rural fellowships. I will bring in Stephen on the specific examples that you asked for.