Chamber and committees

I would not disagree with much of what has been said about the real pressure on staff.

I am interested in our immediate crises, and particularly in the onset of winter and winter pressures across the piece. Obviously, there is long-term workforce planning, but there is clearly an immediate need, particularly in acute settings, when it comes to how we physically keep the show on the road. We are seeing a lot of pressures at the moment, and we are not even at peak winter yet when it comes to admissions and use of service.

I am therefore keen to understand what is needed and what can be done to increase resources and staffing right now, and what would make most difference. I appreciate that that is not easy to answer, but I am keen to get a sense of that, possibly again from Dr Sue Robertson or the RCN, although I can ask everyone, I suppose.

Good morning, minister. I will follow up on that point. We all understand the importance of better understanding the information on and patterns of instances of people overdosing and being treated in or attending hospital. On reporting, I am keen to understand what we can do to get more data. For example, hospital admissions information does not cover accident and emergency attendances, nor does it cover cases in which people are treated by the Scottish Ambulance Service. How can we get more data on where people are treated, and how can we make sure that we follow them up?

I agree with much of what the minister said, certainly on the need for local connections and accountability and the need to improve the status of those services. It will be interesting to see people’s views during the consultation.

I want to ask about alcohol and drug partnership reporting in the here and now. The Government previously committed to providing information from ADPs on spending by integration joint boards. That happened in 2016-17 and 2017-18; I think that 2018 was the last time that we had those figures.

That was going to be a baseline for future reporting, but there has been no further information since then. As part of the intelligence to enable us to understand what is working on a local level and where spend is going, it would be helpful to have such information. Will the minister say something about that? What other intelligence can we garner from ADPs that will help us to map some of this area and meet the MAT standards?

Prior to the summer recess, we had quite a consensual debate on many of these issues, certainly on medication-assisted treatment standards and the need for strong and timely implementation of them—April 2022 has been set as the target. I am keen to hear a progress update from the minister. Also, how will that progress be reported? I think that the minister made a commitment to report to the Parliament six-monthly on MAT standards. Could you address those points, please?

Alcohol and drug partnerships play a very localised role with regard to their relationship with their integration joint boards and delivery. I note that, in the consultation on the national care service, there has been discussion about whether ADPs should form part of a more national service delivery approach or whether they should remain more local. I am therefore keen to hear your views on that issue and the question of where they can be used most effectively.

I draw members’ attention to my entry in the members’ register of interests, as I am a councillor on East Renfrewshire Council.

As we meet this morning, we know that Covid cases have been increasing throughout the summer, and that there have been a number of very seriously concerning situations across our hospitals, with code black status being, or almost being, reached.

I would like to hear the cabinet secretary’s view on the capacity that we have to deal with the current surge, and any future surge, in cases. We know that there are concerns, for example, around staffing levels and staff fatigue. I know that we will come to those issues later in the meeting, but first I want to get a sense of where we are in the pandemic now, in terms of capacity and our preparedness for the future.

I thank the cabinet secretary for that answer. On what he said about recovery of services, a number of health board areas and hospitals have made the decision to cancel operations and surgeries, and there is concern about how long it will take to recover the previous position. Professor Caroline Hiscox, in NHS Grampian, has said that it will take “years” to recover the position in which people are able to get diagnosed and treated and get the operations that they require.

As I indicated in my earlier comments, I want to move on to talk about workforce pressures. Given what we know about those pressures and the number of people who, whether they are doctors or nurses, are considering leaving the medical profession, what is the cabinet secretary’s view on what could, essentially, become a perfect storm? Staffing levels are reducing, and a long period of time is required to recover to a position in which we are able to treat people in as normal a way as we would expect and that everyone in Scotland would want.

The pandemic has undoubtedly exacerbated health inequalities. We have all seen quantitative and qualitative data that shows that. I also think that public health has never been so in focus for people in Scotland and so sharply understood in our homes on a daily basis.

Cabinet secretary, with regard to the learning from the pandemic, what key interventions do you envisage as we look ahead and move beyond Covid into recovery? For example, do you support the suggestion in the paper on non-communicable diseases that was published yesterday by the British Heart Foundation and nine other charities that there should be quick interventions on issues such as the advertising of e-cigarettes, the monitoring of sugar content in foods and better planning of smoking cessation and obesity services?

We are having a discussion at the moment about our long-term future planning, and I think that a lot of our work for many years to come will be dominated by workforce planning issues and ensuring that we get the recovery right. Will you say something about the imminent challenges of the winter? We are about to embark on a difficult winter period in the NHS. I note that the national workforce strategy will be published in December, but by then we will be into the winter pressures, and a lot of the recommendations will take time to flow through.

Will you comment on the pressures on staffing in the winter? The question relates not just to the NHS, but also to social care, because it is important to be able to discharge people from hospital more quickly and to have care packages in place. I am keen to understand the cabinet secretary’s thinking on that.

I am keen to hear more about early cancer diagnostic centres, which have already been alluded to. We know about the delays in setting them up. They add a lot of value through early diagnosis and opening up new pathways for people who do not have clear-cut symptoms, and there is a sense that we could utilise them in every health board area. I am keen to understand from the cabinet secretary what the plans are to roll out centres further and what the timescales for that are.