Chamber and committees

I agree entirely about the importance of locally empowered solutions, and a lot of fascinating work is going on. I am closely observing the work that is going on in Dundee in the pilots that relate to the complex relationships around child poverty, employability and engagement in society. Really interesting work is emerging on that, and it is emerging in Dundee—not in other places. That is great, because it may give us an approach to best practice that we can share with others, so that we can begin to move on. There is a really sound platform that enables us to take that forward. Inevitably, that probably gives rise to greater emphasis being placed on some areas of activity than others, which is understandable.

I am interested in the characterisation that Liz Smith gives—that there is a prescriptive approach from the Government. I do not think that the approach is prescriptive. As I look at the evidence, some voices are saying that the Government needs to be more prescriptive, because we need folk to be absolutely complying with the framework.

As you can probably sense from my evidence, I am not persuaded by the get-more-prescriptive approach. I am much more interested in making sure that people are empowered at local level to define the solutions that work for them, provided that they contribute towards the national outcomes.

Or dentistry.

Not in the slightest.

That would require us to configure the national health service around the circumstances of a few—I do not know how many; perhaps 1,000 or 10,000—individual patients, as opposed to trying to ensure that every patient gets the treatment that they require.

We have circumstances just now in which, unfortunately, individuals with complex healthcare needs have to have a range of different specialist interventions to meet their needs. I can only give a personal observation on this: I do not have healthcare issues, thankfully, but if I did, I would want to see a person who knows what they are doing. With all the greatest respect to Professor Leitch, I am not going to consult him on, say, open heart surgery.

There is a fine line to be walked. We want to retain as much of the really good strength and capabilities that have been built up in the testing infrastructure, but if we move away from that scale of testing infrastructure in the country, some people will undoubtedly become available for employment. We have to work with individuals to ensure that they are appropriately trained and skilled to remain in the labour market, albeit that they might be undertaking different tasks. The Government’s economic objectives are about maximising economic participation by those who are able to participate, hence the pilot projects that we are undertaking to tackle the levels of economic inactivity in Scotland. We want to reduce those levels and expand the size of the working-age population.

Based on the best measures that we have for the prevalence of the virus, we are in an improving position, with one in 19 of the population having the virus. I think further data on that will come from the ONS survey tomorrow.

Some of that territory was aired in oral questions yesterday. I will invite Professor Leitch to comment on that because it gets into clinical territory, but the approach that we are taking is that every patient who presents with a healthcare issue should be able to receive the support that they require. That is the founding principle of the national health service. As Mr Mason has just highlighted, individuals will present with post-Covid infection symptoms in different fashions. For some people, it will affect their sleep; for some, it will affect their energy; and for others, there will be respiratory issues. There will be a variety of different issues.

The founding principles of the national health service say that those individuals should be put on a pathway that addresses their circumstances. For example, if I had a respiratory problem, I would want to see a respiratory specialist so that it could be addressed to the best of their ability. That involves signposting individuals through the national health service to get the clinical intervention that they require.

We are exploring whether there are better ways to do that. All the research projects are looking at whether there are better ways to try to create those pathways as opposed to taking the approach that our health service is founded on, which is, essentially, that we all go into the health service at a general level, some people stay out there, and others go into greater specialisms where that is required. That is the approach that has been taken, but we are exploring whether that is the most effective way of dealing with a set of conditions that have emerged and become significant in the past two years or so in our society.

I do not know whether Professor Leitch wants to add anything to that.

As I said in my answer to Mr Rowley, we have historically low levels of unemployment just now. Unemployment in Scotland is at a very low level—lower than the level in the rest of the United Kingdom.

However, we have a slightly larger economically inactive population. The Government is trying to expand our working-age population by working with people who are currently economically inactive to try to find the means to make them economically active. We are trying to do that through a variety of interventions relating to employability, skills, the provision of early learning and childcare, and the meeting of transportation costs. We are also trying to address wellbeing issues that might undermine an individual’s ability to enter the labour market. Pilot projects are being undertaken with individual cohorts in the cities of Dundee and Glasgow to explore how we learn lessons and expand our working-age population.

Mr Fairlie is right; we have to motivate more people to enter the labour market. Otherwise, people will simply move from one sector to another, which will create shortages and other issues in other sectors of the economy.

The two fundamental issues at the heart of the question are the size of the working-age population and the relative attractiveness of social care employment. The Government is trying to expand that population.

Two factors have been a challenge in relation to dentistry. It has been a high-risk area of activity during Covid, and we have had to reduce the capacity of the system as a consequence on that. We have put in place financial mechanisms to ensure that the profession is supported to do as much as possible, and that is gradually rising as the situation improves. Given that we are now in a less challenging position in relation to the prevalence of the virus, that enables more to be done.

That number has moved from being one in 11 people at its most acute, which is a significant relaxation. Waste water sampling is showing a decline in the prevalence of the virus.

The number of patients in hospital with Covid is now sitting at about 1,500.