Chamber and committees

The plan would be to have that data. It is a fair expectation for the patient and for GPs or those who work in our health and social care system to have.

We expect to publish data around clinical prioritisation in the late summer of this year. That is a new policy that has been put in place to ensure that the public—you gave the example of your patients—will be able to see how long they will have to wait. However, it will probably give a range as opposed to an exact date.

We are working closely with Public Health Scotland and boards to develop the infrastructure in order to collate and publish that data. It is an ambition of ours to have that available in a way that is easy to find and understand for both the patient and the healthcare professional.

It will be monitored, evaluated and reported, of course. The current plans are to receive updated projections from our local health boards. We will then publish the projections for our workforce in more detail. We will continue to make sure that the Parliament is regularly updated, and I am sure that those workforce plans will be regularly scrutinised by the committee, as well as, I suspect, Parliament as a whole. It is our ambition to be transparent and open about the process, and also about the challenges. I have just articulated some of those challenges to Mr Torrance, but I think that we should be up front that this is ambitious and it will be challenging.

I go back to what I think is a good record during our time in Government. Our record speaks volumes.

When it comes to recruitment and trying to look into the future—or even looking at the present vacancies—we have to create vacancies in order to expand the workforce. Again, I will be able to write to the committee with more detail about what percentage of recent vacancies have come on board recently. Actually, Gillian Russell has helpfully provided that: 77 per cent of the nursing and midwifery vacancies that were reported in December 2021 have been recorded in the past few months. That is reflective of the extent of the new posts that have been created.

Those new posts are part of the workforce expansion, but they do not account for all vacancies by any stretch of the imagination. Those remaining vacancies give me a level of concern. However, to go back to my previous point, this Government and successive health secretaries have a good record of increasing and expanding our staffing.

However, it is not just about expansion; it is also about retention. The nurture pillar of our workforce strategy is key to that. In the reform space, it is also about what we ask those who work in the health service to do. There is a question about infinitely growing our workforce in the future. I do not think that anybody would suggest that that will be possible. However, we can ensure that what we ask our workforce to do meets the needs of the public and patients.

We have a good track record. There is no doubt that there have been challenges to workforce planning in the past but, with our current strategy in place, I hope that we will be able to mitigate some of them.

It has been really successful. Taking my cue from the convener’s comment about being succinct, there is little for me to add, given that Emma Harper has rightly mentioned some of the data on the programme. We can build upon initiatives such as ScotGEM, the rediscover the joy project, golden hellos and the work that we are doing on the back of Sir Lewis Ritchie’s report into a centre for remote and rural healthcare. All those initiatives are important for recruitment and retention, particularly in our remote, rural and island settings.

Stephanie Callaghan is absolutely right to make the point that progress on life expectancy has stalled. Improving mental and physical health—which are obviously often linked—and improving access to opportunities to improve one’s own physical and mental health will be critical. That is why our recovery plan is so important. To be frank, because people have not been able to access services in the way that they would have pre-pandemic over the past two years, people are undoubtedly attending our hospitals with higher acuity. They are deteriorating in their own conditions if they have been on waiting lists for too long, and if a person does not get a CAMHS referral in good time, their mental health is of course in danger of deteriorating.

Again, the preventative space is therefore integral to our recovery. However, the challenges are significant. That is why the care and wellbeing portfolio is also hugely important. I am happy to give the committee continued updates on how we are evaluating that. Different pieces of that work will be evaluated in different ways. For example, we have promised to update on the recovery plan yearly, but there is a different evaluation process for funding streams. Maybe I can set some of that out to the committee in further detail.

I hope that most members recognise the incredible work that Public Health Scotland has done over the course of the pandemic. That includes the amount of data that it has provided and its incredible work across the range of services that it provided in response to the pandemic. We did not know that we would be hit by a pandemic, which has meant that some of the work that we wanted Public Health Scotland to do when the organisation was conceived has stalled. There is no getting away from that.

However, I am pleased that my recent conversations with Public Health Scotland have shown that it has been able to pivot slightly away from the pandemic response, although it has not been able to pivot entirely away from that, because the pandemic is still with us. Given that we are moving into an endemic phase, Public Health Scotland is able to do more work on the issues that Ms Mochan has raised, and I give an absolute assurance that those issues are a clear focus for the management and chair of Public Health Scotland.

I spoke to Jaki Lambert of the RCM yesterday, and we had a good and detailed discussion about the very points that Ms Webber has raised. I do not know whether the staff survey has been published yet, so I will refrain from going into detail on it, but, as I understand it, one of the best things that we can do to alleviate some of the concerns is to control Covid transmission. It is very clear from staff responses that the pressure of the pandemic has been unlike any other pressure that they have faced before, and if we have can control the pressure of Covid, it will stop midwives feeling anxious every day they go on shift about whether they will be moved to a different ward or whether any given unit at any given time will have the appropriate number of midwives and nurses. Controlling Covid transmission will help to alleviate that significant pressure.

Investment in wellbeing will also be important, as will as giving our midwives and, of course, other NHS and social care staff the time to access those wellbeing resources. I therefore made a commitment to the RCM that we would continue to invest in wellbeing.

The third point, which was made quite strongly to me, was on the importance of time for training and educational and professional development, which, again, have been impacted by the pandemic. Controlling the pandemic and community transmission will allow us to begin to alleviate some of that pressure, so that our midwives can dedicate more of their time to training and competency.

Yes, I am confident of that for a couple of reasons. First, on the wellbeing aspect, I am pleased that Audit Scotland’s report recognises the Government’s focus on wellbeing, and we will have to continue to focus on that. Paragraph 89 of Audit Scotland’s report says that:

“There is clear commitment at Scottish Government and NHS board level to support staff wellbeing, and it features prominently in the NHS recovery plan.”

To me, the fact that Audit Scotland has recognised our focus on wellbeing speaks volumes. I am absolutely unapologetic about that focus, because staff wellbeing is at the core of retention. Pay and terms and conditions are all important, but people who tell me that they are thinking of leaving the NHS or the social care sector say that it is the wellbeing and mental health pressures that are forcing them to think about whether to leave the profession. I am desperate to try to avoid people leaving because of those reasons; therefore, wellbeing will be central to our plans.

Our workforce strategy was recently published and I remind members that it was co-produced with the Convention of Scottish Local Authorities, which is important, particularly for the social care aspect of it. Workforce planning will be challenging—there is no getting away from that. We will do everything that we can to try to ensure that we increase, where necessary, the pipeline of students that are coming through in staffing cohorts. We will do what we can to recruit domestically, which will be a significant part of our strategy.

We will also recruit internationally, which is not a panacea, but will help to bolster some areas of our workforce. Recruitment will be difficult, because for some specialisms—for example, medical oncology—there are staff shortages not only in Scotland, but globally. Of course, we are not the only health service in the world that is facing those challenges; we are all going to be trying to recruit more nurses and other staff. We need to make sure that the data that supports our workforce plans is as accurate a projection as it possibly can be—the Audit Scotland report focuses on that in some detail.

I will make a couple of points. First, although I do not disagree that the NHS and social care are probably always under some form of pressure, I note, to be fair, that if you speak to anybody working in health and social care, they will tell you that the past two years have been unlike anything that they have ever faced in their lives. I talk to nurses and doctors who have been working in the NHS for four decades and longer. They tell me that, in the 40 years for which they have been working in the health service, they have never experienced anything like the past two years, and that nothing has even come close to it. There is pressure and then there is pandemic pressure; pandemic pressure is above and beyond anything that we have ever felt before.

On the question about more data—[Interruption.].

We will explore that. Every report by the Auditor General on the NHS deserves such consideration. I am keen that we get the balance right. There is reform that is exceptionally important for delivery of service, but reform of governance and accountability is also really important. However, we must not end up so involved in reform that we get distracted from the immediate pressures of getting through the backlog, given the length of time that people have had to wait for various elective procedures.

Accountability is important. Although I cannot make a commitment on what more we might do in relation to the Auditor General’s recommendation, I acknowledge that it is worthy of further consideration.