Chamber and committees

That is a very fair question. Some areas have that service. In the Highland service, which I have talked about, there have been 100 referrals and, in Lanarkshire, well over 500 referrals have been made. We lack a single point of access and the connect between the primary care and secondary care services. That is exactly what the funding is intended to address.

I have every faith that more and more health boards will develop those services much more consistently. Some are already doing that. Some are using the funding and giving us timescales for when the pathways will be more fully developed. However, Murdo Fraser has hit the nail on the head. That is the number 1 issue that comes up from long Covid sufferers time and again. They say that it all sounds good, but they ask whether the approach is consistently working across the country. The answer to that is not yet. That is what we are working on.

You are the second person to sack me in a few weeks.

There was no need for that, Ms Baillie. [Laughter.]

There could be an advantage from such coalescing, but I do not think that it is necessary. I see from the Lanarkshire model that we have had well over 500 referrals—585 or thereabouts—so there is a rich data source.

Ashleigh Simpson would like to say more on that.

I thank you for your question and, indeed, Jane Ormerod for her comment. She, too, has been at those meetings at which I have met people suffering from the effects of long Covid.

In your question, you have expressed the purpose of the national strategic network, in which people who provide local services, those with lived experience and our clinical experts are making contributions to get the level of consistency that we require. I am certain that the committee will have pored over the detail of the funding allocation for each NHS board. From that, you will see that many health boards are looking to have a single point of access and to develop the pathways better. It is clear that they are looking at where such an approach is working well—NHS Lanarkshire provides a good model in that respect—and are trying to get that level of consistency, but Jane Ormerod is not wrong: there is a lack of consistency and a difficulty in accessing pathways.

That is why the implementation support note is so important. It ensures that when somebody goes to their GP—who will be the first port of call for the vast majority of people, if not everyone—the GP will have a flowchart, telling them where the referral pathways should be and what other support services will be available. Work on that is under way; indeed, it is one of the key areas that the funding will support.

I take Jane Ormerod’s point entirely. We are trying to strike a balance here; we are looking for national consistency, as that is important, but that does not mean taking a one-model-fits-all approach. I can highlight a great example from NHS Highland. We all know about the geography of the Highlands and how disparate the population is; NHS Highland has a good virtual model that is working well, and which it is developing further, but clearly, the model has been developed for that health board and is suitable to local needs. There will not be a blanket approach, but Jane Ormerod is correct to say that there must be consistency in access to pathways.

That is a really good question. Recruitment undoubtedly is, and continues to be, a challenge. What we are doing is making it clear to health boards that the £10 million funding, which comes on top of their core allocation, will be available over the next few years. We know that there are some issues with recruitment, but we are working—and will continue to work—with the boards to see what more we can do about those challenges.

The challenges will be different from board to board; our colleagues in NHS Grampian, for example, will face different challenges from those in NHS Greater Glasgow and Clyde. The recruitment challenges are one of the reasons for the full £3 million not being spent this year, but I have made it very clear to health boards that the £10 million will still be available over the next few years.

Yes, in short. Initially, £3 million was allocated, and there was an underspend of, I think, £1.1 million of that. We then went out to third sector organisations because health boards could not spend that money because of recruitment challenges. We have given a clear and absolute guarantee that the profile of the £10 million of funding might well change and might not be just over £3 million per year.

To answer your question in short, that money is part of that underspend.

I think that it has to be spent in this financial year. Certainly, they have to begin the work on spending it in this financial year. Forgive me: I can get you absolute clarity on that post the committee meeting. In essence, the organisations are building on projects that they already have under way.

Obviously, those are individual employment issues. As Jackie Baillie will know, we took the approach to employment that the other nations across the UK took—Labour-run Wales, Conservative-run England and Northern Ireland—with the additional support that we could give to those who were suffering from long Covid. We extended that support beyond when the other countries in the UK decided to withdraw it.

We are talking about important employment issues. I know that various members’ bills are coming up, such as Mark Griffin’s member’s bill on industrial injuries. There have also been calls for long Covid to be described as a disability. Under the Equality Act 2010, it is the debilitating impact of a condition rather than the condition itself that has to be prescribed. Therefore, the effects of long Covid could mean that someone has a disability that would affect their ability to get certain benefits, including social security benefits.

I will continue to look at the issue. It is a challenge. Because employment law is reserved, we have to make sure that we understand the unique impacts of long Covid and the fact that, although there are some treatments for some symptoms, there are no treatments for others. At the same time, we have to make sure that employment law is applied consistently across conditions.

Ultimately, it is not for the Government, health secretaries or ministers to override clinical judgment. That has to be up to the individual clinician.

I get really upset when I hear that people have been dismissed. For me, that has echoes of the mesh survivors, whom we have all interacted with, who, in their own words, said that they were dismissed by clinicians time and time again. I am really concerned about that, which is why so much work has been done on educational tools for our front-line primary care workers—who, I suspect we all agree, do an incredible job under really difficult circumstances, especially given the effects of the pandemic—and the implementation support note.

I would be really disappointed if I was to hear of a recent example of someone being dismissed in the way that you describe. I do not know how recent Murdo Fraser’s example is or the one that you have given but, because of the amount of work that we have put in, I would be upset if there was a recent example of someone being dismissed by their GP. Dr Harden might want to come in if there is anything further to be said on that front.

We have been taking a lot of advice from GPs. For example, Dr Amy Small, who has given evidence to the committee, has attended some of the meetings that we have had on the issue.

The short answer to that is yes. We have already provided additional funding to Chest Heart & Stroke Scotland, but I am very keen to see what more it can do. As you know, it is working on a unique digital pathway with NHS Lothian, and NHS Lothian wants to use its allocation of the £10 million funding for that work. I am very keen to see the evaluation of that and to make sure that we do not suffer from what I often call pilotitis—if the pathway is working well, let us make sure that we get it rolled out even further. I am keen to see how that particular programme in NHS Lothian is working.