Chamber and committees

Okay. That is good.

John Mason has made the point that the virus is not over. I hope and pray that we do not have other variants that mean that we have to go backwards again, but there is no certainty in any of that. I think that, given where we are, given where we have been and given the level of Covid just now, the majority of people in Scotland believe that the restrictions are not unreasonable. In fact, somebody said to me the other day that everybody knows somebody with Covid, so I do not think it unreasonable for us to have some protections, such as face coverings.

In a BBC television interview last night, somebody said that if, after all the suffering that there has been in Scotland, the worst that we had to suffer was having to wear a mask for a few more weeks just to have those protections, such a proposal would be perfectly reasonable. This debate is more about playing party politics than anything else. It is trying to create division where we should be creating unity, so I will certainly support the motions today.

I put to you the point that, although there is massive pressure on all resources, I believe there is a lot of resource out there. During last week’s evidence session—and sessions before it, with Dr Buist and others—when we asked whether health and social care, and social work in GP practices, is working on the ground, the answer was that it is hit and miss. The issue is not just about resources; it is also about leadership and management. I would have thought that that must be about leadership from the top.

I had a look at a Public Health Scotland statistical report and at a Scottish Parliament Information Centre report, which said that the number of cancer deaths recorded as having taken place at home or a in non-institutional setting in the early months of the pandemic was substantially higher than those that took place in hospital. That trend seems to have continued.

In the NHS Fife area, the average number of daily occupied beds for palliative—hospice—support dropped from 20 down to nine, although 22 beds were available. The percentage drop in occupied beds was down from 86.3 per cent to 39.7 per cent.

Fife has the lowest number of occupied beds, by the way. I think that NHS Highland is next, with about 53 per cent occupied. What will be done about that massive drop? We know that some people want to stay at home when they are dying, but some families want a higher level of support and that seems to be missing.

I agree with the Deputy First Minister about the testing staff. I have been for a few tests in winter weather in Dunfermline and Cowdenbeath, and those people have worked through it all. They deserve our gratitude and thanks.

Given that we are going to scale back that work, how many staff are involved? Is the Government saying that health boards should start to look at a programme that will give people opportunity? We know that we have staffing shortages throughout the economy, and we certainly have tonnes of shortages in social care and the NHS. Are opportunities being put in place? Is there a programme for working with people who have given their all during the past year or two and getting them into other posts? Is there a plan in place for that?

That leads me to my next question, which I also asked the Cabinet Secretary for Health and Social Care. In the past couple of weeks, we have taken evidence from third sector organisations that have said that joined-up working can be a bit hit or miss. Some health authorities welcome those organisations and they have an input, but others have to wait until they are called upon. It seems to me that there is a massive resource problem, but there is a massive resource out there in the third sector, health and social care, the NHS and local government, and I am not sure that it is all coming together. We have also asked GPs whether they have all those support services around them, and even they have said that it is a bit hit or miss.

That is a question of leadership. Government is not about micromanagement, but surely we must ensure that we are getting the best from the resources that we have out there. Do you think that we are?

You have spent £40 million on it. Is it delivering the results that the Government expected?

Cabinet secretary, you made reference to the evidence that we have taken. Last week, Lawrence Cowan from Chest Heart & Stroke Scotland mentioned that the British Heart Foundation had done a study

“that showed that there have been significant increases in unhealthy behaviours, such as eating unhealthily and smoking, and an increase in isolation and loneliness.”

That then went on to look at poverty specifically.

Peter Hastie, whom you mentioned, said:

“Health inequalities remain at the heart of everything that Macmillan Cancer Support wants to do. If a person lives in a deprived area in Scotland, they are more likely to get cancer, to be diagnosed later and to die. I cannot see how it would be possible for the pandemic to have improved that situation.”

In the same evidence session, Rob Gowans also said:

“A number of things need to happen. We know that the number of excess deaths in the most deprived areas is twice what it is in the least deprived areas. We need better data and, in particular, data that is disaggregated by age, sex, race and other aspects”

of socioeconomic background. There is a question in that about the data that we are collecting, as well as a question about prioritising and focusing on the most deprived areas, and what we will do about that.

At the meeting, I asked Lawrence Cowan about joined-up working. I assume that we all agree that we do not see the NHS as being just about acute services; we know that there is a primary sector and a local authority sector. It is quite worrying that he said:

“At the moment, we are doing a lot of partnership working with health boards, which is really positive. However, we are doing the running on that and it should be an automatic system, so that when a patient is discharged from hospital, they are discharged automatically to a wealth of services. That happens in some areas, but not in others.”—[Official Report, COVID-19 Recovery Committee, 10 March 2022; c 8, 10, 9, 9.]

I recognise the pressures that NHS services are under, but it seems to me that there is massive resource that we are not pulling together—that is, joined-up government. What is your view on that?

Thank you.

I will ask a question about the redesign of urgent care. I read an article this morning that suggested that £40 million had been spent on that but the results were not great, so you have now commissioned consultants at a cost of £84,180 to review that redesign. Where is that work at, and what is working and not working?

The Health and Social Care Alliance highlights that health inequalities have widened during the pandemic. In its submission, Chest Heart & Stroke Scotland says that cases of poor diet, lack of exercise and isolation all increased during the period. What action does the Government need to take? Is the data available to demonstrate clearly that people from lower socioeconomic backgrounds have poorer health and that the impact on them has been greater?

In relation to Chest Heart & Stroke’s submission, a wide and varied range of public services are out there; we are not just talking about health services. Is any planning taking place? Should specific planning be done on inequalities and deprivation in order that we can recover from that?