Chamber and committees

Mr Macaskill mentioned the relationship involving private home care providers. I suppose that you could say that it is contract based; indeed, it is very much seen as an internal market. Is that part of the problem? When I talk to home care workers, they tell me about their 15-minute visits and having to be on and off the clock. Is there a real disparity between local authorities’ treatment of their own workers who provide care and of those who are employed by the third sector or a private provider? If so, should we start by looking at where best practice is and trying to go towards it?

If a nightclub owner did not enforce the passport, they would be in difficulty. All I will say to you is that you need to take the same approach to retailers. If you are not prepared to take that approach, we will see people ignoring the fact that they should be wearing face coverings in shops, particularly—as I have seen first hand—people in our younger generations.

Coming to my last point, what kind of pressure is being put on the NHS as a result of the growth of private healthcare in Scotland? I read just recently that demand rocketed in the period from April to June this year by more than 1,100. There were 3,400 patients, which was up from 2,300 over the same period last year. The figure for cataract surgery, for example, was up 85 per cent in private hospitals; the figure for hip replacement rose by 144 per cent.

In this country we seem to be moving to a position where the private sector is investing more and more, and there is more growth. That must be putting pressure on NHS staffing. Are you content about the growing situation where the only way that someone who needs a hip replacement or some other kind of medical treatment can get it any time soon is by going private and buying it, if they have the money. For those who cannot afford it, that goes against the very principles upon which the NHS was established.

On you go.

I have a quick question. Returning to schools and the short-term, or the here and now, as we head into winter, the Scottish Government has continued the policy that face coverings should be worn in schools, but what is your immediate advice for education authorities? Education authorities have property managers that manage the school estate, but do they have the required skills and knowledge, or do we need to bring in advisers? Earlier, Murdo Fraser mentioned a figure of £10 million, which is not a lot. What would you advise the Government and education authorities to do in the short or immediate term as we approach winter?

As far as the legislation is concerned, genuine concerns have been expressed about the lack of scrutiny and the lack of evidence to support its objectives. As we have seen this morning, you cannot just claim that the increase in vaccination rates amongst young people is down to the scheme. There is also a danger that if organisations, companies and so on start to mandate the use of the vaccination passport among their employees, enforcement will become the only tool in the box.

That is the main point that I want to make: I am not convinced that the Government is on top of the other measures that have been put in place for the majority of people who do not go to the venues where the vaccination passports are used. Those people are still being put at risk. For example, I have previously raised the issue of retail, and shop workers are still telling me about people, particularly the younger generation, going into shops without face coverings. Indeed, I have seen that with my own eyes.

Going back to Brian Whittle’s earlier point about the best use of resources, can you tell me what resources are being put in to ensure that these other measures are effective? When a senior member of the UK Government’s advisory board resigned the other day, one of the key points that he made was that face coverings were not mandatory in England when they should be. Although they are mandatory here, people are simply ignoring that. The passport is easy to enforce, because nightclubs and other venues have to do so or pay the consequences, but lots of other companies and retail outlets elsewhere are simply ignoring things, with staff being told that they cannot approach people to tell them to wear a face covering. The more that that happens, the more that people will not do it.

With regard to vaccine hesitancy, are you doing enough to counter the anti-vaxxers and the messages that they are putting out? There will always be people who see this as a big conspiracy and so on—you will never sort that—but the misinformation that they are putting out is spreading on social media. I am amazed at the number of people who are quoting stuff at me that sounds very plausible, and that sort of thing is growing. As I have seen at first hand, there is a massive danger of your taking your eye off the ball on vaccination uptake and the other measures that I would argue are far more important in countering the anti-vax messages out there and the very real threat to the vaccine itself.

You need to look at retail, but I have two other points. My first is on the policy that the Government has announced on redirecting people from accident and emergency departments. Dr Andrew Buist, the chair of the British Medical Association’s Scottish general practitioners committee, has said:

“This is about proper resourcing across the whole system. A and E is under massive pressure, so are GPs and this should not result in everyone being redirected from A and E to their GP practice.”

Last week, we discussed with Professor Leitch, among others, the difficulties that people are having in trying to get face-to-face appointments. Will the policy put more pressure on other parts of the system? Is the Government looking at the whole of the NHS? If the Government is trying to redirect people and keep them out of accident and emergency departments, but they cannot then be signposted to where they need to go, what is the point?

I simply say to you that we on this committee have been warning for weeks now that, if primary care and community care are failing, people will end up at the door of accident and emergency—and that is what we are seeing happening. If they are then being sent back into another part of the health service that is failing, that is not going to work.

I will come now to my third point.

I appreciate that. Most MSPs will be getting correspondence from people about the boosters. I saw a couple of pieces of correspondence yesterday. One was from a person who had gone to the website where they saw that they had an appointment in a couple of days. However, they were still waiting for a letter, so there seems to be a problem there.

I also note that boosters for over-80s in Cowdenbeath and Lochgelly are not due until November at general practices, but people who are in their 70s will be getting their boosters before that, even though the over-80s are more at risk.

Is there a specific minister or email address to which MSPs can channel such issues? We seem to have to go round the houses. If we go to ministers, we do not get a response for weeks or sometimes months. If we try to go through our NHS board, we are sent to a website. The situation is a real worry for people in their 80s and 70s, so is there something that we can do to ensure that people who have concerns have somewhere to take them where they will get a response?

Thank you. Everybody understands that the NHS is under immense pressure. Staff are, frankly, under too much pressure. Something will have to give at some point, if we do not get a hold of things. You can understand the worry for people in their 70s and 80s.

I will pick up on death rates. It was said this week that the number of deaths registered in Scotland from all causes was 24 per cent more than the five-year average. I know from people who have contacted me after having struggled to get a GP appointment or to see anybody in a medical centre that they have eventually presented themselves at the hospital, where they have found out that they have cancer or something, and that it has moved on by some stages. Are you aware of that? To what extent is it an issue? Are you monitoring it? Are excess deaths a result of community and other parts of our NHS being shut down? Where are we in relation to general practices giving people appointments when they say that they need an appointment because they feel ill?