Chamber and committees

Those groups have said to us that a plan does not exist.

On that point, how do you respond to the evidence that we were given by Dr Srireddy from the Royal College of Psychiatrists in Scotland, who said:

“We made the shift, we shut the asylums and we have moved into the community—but then we kind of lost interest.”—[Official Report, Public Audit Committee, 16 November 2023; c 18.]

The Royal College told us about the reliance on locums and other members are going to ask about the workforce plan.

Dr Srireddy also said that governance has been a real challenge and spoke of fragmentation. You may not agree, but his view and his members’ perspective was that mental health was, in his words, an “afterthought”.

We also have a pretty clear message in the report from the Auditor General and the Accounts Commission, in which key message 3 says:

“The system is fragmented, and accountability is complex, with multiple bodies involved in funding and providing mental health services. This causes complications and delays in developing services that focus on individuals’ needs.”

Those are quite serious charges. How do you respond to those?

Without batting in defence of homogeneity, we are looking for a bit of consistency, and there seems to be a very mixed picture across the country. That is why, as a committee, we wonder whether you have thought about some of the evidence that we took, in which there was a concern about the legal framework that integration joint boards, for example, operate in. Are you considering reviewing the governance arrangements to see whether they can be simplified, be made more effective, provide better value for money and be more accessible to the people who need the services?

Is the Government looking at primary legislation or at making changes to the oversight and delivery model?

This goes back to at least 2018; I remember raising the matter in Parliament back in the spring of 2018. The last time I spoke to families with lived experience, they were still perplexed, at best, that insufficient progress appears to have been made and that people are still not getting access to the services that they need. Do you recognise that picture?

In the interests of time, I will move things on and invite Colin Beattie to put some questions to you.

I will finish up by asking a little bit more about the funding situation, but I have another question before I get to that. You mentioned that many mental health issues are not, at the end of it, directly your responsibility as the director general of health and social care, but are a function of inequality in society, of economic and social deprivation, and of a lack of access to services. Will you tell us a bit more about what the Government can do, or is doing, to take a more whole-system approach to the matter?

That is the community wealth building model, is it not?

Can you give us reassurance that that is not just a passing fad and that it will be part of the approach to health and social care?