Chamber and committees

Thank you.

Cabinet secretary, you will be aware that I have written to you on a few occasions about specific issues in remote and rural Dumfries and Galloway, such as those in Stranraer. I appreciate your responses, so thank you for those.

I am interested in the centre for excellence for remote and rural health and social care. Sir Lewis talked about education, innovation and collaboration. I am interested in whether the centre will have a role to advocate for people in remote and rural areas, because those folk cannae access the self-help groups and the people who are in urban areas. I know that people use Zoom and so on to engage, so is there a place in the centre for excellence for advocacy to be supported or delivered? I know that Australia has a National Rural Health Commissioner. I am interested in those aspects of the centre for excellence.

My question is related to Sandesh Gulhane’s questions about Caithness and Moray and Dr Gray’s hospital. There is the same issue in Stranraer. I hate to go on about it, but women are delivering their babies at the side of the road. There are real recruitment challenges for Dumfries and Galloway in finding midwives for a midwife-led maternity unit at Galloway community hospital. I am not advocating that we start doing emergency caesarean sections—as a former operating room nurse, I have been there, taking babies out of people by crash section in a rush, so I am not advocating that we start doing that in Stranraer, for instance. I know that Maree Todd visited Stranraer in October last year to engage with the local Galloway community hospital action group and to visit the hospital.

The cabinet secretary does not have to respond to this today, but I know that there are real challenges in relation to midwifery-led units, and I am interested in getting an update on the work that is being done with NHS Dumfries and Galloway around maternity services being reinstated at Stranraer.

It seems reasonable that the order provides the GDC and the NMC with greater flexibility to amend their existing international registration pathways. I know that there are challenges with regard to access to NHS dentistry, especially in my region of Dumfries and Galloway. Will the order ultimately help us with recruitment of dentists and dental practitioners, especially with regard to the issues that are a consequence of Brexit?

I have a quick question on education and skills. The mobile skills unit was developed in order to deliver education in more rural areas. A big lorry-sized van provides simulated training for chest tube insertions or even intraosseous needle insertions, for example, and I know that it has been all over Scotland. Is there an opportunity to focus more on that kind of education delivery in remote and rural areas, using the managed skills network or the clinical skills network?

I am thinking about the need for an advocacy role because we have been looking at cancer pathways for more than 20 years. People from Stranraer, for example, go to Edinburgh for radiotherapy. That trip is 140 miles compared with 87.2 miles to go to Glasgow. That is an issue if we want to support people getting their care closer to home.

People in Dumfries and Galloway go to the South East Scotland Cancer Network, but nowhere in that region is in the south-east of Scotland. Are there opportunities to look at the cancer pathways to ensure that people in Stranraer go to Glasgow instead of travelling 140 miles to Edinburgh?

When Jeane Freeman was the Cabinet Secretary for Health and Sport, she advocated for people being offered choice. People might want to go to Edinburgh for radiotherapy if they have family there and they can stay overnight.

There are on-going challenges in supporting patients and managing expectations. I understand that people must sometimes go to other centres because there is no ability to deliver radiotherapy locally—the new hospital in Dumfries does not offer that treatment, for example.

I would appreciate some follow-up information, so thank you for your offer.

I have a final question about Covid. During the pandemic, services were changed and redesigned, and care was delivered differently. One issue was that people had digital appointments with their healthcare provider. What cost savings do you foresee being achieved by such approaches to service redesign, including, for example, the use of digital?

The cabinet secretary has mentioned spending on child and adult mental health through the communities mental health and wellbeing fund. Obviously, we can continue to monitor the support through and outcomes from mental health funding. We know about the challenges for our healthcare professionals and for everyone else. I am not sure whether the cabinet secretary needs to comment further on that, but I am interested in that specific aspect of funding to support people’s mental health in Scotland.

Good morning, cabinet secretary, and good morning, Richard.

Our briefing paper—the convener has mentioned this already—states that specific funding for Covid-19 no longer exists. We do not get any more money from the UK Government, so any funding for Covid-19 recovery has to come from the Scottish Government’s budget. I am interested to know, cabinet secretary, what level of funding in the proposed 2023-24 budget relates specifically to Covid-19 recovery.