Chamber and committees

Good morning, everybody. You have touched a lot on integrated services and partnerships, which I was going to ask about. Dr Stark has just mentioned poverty, which we know is a huge contributory factor in mental poor health.

I note from our papers that the Promise Scotland’s “Family Support” document outlines 10 principles of intensive family support that will be embedded in practice. I will not read out all 10 principles, but they include

“Community Based ... Responsive and Timely ... Work with Family Assets”

and

“Empowerment and Agency”.

A submission to the committee from Darren Little, of Dumfries and Galloway children’s services strategic and planning partnership, referred to the need for

“Multiagency strategic planning and implementation at a local level”.

We know that, if people work better together, that will support better outcomes. What impact would greater integration of services have on the demand for CAMHS and on service delivery? I will go with that question first, and then I will wind my other two questions into one.

Yes—to Shelley Buckley, and then to Sam March.

We are talking about cross-border co-operation with the EU, but there is also cross-border co-operation with our neighbours south of the border. I am thinking about zoonotic diseases such as severe acute respiratory syndrome, middle east respiratory syndrome, swine flu and avian influenza—even Creutzfeldt–Jakob disease, in the past. We need to make sure that all the scientists are working together. Will the framework improve co-operation within the UK, so that everybody shares their scientific knowledge and we are better prepared for any future pandemics that we need to worry about?

Having read our papers, I think that, when there are changes to legislation in England that could impact our healthcare system in Scotland, we need to ensure that the cabinet secretary keeps us informed and that we have an opportunity to pay attention to what is being taken forward. Especially when we are in a remote-working environment, it can be difficult to pick up non-verbal information, look at what we need to do and ask the right questions, so we need to ensure that the committee is kept fully informed about this kind of issue.

I have a couple of questions about stigma, which was one of the issues that Professor Hazel Borland mentioned in her opening comments. It is good to see you here this morning, Hazel.

I will cite one example in our committee paper relating to stigma. There is a summary from the Promise in August 2020, which talks about the language that we use and explains how we should not use stigmatising language. There are also specific examples of how to act, such as not showing up in branded cars wearing lanyards or in uniforms outside people’s homes or schools. Can Professor Borland talk a little bit about what actions could or should be taken to continue to tackle stigma so that families feel confident that they will not experience stigma when accessing help?

It is just a quick question to ask Dr O’Kelly to clarify a matter. If a person needs anticoagulant therapy, which would require them to have an extended pre-operative assessment and may even affect their post-op recovery, leading to a delayed discharge to enable the anticoagulants to be managed, that would be covered as part of the mesh removal procedure. Is that correct?

It has—

Sure; thank you.

My other question is on the flipside of that. If somebody acquires a complication because of mesh removal surgery, such as urethral transection or something in the ureter that requires additional surgery, such as a urostomy, is that covered as something that happened because of the removal surgery?

As a former healthcare nurse who worked in operating theatres, I am very keen that clinicians, scientists and experts work together, because it is through knowledge sharing that we will tackle this pandemic and any future concerns with regard to suppressing future pandemics. I know that a pandemic committee has been established in Scotland, too, so there are lots of experts around the table. However, are we good at information sharing at the moment? How can we avoid duplication and different people doing the same kind of work?