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I believe that it is for the social care side as well.

I can speak to a more local example that I am aware of. I declare an interest in that I am recused from Government decision making on the new Monklands hospital. However, from a constituency perspective, I am very aware of the close involvement of clinicians in that hospital’s design.

If that has not happened to the same degree in Broadford on Skye, I would be keen to know about that to ensure that NHS Highland and others can learn from that experience, so that we have projects that are informed by clinical experience to ensure that we get them right.

Again, that goes back to the discussion around the nursing and midwifery task force and looking at how we make sure that we are set up to take advantage of the existing opportunities that are available in higher education institutions. The training places that we have available are not fully subscribed, so for those considering a potential career or a career change, look at the opportunities in your local university. There is also the nursing bursary to help to support a transition to or an entry into nursing.

Stephen Lea-Ross referenced the helpful example of the Open University work. I am very keen to look at what more can be done—the discussion is happening at the task force—around the earn-as-you-learn pathway and whether there are more opportunities for that, so that people can either shift within the health service or come into the service.

To get directly to Ms Maguire’s point about training being delivered as locally as possible, we will continue to work with higher education institutes to see what more is possible, particularly for remote and rural areas. I was at Robert Gordon University last week and saw some of the fantastic work that is being done there around nursing and paramedic training. There is real enthusiasm among nursing students for what they are embarking on and where they are looking to serve their time.

I hope that we can continue to provide that opportunity to others, particularly, for the benefit of this discussion, in remote and rural areas, so that we continue to have people to serve in the areas where we need service provision.

Ms Mackay strikes right at the heart of the clear challenge that we are facing in the health service and in how we move forward with reform. If resource was aplenty, of course I would be looking to invest far more in primary care services to help with the prevention work and in community and voluntary sector organisations that are doing incredible work across all disciplines.

As part of mental health awareness week last week, I saw some of that work from a mental health perspective in Aberdeen Football Club Community Trust’s work on the changing room extra time initiative. That is incredible work to prevent more acute presentation. If resource was aplenty, we would go there.

Ms Mackay is right that we have to continue to sustain services, but we also need to drive change. That is where I hope that we will all be able to come together to discuss how we move human and financial resource to ensure that we are improving people’s health in the first place.

That will be most acutely felt in rural and island communities. Paula Speirs talked about the fragility of some services, because sometimes they are provided on a small team basis and, if one person moves on or retires, the service is compromised. We need to continue with the workforce planning perspective, but we also need to look at prevention. Supporting people through hospital at home in rural areas, for instance, is an important innovation. The community care model that treats people as close to home as possible has better outcomes, but it also prevents further deterioration in their health that requires greater intervention in the acute settings, which is what we want to avoid.

As Ms Harper will be aware, there are particular challenges around those in island communities being able to get to the mainland to access services. That means that they often need to travel by plane, which is incredibly costly and requires quite a bit of logistical planning. Ms Harper asked a direct question on whether we would review the situation for people in other rural areas, such as Dumfries and Galloway—the area Ms Harper represents—and the Borders. I am always happy to keep the arrangements under review.

I am cognisant of the financial challenges that are being faced by patients at the moment amid the UK cost crisis and, when it comes to being able to provide any extra funding, Ms Harper will understand the financial fragility that we are living with in government. I am always happy to continue to consider the situation. If Ms Harper has individual examples of where things have proved to be problematic I would be happy to hear about that, in order for us to have an informed review.

Mr Gulhane will be aware of the Scottish Government’s reaching 100 per cent—R100—programme that invests in broadband and supplements digital connectivity as an area of UK Government responsibility. The roll-out is going well and rural communities are being connected in a way that they would not have been had it not been for the Scottish Government’s investment. Work is also being done on mobile connectivity by some of the service providers.

I am racking the back of my former economy briefing brain, but I would be happy to ensure that colleagues in the economy portfolio furnish Mr Gulhane with more information on some of the work that is being done with service providers in rural and island communities to improve the availability of mobile internet connectivity. He is absolutely right that making sure that those areas are able to access digital services is critical, especially when that innovation will be most needed by and will be most appropriate for some of the rural areas.

I appreciate the opportunity to speak to the two Scottish statutory instruments relating to the regulation of independent healthcare in Scotland.

First, the inspections regulations will allow any suitably trained inspector who is authorised by Healthcare Improvement Scotland to inspect medical records. Currently, the regulations state that Healthcare Improvement Scotland can draw on medical practitioners, registered nurses, pharmacists, and registered dentists to inspect medical records during an inspection. That change will enable Healthcare Improvement Scotland to be more flexible in its approach to conducting independent healthcare service inspections.

The second SSI is the modification order, which has three distinct purposes. First, it will widen the definition of an independent clinic, so that Healthcare Improvement Scotland will regulate clinics where services are provided by pharmacists and pharmacy technicians. That will not include pharmacies that are already regulated by the General Pharmaceutical Council or services that are provided under NHS contracts.

Secondly, the order will amend the definition of “independent medical agency”. That provision will now include services that are provided by dental practitioners, registered nurses, registered midwives, dental care professionals, pharmacists and pharmacy technicians. The updated definition will also regulate wholly online services that are based in Scotland. I believe that to be a particularly urgent and important change.

The final purpose of the modification order is to enable Healthcare Improvement Scotland to cancel the registration of independent healthcare services that fail to pay their continuation fees. The inability of HIS to remove services from its register means that, at present, services that repeatedly fail to pay their fees can continue to operate in Scotland. Making that change is likely to have a positive impact on the willingness of providers to pay the fees that they owe and the provision is intended to be used as a last resort.

We have engaged with stakeholders and the wider public throughout the development of the modification order and our public consultation received support for the changes.

The SSIs that are being considered today will ensure that HIS continues to have the power to effectively regulate independent healthcare providers in this growing sector.

There are frameworks in place around the integration of health and social care that should allow for some of those discussions to take place. Where there is an understanding on the part of IJBs and health and social care partnerships that there are particular workforce challenges in the communities that they are looking to serve, those discussions can start there and spread to other forums. However, of course, where we have that convening power or, indeed, where we can provide that guidance, we will continue to do so. There are good examples of some of that work being done already, and we need to build on those and try to provide that advice on a wider basis.

I am happy to share that with the committee.

To answer some of your other questions and bring it back into one answer, for the strategies and plans to be effective, stakeholders have to be consulted on them. In order for us to have an effective and sustainable health service and if we are to have a workforce strategy that means anything, the workforce and trade union representatives must be consulted and must be part of the discussion. They will absolutely be part of the discussion.