Seòmar agus comataidhean

My officials continue to work closely with NHS Grampian daily, and the Government remains committed to providing the health board with the support that it needs to stabilise and sustainably improve.

One of the initial stages of the escalation is the whole-system diagnostic that we have commissioned, which involves KPMG reviewing key areas of NHS Grampian activity. We expect the initial findings of the review to be available by mid-July. In turn, that will inform a tailored package of support and the agreement of an improvement plan for NHS Grampian, with detailed actions and timescales.

Yes, it absolutely will. I acknowledge, welcome and appreciate the work that Mr Stewart has consistently done to represent the interests of local staff, as well as patients. I agree that meaningful partnership working will be key in the successful development and implementation of NHS Grampian’s improvement plan.

The board must work closely with its staff and trade union and professional organisation representatives in its area partnership forum. It must ensure that it listens and responds to concerns that staff raise and that staff views inform future activity. Similarly, we expect the meaningful engagement of local clinical views, not least through the health board’s area clinical forum.

The Government’s assurance board will look for evidence of meaningful partnership working in the development and implementation of NHS Grampian’s improvement plan, so that we can benefit from front-line staff’s ability to see a way to navigate through the challenges, as Mr Stewart has rightly pointed out.

I very much appreciate Oliver Mundell raising this issue on behalf of his constituents and his tenor in doing so. As I come from an island community, I recognise that travelling for healthcare and other services is a challenge and is often necessary, but we want to minimise the level of challenge and make services as accessible as possible. Following Oliver Mundell’s representation, I will, of course, raise that concern with NHS Dumfries and Galloway and explore the alternative options that he has set out.

Yesterday, the Scottish Government set out the service renewal framework, which is about shifting the balance of care and using innovation and technology to provide people with more equitable access to services. The points that Oliver Mundell raises therefore very much align with our policy direction.

I want to make it easier for people to see their GPs, and I am taking steps to address the challenges that general practice faces. That includes ensuring that a greater proportion of new national health service funding goes to primary and community care. GPs play an incredibly important role, and we want to see more of them in Scotland. That is why we are determined to increase the number of GPs by 800 by 2027, with an additional 360 GPs having been added since 2017. As of 11 November 2024, the GP specialty training establishment in Scotland stands at just over 1,200 places, which is a record level.

I reiterate to Douglas Lumsden the point that I made in my first answer: that we have a record GP training establishment in Scotland, which currently sits at 1,200 places. We have more to do to ensure that trainees are able to get into employment, and we are working with the British Medical Association’s general practice committee on finding a sustainable route through the funding pressures, which are hindering the employment of GPs in Scotland.

I point Mr Lumsden to the Scottish graduate entry medicine programme—ScotGEM—which specifically covers rural medical degrees, to ensure that doctors coming through the system have rural medical training so that we can support rural communities that need access to general practitioners here in Scotland.

In October 2024, the Scottish Government published the transport to health delivery plan, which sets out commitments in relation to transport and healthcare across the work of the health and social care directorate and Transport Scotland. Through that plan, we will continue to work with national health service boards to re-emphasise the need for them to consider patient access as part of the care pathway. The plan also recognises that collaborative working among NHS boards, regional transport partnerships and other partners, such as community transport providers, is absolutely necessary in service planning and decision making, and that it helps to address patients having to travel longer distances to access healthcare.

I recognise that the BMA has set out its position that the percentage of the NHS budget that goes into general practice is not sufficient. That is why we are working with the BMA to increase the investment going into general practice. As I said in response to Carol Mochan, we have already increased general practice funding this year.

Further initiatives have come through the budget and through the programme for government, including the additional cardiovascular enhanced services that we negotiated with the BMA. However, I recognise Douglas Ross’s point that, if we are to truly shift the balance of care, we need to shift the balance of resource. I am currently working with the BMA in order to achieve just that.

I very much recognise the view expressed in Carol Mochan’s final point. That is why we are increasing our investment in general practice. We remain committed to increasing the number of GPs in Scotland by 800 by 2027. GP headcount has been consistently at more than 5,000, and the number of GPs has increased by 360 since 2017. This year, we are investing more than £2.6 million in a range of measures to support GPs to remain in the workplace.

We are also making good progress against our GP recruitment and retention plan, and we have established a national framework to support the development of early career fellowships. NHS Education for Scotland has completed its review of the GP retainer scheme, which will be open to new entrants from August this year.

The situation that Mercedes Villalba recounts is not only regrettable but unacceptable. That is an example of why we have escalated NHS Grampian to stage 4 of the escalation framework, so that we can provide additional assistance for it to improve its unscheduled care pathway. We recognise the difficulty in ambulance turnaround times at Aberdeen royal infirmary, which was part of the reason for the critical incident that took place before Christmas.

Everything that we are doing is to support a better flow of patients through the system, including through enhanced frailty services in the ARI, the call before convey work that the Scottish Ambulance Service is doing and an escalation in hospital-at-home services. The work in all those areas is to alleviate pressure on unscheduled care pathways so that the experience of Mercedes Villalba’s constituent does not happen to others.

The Scottish Government has increased NHS Tayside’s formula capital by 5 per cent for essential maintenance and equipment replacement. We have also approved projects to progress with multiyear essential maintenance upgrades for electrical and ventilation systems at Ninewells hospital and Perth royal infirmary, which will require more than £60 million of investment.

Over the next two years, we will also provide £12 million of capital funding to take over the lease of four general practitioner practices, which are Comrie medical centre, Stanley medical practice, Arthurstone medical centre and Nethergate medical practice.

We are also working with all health boards to develop a whole-system national health service infrastructure investment plan, and we will shortly be asking NHS Tayside to identify its three strategic capital priorities.