Seòmar agus comataidhean

I put on the record our thanks to all who participated in the citizens assembly.

One of the key weaknesses in participatory democracy is the lack of information about what will happen after the process, and there can be unclear assurances about how recommendations will be implemented. It is particularly important to retain the trust and enthusiasm of young people. Will the minister outline how we can ensure that people who participate in assemblies and other processes are clear about how their recommendations will be taken forward?

I have concerns about the booster vaccination roll-out in NHS Lanarkshire. Reportedly, there are nearly 5,000 housebound people in the health board area who are waiting for their boosters. I have been contacted by constituents who are housebound but have not been registered as such and have been given appointments at vaccination centres that they cannot possibly attend. Will the cabinet secretary look into the matter, and at whether further support can be provided to NHS Lanarkshire to help it to work through the backlog?

I welcome the First Minister’s emphasis on testing and the addition of lateral flow device tests to the vaccination certification scheme. What is the Scottish Government doing to widen the range of venues and settings where packs of lateral flow device tests are available, to make it easier for more people to test themselves? Do we have a sufficient supply of tests to cope with any resulting surge in demand?

Sadly, alcohol-related deaths in Scotland rose by 17 per cent in 2020, to 1,190. Those devastating figures emphasise the point that action must be taken and that a range of methods, including minimum unit pricing, should be implemented to tackle harmful alcohol consumption.

I know that the Government plans to consult on the marketing of alcohol. Will the First Minister consider implementing other measures, such as mandating nutrition and health information on alcohol labels and placing a social responsibility levy on alcohol retailers?

The pandemic has been an extremely difficult time for all those who are learning and working in the NHS, and I, too, express my sincere thanks to them for their efforts.

We know that the NHS workforce was under pressure before Covid and that the pandemic has intensified that pressure, and it is vital that every avenue is explored in efforts to ensure that our NHS has the staffing levels that it needs. However, it is also important that any decisions are made with a view to the long-term impact.

In its statement about today’s debate, the BMA said about the Conservative motion:

“Simply taking steps such as these without a proper, strategic long-term plan for our whole workforce could potentially be counterproductive.”

Right now, we have staff shortages in the NHS, and the staff who are in post have experienced huge increases in their workload. That means that the number of clinicians who are available to engage in teaching and training is reduced. Any move to increase medical student places must take account of that, or we risk piling even more pressure on existing staff and creating bigger class sizes with fewer teachers, which, as the BMA has warned, could affect the learning experience.

In the wake of the pandemic, proper workforce planning will be essential if we are to secure the sustainability of the NHS, but that must be long-term strategic planning that anticipates how the decisions that we make now will affect the workforce in future generations. The BMA has also warned that, if the Conservatives are proposing that we lift the cap on Scottish students without increasing student numbers overall,

“there are issues around how that is done fairly and appropriately.”

Increasing student numbers is, of course, an important part of long-term workforce planning, but we must also look to the short term. We need to retain the staff who are in place now, but that will become increasingly difficult while the pressures on the NHS continue to increase. Staff are exhausted. They are worn down and burned out. Mental health support will play a key role in supporting the workforce, and I have heard positive feedback about the national wellbeing hub, although it is only part of the picture.

Fundamentally, we need to improve working conditions for staff and ensure that they feel valued and that their contribution is recognised. I have been dismayed by some of the questions that have been asked in Parliament about why GPs are “not seeing patients” or when GP practices can “reopen”. GP practices are open and GPs are seeing patients. General practices in Scotland deal with more than half a million appointments every week. There are, of course, on-going issues with waits for appointments, and I do not want to minimise the distress that that is causing to patients. People are waiting for far too long, which is unacceptable, but that is due to the immense pressure that is being placed on GP services and it is not because their doors are shut to the public. We do GPs a disservice by pretending otherwise, and that will certainly not help retention.

I turn to widening access. I welcome the Scottish Government’s commitment to doubling the number of widening access places to help to create a more diverse medical workforce. The NHS needs to reflect the diversity of Scotland, and there is evidence that a diverse workforce can improve the quality of care. Widening access is essential from a social justice perspective, but it also has numerous benefits for the NHS and patient care.

We know that students from the poorest 40 per cent of neighbourhoods are less likely to study medicine, or the other professional courses such as law, veterinary medicine and architecture. People who are care experienced, young carers and asylum seekers might also be less likely to study medicine. That means that we are missing out a significant pool of people who could go on to become excellent clinicians. That is to our and the health service’s detriment, and it needs to change.

Previously, I asked about flu vaccinations for those who are not prioritised for the Covid booster but are normally eligible for the flu vaccine. The NHS Inform website gives no information about how someone can get their flu vaccine if they are not in one of the Covid priority groups and are in an age group for which the JCVI has not approved a booster. How can those who are susceptible to flu get their vaccine?

I have been contacted by a constituent whose twin babies were born prematurely on 21 October at University hospital Wishaw. I send them our congratulations. They were then transferred to the Victoria hospital in Kirkcaldy, as the special care baby unit at Wishaw was closed due to staff shortages and a lack of available cots. It has now been three weeks, and my constituent and his partner are both living out of suitcases and sleeping in the neonatal unit on a fold-down bed. Will the cabinet secretary look into the matter and ascertain whether alternative arrangements can be made to get them closer to home, if not back in Wishaw?

I thank the minister for her indication regarding working together on my proposal for a member’s bill. Given that it will take quite a while for primary legislation to come forward and that there seems to be a legal impasse between the Scottish Government and local authorities, has the minister given any thought to what temporary measures we could put in place to ensure that women are not harassed when they access such facilities?

I am concerned about the vaccination of people whose priority group has changed since the vaccination roll-out started. Someone who was classed as being clinically extremely vulnerable or at risk but is no longer considered to be so will have received their initial doses earlier than others but might not qualify for a booster because of their change in status. The same could be said of people who were unpaid carers and whose circumstances might have changed because of the deaths of those whom they were caring for. When will people whose category has changed get their vaccine booster?

I will not do as good a job as the Minister for Parliamentary Business would have done.

Motion moved,

That the Parliament agrees to the following revision to the programme of business for Wednesday 10 November 2021—

delete

followed by Ministerial Statement: International Development COVID-19 Support – Partner Countries and Humanitarianism

and insert

followed by Ministerial Statement: Scotland 2045 – Planning for Net Zero—[Gillian Mackay]