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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 14 May 2025
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Displaying 1008 contributions

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Health, Social Care and Sport Committee

Alternative Pathways to Primary Care

Meeting date: 29 March 2022

Paul O'Kane

We have also had discussions—I have been slightly banging on about this—about the need to provide digital spaces in locations in our communities. An obvious example that comes to mind is libraries. I have spoken before about how we can use libraries—and improve and protect their services—so that people can access digital services where they need to. That does not necessarily have to be in the main, public part of the library; there are definitely spaces elsewhere where people can be supported to do that in communities.

In a lot of communities, particularly in rural locations, the GP surgery is one of the few amenities, so it becomes the hub and focus. A challenge or a barrier can be that people might not want to go online alone at home. How do we ensure that an increasing number of facilities are available to people in community settings where they can access information and advice, or indeed get a consultation, online?

Health, Social Care and Sport Committee

Subordinate Legislation

Meeting date: 29 March 2022

Paul O'Kane

Thank you for the statement, cabinet secretary. As you outlined, the legislation attracts a degree of support. My question relates to the responsibility for enforcement. The big challenge with many such interventions is that if they are not enforced, people will often become frustrated. I note from the meeting papers that the duty to enforce will fall on local authorities and their environmental health officers. What does that mean in terms of financial implications for local authorities? I refer to my entry in the register of members’ interests as an out-going local authority councillor.

We know that, throughout the pandemic, there was extra pressure on environmental health teams due to enforcement of coronavirus regulations, and we know that that came with a cost. I notice from the paragraph in the report on financial effects that there will not be additional funding, because it is expected that additional costs will be covered from existing budgets. However, I am sure that the cabinet secretary will agree that local councils are stretched, and that there are huge challenges with the finance that is available. What scope is there to review the workload as the legislation is implemented and to consider what extra resources might be required?

Health, Social Care and Sport Committee

Subordinate Legislation

Meeting date: 29 March 2022

Paul O'Kane

Does the cabinet secretary feel that there is scope to extend that? We now have a number of new-build health and social care centres—very often in our town centres—that are well used, have treatment rooms and all the rest of it, so is there a sense that we should be looking to extend that ban across the estate more widely?

Health, Social Care and Sport Committee

Alternative Pathways to Primary Care

Meeting date: 29 March 2022

Paul O'Kane

My question follows on from some of those that have been asked already and is about the data that is available. Figures from Public Health Scotland show that the number of whole-time equivalent GPs has gone down: we are at the lowest level since 2013. Although the head count is going up, the whole-time equivalent number is a better yardstick in helping us to understand the picture of services across the country.

We have not had any figures on whole-time equivalent GPs since 2019. I do not know whether the cabinet secretary has any information about that; if so, the committee would be keen to see it and to know where we are with whole-time equivalent GPs. Can you commit to providing that information?

Health, Social Care and Sport Committee

Alternative Pathways to Primary Care

Meeting date: 29 March 2022

Paul O'Kane

Receptionists are not the only staff in GP practices. We have heard about signposting and gatekeeping and all sorts of things, and we had some good evidence from Dr Graeme Marshall, who talked about reception teams training with clinical staff and the more administrative staff. Do you see any opportunity to standardise some of that training?

Because of the nature of GP practices, this would be hard, but perhaps we could look at the pay and conditions of those on the more administrative side and how we might enhance their roles. After all, we know that they are doing more than just answering the phone and talking to patients.

Health, Social Care and Sport Committee

Alternative Pathways to Primary Care

Meeting date: 29 March 2022

Paul O'Kane

We have heard evidence from patient groups, particularly the Riverside patient participation group, which I think is from Musselburgh, about digital exclusion and health needs. Those two things coincide. We understand that approximately 10 per cent of the population do not have access to new technology or the skills that are required to use it, and that those people are the most likely to have the greatest health needs—there is a clear correlation. I am keen to get a sense from the cabinet secretary of how those patients’ routes into primary care can be protected and enhanced, given the challenges.

Health, Social Care and Sport Committee

Subordinate Legislation

Meeting date: 29 March 2022

Paul O'Kane

To follow on from that point, I understand that the regulations cover hospitals, particularly—

Health, Social Care and Sport Committee

Alternative Pathways to Primary Care

Meeting date: 22 March 2022

Paul O'Kane

A lot of the answers and discussion have been peppered by mention of the barriers that exist to accessing the sorts of pathways and interventions that there are. I am interested in your views about the potential for the exacerbation of inequalities.

Roseann Logan talked about the need for support and for someone to be accompanied to certain activities and have that intervention. In its written evidence, the alliance spoke about some of the challenges in relation to passes for sports and leisure activities. For example, if someone has never had the support to learn to swim and is given a leisure pass that ends after six weeks, would that increase those barriers, because that person would feel like it did not help them? Related to that, is the financial barrier to being able to continue with some of those activities after that six-week period too high? I am sorry—I appreciate that that was a lot. I drew some of that from the alliance’s evidence, so does Roseann want to start?

Health, Social Care and Sport Committee

Alternative Pathways to Primary Care

Meeting date: 22 March 2022

Paul O'Kane

Good morning, panel. I want to follow the path that other colleagues have been going down on digital exclusion. We have heard evidence from patient groups—in particular, the Riverside patient participation group from Musselburgh, which noted that approximately 10 per cent of the population has no access to new forms of technology, or does not have the skills that are required to use them. Given that those patients are most likely to have the greatest health needs, what else can we do to protect their right to access primary health care? Would Chris Mackie like to go first?

Health, Social Care and Sport Committee

Alternative Pathways to Primary Care

Meeting date: 22 March 2022

Paul O'Kane

I want to explore that further. Chris Mackie’s point about who can support and advise is interesting. I am keen on what we can do in libraries in Scotland. I raised that point previously with Citizens Advice Scotland, which talked about some of its services. I am not sure, however, that there is universal coverage by such services. There is an opportunity to do more on that. Do the witnesses have reflections on that? Do the people whom Adam Stachura deals with through Age Scotland, for example, interact with library services?