Seòmar agus comataidhean

To ask the Scottish Government, in light of NHS Ayrshire and Arran suspending routine hospital visits due to a sharp increase in flu cases, whether it will provide an update on the action that it is taking to support NHS boards in relation to increasing winter pressures. (S6T-02794)

As the cabinet secretary outlined in his answer, vaccinations are the best way of protecting oneself from flu. Last year, the uptake of vaccinations was poorer, so why has uptake been so low this year? There are more than 300,000 fewer adults vaccinated now in comparison with the figure two years ago. Children’s vaccination rates are down, and some areas have had delays in administering vaccinations. Public Health Scotland has reported that all age groups are now affected at levels not previously seen at this time of year, and it has confirmed that cases of flu in Scotland have

“more than doubled in the past week”.

As the cabinet secretary said, prevention is key, so why were there delays in administering vaccinations, and why are vaccination rates significantly lower than they were two years ago?

I appreciate that expanding the apprenticeship model and earn-as-you-learn routes for healthcare workers across professions creates opportunities for people who might not have had the chance to attend university. It also offers the chance to grow skills in local areas. In the past, when I have asked about the apprenticeship model for allied health professions, the Government has pointed to the development of the next generation higher national certificate for AHP subjects, which could offer people a recognised pay-as-you-earn route into those professions. Has progress been made on that since the start of the year? When might we see those routes across the allied health professions?

To ask the Scottish Government whether it will provide an update on the action that it is taking to develop apprenticeship models for healthcare workers. (S6O-05252)

I extend my gratitude to all health and social care staff, who provide an extraordinary level of care and service to so many across Scotland.

Having listened to others’ contributions so far, it is clear to me that the value of social care and its workforce cannot be overstated. Social care provides invaluable and tailored support to thousands across the country; it improves quality of life and allows as many as possible to lead an independent life. However, we know that many are missing out.

Social care forms an integral part of our health system. However, as in many other areas of healthcare, a crisis has been growing in social care for quite some time. It seems as though, for 18 years, that has been blanked from the minds of the Scottish Government. With increasing demand, funding constraints and workforce pressure, the question of how we value and invest in social care has never been more important, but the question of how the Scottish Government values and invests in social care needs to be answered.

A failure to prioritise has fuelled challenges and, despite repeated warnings to the Government, health and social care partnerships now face serious budget shortfalls. That has led to local communities’ care packages being cut—“viciously cut”, as one carer described it—which is forcing people to wait months for necessary support. Integration joint boards’ finances are at risk of collapse, and the continued trajectory of overspend, depletion of resources and reliance on one-off, rather than recurring, savings has, according to Audit Scotland, left a £457 million funding gap.

The lack of funding for health and social care partnerships is not a new phenomenon—it has been a problem for some time. Year after year, the Scottish Government chooses to ignore it. The Government might cite the rising demand in the sector or in other areas as evidence that care is becoming more complex, but that has been exacerbated by a lack of funding in the first instance—the funding has just not kept up with demand.

Underfunding is not an isolated issue; it is a systemic problem that is seen right across Scotland. In my South Scotland region, South Ayrshire IJB faced an end-of-year overspend of more than £2 million, which has left the IJB with concerningly low reserves. That significantly limits its ability to respond to unexpected budget pressures. Levels of delayed discharge in South Ayrshire already sit well above targets. That is a symptom of overspend and a reduction in the funding that is available. There is a need to look at the root causes of that.

Of course.

Thank you. The reality is that we might talk about these initiatives, but when we talk to our constituents, we find that it is very difficult for the funding to follow. The crisis is such that, even though there are small pockets that we can talk about positively, they are not replicating themselves across Scotland, so many of our constituents sit waiting for care.

In closing, I make it clear that the long-standing underfunding of social care in Scotland is not a new problem. It is a direct result of mismanagement and, I think, a lack of leadership by the Scottish Government. Thousands are waiting for social care assessments and support; delayed discharges remain stubbornly high; and, as we have heard, the number of care homes has plummeted.

In the summer, I did a piece for the Scottish Parliament on whether we value social care in Scotland. This will be my last word—that the conclusion from not just me but the sector and carers is that we do not value it in Scotland. It is time that this Government valued social care, and the money should come forward for it.

I, too, thank Elena Whitham for bringing this important debate to the chamber. As the motion says, and as other members have noted in their contributions, bereavement is not always an easy subject to discuss, but all of us in the Parliament, and our constituents, will experience some form of bereavement at various times in our life.

Bereavement is a complex and very personal experience. Everyone is different and there is no single way to grieve. We will all know personally, having had our own experiences or from seeing family and friends grieving, that everyone experiences it in their very own way and that people have their own beliefs, rituals and plans to help them to deal with death. However, we also know that people struggle. People experience things that they never imagined they would, and life is not always kind when those moments strike us. Sometimes we are prepared, and sometimes we are utterly unprepared. It is for those reasons, and for many other reasons that members have mentioned, that we need good bereavement support to guide people through what is often a very difficult time.

From my research for the debate, it is clear that people need both practical advice, as other members have mentioned, and on-going emotional support. Registering a death, following the rules for burial and dealing with costs can be both practically very difficult and emotionally draining. The time that follows, grieving in the longer term, is complex for many people. As other members have said, there is no timeframe—people have to deal with bereavement and grief in their own way and in their own time.

We know from the UK Commission on Bereavement’s report, “Bereavement is everyone’s business”, which the motion mentions, that, although we might imagine that people have support networks, the data tells us that the situation is quite different. According to the report, 28 per cent of the adults who responded to the consultation said that they received no support from family and almost 46 per cent said that they did not get support from friends following bereavement. In addition, 61 per cent of the adults who responded said that they had difficulty with at least one practical or administrative task following bereavement. That makes us think: these things will happen, and people need support in place. Finally, more than 40 per cent of the adults who responded said that they had wanted formal bereavement support but did not know how to go about receiving that support.

People find the subject of death so difficult. My own story is that I remember once dropping off my kids at school and going over to another mum to say how sorry I was about the death of her father. In that moment, I could see that she was very upset, and the reason was that people were avoiding her, which was so difficult for her to deal with, on top of all the grief. She really wanted people to recognise her bereavement and to say something about the loss of her father, but clearly so many people were finding it difficult, and their reaction was to walk away and say nothing.

Many of my thoughts in this debate are about how we support people to be a support to their family, friends and colleagues when they are experiencing bereavement and grief. We will all experience the death of a loved one, and it is incumbent on us all to try to support people. I am pleased to see in the update to the report that there has been some positive work across the four nations. That includes looking at how we support people in employment with bereavement policies and how we do work in schools. The Scottish Government has done some work on a palliative care strategy, including bereavement support. There are also the organisations that other members have mentioned. People tell us how important those organisations are and, as a Parliament, we must make a commitment to them.

All the measures that have been mentioned are very welcome, but, as always, more needs to be done. That is why the debate is so important. It is important that we talk about bereavement in order to understand its impact and the profound changes that bereaved people can face in dealing with the practical and emotional consequences. I welcome the debate, and I thank all members in the chamber for contributing to it.

All my questions have been answered.

I think that the witnesses have already answered some of my questions, which are around training and competency. Just to be clear, there are voluntary standards, which we have been told will support regulation and improve safety, and I wonder whether you think that they will do that. Alternatively, do you think that we need to have mandatory training qualifications?