Seòmar agus comataidhean

Thank you.

I want to ask a wee bit about capital investment. The Scottish Government previously said that it intended to publish a capital investment strategy for health. Do you have any clarity on when that might happen?

That is helpful to know. During those discussions, will we get some clarity about the pause on the national treatment centres? Is that something that you are considering?

To ask the Scottish Government what action it is taking to improve the recruitment and retention of nurses, in light of recent reports that the number of students accepted on to nursing courses remains below its targets. (S6T-02253)

This is the third year in a row in which Scotland has failed to fill places on nursing courses. There are currently 2,380 whole-time equivalent nursing and midwifery vacancies in Scotland and we know that there has been a reduction in the overall number of nursing posts advertised here. What is the Government doing specifically to ensure that those studying nursing are guaranteed a job when they qualify?

The cabinet secretary is correct that the Government-led nursing and midwifery task force should play an important role in improving recruitment and retention of the workforce.

However, there is little clarity in the proposed budget about how the task force’s recommendations will be fully delivered. Does the cabinet secretary agree with me on that, and can he confirm that he is committed to fully resourcing the delivery of those important recommendations?

While you were speaking, the opportunity for people who are in training to go to the islands came to my mind. Do you think that more could be done in that regard so that people see the benefits of the work that is done there, and also the lifestyle, which they might be interested in?

For me, as a member of the Health, Social Care and Sport Committee, our inquiry into remote and rural healthcare painted a sobering picture. Patients who live in such areas face unique challenges in accessing healthcare, so I welcome the debate, which will enable us to have an open and frank discussion about the harsh realities that are experienced by so many Scots who live in those areas.

The oral and written evidence that the committee received only reinforced what we—and, I believe, the Government—already knew: that remote, rural and island communities experience greater inequalities in accessing healthcare when compared with communities in urban and central areas. The fact that someone lives in a remote and rural community should not limit their access to basic and specialist care. Why do cancer patients in remote, rural and island areas receive less specialist care? Why are maternity and gynaecology patients in such areas forced to travel long distances to give birth and attend appointments? Why do communities that have a particularly high elderly population have problems in accessing palliative care and support?

To address those issues and the others that members across the chamber have mentioned, the Government needs to be honest about how bad the situation is for many people in Scotland. The challenges to do with staff recruitment and retention are a major issue across the whole of Scotland, but they are particularly hard felt in rural communities, as we have heard. Even a small number of vacancies can cause huge challenges in running services safely. A lack of suitable training and development opportunities, unattractive pay and conditions, and a lack of access to affordable housing act as significant barriers.

The Government must work with trade unions, local government, professional bodies, training providers and NHS boards to discuss opportunities for creating better training, living and transport flexibility. “Cross-portfolio” does not just mean talking about it—it means actually delivering results across portfolios.

I also urge the Government to consider apprenticeship opportunities—perhaps that is what the cabinet secretary discussed earlier—for healthcare workers across our professions. At a meeting that I held last week, the British Dietetic Association conveyed its willingness to engage with the Government on that and to discuss how greater flexibility could be worked into the system to promote better uptake of apprenticeships in healthcare roles. I wonder whether the cabinet secretary will respond to that in his closing remarks.

Many professionals have raised the issue as a way of recruiting and retaining excellent staff from diverse backgrounds. However, despite what the cabinet secretary said in his opening speech, there seems to be a difference on the ground. Things do not seem to be moving very quickly.

I really appreciate that intervention. It sounds as if we could put some effort across the Parliament into moving a bit faster for those professions, particularly those that are highlighting to us that they really need this to happen in remote and rural areas.

A debate on rural healthcare cannot be complete without discussing maternity services, and I am sure that other members will raise that. Patients who live in my region of Dumfries and Galloway are all too familiar with the challenges in accessing pathways and services. As has been discussed many times in the chamber, expectant mothers in Stranraer are forced to travel an average of 75 miles or more to deliver their babies. That is unacceptable. The thought of having to make that journey while heavily pregnant makes me nervous, never mind expectant mothers. The Government is aware of that and must do more.

I fully agree with Douglas Ross. He has spoken about that often in the chamber.

On women’s health, accessing something as basic as gynaecological care should not require entire days of travel. The women’s health campaigner Rebecca Wymer has said:

“women make up 51% of Scotland’s population so gynaecology is not specialist care. Gynaecology is a basic human right”.

Therefore, we should have those services in rural areas.

Alcohol consumption remains a prominent problem in Scottish society, but remote and rural communities are particularly disadvantaged when it comes to prevention and support. I hope that we can talk more about that. We should be talking more about the relationship that Scotland has with alcohol.

The Government must listen to the vast number of charities, unions, health boards and patients that are crying out for reform in our rural health services, because one size does not fit all. We are discussing problems with rural NHS services that I think have been exacerbated by poor decision making and governance. We need more honesty about what is actually happening to patients out there. The challenges that are being discussed today are real. In a country that prides itself on universal free healthcare—as I know we all do—it is frankly shocking that this Government has allowed things to get so bad. I hope that we can work to get things done, because the situation is not good enough at the moment.