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Will the member take an intervention?

The results of the Scottish health survey for 2021 were published earlier this week. The summary report says:

“Average levels of mental wellbeing ... were lower in 2021 than in 2019”.

The survey highlights that the experience of

“Depression, anxiety ... attempted suicide and ... self-harm ... were ... more common in the most deprived areas.”

The figures highlight the Scottish Government’s failure to address the root causes of mental health difficulties, which has had a direct and detrimental impact on the mental health and wellbeing of the Scottish population. Importantly, the Government is failing to address the health inequalities that impact the most vulnerable people in our society. Will the Deputy First Minister clearly outline how the Scottish Government, across Government portfolios, plans to improve mental wellbeing in Scotland? Will he set out a timeline for ministers to report back on how the Scottish Government will eradicate the health inequalities that are deepening divisions in communities across my South Scotland region?

As the minister has said, the bill as currently constituted would allow people who are in very difficult financial circumstances to borrow money on the basis of a valuation of their items of around £1,000. It seems that, as you have said, almost every consumer debt and money advice organisation has highlighted the serious pitfalls that that presents for people who are struggling with debt—in short, a bill that is designed to help businesses is suddenly incentivising irresponsible lenders to target individuals in financial distress.

I am glad of the minister’s answer. However, will he seek to speak with colleagues in other portfolios to amend the bill accordingly?

I take this opportunity to thank all my colleagues on the Health, Social Care and Sport Committee for the work that they put into the report. I am pleased to open the debate for Scottish Labour. My party fully supports the report and looks forward to seeing its recommendations coming to fruition.

There is a lot in the report that the Government must act on. If it fails to do so, it will let down many people who would benefit from the great reform that is outlined.

I am confident that we can, with the right approach and good will, take into account the testimony of experts and the public on matters as important as self-referral and patient records, and that we can, in doing so, make Scotland a real pioneer in championing alternative pathways to primary care.

A key takeaway from the report is that the Scottish Government has failed to explain and promote its vision for primary care and to say how it will adequately inform patients of how to access alternative pathways directly. That is something that the committee heard time and again from people who deal with patients day in and day out.

The narrative that is spun by the Government—that there is wide public awareness of reforms to primary care—is simply not true, as is backed up in the report. Few patients fully understand the self-referral process. That is, in large part, due to a failure to properly inform the public of the changes and of how they can access services and make sense of the arrangements. We must do better on those points.

From Dumfries to Thurso, the way in which people can self-refer varies significantly—from location to location and from category to category. We need to help people to understand the processes in their areas so that they can access the services that they need. For example, although the option to self-refer to pharmacists, opticians and dentists is reasonably well understood in many areas, there is far less public awareness of the option to self-refer to services including audiology and mental health services. Given that the mental health services backlog is growing day by day, it strikes me that changes in that area could be of great benefit to many people throughout Scotland who are struggling. It would not be especially costly to the public purse to help people to navigate the system for mental health wellbeing and support.

The lack of a single electronic patient record is, of course, key to all the blockages. We heard that time and again, and the committee convener referred to it. Single electronic patient records would streamline the process by which people are referred to, and self-refer to, the alternatives to primary care. That is probably the single recommendation that we heard most consistently during the creation of the report. Although there is no doubt that there are serious logistical barriers, they can be overcome, so we must do better on that. Until that issue is resolved, wider understanding and use of the pathways will be limited. That begs the question why that is not the Government’s top priority: it has to be. I ask the cabinet secretary to respond directly to that in his closing remarks.

The Government has made commitments on workforce numbers and on increasing capacity in primary care. Time and again, those commitments have not been met in any serious way. Therefore, it is perfectly understandable that services that deal with referrals and advice are often overwhelmed. Understaffing leads to an unfair perception of the services among the public. We heard that as we collected evidence on how the public interact with the people who provide the services—in particular, in the new pathways. We cannot expect a first-class health service when staff are overworked and overtired, and when the patients and service users who come through are not fully aware of how the service works.

I have no doubt that the prevailing economic climate makes life difficult for all aspects of our NHS—not least staffing. However, the cuts that were announced last week are not justified. Some £400 million was slashed from key health and social care budgets. The direct impact of that will be incredibly harmful for some of the most vulnerable people who are in need of care, and it will make work on what is in the report all the more difficult. It is remarkable to me that, on the same day as the Scottish Government launched an awareness campaign encouraging people to get the right care in the right place, Scottish National Party ministers cut the primary care budget by £65 million and the mental health budget by £38 million. The reality of those cuts to ordinary people will be devastating, and they will make it very difficult for people to do their job of building sustainable first-class services.

The cabinet secretary will know that I absolutely agree that one of the biggest challenges that we face in Scotland is the current climate of austerity from the Tory UK Government. However, we must have more honesty in Parliament about the SNP’s inaction and inability to produce a vision of how we can make changes happen. It is really important that the Government health team looks at what can be done, as opposed to constantly talking about what happens because of Westminster and the Tories. I want the SNP to have a vision and to talk about the things that it can do. I understand that there are inflationary pressures, but one of the biggest things that we could do, of course, is ensure that we get a Labour Government when we get the chance. I ask SNP members to help with that, if they get the chance, at all.

As I have said, Scottish Labour is committed to getting primary care right for patients and staff. I ask the Government to reconsider the cuts and to ensure that we can make headway with the report and the excellent outcomes that we could have from it in Scotland.

To ask the Scottish Government what discussions the Cabinet Secretary for Social Justice, Housing and Local Government has had with ministerial colleagues on any potential impact on levels of personal debt of the inclusion of individual consumers under the Moveable Transactions (Scotland) Bill. (S6O-01529)

Training advanced clinical professionals is vital to ensuring that the NHS develops and improves the level of care that it provides. Allied health professionals from across Scotland, including many of those who were in this Parliament last month—there were nearly 100 of them—are seeing the pressures that specialised NHS staff face daily.

AHPs are our third-largest workforce, and their skills can and will improve patient outcomes. Will the minister commit to listening to and working with AHPs to ensure that they are supported and adequately resourced, so that NHS service planning includes pathways for AHPs to further develop advanced clinical roles, ensuring clinical leadership from them across health and social care?

I think that Nick Morris might be able to answer this question. I am interested to know whether the framework bill gives us enough information about some of the legislative stuff around adults with incapacity and mental health issues. Is there enough in the framework bill to help the transition with the multi-agency public protection arrangements and so on?

Thank you for that information.

Does anything need to be added to the bill to ensure that there is a statutory responsibility to enable carers to get breaks and support with breaks?

That is helpful. Thank you.