Seòmar agus comataidhean

Is it not easy to reach out to children in what I think you said we can no longer call “hard-to-reach areas”? At least everybody knows what “hard to reach” means. Children tend to be in schools and, if you visit schools, you can reach the hard-to-reach children there because they have to go. Is that not a simple answer to a question that has been made too complex?

We can consider our response later, but it occurs to me that one option would be to invite the minister back after he has had an opportunity to finalise the process. I entirely understand that he cannot prejudice the process and that he must properly consider the 780 consultation responses before coming to a conclusion. I also appreciate the evidence that we have heard about the planning system being able to do only so much. However, in life, things have always been difficult. As Seneca said more than 2,000 years ago,

“It is not because things are difficult that we do not dare; it is because we do not dare that things are difficult.”

I leave that helpful thought with the minister.

That would be helpful.

I have one further area of questioning that is also important and lies within the minister’s portfolio. The Scottish Government’s response seems to have been that it cannot mandate community energy but that it can use the planning system at least to encourage or require it. I have not read the draft national planning framework 4, I must confess, but I read in our papers that it makes no reference to community benefit and only one passing reference to community ownership of renewable energy projects. If I am right in assuming that we want to use planning law as a tool or compulsitor to try to deliver more community interest, whether ownership, benefit or a mixture of the two—both are desirable, although ownership is immensely preferable in the long term—why is there is scant reference to it?

I would also say in passing—I know that this is not the minister’s responsibility—that the same criticism applies to the Bute house agreement, in which, extraordinarily, there seems to be no strong emphasis on delivering that policy. I had no part in the drafting of the agreement, but one would have expected that the issue might have been a prime candidate, given the political support for community ownership from the constituent parties to the Bute house agreement.

Can the Scottish Government do more in NPF4? I will put you on the spot, minister: can we use the final version of NPF4 as the means to deliver the policy by including a much stronger reference to the need for community ownership or, if that is for whatever reason not possible, strong and major community benefit, so that communities really benefit from the natural resources that, to many people’s way of thinking, are theirs?

Indeed. Citizens assemblies are one of a number of different ways to achieve that objective. What key lessons have been learned from them?

Good morning to all our witnesses. I am very grateful that you have, collectively, brought to Parliament the issues around health in rural Scotland, as they are very important.

I start by posing some questions to Mr Baird in respect of his petition, which urges the Scottish Government to create an agency to ensure that health boards offer fair and reasonable management of rural and remote healthcare issues.

Mr Baird, I am sure that you are familiar with the broad arrangements in Scotland, whereby there are 14 regional NHS boards and, since their establishment in 2014, 31 integration authorities. More recently, in 2020, the remote and rural general practice working group published its report on “Shaping the Future Together”. The Scottish Government accepted all the report’s recommendations, including the recommendation—perhaps the most relevant one—to commit to the development of a national centre for remote and rural healthcare in Scotland.

I mention that because it is important to give a backdrop. Following on from that, I have two questions for Mr Baird. I will put them both together.

First, how could the Scottish Government reform the way in which the NHS and social care are currently organised so as to better address the needs of remote and rural constituents and populations? Secondly, will the development of a national centre for remote and rural healthcare for Scotland help to address some of the issues that you raise in your petition?

I did not quite understand why you did not find acceptable the suggestion, which you say that you had already considered anyway, that each board should have a member whose role would be thus. Why do you not want that? Although that might not be the whole solution, I would have thought that it might be part of it.

I have listened with interest to what the petitioners have said. I will mention two issues. One is that Mr Sinclair and our two online witnesses call for reinstatement of local provision of services, whereas Dr Baird calls for a slightly different additional model of advocacy. Both arguments have a rationale behind them. I understand that, but our job is, to some extent, to play devil’s advocate.

I will put this to Dr Baird to see what his response is. Rhoda Grant, Emma Harper, Colin Smyth and I represent constituencies that are largely or partly rural, so we are performing an advocacy service of a sort in the casework that we do. I expect that we all take that job very seriously. It is a big job, and we each represent tens of thousands of people. How on earth can one centralised body hope to advocate for the interests of people throughout the country who live in a plethora of differing remote communities, each of which has its own particular needs, problems, interests and challenges? How could one centralised body effectively perform such an enormous role? How would it be accessible to people? Is there a risk that it would be just another faceless organisation, adding to the number that exist already?

I am sorry that I am putting it a wee bit provocatively, Dr Baird, but I am trying to make a point, as someone who takes advocacy for the remote and rural areas in my constituency seriously. It takes me a day properly to go over a case with an individual, if I want to do it justice. We need to really listen in order to be able then to represent and articulate that individual’s concerns properly. It cannot be done quickly and we cannot cut corners. It is inevitably, and rightly, time consuming. How on earth could a national agency be efficacious?

I do not think that you said you welcomed the national centre for remote and rural healthcare—or perhaps you did—but you said that it was a step in the right direction. Could that new body be set up in such a way that its remit could take up the issues that you have raised? We can raise that with the Scottish Government following this meeting, if you and your colleagues think that that would be a good idea. Would that be a step forward?

I am putting to you that that new body could be tasked specifically, in law, with the remit of addressing the access issues that you raised. It may not operate perfectly in practice, but if we clearly define the remit, duty and tasks that the new body should perform when setting it up then, surely, if we task it to address inequities of access for people who live in remote and rural Scotland, that would at least give the opportunity for things to improve.

Thank you for your answer—you have covered a lot of territory. I will pursue some of the points that you made. Your petition calls for an agency—presumably, that means one agency, if I have understood it correctly. How is one agency going to deliver the kind of advocacy that would be required from the bottom up?

As I understand it, you are suggesting the establishment of an agency not to deliver or procure service provision, but to advocate that services be provided more effectively to people who live in remote and rural areas, and to ensure that inequities in access are addressed and not ignored, with no stonewalling or gaslighting. If that is the case—I put this to you as a devil’s advocate, I suppose—would it not be more efficacious, in respect of achieving what you wish to achieve, to have an advocate for the rural voice on each health board?

Would that be perhaps be a different way to proceed, rather than the establishment of one presumably centrally based agency, or wherever it is based? It would have to be based somewhere. Would that be an alternative model that would not change the way that health boards operate, because they would include an advocate among their number with a specific remit to make sure that remote and rural issues are not overlooked and are addressed? I put that to Gordon Baird and the other petitioners, because you are all covering interlocking aspects of the issue. Would that be a better model than having one agency that would inevitably operate on a high level?