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The plan was to have 10 NTCs across the country, and we are moving towards phase 2 of that work. The work is being considered in our capital programme, which is being reviewed because of the cuts to our capital budget, and is primarily focused on elective procedures—predominantly around orthopaedics, ophthalmology, endoscopies in some cases, and so on—rather than acute care. Caroline Lamb can say whether anything has been considered around cancer care with NTCs—I do not know off the top of my head.

It is difficult to assess the number of people who have long Covid. Some of the patients whom I have met who are experiencing long Covid have seen a detrimental impact on their employment. In some cases, they have had to give up their employment because they are no longer able to continue with the job that they were in. Others have been able to adapt their working environment so that they can accommodate their issues with long Covid, and others still have been able to continue with their employment.

The situation is therefore variable, and, at this stage, I could not give you a figure for the economic impact of long Covid and we have not carried out an assessment to enable us to do so. Again, it will have an impact on individuals in different ways and it will depend upon employers being prepared, as they should be, to make reasonable adaptations for employees who have a long-term condition so that they can continue with their employment. It is important that employers do that while it is necessary.

The national treatment centre in your area of Fife is helping to deliver on-going improvements in the delivery of orthopaedic and ophthalmology services, which will help to reduce the waits. I do not know the exact data for Fife, but I know that the Highland NTC is ahead of schedule with its programme, which is helping to reduce waits for patients in that health board area and will support NHS Grampian, too, because its patients will go to Highland NTC as well. Once we bring on phase 2, the NTCs at the NHS Golden Jubilee and at the Forth Valley hospital will give us additional capacity, which will help to reduce waiting times in those individual board areas. However, that work is taking place in the wider context of the increase in demand that we are facing.

On the impact that NTCs will have on unscheduled care, one of the challenges that one always has is that acute priorities can often displace elective work. The benefit of having NTCs is that they are a protected environment and are for elective purposes, which gives greater certainty around the amount of elective work that can be taken forward, as it can otherwise be buffeted around in the general setting of acute priorities, where unscheduled work is having to take priority over elective procedures for clinical reasons. The NTC environment gives us a level of protection in the system, which will assist boards much more effectively with their planning not just over months but over a whole year.

I know the 218 service from my time in the justice portfolio. It is not funded under the health portfolio; if I recall correctly, it is funded directly through the community justice programme. I know that the Cabinet Secretary for Justice and Home Affairs has been engaged on that matter. I think that the issue was raised in Parliament and that she said that she would engage on it. That was in relation to community justice funding that was having an impact.

Christine McLaughlin can say a bit more about that.

CAMHS have expanded enormously over a number of years, but demand for them has also increased significantly. I recognise the concerns that Paul Sweeney has raised about children’s and families’ unnecessary waits to access some of those services. The intention behind our delivery plan is to ensure that there is a much more consistent approach to how services are delivered across the country. Members will be aware that some boards are performing better than others on service delivery, but there is a need to achieve greater consistency.

I cannot give a commitment on the funding aspect at this stage because we are going into the budget round for next year and we will need to see what the budget settlement is. However, we need to continue to expand and develop our CAMHS as a priority. I know that the Minister for Social Care, Mental Wellbeing and Sport, Maree Todd, spends a lot of time trying to ensure that we are taking the right approach to getting greater consistency of service delivery across the country, because variation of service provision is one of the biggest challenges that we face around CAMHS. The objective behind the delivery plan is to ensure that there is greater consistency of approach.

It will take a holistic approach to consideration of some of the challenges with the delivery of healthcare in rural and remote areas to inform the approach that we should take to address them, and that will include areas such as midwifery as part of its programme. Your constituency is an area in which the centre will particularly be able to work with the local board and the different clinical groupings to try to address some of the challenges that it faces.

First, I will just correct you. We are not struggling to find 800 GPs—we are ahead of the trajectory to recruit that number. Also, in relation to recruiting to GP specialty training, this year, we not only reached 100 per cent but even more applied for the training than the spaces that were available.

We are in a strong position to deliver on our commitment to recruit 800 GPs during this parliamentary session and to increase the number of GPs in training. I note that, this year, all specialty options were taken.

In addition, we have been expanding medical training places. We have made a commitment to increase the number of medical students in Scottish medical schools by 500. This year, we have increased that by 300 places and we are on target to increase places by another 200. Believe it or not, the BMA has asked us to slow down a bit, to make sure that there is capacity in the system to train those medical students.

We face challenges in relation to our medical workforce—I would not want to give people the impression that we do not—but it would be wrong to give the impression that we are struggling, because we have been able to recruit to the places that have been made available for general practice and for the training programmes.

However, we must continue to do more, because general practice is under huge pressure. A big part of that is not just the GP workforce but the multidisciplinary team that we have in primary care. A key part of what we must do in primary care is to ensure that we have a broad range of healthcare professionals that can meet patients’ needs and can meet the increasing demands that primary care will face. Having that combination will be key to ensuring that we meet those demands as best we can.

I will deal with those issues in turn. There are challenges in rural general practice—there have been for many years, particularly in single-handed practices. When GPs in such practices choose to leave or to retire, it can be difficult to recruit replacements. That can be for a variety of different reasons, but I agree and accept that there is a challenge in some parts of rural Scotland.

On what we are doing to address some of those issues, first, we have the Scottish graduate entry medicine—ScotGEM—programme, which is about recruiting and encouraging doctors to work in our rural environments. We also have the bursary programme—I wrongly called it the “golden hello”, but that is not what it is—which is, again, about supporting individuals, who may be GPs, to work in rural areas by giving them financial support, or a financial incentive, as part of the programme. The third thing that we are doing is—as the committee will be aware—setting up the centre for remote and rural healthcare, which is a programme designed to consider specifically how we can create and deliver greater resilience, in particular in primary care, to deal with the systemic challenges that we have in recruiting people into our rural areas. That combination of programmes to retain and support people in rural settings, and the creation of those financial incentives, is all aimed at supporting getting people into general practice in our remote and rural areas.

On the point around the number of practices that are now in the NHS, that has happened historically. Over the years, some people give up their contract, which is taken over by the NHS. That happens in urban as well as in rural areas.

Yesterday I had a meeting with the health and social care partnership in Grampian and the chairs of the integration joint boards, so I know that they are taking forward a programme of work to look at creating a much more sustainable approach to the delivery of primary care within the NHS Grampian area, and that they have a plan to deal with some of the very specific issues that they are experiencing within the NHS Grampian area. They expect to have that programme of work completed by the end of this year. I have explained to them that I want them to look at how they can work in an innovative way using the existing system to deal with some of the particular challenges that they have in their area.

Before I bring in Ms Minto, I should say that a range of work is being taken forward by boards through the long Covid treatment pathways, which are being delivered as part of the £10 million that we have made available for long Covid services. I think that nine of our health boards have their long Covid treatment pathways in place, and around five are still developing them.

For example, NHS Greater Glasgow and Clyde’s long Covid service allows general practitioners to make direct referrals of patients for assessment and for appropriate treatment options to be made available. We have also allowed boards to design services that best reflect their local circumstances and what they believe to be most appropriate for patients in their areas.

A range of services is available, but one of the challenges has been to ensure that clinicians know that such services are available to refer patients to. Some of our boards have therefore been undertaking work with colleagues across general practice to ensure that they are aware of how patients can be referred directly to these services. Some will also accept self-referrals from patients for assessment and for an appropriate treatment programme to be put in place that reflects their individual circumstances.

I do not know whether Ms Minto, who leads on some of this area of work, has anything more to say.

Some of the additional finance that we are making available for the increase of pay rates, for example, will obviously benefit those organisations in the voluntary sector in relation to the payment of their staff. All parts of social care will benefit if we can retain and recruit staff—the independent, voluntary and public sectors.

We need to make the career environment attractive to individuals, so the rate of pay must reflect that. Would I like to go further on pay in the social care sector? Absolutely. However, we have to operate within the current financial environment. The reality is that £12 per hour is a significant uplift, but going beyond that would create significant financial challenge across the portfolio.

Offering the right pay is one aspect of making the environment attractive to people. As I mentioned in answer to Paul Sweeney, another is creating good career pathways. As you will know from your own pathway, that is critical to supporting not only social care but healthcare in general.