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I do not know where the 2,000 figure from the BMA comes from, or from what analysis. I understand that groups such as the BMA lobby and push for what they think is the best approach. I always engage with the BMA in a meaningful way, and, in fact, I think that I am meeting it to discuss primary care this afternoon.

We will continue to look at what more we can do to support primary care as a critical part of our healthcare system, which will be under even greater demand in the years ahead, given the demographics that we have as a country and the disease burden that we face. I will always look to see where there is more that we can do, and engage with the BMA around the issues that it raises to understand the rationale behind the calls that it makes.

The challenge is that people can choose to leave general practice at different points in their careers. It is not always the case that they choose to retire when they get to retirement age; some might choose to do so earlier. The challenge, therefore, is trying to plan to ensure that we have the right intake into medical education and the right cohort of specialities available to allow people to specialise after their foundation years and to do all that in a way that reflects future need and demand.

Moreover, the vast majority of our general practitioners are independent contractors, and they can choose to change the hours that they work, retire earlier and so on. There are variables in there that we cannot always control, but we have to try to balance the system to ensure that the training and education and the move into specialities are sufficient to meet what we think will be the intended need. At local level, the health boards, which have the direct contracts with general practice, will be monitoring the situation and trying to put in place the right arrangements that might be necessary, should the numbers of GPs in their area change or should there be a significant increase in their population, to ensure that they have the right level of services to meet local demand.

The challenge is that if we try to do what we think should happen in Grampian, say, remotely here in Edinburgh, we will not always get that right, because we will not be as close to the community as we need to be. That is why designing local services is best left to local health boards, because they can engage with local communities, understand exactly what is needed locally and therefore try to design the most effective services. It is about trying to balance the system at a national and a local level, and to do so over the long term. It is challenging, but it is exactly what we are trying to do.

Yes, that is our intention. We are engaging with the unions, in particular, to manage implementation. I think, from the discussions that have been had, that there is a desire on everyone’s part to deliver implementation within that timeframe, but in a way that does not create unintended problems for existing NHS staff. So far, our engagement with the unions has been very much about trying to get the balance right. I do not know whether Caroline Lamb has anything more to say, but that is still our intention. We are just trying to ensure that we take the employee side with us in order to get the balance right.

Yes, it does. I am aware that Dumfries and Galloway has benefited from the ScotGEM programme. I raised the issue at the last meeting of the four nations’ health ministers, where we discussed recruitment and retention issues—in particular, issues in our more rural areas. I highlighted the ScotGEM programme to the other ministers and I have offered to share our information on how the programme operates and the benefits that we have had from it. There is interest in looking at how the ScotGEM programme has worked.

On your latter point, it is still our objective to achieve the 10 per cent target within the current parliamentary session and to take that forward over the next three years.

I do not have the information on the specific measures that you asked about to hand, but I would be more than happy to come back to the committee to give it some more detail about specific measures that we are looking to take to address the consistency of service provision.

John Scott made a range of recommendations in his report, and we accepted all the key ones. Implementing some of them will require changes to primary legislation and I hope that we can aim to introduce primary legislation during the current parliamentary session to give effect to some of the measures that will be needed to do that.

Good morning, convener. Public Health Scotland continues to monitor Covid-19 levels and is testing for the new variants. That is largely being carried out through people who have been admitted into our hospitals, who might present with symptoms, and that is being used to inform our approach to how we continue to manage Covid-19.

Members will be aware that the decision was made a number of months ago, in line with other parts of the United Kingdom and countries globally, to manage Covid-19 in the way that we would manage any other seasonal infection. That continues to be our approach, but we are monitoring very closely any changes to the pattern and rates of infections. That will inform any further decisions that we make about any changes to our approach that we might have to make.

We will also continue to keep in place a range of testing arrangements for individuals who are being discharged from hospital into social care settings, for example. We have taken a slightly different approach on that from some parts of the UK in order to maintain a level of vigilance. That means that a level of testing is still taking place for vulnerable categories of patients, particularly if they are going to be transferred into social care settings.

We are engaged with the chief medical officer, who is engaged with the other CMOs across the UK, and work is being taken forward through the genome sequencing process, which is, obviously, operating at international level. I do not know the full clinical details around that, but work is being carried out to test the impact of the existing vaccination programme against the new variant.

I also understand that vaccine producers are monitoring whether they have to make any amendments to their existing vaccines, but all that work to monitor the on-going situation is being taken forward across the UK and globally. At this stage, we are still waiting for those reports to come back, but there is a level of vigilance in place to ensure that our decisions are made on an informed evidence base.

Our social care staff are critical in supporting and sustaining our health and social care systems, which are interlinked and are key to each other. The social care setting has traditionally been undervalued, which has been reflected in the rate of pay within social care compared to that in healthcare.

We have taken forward a programme of work to make social care a more attractive working environment and to reflect the value of our social care staff, which has resulted in an increase in their pay. Pay has been increased to £12 an hour over the past two years. We have already taken it up to £10.90, and the pay increase in the sector will be equivalent to more than 14 per cent in two years.

The objective behind that is to make care a more attractive profession and to support the retention of social care staff to make the sector more resilient. The principal objective is to try to get more people into care and to support and encourage those working there to remain there in future by providing them with better pay.

Any form of industrial action is hugely disruptive to our NHS, not only to staff and to the management process but to patients. To see that, we only have to look at England, where there has been repeated industrial action and where I believe that more than 7.5 million patients are on waiting lists and that almost a million procedures and appointments have been cancelled as a result. That is the immediate impact, and there will be a cumulative impact caused by backlogs in the system.

The system and staff are already under enormous pressure and adding persistent industrial action to that demoralises staff even further and makes them feel undervalued, bringing all the challenges that go with that. My deal with the junior doctors involved acknowledging and recognising the real challenges that they face because of pay erosion, and we managed to negotiate an agreement with them to avoid industrial action.

My big concern with industrial action is that it is not only disruptive to patients but demoralises people who work in the system even further, which has consequent challenges, and puts people off working in the NHS as a result of the disruption and difficulties.

There is a monetary cost to settling those matters. However, we would create even bigger challenges for ourselves if we did not try to address the issues. The challenges that we would have faced from industrial action would have been even greater—they would have been worse—than dealing with the financial challenges arising from the pay settlement.