Seòmar agus comataidhean

As a declaration of interests, I say that I am an NHS doctor and am in the pension scheme.

I would have liked to have seen this go a bit further and help consultants and those in the NHS who cannot do extra work because of the pensions causing an issue, as we have seen in Wales. However, I understand that that is not part of the consultation.

Again, I declare my interests as an NHS doctor working in primary care.

I put on record that, although I am supportive of us having online access, I want to ensure that people who struggle to get online do not feel that they are unable to access appointments, especially if they go exclusively online or the majority are online and so are no longer available when those people call in. We need to ensure that we find a balance.

I am not as disciplined as Paul O’Kane and Emma Harper. [Laughter.] I am keen for long Covid to form a cornerstone of future work because of how little we know about it, although we are definitely gaining understanding. Given the number of people who are affected and the devastating impact that long Covid is having, I am keen for work to be done on it. Would Audit Scotland be able to look at what is going on, how it is going on, what planning there is, how money is being spent and whether patients are getting what they should be getting?

I want to turn our attention to long Covid and the work that is being done within NHS Scotland on that. We have seen that there are more than 90 clinics in England, but there is none in Scotland, as far as I am aware. What have you seen of the work that is being done on how to address long Covid? What plans are you hearing about for long Covid clinics or treatment for patients through reform of the NHS? This is obviously a huge area, with more than 100,000 Scots suffering.

Yes, thank you.

All that is very interesting, but it is not quite what I understood to be happening. I am also interested to hear that work on long Covid is still in its early stages.

In 2019, Auditor General, your predecessor pointed out that the Scottish Government’s commitment to recruit 800 GPs would be all but undone by people leaving the profession. Is there enough focus on retention? Do we need to see more ambition if we are going to get a grip on workforce planning?

I note the work that we are doing and the reasons that we are doing it, but we are not doing enough on pensions. The current NHS pension scheme is hindering NHS consultants from doing extra work, because essentially, they are having to pay to go to work. We also need—and I would love it if we could do that in the committee—to have an employers’ contribution recycling scheme, as we have in Wales, to enable consultants to do more work. I would like to see more work being done on that and for the committee to write to the cabinet secretary about that.

I note that councils will be granted about £10,000 to look after the health needs of each person who comes from Ukraine. Is that money being used in the regulations and is it ring fenced to help people from Ukraine to address their healthcare needs?

I will pick up on Evelyn Tweed’s question about how the NHS in Scotland was not financially sustainable before the pandemic. I have two questions.

First, what steps could we take to make the health service more efficient?

Secondly, what work have you done, or seen, on silos and pots of money? I can give an example. A department might have one pot of money to employ locums and another pot of money for its current staff. Money cannot cross from one pot to the other, so current staff are not paid what locums are paid and therefore do not do internal locum work.

I wanted to come on to that. It is very difficult, if not impossible, to know what you need and what you have to do if there is a lack of data. Are we seeing progress, or a lack of progress, in relation to data collection and analysis? What gaps are there, and how do we fill them?

Cabinet secretary, as you have just said, data is vital. However, as a GP, I cannot see what my psychiatric colleagues have written, and when I was doing my psychiatric block, I could not see what the child and adolescent mental health services doctors had written, even though I was covering for CAMHS overnight. We have patients who have to tell their story and repeat it. There are occasions on which, although we have the key information summary service, the out-of-hours provider is unable to see what I have written, and vice versa.

All in all, the sharing of information in a patient’s journey is not currently adequate, which is a real safety concern. What can we do quickly to try to solve that? Secondly, when there is data sharing, what are the data protection implications that arise?