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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 5 April 2025
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Displaying 986 contributions

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Health, Social Care and Sport Committee

Health Inequalities

Meeting date: 24 May 2022

Paul O'Kane

Those were helpful points on the broader context. An important part of any Covid inquiry should be to look with laser focus at a lot of those issues and try to understand their impact.

Claire Stevens alluded to this already, but some unintended positives came out of the pandemic. That was probably about communities coming together in a way that they had not done before, and voluntary health organisations in particular stepping up. How do we measure that and protect it in the future? I think that we would want to see investment in the sorts of softer services that have made the difference for people.

Health, Social Care and Sport Committee

Social Care

Meeting date: 17 May 2022

Paul O'Kane

Good morning, minister. In evidence to the Public Audit Committee, the Auditor General said:

“We know that the social care workforce has been under immense pressure during the pandemic”.

You spoke about that in your opening statement. The Auditor General went on to say:

“indeed, that was the case even before the pandemic ... The Scottish Government now needs to take action to improve working conditions for this vitally important workforce, otherwise it will not be able to deliver its ambitions”

in the longer term

“for social care.”—[Official Report, Public Audit Committee, 3 March 2022; c 3.]

The Audit Scotland briefing outlines what those pressures and challenges are, and it is clear that there is an immediate need to resolve some of them.

I am also interested in the exacerbation of those issues by the cost of living crisis. It is very clear that many of these workers—who are very often women and lower-paid workers—are struggling to make ends meet and to be able to do their job because of the rising costs of getting to work between their shifts on public transport or in their car. What is your assessment of what needs to be done immediately to deal with some of that?

Health, Social Care and Sport Committee

Social Care

Meeting date: 17 May 2022

Paul O'Kane

I certainly will—scrutiny is the job of all of us so that we get this right.

I wonder if I can just scrutinise the benefits and the understanding of them among the respondents to the consultation. We have heard that the Government’s analysis acknowledges that a large number of criticisms were made in the consultation process, in all formats of submission. Two of the principal reasons that were given were the complexity of the issues and the lack of detail in the proposals. Does the minister accept that people are struggling to engage and to understand the benefits that we have just talked about? I know that the minister has committed to further engagement work, but it is clear that people want to see that detail and to continue that conversation.

Health, Social Care and Sport Committee

Social Care

Meeting date: 17 May 2022

Paul O'Kane

Audit Scotland is particularly concerned about, or interested in, the learning that can be taken from previous public sector reform. Its analysis highlights that the expected benefits are often not clearly defined and that, even where they are defined, they are not always delivered, particularly in the short term. Are you confident that the benefits have been defined and can be delivered?

Health, Social Care and Sport Committee

Audit Scotland Report: “NHS in Scotland 2021”

Meeting date: 10 May 2022

Paul O'Kane

I heard the cabinet secretary’s initial answer to David Torrance’s question on workforce pressures, and his answer about Brexit. When the Auditor General for Scotland gave evidence to the committee, he spoke about historic problems with staffing. He said:

“We know, and have previously reported, that the NHS has, historically, struggled to achieve all its staffing ambitions.”—[Official Report, Health, Social Care and Sport Committee, 19 April 2022; c 3.]

Will the cabinet secretary acknowledge that there has been something of a historic failure to deliver a workforce plan, and that there were failures in meeting staffing targets before the pandemic?

Health, Social Care and Sport Committee

Audit Scotland Report: “NHS in Scotland 2021”

Meeting date: 10 May 2022

Paul O'Kane

The Audit Scotland report states that

“The NHS was not financially sustainable before the Covid-19 pandemic”

and that six boards require additional financial support from the Government or to use non-recurring savings in order to break even. Is the cabinet secretary confident that those boards will be able to achieve financial balance in 2022-23, or is it likely that on-going support will be required? What is his assessment of the issues that are being experienced by the boards? Is it a case of weak financial management, or is a lack of adequate resourcing a more fundamental issue?

Health, Social Care and Sport Committee

Audit Scotland Report: “NHS in Scotland 2021”

Meeting date: 10 May 2022

Paul O'Kane

I do not think that anyone would deny that the pandemic has exacerbated the pressures. I was just pointing to the fact that the Audit Scotland report says that there was no financial sustainability prior to it. The committee will be keen to hear an update on the progress of the boards to which I referred when we get to the financial year end.

I will ask more broadly about the increase in funding. The Scottish Government committed to a £2.5 billion increase in funding for health and social care over the parliamentary session. However, the medium-term framework for health and social care has not yet been updated. In the absence of any medium-term financial framework, how can the cabinet secretary be confident that the additional funds that were committed will be allocated and used effectively? When will the updated medium-term financial framework be published?

Health, Social Care and Sport Committee

Audit Scotland Report: “NHS in Scotland 2021”

Meeting date: 10 May 2022

Paul O'Kane

I will continue in that vein. We have seen evidence in the Audit Scotland report that data and planning have not been adequate. That answer suggests that we have to do a lot more to understand and profile where we are.

I return to the cabinet secretary with a question about nursing places and vacancies. There are 6,674.4 whole-time equivalent nursing and midwifery vacancies in the NHS, and we have heard some of the cabinet secretary’s reasons for the challenges in that. Will he also accept that the reduction in the number of nursing training places—a decision that was taken by his predecessor—has exacerbated those challenges?

Health, Social Care and Sport Committee

Audit Scotland Report: “NHS in Scotland 2021”

Meeting date: 10 May 2022

Paul O'Kane

I am trying to ask you a question and get the answer.

Health, Social Care and Sport Committee

Audit Scotland Report: “NHS in Scotland 2021”

Meeting date: 10 May 2022

Paul O'Kane

The £10 million fund was announced in September of last year, but there was no spending until the beginning of this financial year. Why was that and what is the long-term strategy for funding this crucial work?