Seòmar agus comataidhean

It would be useful for further scrutiny if the committee could have more detail on that in writing.

I want to ask about the structure of the national care service. We are still going through the responses and the structure is not yet finalised in respect of the proposal to create community health and social care boards to replace IJBs. Does the cabinet secretary think that many of the issues that have been experienced with financial accountability and leadership in IJBs will be solved by creating a new structure?

Last week, we heard a lot of important evidence and, as Sue Webber said, it was quite emotional at points. We heard about the planned development of specialist baby loss units. Those units are not anticipated to be fully available across Scotland until 2024. As a starting point, I would like to understand what percentage of parents get access to a specialist bereavement midwife now. What can we do to speed up specialist interventions, particularly through the baby loss units?

If the minister could write to the committee with the specific percentages that I asked for, that would be helpful, just so that we can have that empirical data. I notice that the minister is agreeing, which is great.

I have a further question about more specialised pathways for women, particularly in relation to mental health and increased vulnerabilities such as substance misuse issues. What specific pathways or interventions are being developed to support people with mental health or substance misuse issues?

No, convener—that was most helpful.

We have heard about the work that is being done and the huge support that is being provided by the third sector, and I am keen to hear your thoughts about the sustainability of third sector organisations. The perinatal and infant mental health fund, which was launched in May 2020, has provided £665,000 to support 16 organisations. Is that fund providing the sustainability that is needed, or do we need to go further and find other ways of mainlining that funding? I direct that to Clea Harmer, and to Cat Berry, if we have time.

I thank everyone for their contributions this morning. What is coming across is a sense that the approach needs to be evidence led and that we need to take our time with it. Necessity may be the mother of invention, but we want to take time to learn from the experience of the past 18 months.

I will touch on two points. On digital exclusion, I agree with what has been said about ensuring that people have the right support. My concern is that we often end up with a two-tier system, even within a digital offering. People who do not have access to the internet sometimes cannot do audiovisual participation and end up participating via a phone, which is not always the best option, particularly—Karen Wylie alluded to this—in relation to children’s hearings and family courts, in which the issues that are discussed are very emotive and can be very stressful and challenging for people. Participation on a phone can often mean that it is difficult to read people’s tones or get a sense of what support someone might need. In addition, if someone is being supported by an advocate or legal counsel, it can often be hard in a digital setting for that relationship to be well established and for the person to get the right support. There are certainly things that need to be looked at to ensure that there is parity of access, even within digital offerings.

Ruth Crawford touched on the public’s access to the courts and how, where appropriate, members of the public can ensure that they can be present, if they choose to be. Obviously, our public galleries at Holyrood have been empty for the duration of the pandemic, but we broadcast all the public meetings of the Parliament via the website through Scottish Parliament TV. The difference is that we have not quite reached all court proceedings being digitally available or available in live time. I am keen to understand how we can protect the right of the public to be present in court if there is a move to a digital setting.

I am currently a serving councillor. We have a strange process if a member of the public wants to join the meeting. They have to request to do so prior to the meeting and be let into the system that we use, otherwise they have to watch it after the live event on YouTube. We need to look at such issues so that we protect people’s fundamental right to be present.

I want to follow up on the point about how local government has worked across the piece to drill down into people’s experiences and what services they require. I am interested in the work and recommendations of Professor Bruce Guthrie, at the University of Edinburgh, in this area—in particular, the idea that we can use NHS data, such as unique addresses, to understand whether people are living in sheltered housing or a care home, or in a care-at-home scenario.

I am keen to understand how we ensure that, in the national care service, we still get good-quality, localised data and information about a person. That helps us to see the bigger picture with regard to housing mix, housing need and requirements in an individual area, whether it is rural or urban, and other such issues.

The point is well made that the approach cannot be one size fits all and that we need to look at varying aspects. NHS England operates an app that covers all the things that Chaloner Chute mentioned, such as GP appointments, prescriptions and Covid status. What are we learning from that? That has been in place for a period—why do we not have an equivalent? Does Jim Miller or anyone else know anything about that?

Thank you for that comprehensive answer. Following on from that, I have two questions. How will we use the data that we hope to bring on stream to chart somebody’s journey through health and social care? A person might present to their GP but then go elsewhere, or might feel that it is appropriate to present at an accident and emergency department. There is a discussion at the moment about where presentations happen. How will we link the data to look at people’s journeys?

Secondly, how will we chart unmet needs? Some people are not having their needs met in the most appropriate place. I ask in particular in relation to digital formats, which people are using more and more.

Good morning. Witnesses have already touched on the necessity during Covid to upscale and move forward what we are doing in relation to digital. Obviously, NHS 24 has had a key role in developing many of the services, and it is fair to say that, within that, there has been a degree of quick movement and upscaling of projects that were already planned.

I want to get a sense of Jim Miller’s reflections on what has worked well and what has been challenging. In my experience, certain applications have worked better than others and have needed refining and testing. Jim, can you kick off with your reflections on that issue?