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I mentioned that in my opening comments. We have set up the medical associate professions implementation programme, which has a board that includes key partners from NHS Scotland and the royal colleges. The purpose of that programme is to ensure that, going forward, we have a clear implementation process for PAs and AAs as regulated professionals and how they will be deployed and used in NHS Scotland.

I have also set out clearly to the BMA the difference between the approach that we are taking and that of the UK Government. Many of the BMA’s concerns relate to the way in which the UK Government has dealt with the regulation of PAs and AAs and how it has set that out in its workforce plan, which has conflated two issues. We are taking a different approach in Scotland: it will be much more evidence based and managed and those roles and the way in which they will be used in NHS Scotland will be clearly defined.

Absolutely, given the role that some AAs and PAs play and the need for us to have a statutory regulatory process in place. In my opening statement, I said that patient safety lies at the heart of this; it is about accountability for healthcare professionals in their roles and the important role played by PAs and AAs.

You mentioned, for example, the role that anaesthesia assistants can play in the theatre environment. It is important that they are accountable for how they manage that provision. Of course, they do provide those services under medical supervision, but it is important that there are clear lines of accountability and responsibility.

That is all the more reason for having a regulatory environment in which there is statutory regulation of those groups. It is in patients’ interests as well as the wider healthcare system’s interests for those roles to be properly regulated and clearly defined and for there to be clear accountability for any decisions or actions that those professionals take. They should be held to account in the way that other healthcare professionals are.

I have nothing to add.

I move,

That the Health, Social Care and Sport Committee recommends that the Anaesthesia Associates and Physician Associates Order 2024 [draft] be approved.

The reality is that about £1.3 billion is invested in mental health services. About £290 million of that is central funding from the Scottish Government, and that has increased—in fact, it has doubled since 2020-21. Over the course of the past two to three years alone, we have doubled the level of that investment and maintained it, despite the difficult financial environment in which we are operating. That has allowed a very significant expansion of mental health services in Scotland, and we want to sustain and maintain that. Over the course of the past couple of years, there has been a huge increase in the level of investment that we are putting into mental health services.

Yes, it is part of a long-standing piece of work that we have been taking forward with the UK Government. Back in 2019, the then Cabinet Secretary for Health and Sport signalled agreement with the UK Government that we should introduce legislation to regulate AAs and PAs. However, there were issues around the wider regulatory framework, which was part of that discussion, and with carrying out a significant review of the regulation of healthcare professionals. The view was that trying to do all that at one time would not be effective, because it was too complex, and it was decided to deal with the AA and PA aspect of regulation separately from the wider work on health regulation. That is a separate piece of work, which is why the AA and PA aspect is being dealt with through a standalone order.

Through our medium-term financial framework—I think that we published that in 2022. Is that correct?

We have already met that target—we are ahead of schedule on it by two years, I think. That has already been delivered within this parliamentary session.

The staff are key to the health service, and it is important that we provide them with the financial recognition for the important role that they play. That is why, in the past financial year, we have progressed our agenda for change commitments; it also accounts for how we have engaged with staff on pay negotiations. The pay increase inevitably creates financial stress in, and challenge for, the system, but it is critical that we do that, because staff are key to the delivery of our health services. The increase will have to be met within the existing budget allocations that are set out in the 2024-25 budget.

On social care, a key aim of our additional investment of over £800 million in the past couple of years is helping to address the pay issues in social care settings. We know that pay is a major challenge when it comes to recruiting into social care, and we also know that social care is critical to the performance of our NHS. Therefore, if we want our health and social care system to function effectively, we must ensure that we provide resources where we can to pay staff for their important role. That is the approach that we have taken on negotiations and through the agenda for change programme in relation to pay for health and social care staff.

Good morning.

I do not think that you would ever get a cabinet secretary for health to say that they would not want more resource to invest in the health and social care system. In the light of our very challenging budget settlement, we have achieved the best possible outcome that we can for the health and social care budget.

Notwithstanding that, efficiencies and savings will have to be made for us to live within the budget settlement that we have and the growing demand that we face. I think that this is the best outcome that we can achieve in challenging financial circumstances; however, there will be continued challenges for the health and social care system even with this budget.