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Yes. One of the potential benefits of a national care service is that it will allow us to create more consistent pathways for training and career options for individuals in the social care setting, with opportunities for people to move around the system in a way that they might not be able to do at present.

Part of the challenge is that it social care is a fragmented sector. We have public sector provision, voluntary sector provision and independent sector provision and, despite the fact that there are national standards for care delivery, how they operate often varies. One of the benefits of a national care service would be that we could take a more consistent approach across those three areas, which could help staff with training and potential career routes.

Addressing the fractured nature of the way in which the social care system operates at present is one of the core purposes behind the national care service. It could deliver much greater consistency across the country.

Yes. I am particularly pleased to see that fund reopening because I set it up when I was Minister for Public Health. When the fund was being closed at the UK level, I chose to establish an ILF here in Scotland. Our reopening it—with an initial budget provision of £9 million in the next financial year—will enable us to open it up to around 1,000 additional disabled people who often have much more complex needs.

One of the real strengths of the independent living fund is that it gives individuals, particularly those who have complex care needs, much more control over how their care arrangements are delivered and by whom. I am therefore particularly pleased that we are able to reopen it for new people to apply to it. We are now taking forward the necessary work to put in place arrangements for opening up the independent living fund for individuals in the next financial year.

We have previously discussed the services that have been provided for long Covid, including some of the pilots that have been taking place in England and how some of that could inform our learning here in Scotland. I know that some health boards have looked at that and learned from it. For example, NHS Greater Glasgow and Clyde has been using some of the long Covid funding to bring in paediatric occupational therapists to work specifically with children who are experiencing long Covid, and also, where necessary, using paediatric physiotherapists to support those children.

Health boards are trying to adapt their services to make sure that young people who are experiencing long Covid have access to clinical teams that can provide them with the support that they require, and they are using some of their core funding to design such adaptations. NHS Greater Glasgow and Clyde, for example, now has some paediatric services to address the needs of young people with long Covid.

If the member has an individual case that he wants me to look into, and he wants to share the details with me after this meeting, I am more than happy to do that. Long Covid does not just affect adults; it also affects children, and services are being designed that will make sure that we also meet the needs of those young people.

A big part of that is because we have to deal with the backlog that built up during the pandemic. During the pandemic, a lot of our elective and diagnostic procedures had to be stopped and that resulted in a significant backlog that we are having to manage within existing capacity. New people are being added to the lists, but we are still dealing with the people who were already on the lists. That accumulation has made the situation extremely challenging and it will take some time for us to recover to the pre-pandemic levels.

Also, in some areas, the level of referrals has increased quite markedly. For example, we have seen a significant increase—of almost 45 per cent in some areas—in the number of referrals to our cancer pathways, which is way above what it was before the pandemic. We are having to deal not only with the backlog but, in some areas, with a significant increase in the number of referrals into those diagnostic pathways, which has an impact on waiting times overall. You will be aware that boards are making steady progress, particularly around long waits—we have seen a steady decline in outpatient and in-patient long waits—and we are continuing to work with boards around that, but it will take some time for us to be able to get back to pre-pandemic levels.

We are also working through the Centre for Sustainable Delivery on a programme of work to ensure that we are maximising capacity in our services. The centre is carrying out work with a new digital tool to consider how we can maximise the use of theatre times, which could potentially give us an additional 30 per cent capacity. Through the Centre for Sustainable Delivery, we are trying to get consistency across boards around how they maximise capacity and the use of resources in their existing services, because some of them are not operating at their pre-pandemic capacity and we need to ensure that we get greater efficiency there.

The issue involves that combination—the history, the increased referral rates and our trying to ensure that we maximise the capacity that we have in the existing system in order to use it to its full potential.

It is still a priority for us, but it is a challenging area of policy to take forward in the existing financial climate. Our options for making more progress on it are limited, largely because of the financial consequences and our not being in a budgetary position where we could actually advance it. It is still a priority and we will progress it should finances become available to allow us to do so, but at present we do not have the financial provision to be able to take it forward.

The plan was to have 10 NTCs across the country, and we are moving towards phase 2 of that work. The work is being considered in our capital programme, which is being reviewed because of the cuts to our capital budget, and is primarily focused on elective procedures—predominantly around orthopaedics, ophthalmology, endoscopies in some cases, and so on—rather than acute care. Caroline Lamb can say whether anything has been considered around cancer care with NTCs—I do not know off the top of my head.

It is difficult to assess the number of people who have long Covid. Some of the patients whom I have met who are experiencing long Covid have seen a detrimental impact on their employment. In some cases, they have had to give up their employment because they are no longer able to continue with the job that they were in. Others have been able to adapt their working environment so that they can accommodate their issues with long Covid, and others still have been able to continue with their employment.

The situation is therefore variable, and, at this stage, I could not give you a figure for the economic impact of long Covid and we have not carried out an assessment to enable us to do so. Again, it will have an impact on individuals in different ways and it will depend upon employers being prepared, as they should be, to make reasonable adaptations for employees who have a long-term condition so that they can continue with their employment. It is important that employers do that while it is necessary.

The national treatment centre in your area of Fife is helping to deliver on-going improvements in the delivery of orthopaedic and ophthalmology services, which will help to reduce the waits. I do not know the exact data for Fife, but I know that the Highland NTC is ahead of schedule with its programme, which is helping to reduce waits for patients in that health board area and will support NHS Grampian, too, because its patients will go to Highland NTC as well. Once we bring on phase 2, the NTCs at the NHS Golden Jubilee and at the Forth Valley hospital will give us additional capacity, which will help to reduce waiting times in those individual board areas. However, that work is taking place in the wider context of the increase in demand that we are facing.

On the impact that NTCs will have on unscheduled care, one of the challenges that one always has is that acute priorities can often displace elective work. The benefit of having NTCs is that they are a protected environment and are for elective purposes, which gives greater certainty around the amount of elective work that can be taken forward, as it can otherwise be buffeted around in the general setting of acute priorities, where unscheduled work is having to take priority over elective procedures for clinical reasons. The NTC environment gives us a level of protection in the system, which will assist boards much more effectively with their planning not just over months but over a whole year.

I know the 218 service from my time in the justice portfolio. It is not funded under the health portfolio; if I recall correctly, it is funded directly through the community justice programme. I know that the Cabinet Secretary for Justice and Home Affairs has been engaged on that matter. I think that the issue was raised in Parliament and that she said that she would engage on it. That was in relation to community justice funding that was having an impact.

Christine McLaughlin can say a bit more about that.

CAMHS have expanded enormously over a number of years, but demand for them has also increased significantly. I recognise the concerns that Paul Sweeney has raised about children’s and families’ unnecessary waits to access some of those services. The intention behind our delivery plan is to ensure that there is a much more consistent approach to how services are delivered across the country. Members will be aware that some boards are performing better than others on service delivery, but there is a need to achieve greater consistency.

I cannot give a commitment on the funding aspect at this stage because we are going into the budget round for next year and we will need to see what the budget settlement is. However, we need to continue to expand and develop our CAMHS as a priority. I know that the Minister for Social Care, Mental Wellbeing and Sport, Maree Todd, spends a lot of time trying to ensure that we are taking the right approach to getting greater consistency of service delivery across the country, because variation of service provision is one of the biggest challenges that we face around CAMHS. The objective behind the delivery plan is to ensure that there is greater consistency of approach.