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Do you mean multi-year budgets?

I think that the 218 service came through the justice funding that went into IJBs; it was not from health funding. I am not entirely sighted on exactly what has happened with the justice funding. I think that it would probably go back to the old justice boards and the funding that was transferred across to IJBs, rather than coming directly from the health portfolio. I would imagine that it is a matter that the justice secretary would be able to respond on, because it is not something that sits directly in my portfolio.

We do not micromanage services on the ground within individual health boards, but, clearly, there is a requirement for boards to ensure that there are safe staffing levels. Where there are concerns, there is a mechanism for staff to raise them and escalate them within the board.

There is a lot of work going on around the safe staffing legislation that we introduced. If concerns have been raised with you directly by staff, they should escalate them through the local mechanism to ensure that they are addressed. My expectation is that boards would address such concerns and do so quickly.

I have heard some of the commentary on that, and I do not subscribe to it. We have a range of health regulators that regulate a range of professional groups. In my view, the GMC taking on the regulation of AAs and PAs will not cause any confusion, so long as there is a clear regulatory body that is responsible for dealing with any issues relating to AAs and PAs. I have heard some of the commentary, but I am not persuaded by it, given the fact that we have a range of other regulators that cover a variety of professional groups. I do not see why that would create any confusion for the GMC, given that it does not do so for other health regulators.

I do not know what the exact costs associated with that are, but the UK Government has decided to fund the GMC to support the introduction of the regulation of PAs and AAs. Eventually, we will move to the normal self-funding model, which the majority of the regulators, if not all of them, operate.

How we use PAs and AAs in NHS Scotland will be determined by us. That will be the approach that we will take through the group that we have set up. As I mentioned, it will consider the role of PAs and AAs.

We have taken a very different approach from that of the UK Government, about whose approach to the matter the BMA has flagged up concerns. The use of PAs and AAs is a key part of the UK Government’s workforce plan, and a lot of concerns have been raised about the proposed fairly rapid expansion of their use. I understand that, which is why we have taken a different approach here in Scotland. I have outlined to the BMA that we will take much more of an incremental and evidence-based approach to how PAs and AAs will be used in NHS Scotland and how they will be deployed and utilised in the workforce. We have put in place a process to manage that.

We do not intend to replicate the rapid expansion of the use of PAs and AAs that the UK Government is planning in NHS England. We are taking a much more evidence-based approach to their use and how that will be defined, which will be much more limited.

I go back to my earlier answer. There was a debate around that, and it was part of the consultation in which we asked for feedback on which body would be the most appropriate to regulate PAs and AAs. The very clear majority—just under 60 per cent—said that the GMC should be responsible for that. The GMC has also been clear that it believes that it is capable of carrying out that regulatory function, and it has already begun putting arrangements in place to manage the process. It gave evidence to the committee, and we have met with it and discussed the matter.

I used to be regulated by the Health and Care Professions Council; it regulates a range of bodies and different professional groups, and I do not think that that causes confusion for the public. The idea of another regulator taking on an additional bit of regulatory work is not greatly difficult for the public to understand.

No—it will not be sufficient. It is one aspect. Part of the challenge around social care comes from the fact that we, as a society, have not valued it as much as we value other professional groups, particularly when comparing social care with health. That is a wider societal issue, which we have to be honest and open about, but the consequences of not valuing social care are now clear, given the challenge that it now faces.

Pay is one part of the matter. The other important aspect is to see social care as a career of choice, with a career pathway and progression and opportunities stemming from that. We are exploring whether we could do more to create career pathways in social care, to encourage people to go into it and build up experience within it, and to pursue opportunities to go into other professional groupings.

One area of work that we are considering is the potential creation of pathways into regulated professions, perhaps through approaches such as the nursing apprenticeship model, so that someone’s extensive experience in social care will allow them to progress into some of the regulated professions through a different route from those that are available at present. Creating career pathways is critical to encouraging people to go into social care.

As I say, pay is one part of it, but social care has to be a credible career option for people, and we need to do a lot more around that. Some of the work that we are doing is aimed at encouraging people who are going into social care by providing them with specific routes into other professional groupings if that is what they choose at some point in the future.

Is this in relation to people with long Covid not having access to—

Do you mean for long Covid?