Seòmar agus comataidhean

Good morning. I will begin by asking a question about availability of data. Earlier this week, we learned about waiting times. There are 680,000 people on NHS waiting lists, which means that one in eight Scots is on such a list. When it comes to data, is it possible to determine a relationship between a person’s cause of death and whether they were on a waiting list? If we want to understand excess deaths, how do we understand the impact of people’s being on those unacceptably long waiting lists? I ask Dr Miles to comment.

The RCGPS’s submission recommends that

“To increase the support and care that GPs and their teams can provide for those patients, mental health clinicians should be made available to all GP practices”.

One of the reported outcomes of the lockdowns and two years of Covid has certainly been an increase in mental health issues. I have no doubt that GPs will have seen that. What is the current position in that respect?

Secondly, with regard to integration joint boards, is integration going right down to medical practices, with mental health, social work and other services all being available through them? Are we seeing that level of integration across Scotland, or is the situation patchy?

I think that every MSP will be getting a lot of emails about schools and the continued wearing of face masks in schools. I looked at this morning’s newspaper headlines—I see one that says, “Door chop is totally unhinged”—and every one of the newspapers seems to be having a go at yesterday’s announcement. I note that Hugh Pennington said:

“I’m not sure how much science is behind it. I’m sceptical it’s going to make much of a difference. It really is showing that something is being done for its own sake.”

What is the evidence behind it?

Perth and Kinross Council, which is Mr Swinney’s local authority, made clear in The Courier today that it has

“dismissed government proposals to chop the bottom off classroom doors to improve ventilation in schools.”

Where are we with schools? Parents are rightly concerned that kids have lost a lot of education in recent times. There is a view that continuing to wear face coverings in school—when face coverings are not being worn in many other places—is a distraction and gets in the way of education.

We then have all the measures that were announced yesterday, which include cutting off the bottom of classroom doors. Should we not be empowering local authorities to produce detailed reports that show what is happening in schools and where they are at, and then to take the responsible steps that they believe need to be taken at local level, or is the centralised control of 32 education authorities and a whole load of measures the right way to do it?

I am certainly not criticising anybody in the NHS, and I have never criticised the Government for the steps that it has had to take throughout the pandemic—I have certainly supported it. Although you can rake through the data and find a lot of that information for, for example, NHS Fife, it is not clear to me when we are going to get in about tackling that problem or whether we have a plan to tackle it. The private sector is the only option that seems to be available to people who are on long waiting lists for operations such as hip replacements. Therefore, we have a two-tier health system that is operating on the ability to pay. All I ask is that we start to see much more evidence of the Government’s plans to start tackling that.

My daughter is a principal teacher in a high school, and I talk to her constantly about the challenges in schools, so I am well aware of them. However, when the Government comes forward and says, “We’ll put £2.4 million into mechanical fans and £300,000 into undercutting doors,” I have to wonder how you have come up with that solution and how engaged local authorities have been in it. Is there, at local authority level, some report that sets out the challenges in that particular authority?

I go back to Hugh Pennington’s point that there seems to be no real evidence for this and that it is almost a case of being seen to do something. Where is the evidence that, say, spending £300,000 to cut the bottoms off doors in schools is the answer?

I want to move on quickly and ask you about the backlog in the NHS. A number of months ago, I raised with you the rise of the private sector in Scotland, the use of which seems to be increasing. I am dealing with the case of a constituent who went to the private hospital at Murrayfield, paid £200 to see a consultant, was quoted £14,500 for a hip replacement and then, two days before the operation, was told that the cost would be £15,500 instead. She was told to take it or leave it, because there were lots of people looking for hip replacements.

That was the private sector, but what about the people who cannot afford £200 for a consultation or the £15,500 for a hip replacement? Will we, at some point, start to see details of the backlog, health authority by health authority, and specifically where that backlog is? A lot of people out there are in a lot of pain, and they are on waiting lists for hip replacements, cataract removal and so on. You can see why there has been growth in the private sector, but it is fundamentally a result of the NHS failing to meet people’s basic needs. Where are we at with all this? What do the waiting lists and waiting times look like, and how are we going to tackle that, other than by saying to people who can afford it, “You can go to the private sector” and to people who are poor, “You can stay in pain”?

Given that vaccination rates in the cities are so low, are they giving the Government concern? Are you proposing specific actions, or are you simply letting the programme run and seeing whether the uptake comes?

What about the cities? Nobody has picked up on that. As I said, in Glasgow, 52 per cent of people have had their vaccination, and Edinburgh is a bit higher at around 59 per cent. There seems to be a problem in the cities compared to Fife, which is at more than 70 per cent, and the islands, which are at more than 80 per cent. Is there a problem with people not getting the booster in the cities?

I asked about the over-80s.

There is a dip in the over-80s group.