Seòmar agus comataidhean

We need people to be empowered to understand that they will be part of the co-design process and that the bill is a framework that we will build on. Is that what we are asking people to believe and trust—that they will be part of the co-design?

When you made your opening statement, minister, you talked about the fact that you are a Highland MSP. The Highlands is a rural area. I am an MSP for South Scotland, which is also rural. There are complexities in designing impactful changes, so I am glad to hear about the processes that will be undertaken, especially those that will look at services.

In Dumfries and Galloway, there are no council-run care homes, but in the Borders, for instance, there is a mix of private and council-run care homes. Is that going to affect the work that is taken forward? Will that look at the fact that individual areas have specific needs?

In its report on the bill, which I have in front of me, COSLA made a positive statement. It said that it recognised that a national care service in some form

“could provide national leadership on matters such as workforce planning, training, terms and conditions, national standards, ethical procurement, registration, inspection, and improvement.”

However, COSLA had concerns, and it asked for the bill to be amended. That means that you will need to work with COSLA and with the relevant representatives, as you have indicated. I just wanted to clarify that.

Jeff Ace talked about a Scotland-wide approach, with combined or joint services. Do you mean combined human resources as part of joint work and integration, or combined financial services? Is that something that could work for NHS Dumfries and Galloway, which is a small board, or does there need to be a Scotland-wide approach, as well?

I have a quick question for Jeff Ace about international recruitment. You have been quite successful in recruiting nurses. Not only a warm welcome, orientation and training are required; a wider holistic approach is required. Is housing a challenge in recruiting folk to remote or rural areas such as Dumfries and Galloway? If so, what can be done about that?

The recovery plan is a five-year plan; coming out of Covid is not an overnight fix. It will take time, and I know that as a nurse myself.

I am interested in the cancer diagnostics centres. One was created in Ayrshire and Arran, one in Fife and one in Dumfries and Galloway. Prevention and early diagnostics are happening in NHS Dumfries and Galloway, where there is a trial of self-sampling for cervical cancer diagnosis. Would Mr Ace like to comment on that?

You have said that it is about a holistic approach. As I read the papers, I saw information about continuing feelings of being let down, of prolonged and continued anxiety and of disappointment, because the expectations were already low and they were not being met. It seems that there is also conveyance of lack of empathy for their experiences. It is almost like there needs to be a Maggie’s centre equivalent for people who have had mesh injuries. It is quite difficult to read some of what has been presented. How would you describe the holistic approach? I know that psychologists and clinical nurse specialists are involved. How would you see progress being taken forward based on feedback from surveys about people’s experiences?

I have a question for Jeff Ace, but before I ask it I remind everybody that I am a former NHS Dumfries and Galloway employee and was part of the Covid vaccination team as a nurse during the pandemic.

What particular changes have been made for service delivery? We met last Friday, as part of our normal updates. Parts of Dumfries and Galloway are really remote and rural, so one of the things that you talked about was the development of home teams. Will that help to manage the service in a better way—not necessarily to make savings, but to improve efficiency?

Yes—I have a quick point. The deputy convener mentioned the Shouldice approach. A Shouldice repair has strict criteria such as losing weight, having no alcohol and being able to exercise. It might be difficult to apply that in Scotland, where people who present as needing an inguinal hernia repair that uses mesh, for instance, might have additional comorbidities. We cannae compare apples wi oranges.

I will go directly to the communication theme. I am looking at the NSS website and the NHS Greater Glasgow and Clyde website. The NSS website is quite clear on the pathway and what the process would be, but the NHS Greater Glasgow and Clyde website is a bit clunky for finding the information that people need—that is obviously not something that you can control, Dr Lamont.

I am interested in how women are communicated with, from the start of the process through to referral and as the process goes on. Is there open dialogue and does it happen by contact with the direct clinical nurse specialist, for instance? What is the process for communicating to keep people feeling that they are well informed?