Hansard

I will start by apologising to the chamber. My Surface has had a moment with Zoom over the past five minutes, so I currently have my phone propped up while I try to make this speech. I hope to get the issue fixed ahead of my closing speech.

I thank Labour for bringing this important debate to the chamber. I hope that, together, we can recognise the importance of our health and social care workforce. Despite the workforce’s dedication, it continues often to face significant challenges that require not only urgent attention but concrete action. I hope that we can use this opportunity to highlight the key issues raised by those working on the front lines and to discuss the steps needed to ensure a sustainable and effective workforce for the future.

I will start by talking about mental health. I thank Scottish Action for Mental health for the support and briefing provided ahead of this afternoon’s debate. We know that access to timely mental health support remains a serious concern in Scotland. The on-going lack of meeting the 18-week waiting time for NHS psychological therapies and child and adolescent mental health services points to a system that is struggling to meet demand. Although there has been a 69 per cent increase in the NHS psychological services workforce over the past decade, and a 128 per cent increase in the CAMHS workforce since 2006, demand continues to outstrip capacity. That is particularly evident in the lack of community-based mental health provision and the vacancies in some health boards, including in NHS Forth Valley in my region, which has a significant number of unfulfilled psychiatrist roles.

The Scottish Government’s mental health and wellbeing workforce action plan sets out some priorities that are generally welcome, including a commitment to evidence-based workforce planning. However, SAMH points out that there are clear gaps that need to be addressed. The plan does not provide essential benchmarking or mapping, nor does it set out targets or an assessment of workforce needs. It also fails to fully recognise the third sector’s vital role in delivering mental health treatment and support. SAMH poses the question to the Scottish Government whether it will conduct a needs assessment of the mental health workforce, including the third sector, to establish clear targets. In addition, we need to see the Government guaranteeing sustainable funding for third sector mental health providers, which are doing huge amounts of work.

In the 2021 programme for government, a commitment was made that, by 2026, every GP practice would have access to a mental health and wellbeing service, which would be backed by funding for 1,000 additional dedicated staff. That was to be supported with an annual investment of £40 million by 2024-25. However, it is disappointing that the commitment has been paused due to financial pressures. I hope that, with additional money coming from Westminster, we will see it restarted.

As at March 2023, 17 per cent of GP practices in Scotland reported having no access to mental health workers. The need for investment in primary care is clear, and we must ensure that people can access the mental health support that they require at the first point of contact.

The Royal College of General Practitioners has shared important information on GPs. The single most impactful outcome for primary care would be an increase in the number of general practitioners—and that needs to be measured by whole-time equivalent rather than by headcount.

Data shared by the royal college, which originated from the GP workforce survey, reveal that the number of WTE GPs has decreased, with a reduction of 0.7 per cent between 2023 and 2024. Since 2015, the WTE GP workforce has declined by 4.2 per cent, while the number of WTE medical and dental consultants has increased by 21.2 per cent. The divergence is particularly concerning as GPs carry out 90 per cent of NHS patient consultations on any given day.

It must be recognised that some progress has been made, and the royal college welcomes the Scottish Government’s general practitioner recruitment and retention action plan. However, the royal college stresses that the plan must be adequately resourced and effectively implemented, as must other plans.

Workforce and workload data for Scotland’s GP workforce remains poor.

The number of GP practices in Scotland has already decreased, reflecting a concerning trend towards fewer practices overall. Evidence consistently shows that countries with strong primary care systems have better health outcomes and lower rates of unnecessary hospitalisations. The RCGP has also welcomed the First Minister’s recent speech on renewing the NHS, and his commitment to increasing the proportion of new NHS funding that is allocated to primary and community care. However, we need that to be progressed at pace.

The BMA highlights its on-going frustration with Scotland’s workforce plans, which in its opinion have lacked the necessary detail and long-term solutions. It continues to call for a comprehensive plan that sets out the required number of doctors in both primary and secondary care, along with clear strategies to improve recruitment and retention at every stage.

Alcohol Focus Scotland is calling for urgent action, as many feel undervalued and at risk of burnout. The alcohol and drug workforce survey highlighted high workloads, large case loads and heavy performance-reporting burdens. Among respondents from statutory services, 63 per cent reported feeling under pressure most or all of the time. Additionally, Audit Scotland has noted slow progress in implementing the Scottish Government’s drugs and alcohol workforce action plan, particularly in workforce mapping and developing a competency framework.

Scotland’s health and social care workforce is the very backbone of our country’s wellbeing yet, across mental health, primary care, general practice, social care and addiction services, we see challenges, staff shortages, unsustainable workloads and a lack of long-term workforce planning. Reform and workforce planning need to happen at the same time, and we need to ensure that we have the workforce to sustain and improve services and produce the workforce plans that we need to realise ambitions on reform. Both have to be done at the same time; otherwise services will continue to struggle to meet demand.

I welcome the First Minister’s renewed focus on supporting and strengthening the NHS. His commitment to increasing the share of new NHS funding that is directed to primary and community care is a step in the right direction. However, now is the time for the Scottish Government to deliver the solutions, investment and commitments that our workforce and the people whom they care for deserve.