Hansard

I am pleased to close the debate on behalf of Scottish Labour, and to welcome the anticipated passing of the bill at decision time.

Jeane Freeman has always been a committed cabinet secretary who fights her corner. We will find agreement this afternoon, in her final debate, and I hope that she will take pride from having been part of the ScotGEM programme.

I thank the committee for its work on the bill. Stage 2 was not particularly onerous because no amendments were lodged, which is perhaps a reflection of members’ agreement on the bill’s single simple purpose.

Although the ScotGEM programme is the driver for the bill, it also addresses an anomaly from the 1960s, when the creation of the University of Dundee as a separate institution with a clinical school prevented the University of St Andrews from awarding medicine and dentistry degrees. Although the bill will remove that legal barrier, it will not result in the University of St Andrews being able to award such degrees beyond the ScotGEM programme, at this time.

The 2019 programme for government set out the intention to create a new medical school. The University of St Andrews has submitted a bid in the open competitive commissioning process. Although that process is currently suspended, the bill enables the university to compete in it, so I wish it well. That would place its academic offering on an equal footing with those of all other UK universities. Because it is the only university in Fife, that would also result in the first awards of medicine and dentistry degrees from the kingdom.

However, I appreciate that there are other matters to consider that were raised during scrutiny of the bill, and that further issues including widening access, NHS recruitment and the potential impact on the north-east must also be examined. Those issues reflect the views of Aberdeenshire health and social care partnership and the University of Dundee, both of which have expressed a preference for partial removal of the prohibition. The University of Dundee has also expressed concerns about training capacity for its students, if St Andrews were to start awarding medicine degrees, and its ability to place students in local hospitals. Those concerns are about capacity and competition in a shared geographic area with limited opportunities, so they must be resolved.

Although the purpose behind the bill is delivery of the ScotGEM programme, it will open up other opportunities for the University of St Andrews. On balance, I agree that it is appropriate that the bill will achieve that broader purpose.

I welcome the ScotGEM programme, which is innovative and is the first of its kind in the United Kingdom. I hope that it will be successful in increasing our GP workforce and could be considered for other institutions. I wish the first cohort of students, who will graduate in 2022, all the best in their future careers.

I also support the financial incentive for a commitment to NHS services. It would be interesting to know whether it is attractive to students, and to know how many of the 55 current students have taken up that offer. Retention of graduates is an issue. If this model is successful in securing commitment to the NHS, it could be considered for other professions in which we experience shortages.

We compete internationally for healthcare staff as well as for other key workers. It is also unclear what the impact of the new immigration system will be, but it will certainly have an effect on the number of European Union workers who will be able to transition seamlessly into working in the UK. We need to find ways of securing our workforce.

The challenges that health boards and integration joint boards face in recruiting and retaining GP and primary care staff are well known. In my region there has been a steady flow of retirals and resignations, and in some cases it is proving to be very difficult to replace the GP workforce. In Fife, a number of general practices operate closed lists, and some have now come under the direct control of NHS Fife. Many practices rely on locum cover and are described as being in a high-risk situation. That has also led to difficulties in delivering out-of-hours services in local hospitals, and to the recent closure of a palliative care ward because a responsible medical officer could not be identified. The impact of a shortage of GPs is therefore being felt in areas other than primary care.

Although the ScotGEM programme will not resolve all those issues, it is a positive intervention. As a member for Mid-Scotland and Fife, I am pleased to have seen the development of the course. Its focus on rural medicine and healthcare improvement is welcome. It also seeks to focus on acute care issues. I hope that, as more cohorts come through the course, the benefits can be realised across the whole of Scotland.