I am delighted to be taking part in the debate, and I thank Labour for bringing the issue to the chamber. It has been an interesting debate on a subject that could, as Alex Neil has just said, have done with more time for members to develop the main points. The fact that there has been little attempt to leverage political discourse into the debate highlights how important the subject is.
Alex Rowley started the debate by highlighting how problems between the NHS and social care services are leading to delayed discharges. Miles Briggs developed the point and suggested that the level of delayed discharges indicates the pressure that our social services are under.
I highlight that we agree with much that is in the Scottish Government’s outline vision and objectives. It is entirely right that we should aim for everyone to live longer and healthier lives at home or in a homely setting. Alex Neil focused on the fact that treatment at home is medically and financially the better option. That should receive support from across the chamber.
Central to that vision is the development of integration joint boards. In his speech, Alexander Stewart highlighted the fact that initiating such a fundamental change will inevitably hit bumps in the road.
However, as the Health and Sport Committee reported, plans for measurement of health and social care are being hampered by lack of leadership, which Michelle Ballantyne raised in her speech. There is a sense that there is no governing body steering the ship. Willie Rennie was keen to develop that issue. At this point, 21 integration joint boards are failing, after three years, to deliver the transformation that is required.
That view is backed up by an Audit Scotland report that states that progress towards the 2020 vision is “too slow”. That report also mentioned that financial sustainability of the health service in the medium to long term and recruitment of the right number of key staff are key.
Workforce planning, or the lack thereof, was one of the main thrusts of today’s speeches and the Labour motion, and we have heard calls for a cohesive strategy to alleviate the shortage of trained healthcare professionals. We are certainly able to support some of the SNP policy at the top level. However, when we look below the surface, we can see that more thought is required in order to create a sustainable and stable workforce.
I would like to highlight the unintended consequences of lack of forethought and planning in relation to the policy of providing 1,140 hours of free childcare for three and four-year-olds. It is a fact that, now, carers are transferring from the social care environment to the childcare environment, because the same skill sets are needed in both areas. Only a couple of weeks ago, nursery owners told me that they are recruiting more and more staff from the social care sector. The matter has been raised time and again in the chamber, but the Government has been slow to react and to recognise that all social care and health policies are interconnected and interdependent.
Integration of social care and healthcare is the way to go, and we support the drive to achieve it. However, there is an issue with governance in relation to implementation of the policy, as was highlighted in the inquiry by the Health and Sport Committee. The best that one can say is that progress on delivery is patchy across the country.