Primary Care

Part of the debate – in the Scottish Parliament on 3rd March 2021.

Alert me about debates like this

Photo of Jeane Freeman Jeane Freeman Scottish National Party

I am afraid that I am going to disappoint Mr Whittle in that, in the time that I have available, I will not be able to go through all the plans. However, I will happily do that on another day.

I start with what I did not say in my opening speech on the question of data, which the committee rightly identifies as critical. I assure the committee that work is under way on that, building on the progress that has been made in response to the pandemic and in discussion with the BMA and the RCGP. Work is also under way on what more can be done to give the citizen access to their health data and health advice, using some of the learning from building our test and protect app. That is actively under way as we speak.

I confirm, as the convener asked me to, that work has been restarted on implementation of the Health and Care (Staffing) (Scotland) Act 2019. That is a very important act and it will come into its own in relation to the independent review of adult social care.

The pandemic did not start the reform of primary care. Primary care, which is provided by GPs, dentists, pharmacists, optometrists and their teams, has benefited from sustained and record investment under this Government, and our primary care reform focuses on new models of care that put individuals at the centre of decision making.

While the pandemic has paused some work, it has accelerated work in other critical areas. I would argue that the role of community pharmacy is now much better understood and embedded in primary care than it was pre-pandemic. The use of digital technology is now widespread across primary care and it is moving into secondary and acute care, improving access for the citizen but also providing speedier care and more accessible care. Community pathways were initially stood up to respond to Covid, but they are now a central element in the redesign of urgent care.

Importantly, there is increased partnership working between primary, secondary and community care and the third sector. That is providing a foundation in, for example, patient-centred diagnosis and care, which is specifically relevant to how we respond to issues around long Covid. We have the primary care team as the central holder of care for the individual, but it can use digital technology to access specialist, peer-to-peer support in order to determine whether further tests, diagnosis and intervention are necessary.

The centre for sustainable delivery was stood up during the pandemic response. It is situated at the Golden Jubilee hospital, but it has the very specific job, as a stand-alone centre, of getting us past that thing that has bedevilled us for so long—having examples of good practice and good delivery that are not rolled out across the country. A central part of the centre for sustainable delivery—I know that Mr Whittle will welcome this—is to make sure that, where we have good examples of the use of social prescribing linked to primary care, we roll them out across the country, as well as other innovations that exist more in the acute setting.

The workforce is, of course, the central underpinning of any improvement in primary care. We have more GPs per head of population in Scotland than elsewhere in the UK. We have increased the number of student nurses in training, with their fees paid, of course, and with the bursary. We will have trained 500 advanced nurse practitioners by the end of this year. We are increasing the number of pharmacist training posts and the number of paramedics, and we are on track for 800 additional GPs by 2027. However, what is critical is not to be thirled to plans that were in place previously but to recognise that, if we are going to improve primary care, we need to review constantly the skill mix that is needed and therefore the workforce planning that is right to deliver it. That is all currently part of our forward planning work. I doubt that we will have time to advise the chamber of the work before the parliamentary session ends, so I intend to write to all MSPs advising them of the work that is under way in forward planning for the rebuilding of our health and social care service.

Again, I thank the committee for what is a very helpful report. I assure the committee of the Government’s commitment to taking forward its recommendations within the overall planning for that foundation—I repeat—of our NHS: our primary care.