1. To ask the Scottish Government what its position is on whether orthopaedic appointments and surgeries, when they do not require the use of general anaesthetic, should be carried out in local community hospitals. (S6T-01410)

Health boards will always try and offer patients appointments in their local area. However, patients may be offered an appointment at a different location, such as a national treatment centre, to ensure that they are seen as quickly as possible. Treatment decisions are made by clinicians, taking into account the patient’s treatment needs and ability to travel.

Estate availability and staffing are key considerations for health boards to maximise the number of patients seen. Boards may try to protect theatres for arthroplasty procedures requiring anaesthesia or spinal blocks and undertake local-anaesthetic cases in community hospitals, treatment rooms and day theatres.

The national treatment centre is a great addition to the Highlands and we all appreciate it up there. However, patients in Caithness welcomed orthopaedic surgeons travelling to Caithness general, for example, to carry out minor surgeries and to review cases. That meant that they did not have to travel all the way to Raigmore, which could take two hours. An orthopaedic surgeon could carry out a series of, say, 40 case reviews on his list over a period of two days. Surely that is good use of the surgeon’s time and national health service resources.

I recognise the concerns that Mr Mountain has raised. As he also acknowledges, the national treatment centre in the Highlands at Raigmore will offer significant additional capacity for elective procedures in the Highland area. I also recognise the need to minimise the need for patients to travel excessive distances within the Highlands—in particular, where they have longer, enduring painful conditions or where they are going through on-going treatment.

I would certainly encourage NHS Highland to look at how it can minimise the need for patients to travel to Raigmore, where possible, and to look at whether there is scope for further procedures to be undertaken at Caithness general hospital, including review visits where possible. I am also conscious that not all of that work requires orthopaedic surgeons. Some of it can be carried out by MSK—musculoskeletal—physiotherapists or by advanced nurse practitioners who specialise in orthopaedics, all of which could help to reduce the need for patients to travel to centres such as Raigmore.

I welcome that answer from the cabinet secretary, but my issue is in relation to patients in remote rural areas, where being able to see an orthopaedic surgeon is extremely useful, especially when a case is being reviewed, for example, after an operation. My constituents are concerned, having heard that NHS Highland will have to reduce its budget by £60 million, that this is one of the outcomes of that. I ask the cabinet secretary to urge NHS Highland to speak more fully with the orthopaedic department to make sure that it is taken along with NHS Highland’s plans.

I would expect the health board to look at how it can maximise the benefits that it gets from the clinical group that it has within its orthopaedic department at present and how it can utilise those skills to the best of its ability in order to meet the needs of those who require orthopaedic procedures within the NHS Highland area, whether that be treatment that is being carried out at the national treatment centre at Raigmore or procedures that can be carried out in district general hospitals. I would certainly want to encourage the board to do so, and I will make sure that I raise the issue with the board and encourage it to look at what further action it can take in order to address the concerns that have been raised by Mr Mountain.

I thank my colleague, the member for Dumbarton, who lodged the parliamentary question that uncovered the extent of orthopaedic waiting times in Scotland as reported in the press over the weekend. The Government is quick to point to the national treatment centre that opened in Fife back in March, but people are still languishing on orthopaedic waiting lists. Does the cabinet secretary accept that his predecessor failed to deliver an end to the two-year orthopaedic surgery waiting times and can he confirm how many orthopaedic surgeries have been carried out this year, so far, and say whether the new national treatment centre will meet its target?

I am sure that everyone in the chamber, including Mr Sweeney, recognises that we have gone through a pandemic, which has had a significant impact on capacity in our national health service. That has resulted in many elective procedures having to be significantly reduced in number or cancelled, which has resulted in a significant backlog.

The NHS in Scotland faces the same challenges as are faced across the rest of the United Kingdom and, to some extent, in healthcare systems globally in that we are having to work our way through those significant backlogs. We have made steady progress in reducing them, particularly for people who have had the longest waits. Capacity is increasing across our territorial health boards and we are adding to their capacity through the creation of the national treatment centres, which have already started to open and provide additional capability. That will help us to reduce the overall times that people will have to wait.

I do not want anyone to wait for a procedure longer than they have to but we also have to acknowledge the significant disruption that there has been to the NHS over the past two years. It will take some time to reduce those backlogs but we are doing everything that we can to increase capacity and reduce the waits as much as we can.