 Welcome everyone to the Health, Social Care and Sport Committee's 11th meeting of 2021. I've received no apologies this morning. The first item on our agenda is to decide whether to take items 4, 5 and 6 in private. Are members agreed? Thank you, we are agreed. Our second item today is an evidence session with the Minister for Mental Well-being and Social Care on his priorities for session 6. I welcome Kevin Stewart, the Minister for Mental Well-being and Social Care, and supporting the minister this morning we have done a bill, director of mental health and social care, and Gavin Gray, the deputy director for improving mental health services, both from the Scottish Government. Welcome to you all. Minister, I believe that you've got a short open statement. Thank you, convener, and good morning to you and to the committee. Thank you for giving me the opportunity to appear in front of you today. I welcome the opportunity to set out my strategic priorities for the current session for the committee. Right now our NHS and social care systems are under more pressure than they have been at any point in the pandemic. The Government has responded with a comprehensive programme of investment in action in our mental health and social care sectors to address those challenges and to build a health and care system fit for now and for the future. That must be one that focuses on people meeting their needs in a holistic way and informed by their experience. I'll start with a brief summary of my vision for mental health and wellbeing. I want our work to focus just as much on supporting and creating conditions for everyone to have good mental wellbeing as it does on transforming our mental health services. Our transition and recovery plan outlines the breadth of work that we are doing, containing more than 100 actions. We are determined to build on some of the amazing work that has happened across Scotland during the pandemic. That includes the establishment of mental health assessment centres and the role of computerised cognitive behavioural therapy among countless other things. The transition and recovery plan requires similarly ambitious investment and that is why it is supported by record levels of funding for mental health. We have doubled the mental health budget compared to the previous financial year, with our core budget now standing at over £0.25 billion. That includes our £120 million recovery and renewal fund, which is the single largest investment in mental health in the history of devolution. Over £80 million has already been allocated from the fund this year. Of that, £43 million is to improve the mental health care that children and young people receive, including £40 million for child and adolescent mental health services. Additionally, we have committed to increase the direct investment into mental health services by at least 25 per cent and ensure that, by the end of the Parliament, 10 per cent of our front-line NHS budget will be invested in mental health. Together, that will be truly transformational for our mental health and wellbeing. We will continue to work with our partners and stakeholders and with people with lived experience to make sure that our response continues to evolve as we continue to recover from the pandemic. I see my priorities in social care under three broad headings. First, improving access to care. The pandemic showed and continues to show us that there is a need to significantly improve access to care and support for people and that work has to be done now. I know, for example, how much pressure unpaid carers are under and that cannot wait for the national care service. We are committed to overhauling of the current mechanism of eligibility criteria. We are planning to extend the support in the right direction programme to March 2023, with funding of £2.9 million. We have invested an additional £28.5 million for local carer support. Secondly, we recognise that the workforce is absolutely vital in delivering the ambitions that we have for social care across Scotland. We must ensure that the principles of fair work are adopted across the sectors as standard, improve pay and conditions and career progression for social care workers. Last month, we made a step forward by investing in the social care sector to ensure that front-line care workers receive a minimum of £10.2 an hour. There remains more to do on that front. The Government is committed to increasing public investment in social care by 25 per cent over the lifetime of this Parliament, equating to an increase of around £840 million. The recent investment to relieve winter pressures will maximise the capacity of care-at-home services, enable more social work assessments to be carried out and support social care staff. Finally, we will be taking forward our commitment to establish a national care service. We have already consulted on our proposals in this space. The independent review of adult social care was clear to improve people's experiences of social care. We need to create a comprehensive system that cares for and supports people in a holistic way and that empowers them to thrive. A human right has to be at the heart of all that we do here. We will introduce legislation for the national care service by the end of this parliamentary year and aim to establish the national care service by the end of this parliamentary term. I look forward to working closely with you and with the committee as we take forward this very important agenda. We are going to do your mental wellbeing part of your portfolio first and then we will move on to talking about social care in the second half of your session with us, if you do not mind. Drivers of mental health and the implications of mental health go into a lot of areas in Scottish society. I am very interested in how you, as minister, were responsible for mental wellbeing and working across other portfolios. It comes to mind that it is very important in terms of education and justice. How are you making sure that the drivers of mental health and the response to people with mental health issues across all Government portfolios is taken into account? That is absolutely vital. Let me give you examples just over the past couple of weeks some of the cross-cutting work that we are doing. The committee will be well aware that the other week I held a joint debate with Angela Constance, the Minister for Drugs Policy, looking at how drugs policy and mental wellbeing work together. In the past couple of weeks, I have met the justice and veteran secretary on a number of issues, but primarily our last meeting was looking at what we need to do as we move forward to improve mental health and mental wellbeing services for our veterans community. Again, in the past few weeks, I have met Jamie Hepburn and his further education role to see what more we need to do in supporting students, whether that be university students or college students. That is cross-cutting. The First Minister has made it quite clear to all of our ministers that we should all be working together, breaking down silos and making sure that we are doing our level best for people. Although I have overall responsibility for mental wellbeing, I think that every minister in the Government recognises that they have a role to play in ensuring that we do our level best for folk as we move out of this pandemic period. We are coming back to the mental health of our population, as you have alluded to several times in your statement, during the pandemic that it might have for many people gone to something that they are managing to crisis point. In terms of the mental health strategy, have you got plans for a review of that, taking into account some of the issues that in the last 19-20 months have been an issue? Have you got plans for a review? Well, convener, at this moment in time, what we need to do is to see what is required in the here and now. Many members of this committee will have heard me say before in this role but also in my previous ministerial role that the way that we should conduct ourselves in that regard is to listen to the voices of lived experience. In the past six months, I have spent a large amount of my time listening to people out there and their experiences of services at this moment in time. Some of that is good, some of that is not so good, some of it is indifferent. What we need to do in the here and now is ensure that the best practice that is going out there is exported right across the country. Let me give you an example, because that is always the best way. The other week, NHS Grampian won an award at the health awards for the Grampian resilience hub, which has been extremely beneficial for lots and lots of people over the course of the pandemic and in the here and now. Last Thursday, a week past Thursday, was the first time that I met anyone from the hub personally. However, I have heard a lot about their work by talking to folk with lived experience. I know, convener, that you are going to be doing an inquiry very soon on perinatal and infant mental health, which is an area that I have a great interest in as well. I met women in your constituency, convener, the other week, in Latin, who are the voices of lived experience of women in that northeast corner of Scotland. Again, they were telling me what was working well and what was not, but I think that everyone there said that the Grampian resilience hub was a lifeline for them during that pandemic period. That is the kind of service, that kind of delivery, is what we need to look at ensuring that it is happening right across the country. We know that face-to-face services have not happened for a long while, so we are getting back to that, but what actually works for people. For those women, the resilience hub works for them. Let us see what we can do in exporting that best practice beyond Grampian to other places, pick up that good practice and do our level best for folk right across the country. In terms of the not-symbols of the legislative programme, is there anything that you want to flag up that is happening in your portfolio with regard to mental health in legislation? I think that there is a number of things going on at this moment, as there always is. There is the Scot review at this moment, looking at the legal aspects of how we deal with mental health difficulties. That is going to be very important. As always, there are folks who are saying that we need to look at various bits and pieces of legislation and connected with the Scot review. There are folk who are saying that we should look at some aspects of adults within capacity legislation now, but we need that review to take place and do all of that in the round. What we need to do as we move forward, and I mentioned it in terms of my opening remarks, is that we need to take a human rights-based approach to all that we are doing as we move forward. I know that many of the folk around this committee table have taken a great interest in embedding human rights into legislation. There must be more of that, no matter what the challenges posed by the court case that the UK Government brought to the courts about previous attempts by the Parliament to embed human rights. We have to continue on in that vein. That is very important. That Scot review is very important in that regard, as far as I am concerned. Those answers are a good basis for me to go to my colleagues. We are going to dig deeper into some of the issues that you have mentioned. We have Evelyn Tweed. I am looking for Evelyn. She is normally sat on that side and she is now sat on this side. Good morning, minister. Can you share with the committee what effect you think Covid has had on the wellbeing of Scotland's population? It has had a huge impact. Talking to folk on a regular basis for some, the situation has been quite horrendous in terms of the differences that it has made to their lives. We have all faced the stress of the pandemic period, for some that have been much worse than others. For those who have lost income, those who have unfortunately been bereaved during the pandemic, some of the lifeline things that they were able to do before that kept them in fairly good fetal went by the wayside in terms of the lockdowns. I do not think that we can underplay at all the impact that the pandemic has had on people across the country. We can see from the survey work that has gone on over the peace that almost everybody has been affected by what has gone on. Can you tell us what action the Scottish Government is taking to deal with the long waiting lists that we have heard about? Waiting lists are a worry. We are taking action on that. I mentioned in my opening remarks the investment that we are making in child and adolescent mental health services, which is extremely important. We can already see in certain parts of the country the difference that that investment is making as new folk are being recruited into post. I was in Dundee on Thursday of last week at the youth unit there, and I was hearing from staff the difference that that investment will make. I should say, convener, in terms of some of the pressures that have been on staff during the pandemic period, that unit and those folks attached to the work of that unit, which covers the north of Scotland, at one point were 19, one-nine staff down because of Covid and the pressures around about it. Those folks have worked immensely hard during the course of all of that. They have behaved admirably. I have to say that they were extremely enthusiastic around about not only the current investment into CAMHS but also our ambition in moving to more preventative measures, including that school councillors are moving to mental health link workers into GPs and the investments that we are making into communities. While the focus is on acute services and waiting lists and waiting times—I understand that—the best thing that we can do as we move forward is to stop folk having to enter acute services by putting the right preventative solutions for folks in place. That is something that I am very much determined to do. Van Desch-Gelhani has some questions on the impact of Covid. Good morning, minister, and so is a question of interest. I am a practicing NHS doctor. The Government's heat target for starting psychological therapy after referral is 18 weeks, and psychological therapy is absolutely vital to the way that we can deal with patients who have mental health issues. My first question is, when was the last time the Government's heat target was achieved? I do not have that in front of me. I am more than happy to write to the committee with any detail that I do not have in front of me today. What I would say to Dr Gelhani, though, is that it is our ambition to ensure that we get waiting times and waiting lists down. Dr Gelhani has to recognise that we are going through a very difficult period in terms of Covid. I am quite sure that Dr Gelhani is going to come back at me and say that some of those problems existed before Covid. That is fair enough, but that Covid situation and that pandemic situation has exacerbated difficulties for people and has put a huge amount of pressure on services. I would say to Dr Gelhani that we have put in place a national standard for CAMH services. My officials, at this moment, in co-operation with stakeholders, including the Royal College, are going to do exactly the same for psychological therapies as we move forward. That is important. Again, we are going to be extremely ambitious as we move forward in all of that. I would say that, certainly, even in 2017, the targets have not been met since then, and through Covid, through the amazing adaption and digital appointment that have been offered, it has been an increase to 82.7 per cent of people being seen within 18 weeks. Covid is not the reason that we are missing the targets at all. How could we improve access to psychological therapies and address the fact that we have not hit the heat target at all since 2017? I would disagree profoundly with Dr Gelhani when he said that Covid has not had an impact, because it most definitely has. I think that Dr Gelhani should spend some time talking to those folks with lived experience and to those folks who are working in front-line services about the impact that Covid has had. On his point about digital services, which I think is an important one, we have, during the course of the past period, adapted quite quickly. Digital services has been one of the things that we have invested in—cognitive behavioural therapies, for example, which have worked well for many, many folks. We are going to continue to invest in digital services as we move forward. That works well for many—no doubt about that. However, there will still be the need for group therapies and for individual face-to-face consultations as we move forward. There is a lot of learning that we can take from what we have gone through. We are looking at how we can embed some of that learning into services as we move forward to create hybrid situations where that is required. However, in all of that, convener, as always, what we need to do is take the person-centred approach and see what is best for the individual. A lot of that is down to the clinicians themselves and what they think is best for a particular individual. Lessons learned from the pandemic were out of doubt. We will take full advantage of the technological changes that we have made as we move forward in order to get it right for people. I know that there has been a lot of work around tackling stigma, and because now it is less stigmatised to say that you have anxiety or a mental health disorder, that has contributed to the challenges where now we have more people that are basically coming out and saying that they have struggles, so that has affected the ability to tackle it. I know that the Government has been doing work around destigmatisation and support for mental health in that way. We have seen even pre-Covid over the past number of years arise in people coming forward with mental health conditions. A lot of that is down to the fact that we are changing the way that folk think about their mental health. A lot of that destigmatisation is down to a lot of hard work on the part of many stakeholders, but the amount of investment that the Government has made over the peace and the CME campaign. Just the other week, in order to ensure that that campaign continues to thrive, the Government—and, of course, this is also down to the Parliament in terms of the budget rate process—agreed that we would provide them with £5 million over the next five years so that they have the comfort of knowing what they are going to be able to do over the peace. I think that it is a really good thing that we are destigmatising all of this, but I think that we still have a long way to go. Let us be honest, there are still a lot of folk there that will not discuss mental health issues and will not discuss their own mental health. I think that there are areas where folk are very wary still of discussing aspects of all that. Probably the best example still is an unwillingness on the part of many folk to talk about suicide and suicide prevention. Again, the work that has gone on here in Scotland by the national suicide prevention leadership group has been recognised by the World Health Organization in terms of what we have been doing here, but we need to go further. That is why we have said that we will double the suicide prevention budget during the course of this Parliament. In all of that, we need to get folk to start speaking about those issues, which are often still to be. I know that I have rabited on there for a fair while, but there are a number of organisations and groups that have a major part to play in helping us with that. I went to an event at St Myrran football club the other week. George Adam would, of course, say at the centre of the universe—I do not know if I could agree with that—but St Myrran was a seventh year of a conference that was initiated by a local lad who had seen some of his own mates die by suicide who thought that enough was enough. That event was immense. It was heart-rending and difficult, but it made people think about what is going on out there, what some folk are going through and what we need to do to help folk in their time of greatest need. That community-based approach is the best way in some regards. We have brought a lot of footballers together for a very good competition, but that message was at the heart, and we need to do more of that. Gillian Rennart, do you have some questions? I will need to move on to children and young people. The mental health benefits of social prescribing are well known. Does the minister have a sense of the impact of the pandemic on social prescribing? As pressures increased on primary care, do healthcare staff have reduced time to engage with social prescribing? I think that it would be fair to say that time at this moment is precious, and I do not have any evidence in front of me to give to Ms Mackay around about these impacts. Those are things that we are looking at very carefully. I know that Ms Mackay has got a great interest in data. I have freely admitted to the chamber that some of our data collection is not the best, and in some regards there is a duplication of data gathering, not by the Government, but by a number of agencies. I have called it a stock take. We need to do a wee stock take, a wee audit, and that is one of the areas where we probably need to do a little bit more. I do not want to pre-empt Ms Mackay's next questions, but she knows, because I have answered questions in the chamber, that we are also lacking in data around certain minority groups, which we need to do much, much more work on as we move forward. Can I come to Carol Mocken, who has questions on children and young people's mental health? Children and young people services, I know that you mentioned briefly around CAMHS, but it is a very important area for the young people and their families. Of course, we know that the waits have been quite long, but in general, in terms of CAMHS services, I wondered whether you could give us some information about three aspects. The waiting times, which you have touched on, which we really need to get right for people and get those waits down. Also, there are a number of rejected referrals in CAMHS services, and as a Government you have acknowledged that and said that more work needs to be done and what can be done for those young people. The third aspect is about unmet need, because we know what the schools have been out in Covid and that we had a drop in referrals to CAMHS services. Medical staff have identified that as possibly young people who miss that window, and we should make sure that they are getting any support that they need at this time. I know that Ms Mocken has a real interest in community-based services and preventative measures, and, as I said earlier, I want to move much more to that so that folk do not have to enter into acute services. Let me give you a wee flavour of the CAMHS situation at this moment. I have to say that some of the statistics are not brilliant. Some of them show that things are on the move without a doubt. What I would say is that, for each of those statistics, each number is a person, and that person also has a family. I certainly will not be forgetting those things as we move forward. During the course of this past quarter, 4,552 children and young people started treatment during that quarter. Those statistics were published on 7 September. That is an increase from the previous quarter of 4,096. That is up 28.3 per cent from the same quarter in 2020. We are getting back to clinicians being able to see more folk, and that is a good thing, but we still have a way to go. 72.6 per cent of CAMHS patients started treatment in 18 weeks in that quarter. That is slightly up, ever so slightly up from the previous quarter, which was 72.4 per cent. It is up dramatically from the same quarter in 2020, which was 61.7 per cent. However, we have to understand that there was a massive impact with the pandemic at that time. 10,193 children and young people were referred for CAMHS in that quarter. That is an increase from both the previous quarter, which was 7,883. The same quarter in 2020 was 4,052. As you have already pointed out, there was a dip during the course of the pandemic of folk being referred. 22.2 per cent of referrals to CAMHS were not accepted. That was similar to the last quarter. I know that Ms Mawkin believes that there should be more interrogation of that, and I agree with her on that front. We will look at all of that as we move forward. That gives you a flavour. I have a lot more in front of me here, but I am sure that you do not want me to take up a huge amount of time with all of that. I will do so if you wish to send all of that to the committee in writing, so that you have all of the information at your disposal. That would be very helpful, Carole. Can I ask a bit more about the need if you have a plan or if you have spoken to any of the organisations about what we might be able to do to identify any young people that have been missed? In all of that, I say that it is my job to make sure that we are doing our level best for everyone. I make no bones about the fact that long waits are unacceptable, and we, as a Government, remain committed to meeting the standard that 90 per cent of patients begin treatment within 18 weeks of referral. I am going to be a little bit parochial for a minute, and I hope that folk will excuse me. When I was first elected to this place, I have to say that camp services in Grampian were pretty poor, and I used to get a fair amount of correspondence in my mailbag and my inbox about that. Camp services in Grampian were transformed, and even during that very difficult period, I had no real complaints about camps in Grampian. If you look at what has happened there over the course of the pandemic period, it has been pretty stable there, given the circumstances. That transformation made a real difference in service delivery, much more community-based and less reliant in some regards on the end services. We have the ambition to ensure that that change happens right across the country, and it would be fair to say that different health boards areas are at different levels in terms of making that change. The concentration that I have made is speaking to health boards who have not made the shift that they have yet. In order for us to meet the need, we will have to make those changes. It would be fair to say that quite a lot of my time has been spent talking to health boards and challenging them about what they can do to make that change. Some of that might not be so easy at the moment, but some of it should be easy to do now and would make things much better for patients and staff. I am more than happy to give the committee in writing the standards that we have set about that and the ambition that we have and even down to who I have been speaking to, if that is what you require. I want to ask you a little bit more about prevention. You mentioned earlier on school councillors, GP mental health link workers and so on. From the prevention point of view, we have heard quite a lot of evidence about different topics and how it can be quite difficult for the professionals to focus on prevention. What measures are you looking at putting in place to see what the impact of that is and to make sure that it is prioritised on the ground? You have picked a good example of prevention and trying to keep folk out of acute services, because I think that the school councillors quite new are already making a difference. There was a report published—oh gosh, do not hold me to this—time, at the moment, not to be sure about, six weeks or two months ago, about what the school councillors were finding. What difficulties young folk were coming to them with and gave details of reveral, and that is not necessarily just to acute services. I was getting pen pictures of the other things that were going on in terms of signposting young folk to the right help at that point. For some young folk, the listening ear is enough. Somebody recognising that they have a challenge is often all that we need in this life. How many of us go to somebody and say, this is my problem at the moment, and telling them that, we but advice, that is cathartic in itself and can be immensely helpful. In terms of the huge amount of work already that is going on in that service, it is quite incredible. Again, convener, we can provide the committee with the links to that. It is public. I am looking at Donna. It is public. It is how the counselling has been rolled out across each local authority, because obviously it is good for us all as individual MSPs who are obviously speaking to our local authority. Each local authority has done things slightly differently, convener. Again, we have a lot of learning from that, because we will be able to see where performance is maybe better. Again, we can export that best practice. The other aspect of prevention is that we provided local authorities with monies for prevention work with young people. Again, that is something that I have been keeping a very close eye on. I think that some local authorities have moved very quickly in supporting services, establishing new services where required. Others are lagging behind, and there are a few local authorities that I am afraid to say have not done very much at all. That is something that we are keeping a very close eye on, because I want to ensure that those investments are reaching, particularly the community groups who were at the very front line during the course of the lockdown periods and still are at the front line, who have done great work in preventing young folks from entering acute services. We need to move on, but health inequalities, too, ever? Thank you, convener. I hope that that will follow on quite nicely from what Ms Callaghan was saying, and Ms Mocken has spoken. I want to ask you about the health inequalities across Scotland. You have already mentioned the established and successful CAMHS service in Grampian, whereby in Lothian it is quite a different story for the many young people who are trying to access services. The rolling out of the counselling is done quite differently across local authorities. Some are lagging behind, some are doing very little, but, as a taxpayer, I suppose that we want to make sure that every single penny that we spend is being spent well and is being spent on the intended purpose of the investment. What actions are we taking to address those inequalities and delivery of the mental health services across the country? You talked about inequalities and delivery, and I will come to that in a second. Population health inequalities, as I have said before, and I will continue to say, the main driver of health inequalities, including mental health inequalities, is poverty. We all have to recognise that that is the case. Some of the difficulties that people face at this moment have been exacerbated by some of the decisions that have been taken in recent times, including the cut to universal credit, which is at a major impact on individuals and families right across Scotland. I will not go on too much about that, because I could go into a rant that would last all morning, let us be honest with you. Let us look at the difference in delivery. I spoke earlier about the standards that we have put in place for CAMHS. My expectation is that, right across the country, those standards, high-quality standards, are met in terms of delivery for people. That is one of the things that we need to do. Ms Webber is right that there is a stark difference between delivery in Grampian and Lothian. It is the way that the services are delivered. We need to move, transform, in the right way, to do our level best for folk and follow the example that has happened in the north-east of Scotland. Those standards in CAMHS are already making a big difference in terms of the thought processes of some as well. However, we need to go further. That is why officials, along with stakeholders, are now working up new standards for psychological therapies. We will be doing similar in other areas of business, too, so that everybody knows what is to be expected, whether that is those folks delivering the services or those folks who are in receipt of services. Beyond that, convener, in all of this, and I cannot emphasise this enough, where services are working well, and I am not saying perfect, but where services are working well, what you tend to find is that the voices of lived experience are at the very heart of the shaping of those services. That is where we need to get to. We need to be listening much more to the service users and their input in terms of what works for them and what does not. If you go and talk to folk in Grampian in the main, it is said that it is not perfect, and folks will, without doubt, have their gripes and say that that did not work well for them. In the main, folk have a good feeling about that service that they have been listening to. Alternatively, on the other hand, I am picking up Grampian in that regard. I might be accused of parochiality. In terms of perinatal and infant mental health, Grampian has not done so well at all. I think that a lot of the reasoning for that is that the voices of lived experience have not been at the heart of that service. I am sure that you will find out more about some of those things in your inquiry. In terms of that aspect, other areas of the country—Lothian—do very well in that regard in Grampian in the north, not so well. You have hit upon something as a committee that we want to speak to people with lived experience as well on our inquiries. Can I come back to Sue who has some more questions? Thanks, minister. It is just a very brief one. We have only 13 health boards, but many more local authorities. I am with such a small group or cohort of healthcare providers relative to elsewhere. What can the Scottish Government do now to make sure that the process and the best practice, like Grampian, is rather than just speaking about its great and Grampian, perhaps not so in Lothian? Why can't we just be much more forceful about prescribing best practice so that it is implemented consistently across the country? I think that I have answered that in my questions this morning in terms of standards. Set standards now for CAMHS, set standards next for psychological therapies and we will move on. That gives folk that framework, that foundation of what is expected of them in terms of service delivery for the people in each of those areas. It also gives the service users, the patients, the knowledge of what should be expected. Can I move on to questions around healthcare workers in the mental health sector from Emma Harper? Thanks, convener. Good morning again, minister. As a registered nurse, I have been participating in vaccines and hearing from colleagues directly about how they have been coping or not coping with their mental health. I know that there has been a lot of work taken forward with the national wellbeing hub and clear your head in different programmes to support the healthcare and social care staff. I am interested, minister, in how are we monitoring and evaluating the way that those programmes are being engaged with? I think that the proof of the pudding here is in the eating in terms of what we have done here. We know that staff are accessing mental health wellbeing hub and the other services around it. As the committee knows, we have invested more money in there. However, it would be fair to say, and it goes back to your point earlier, about stigma. Some staff feel stigmatised in using those services. We have got to get folk over that hump. Talking to folk in health and social care, I have been saying all the time that we must continue to signpost those services. At times, we must cajole folk to go on and use those services. Once folk do, it can make a real difference. In some cases, in a fairly short time, not in every case, obviously. However, talking to somebody the other week who had used the services, even those initial calls they felt, in their words, the burden had been lifted. Folk are under a lot of pressure. Those services are there, and I want them to be used. However, it is vital that all of us, whether it be in this place or whether it be out there on the front line in health and social care, whether that be within the NHS, health and social care partnerships or in third sector organisations, we must all be highlighting that that is there and that folk should access it if it is needed. All of that shows still that we have a lot of work to do in terms of de-stigmatising some of that. I know that we have asked our NHS and our social care staff to work through unprecedented times, and often in unfamiliar settings. Many have been asked to learn new skills and work in new roles and in unfamiliar teams, for instance. I am interested in how mental health impact might retain staff so that we can address all of that so that we do not lose our staff because of poor mental health. I will write in some more depth about the detail of access of the mental health, wellbeing hub and other services and give the committee an indication of what they are doing and what kind of difficulties folk are coming to them with. In answer to Ms Harper, without giving her the in-depth statistics that she wants here, I am spending a lot of time speaking to folk on the front line. It is quite clear that a lot of folk are under a lot of strain. Sometimes that is because of work, sometimes that is because of the home pressures of the pandemic, and there are a lot of different things going on out there. What we all need to do and to be aware of is that there are folk out there who are not feeling at their best at this moment. We as a Government but also as individuals need to do what we can to support people in the best ways. We have had suggestions from staff around some of the wellbeing issues that we have acted upon because, why would you not if a difficulty is highlighted to you? That increased investment that we have put in is because it was suggested that we need to go further in some instances. Beyond that, there are individual health boards as well who have gone even further in meeting the needs of staff during those times. I know that Fife, for example, had a substantial donation from a member of the public who went in to support staff. Sometimes those are the most simple things—free hot drinks, free food. All of that can make a difference and take pressure off. I am open to suggestions around that, as is the cabinet secretary. We have a short supplementary from Gillian Mackay before we move on to questions from Paul, who is going to be talking about suicide prevention. Obviously, during the pandemic, there have been times when staff may have been the only person who was dying and was there with people who loved ones who could not get to see them during lockdowns. That is probably quite a traumatising event for some of those staff. As part of the wellbeing hub, is there any specific support for people who may be feeling those particular situations? Yes. You hit upon a really good point. Some folks have seen some very traumatic scenes happen before their eyes. I have heard some pretty bleak stories from folk as I have been doing the rounds and talking to folk. We have to ensure that we do our level best for a number of folk who have seen difficulties, deaths in the past, but for many that has been so much more. We have to take a nice sense of that and wrap around the support that is required. I move on to questions from Paul O'Kane. Good morning to the minister. I appreciate that the minister has touched on suicide prevention in previous answers, and those were very informative. Obviously, at the moment in Scotland, we have high rates of an increasing rate of suicide. When we take that as a comparator across the UK, indeed, we are higher than England, Wales and Northern Ireland. My first question would be, are we engaging with other parts of the United Kingdom to understand perhaps their experience and what has been done there? What innovation? How can we share best practice? Notwithstanding the work that I think is going on already, where can we learn from other people as well? Thank you, convener, and I thank Mr O'Kane for his question. Let me be brutally honest with the committee. I am happy to nick good ideas from anyone anywhere. I think that some of the things that we are doing here are pretty groundbreaking. I think that we owe a debt of gratitude to the national suicide prevention leadership group, as I said earlier, recognised by the World Health Organization in their most recent report. That is the report that is worth reading. There are some good tips from across the globe that say that I am more than happy to nick as we move forward. We had a very small decrease in suicides in Scotland last year, but one suicide is one too many, as far as I am concerned, and we have a fair amount of work to do. I should also say that, convener, and I think that the committee may be aware of that as well. I think that, again, we have a lot more to do when it comes to self-harm as well. That is why I have said that we will develop a separate self-harm strategy as we move forward. A lot of work has been done by stakeholders and academics here in Scotland on that issue. I think that we have more to do, but I think that we can. My understanding is that I stand to be corrected that moving in that direction will be the first country in the world to move to having a separate but connected self-harm strategy. I thank the minister for that answer. I think that we all in the committee would want to also say ourselves with those comments that one suicide is one too many and to welcome any decrease. Can I ask just about every life matters in terms of the prevention action plan, which was obviously just reviewed in March? The outcome of that review is that perhaps progress has been maybe slower than anticipated in some areas, and I think that you alluded to that yourself, that we do need to go further and do more. Notwithstanding the challenges that we have all experienced through pandemic and lockdown and the exacerbation that has obviously placed on services and people's lived experience, I suppose that what I am keen to understand is how we are going to drive forward to what is in that plan a very ambitious target around reducing the rate of suicide by 20 per cent by 2022. How achievable does the minister still feel that target is and what further actions does he feel that we need to take to get there? There are a number of things that we need to look at. I talked earlier about doubling the budget over the course of this Parliament. We have to make sure that every penny spent is well spent. We have two pilots going on at this moment in time—an Ayrshire and Highland—a roundabout support for those folks who have experienced suicide. I think that the findings from that are going to be very important. That may well lead to a national roll-out. The other thing that I am keen to explore is how much more can we do in communities themselves. I mentioned the St Myrran event earlier, but there are a lot of small groups that I have come into contact with in recent times that are doing sterling work. How can we build on that? Yesterday morning, I met the trustees and the family of Chris Mitchell Foundation. Chris was a footballer whose professional career ended because of injury, who then carried out suicide. Some of the work that they have been doing with football clubs could be expanded on. I think that some of the other work that is going on by the SPFL we should build on. We need to get to certain areas of the population that sometimes normal health messaging does not get to. We have to continue to adapt and to think out the box in terms of what is required to get that right as we move forward. I think that there is work to do. I think that we should recognise the immense partnership that there has been between Government and COSLA and that national suicide prevention leadership group. I welcome what the minister said about the grass roots organisations, which we all probably have experienced in communities. Does he feel that there is a space to help to fund some of those organisations on a more localised level and to move that forward when it is required? One of the reasons why we announced the adult community mental health fund the other week is so that those groups can access funding. There is plenty of detail around that and more will come and we will share that with the committee. I want those grass roots groups to apply. Let us be honest. I want them to apply for this fund. That is why I will supplement your question on this from Sue Weber. You have mentioned a number of times about the importance of listening to the voices of those with lived experience. We have also heard from Paul there that suicide prevention action plan from 2018 was reviewed back in March. It stated that the vision is to support our key strategic aims in Scotland where people at risk of suicide feel able to ask for help and have access to skilled staff and well-coordinated support. I have been contacted by a friend who had two ladies who both tragically committed suicide very recently and had cried out for help many times. Both were looking for access to rehab services. One woman was told that they could not help her because she was not on benefits and looked amazing. She took a paracetamol overdose when drunk and died four days later. Her other friend lost her job of 33 years and was in the system and well-known and had asked and was desperate for help. She hanged herself and left her young family behind. They were both able to ask for help but it was denied. This is the harsh reality of what is happening again and again in our communities. What is the Scottish Government doing now to help those people? Those are suicides that could have been prevented. I just wanted to make sure that, in terms of today, their life did matter. I want to let those decisions-making positions to be able to do something about that going forward. I have mentioned any particular instances but if you would like to respond to Ms Webber. I think that Ms Webber knows that I can't respond to individual cases, that's not possible. Ms Webber should feel free to contact me about the situations. Ms Webber hits upon a point that came up in discussion yesterday morning. I think that it is something that we need to all recognise and that we need to build in to the action plan but also in terms of how we deal with folk in the front line. It was said to me yesterday that for many folk on the outside it looks like some folk have got the perfect life. They are pretty wealthy, they have a nice house, they have a good job. We never know the turmoil within. You might have all those things and still not be happy and still be unwell. I think that the point that Ms Webber makes around those folks who make judgments based on the externals of that person, that's wrong. That's something that we have to put a stop to. We have to listen more. Again, it comes back to that person-centred approach. I think that there's work that needs to be done there. It's another kind of stigma, isn't it? I was going to say that it fits into that stigma. It's another stigma that we have to get rid of. While I comment on the individuals, I get that point completely. I think that it is a very good point to make, because it was made to me just yesterday. I think that we have to get over that and get rid of that stigma, too. There will be people watching this who have their own lived experience and will find that resonates very much. I am letting the session run on. As you can probably see from the clock, you are able to stay for an additional 15-20 minutes, so that we can give the social care aspect of things a good airing, because we are coming to the end of talking about mental health and our final theme for David Torrance. I am in your hands, as always, convener. That's good news, but I always like to ask. Primary care and community services, how have pathways to these services been improved since the publication of a mental health transition and recovery plan? I think that there is much that we need to do there. I touched on that earlier in terms of our ambition and our vision during the course of this parliamentary term, to put mental health, link folks into GP surgeries. I know that others around the table will know where that has happened already in pilot schemes. That makes a huge difference in terms of linkages. Absolutely no doubt about that. I think that that will make a big difference as we move forward. I think that we will be talking more about that in the very near future. The first sector plays a vital role in delivering services. What representation does it have on the bodies of the Scottish Government and NHS boards to provide mental health services? The third sector representation in some places is better than others. In terms of how we, as a Government, interact with the third sector, I speak to the third sector all of the time, it is represented on many of the strategic groups and bodies that we have. It would be fair to say that in terms of health and social care partnerships in particular, some of them are pretty good dialogue and representation, but without votes at the table in health and social care partnerships and others, not so much. In your first answer to me, you asked me to talk to people on the front line. Just yesterday, I was in GP talking to patients and staff on the front line. In 2017, we were promised 250 link workers by the end of the Parliament in 2021. That was backed by evidence given to this committee in 2019. As of a Scottish Government publication in October 2021, only 218 link workers are in post. Most concerningly, there are zero link workers in Aberdeenshire, 4th valley, Midlothian, North Highland and the Western Isles. Why are those five areas without link workers as we are all aware of the vital role that they play? As Mr Gohani knows, those are not mental health link workers. They are community link workers. I do not have the detail of all of that in front of me. As he said, 218 are in post. I will write to the committee or get colleagues to write to the committee on other aspects of those. However, I would say that those are community link workers and not mental health link workers. Coming back to the cross-portfolio thing, the accident and emergency police what has been the difference in terms of having mental health specialists and how well-covered are those first responders? I am thinking particularly of the justice system and the police in terms of having mental health expertise, because often people could be advised to phone the police but the person is actually presenting with a lot of mental health issues. What has been the difference there in the last few years? I think that there has been a huge difference in terms of some of the things that we have done in recent times. Again, it would be worthwhile that you talk to other organisations about what different interventions have meant in different places. Let me give you an example, because distress brief intervention work is happening in a number of parts of Scotland. It has been expanded and we will no doubt roll that out further. You can tell if you talk to the folks working in that area the real difference that that can make. Take, for example, the police. Pressure comes off the police if they can get others in to help folk at a time of need, rather than officers being tied up often for long periods of time. A lot of the time, although most of our officers are pretty immense, not having the skill set to deal with the difficulty that that person is facing at that point. Those things make a huge difference. Another example that I have seen not quite so recently is work that went on in Fife at the Victoria hospital around about a joint partnership with Shelter NHS Fife and the Government. Focusing on the housing aspect, but also dealing with mental health, is getting folk housed and the support to take the pressure off the A&E there. There are a lot of things going on and a lot of learning that we are doing at this moment in time. It is that point of what is working, what is working well and how do we export that elsewhere. That co-operation that exists in many places is beneficial for all those organisations, but it is absolutely immense in terms of outcomes for an individual that is often very vulnerable and in a lot of distress. Thank you. We must move on to talk about social care. I am going to bring in Paul O'Kane. Thank you, convener. I should draw members' attention to my declaration of interest as a serving councillor in East Renfrewshire Council. The minister, before his first time, had the opportunity to talk about the national care service with the committee. I am sure that it will not be the last time in the progression of the proposal in legislation. Obviously, we are at the end part of the consultation phase. I want to start my questions by asking about scope. Obviously, the scope of what is in the Government's consultations is very different from what was in Fili. It goes further. There has been a degree of commentary around that, it is fair to say. For example, Fiona Duncan, who is the chair of the promise, expressed that she was puzzled as to why children's services were in there and expressed some concerns about how we would deliver the promise if it became part of national care service. I was at the cross-party group on learning disability. Lots of folk there are concerned about the consultation scope and the particular needs of adult social care getting lost within that. What was the rationale for arriving at this scope in the consultation and why has it gone beyond Fili? How does he envisage the bill looking in comparison at the consultation once we have processed a lot of those responses? I appreciate that a lot. Are you giving me half an hour, convener? I will try to be as quick as I can. Obviously, our ambition in the national care service is a service that puts people at the heart of the new arrangements so that their care is holistic and enables them to have the life that they want to lead. Fili answered a lot of questions about adult social care—that was his remit—but he himself said that there were a lot of unanswered questions. Mr O'Cain talked about why he enhanced the scope. If you look at some of the difficulties that folks tell me they face—and I think that, convener, it is recognised in here—transition periods are often very difficult for folk. I think that that is recognised in relation to Pam Duncan Glancy's proposed member's bill. In all of that, we thought that we should ask the questions about bringing it all together, getting rid of those transition periods and seeing what folk out there think. I will be honest with you. Mr O'Cain mentions learning disability groups being wary about all of that coming together. I have talked to a fair amount of folk through the learning disabled community. I have to say that a very small minority of folk have expressed concerns. I know that, for some, change is threatening, but we also have a huge opportunity here to get this right. That is why, in terms of the consultation, we have asked the questions that we have. We will look at the responses and analyse them. We will look at all that we have garnered from all of the meetings that were held with folk over the piece 2. We will come to a conclusion around the way forward. We have to get this right. That is all about people. I think that some of the responses that I have seen focus almost entirely on people and others do not. Again, what I would say to the committee is—I am sure that you will over the piece—going out and talking to folk, they want change. People do not feel that the delivery of social care in many places is right. People think that the postcode lottery, which very much exists, is unfair. People feel that there is a lack of accountability. We have to get that right. We will have the minister coming back to go into the detail of that. The response to the consultation will be— Exactly. Paul, do you want to pick up on anything else? Thank you, convener. I thank the minister for that response. I am sure that I will be keen to come to the cross-party group and learn disability as well, so I will book him in for that. I think that the last comment that you made there about people want change is that, broadly, my experience of talking to people is that there is a desire for change. I think that that is about cultural change rather than solely focused on structural change. Can I maybe tackle that one? That is a big question, although it was a shorter sentence than Mr O'Kane's previous. I know that folks will be looking at the framework of legislation and regulation, but Mr O'Kane is right that there needs to be cultural change as well. Absolutely no doubt about that, there needs to be cultural change. And we need to have that human rights-based approach and listen to what people have to say. That has not been happening in many places across the country. There are some things that are going on out there, have gone out there, that are absolutely ludicrous, it has to be said, in terms of delivery. The consultation talks about getting it right for everyone, and that is where our ambition should be. Some of the stories that I have heard, you think that in some cases it was about how we get it wrong for folk with silly situations that should not happen. I do not want to go into some depth in case I end up in a situation where I am identifying circumstances, but we can provide the committee with some of the contributions that have been made at the consultation events, which quite frankly are ridiculous, and where folks have not been held accountable. There has to be that accountability in order to be able to change that culture to you. Just on the point that has been made about accountability, we have had structural change already in this space around the introduction of integration joint boards, integration of health and social care, and what is seven years' worth of work there that is not quite yet well analysed. I am just keen to understand that local authorities are obviously very concerned about the changes proposed in terms of accountability, because accountability essentially moves to ministers, rather than local authorities. It would be helpful for the committee to understand what discussion is on going with local authorities around their role. Obviously, COSLA has been very critical also, so it would be useful for the minister to explain what discussions he is having before we get to the publication of a bill. Again, accountability ultimately will rest with ministers, but what is also important and sadly lacking in various places at this moment is local accountability. Local accountability is as important, if not more important, than the accountability to the minister whoever that is in the chair at that particular point in time. Let us not shy away from that, because there are some folks who say that all of this is going to be nationally run. We absolutely need a framework of quality standards that are matched right across the country, but that is also about local delivery and adaptability. It does not matter who is sitting in my chair in the future, because they will not be running the entire show on a day-to-day basis. The scenario in which it is dictates recentralisation—not the case, it cannot be, because it is about local delivery and local accountability, but it is also about a set of standards that folks should expect to be delivered. It comes back to what you were saying before, but mental health is like the standards nationally, but also what the people on the ground can expect no matter where they are in Scotland. Absolutely. I have to say that some of the anomalies in terms of delivery are really stark, where you can be in one place and five miles down the road, the level of service, is totally different or in some cases non-existent. People do not think about local authority boundaries, or health and social care partnership boundaries, or health board boundaries. They think about the service that they need, and we have to get that right across the board, across the country, and that is why this change is vital. Very short supplementary, please, and then I will need to move on to questions on winter preparedness. I suppose that local service being X in one place and non-existent in another is just relevant to what we experienced in terms of the mental health stuff earlier on. In terms of the economic modelling that is going, or is the economic modelling under way to cost of proposals, I am also here looking at this chart that shows the number of care homes in Scotland, for example, of 1,069. 63 per cent of which are in private ownership and 23 per cent are run by the voluntary or not for profit sector, which means that the balance of 142 is under local authority control. There are a lot of numbers there, but in terms of the economics that might be behind us funding something, or the reforms that might be happening, what economic modelling is taking place right now? There will be a huge amount of modelling in various areas, and some of that work is on-going. Some of that work will continue in terms of looking at the results from the analysis. Obviously, there has to be a huge amount of work done looking at those 1,300 or thereby responses and everything else that has come in from consultation events. I can assure the committee that there will be a lot of work going on in all of that, because we have to get it right. I can also assure the committee that, as I have done in my previous role when it comes to legislation, I am happy to come back here as needs be and to deal with issues subject by subject, if necessary, because that is the way that we get good legislation. I can say to Ms Weber and to everyone around the table that there will be a lot of hard graft here, because I have a determination that we get that right. Can we move on to talking about winter preparedness in the care sector, Emma Harper? We have our winter preparedness plan for 2021-22, and there is a parallel health and social care winter overview. I am interested, minister, in a short list that we have in front of recruitment and retention, which links back to my previous question. Nursing staff in care homes, infection control in care homes, staff wellbeing, services and support for unpaid carers and delayed discharges. I know that there are challenges in a complex way to manage our health and social care system. I am interested if you can give us just a brief overview on how the plan will practically assist providers and social care services in meeting the challenges for the sector over this winter. I can give a brief answer to that, because Emma Harper has covered a lot of grind. As the committee is aware, the cabinet secretary announced funding to specifically support winter pressures £300 million. There was equity between health and social care on that front, and that includes £62 million for enhancing care at home capacity, £40 million for interim care and £20 million for enhancing multidisciplinary teams, and up to £48 million for the pay increase that I mentioned earlier on. That investment in the plan itself being published does not mean to say that the work stops there. The cabinet secretary and I have been in discussion with a number of health boards, health and social care partnerships and local authorities over the past number of weeks to hear from them what the pressures and challenges are and to see what other help we can provide. That will continue as we move forward. That is, without a doubt, the most precarious time in the pandemic. In some areas, there is a difficulty with staffing, often because of Covid outbreaks, often because of other illnesses. Quite frankly, it has to be said as well that many folk in the front line are shattered. They are tired. We have to take cognisance of all of that in terms of how we get all of that right as we move forward. Some of those meetings that have taken place with health boards, health and social care partnerships and local authorities, together, we have been looking at what else can be done to take pressures off. How does everybody work in partnership in tandem in terms of reducing delayed discharges? What can we do in terms of that multidisciplinary team approach to plug gaps? If there is a Covid outbreak keeping staff off or other things keeping staff off, how can we plug those gaps? There is some good thinking and good action taking place in some places that we are advising other places to consider and to do if necessary. That is going to be on-going throughout this piece. Probably Ms Bell has been on more calls than anyone else over the piece, and that is continuing on a day in daily basis. It is very short. I know that there will be cognisance of an approach that will deal with rural areas such as Dumfries and Galloway and Scottish Borders in my south Scotland region, and that can be a yes or no answer in that question. Obviously, some of the thinking has to be different in rural areas than it is in cities. For example, sometimes it is not easy to plug a gap if there is illness in a remote rural place. Some places have looked at their expression, not mine, flying squads, so that they can deal with care at home in certain places where a gap has been created. A lot of people are thinking out of the box about how we do our level best for folk in all of that. That needs to continue, and we need to continue to push that. What we require and some of the folk in the calls that I have been on are probably sick fit up of me saying that this is collaboration, co-operation and a lot of communication in order to get this right over the piece. We move on to questions about unpaid carers. Minister, are you confident that all unpaid carers that require practical or respite support are able to access it? No, at this moment, I am not confident that everybody can access respite support. I should say, convener, that I want to get away from using the word respite as well. I prefer short-term breaks. I think that that is the much better way of describing it. As somebody said to me, respite is often seen as a burden and we need to get away from all of that. However, what I want to do is to ensure that, as we move forward, the short-term breaks become a right, and that is why the national care service consultation contained questions around that. I think that it should become a right. At this moment in time, I would be telling parties if I said that everybody can access what is required at the moment, because I know that that is not the case. I was talking to carer centres managers only yesterday, and there is a combination of things going on that add to the pressures. Day services have not fully opened up in some areas. Sometimes that is done to space difficulties, sometimes that is where they have been in the past. We need to continue to open those up safely. Equally, as we said to me yesterday, there are some carers who are still afraid to put their loved ones to daycare services or on short-term breaks, because they are still feared about the pandemic. Again, we will have a job of work in relation to, as we move out, regaining folk's trust to help them to get back into the routine that they were in before. That is going to take a while. I could not say that we are doing everything to meet the needs at this moment in time, but, as we move forward, we need to ensure that we are doing that. That is why that bit of the consultation is a very important one, as far as I am concerned. Can you also outline for the committee what statutory services are available to directly support unpaid carers? There are a number of statutory services under the carers act, in relation to meeting the needs of carers. We know that, in relation to the act itself, the act is better in terms of delivery in some parts of the country than in others. Again, it is this situation whereby we need to make further change. I think that the carers act is grand. The money that we have given to local authorities, substantial amounts of money, are not necessarily reaching carer services in all of those areas. Again, we need to change that as we move forward. That might mean change in relation to the national care service legislation, if not that might mean looking at what we need to do to secure that that money goes directly to carers and carer centres, as anticipated. Ring ffencing is the word, because it would be fair to say that, in some areas, it is not open and transparent where all of our investment is going. I think that we can all agree that unpaid carers are the backbone of family, friends and neighbours for looking after people. There has already been talk about the ethos and the culture, and that is really having to change. It is time that we started really valuing care and roles much, much more. You spoke about the pressure on unpaid carers as well, saying that they cannot wait. That is something that I would agree with very, very strongly. You have also mentioned professionals on the front line that they are shattered, tired, carers are absolutely in that position as well. They have had to pick up on services of clothes. That is not a criticism. At the end of the day, we had to prevent the spread of infection and save lives, if you like. However, that burden has fallen on carers, and it is a very physical burden, as well as a mental burden. I am wondering what can a practical hands-on support for carers bear in mind that they cannot wait? What can they expect to start seeing on the ground right now over the next few weeks? Some of them are reaching a point where they cannot cope. They are not going to be able to continue in their care and role unless they get that support. I know that folk cannot wait, and that is why we have already put in additional investment. Let me just run through some of that, convener, if you do not mind. We invested an extra £1 million into the short breaks fund at the Shared Care Scotland and Family fund last year, and £300,000 in our Young Scot Young carer package to support carers of all ages to enjoy some time away. However, as we know, some folk will not do that at this moment, and we need to encourage that. This year, we have already committed an extra £570,000 for the short breaks fund. We also recently launched a £1.4 million ScotSpirit holiday voucher scheme for tourism businesses to sign up to help low-income families, unpaid carers and disadvantaged young folk to take a break from carering. The other thing that I want to do in the short term—again, we have to have co-operation from partners, including COSLA—is to get rid of eligibility criteria, particularly some of the local eligibility criteria that is cropped up. I think that that is majorly important in terms of delivery. We know that unpaid carers, as you rightly point out, Ms Callaghan, have seen a decline in their mental health over the course of all that. That national wellbeing hub that I mentioned earlier is open to carers as well. We were talking yesterday, as I said, with managers from carer centres. Although a lot of work has been going on to signpost vote there, we still need to do more on that front. We also, in terms of the national wellbeing hub, have a dedicated section for unpaid carers. We are developing a dedicated page for them, which is on the cards, too. Those are some of the things in the short term that we have done, are doing and will do. I move on to questions from David Torrance. It is on the remobilisation of social care support services, which I find a bit of an anomaly because nobody has not been mobilised, they have been ultra mobilised. That is maybe not the wording that we should be using, but David Torrance, over to you. Thank you, convener. The pandemic has seen a reduction and even the end to some of the care at home services. Many community-based organisations and third sector organisations have been unable to provide services because of pandemic restrictions or have even been forced to close. Minister, is there a core of the social care remobilisation plan? Who are the key stakeholders involved, if that is the case? In terms of remobilisation, the folk that we have got involved in that, I am going to turn to Ms Bell, because I can remember off the top of my head who all sits in that for us. On the group that was originally involved, there were a really wide range of partners across the NHS, health and social care partnership, SIGBs, COSLA, the third sector, professional bodies, etc. We are now in the implementation phase of that, so we are working individually with local partnership areas. Again, there is a wide range of partners locally, such as NHS boards, integrated joint boards, local authorities, the third sector and people's organisations with lived experience. The phases are changing and we continue to engage with national bodies, but we are also at the point now that we are engaging with local partnerships. We are talking about remobilisation, but folk have put in a hard shift over the course of all of that. Some services were disbanded during the course of Covid, but the vast bulk of folk who were in those services went on and moved and worked elsewhere. We owe a huge debt of gratitude to those folks that have kept our most vulnerable folk cared for during these very tricky 20 months. I am sorry for repeating myself, but this is the most precarious time. It would be fair to say that, in many areas, there are staff shortages. Some of that is down to this, some of that is down to the fact of Brexit. One service that I spoke to had lost 40 per cent, four zero per cent of their staff, who returned to their home countries after Brexit. That is inevitably going to have an impact. We know, because I have heard the stories, that other folks have left social care for the moment because they are tired. They have gone into what they see as easier jobs and hospitality. We all hope that those folks come back. Again, the national care service gives us the opportunity of national pay bargaining for those folks. It is a real hard look at paying conditions and, beyond that, giving people the opportunity of career progression. While I say that, one of the other things that we all have a duty to do is to recognise that care is a profession. We have got a wee bit of education with some folk around about that, but we should continue, and I hope that the committee will continue to refer to it as a profession as we move forward. Those issues came through very loud and clear last week when we spoke to care organisations. I move on to questions from Sue Webber on delayed discharge and interim care facilities. I understand the rationale for interim care facilities, but it will surely result in more of some of the most vulnerable people making multiple moves over a short period of time from one facility to the next. If there is no care package in the community after the six weeks, and if community care issues could be solved in six weeks, why has not that happened already? I suppose that that is all the stuff that is going round in my brain. As again, the delayed discharge is not new. Yes, if anything, during Covid we had some rapid discharges from hospitals into care facilities that we are now looking back a little bit reticent about those decisions. I am trying to figure out what happens if those six weeks there is nothing there in the community, but also how many people are currently in what is classed as an interim care facility? Where is this data recorded? Are they still classified as delayed discharge so that we can get a sense of how things are progressing? There is a huge about in that question. Ms Webber says that it is all buzzing about in her head, but I think that it is probably all buzzing about in her head at this moment in time. I explained earlier to the committee about the level of engagement that we are having with partners around getting all of that right as we move forward. We have a significant amount of folk in hospital at this moment who should not be in hospital, and it is best that they are not in hospital. Some of that solutions will be on an interim basis, but the ambition here is to get folk back into independent living, if that is possible, with the support as soon as we possibly can. Rather than me going on about all the possible connotations and possibilities around that, why do not we write to the committee about what we are doing? Some of the information that Ms Webber is asking for at this moment in terms of who is currently in an interim situation, we do not have. Let me write back to the committee in some more depth about how we are handling all of that. Hospital at Home was first introduced in NHS Lanarkshire in 2011 and shows great results. Jean Freeman announced £1 million in funding in March 2020. My question is after 10 years, after Hospital at Home was first introduced and after £1 million was invested just a year ago, do 10 boards not have adequate hospital at home resources to prevent admissions? Just recently, the cabinet secretary, Hamza Yousaf, announced additional resources for hospital at home. I think that hospital at home is a great way forward. I have had the pleasure of meeting teams recently in Edinburgh and in Lanarkshire. The deputy CMO, Graham Ellis, from Lanarkshire, has been a great advocate of hospital at home, and that is why we are making those further investment to expand it even further, which I think is a good thing. Can I come to a question from Stephanie Kill on this? Thank you very much, chair, and just to note again that I am currently a councillor at South Lanarkshire Council. I am also going to mention South Lanarkshire straight after Sandesh has done the same there. I was at their briefing on Friday last week, and they spoke of the increase in demand for supported discharge being 30 to 35 per cent. Despite a 30 per cent improvement in discharges from their hospitals, you are looking at a situation where your kind of stand is still there to some degree. I am wondering as well the third sector has been absolutely critical in all of this. Is there any particular further support that might be offered to the third sector? Some of those solutions have to be found locally, and that is one of the reasons why we are having the conversations that we are with partners across the country. We have to mobilise everything possible at this moment to ensure that we are doing the right thing for folks as we move forward. We do not have the luxury of not involving everyone in all of that. Again, I would come back to the point of collaboration and co-operation, because that has to be between local government, health and social care partnerships, NHS boards and the third sector, so that we are doing our level best for everyone in those precarious times. Can I move on to questions from Carole Mocken on the rights for care home residents? Really, just to directly ask the minister around the rights for care home residents, we all know what happened over the pandemic. Are we at a stage now where the minister feels that the opening up of care homes to visitors provides adequate access to family and friends to ensure the wellbeing and the health of the residents? I should say to the committee that every week I get a report about how open with care is working and where it is not. Obviously, there are still difficulties in certain places with outbreaks, but open with care should allow greater access for relatives. Even if there is an outbreak situation, there are still ways and means that relatives can still access their loved ones in care homes. The committee will know that we have had two consultations on the go, which have now come to an end. I cannot remember how many responses we have had to that. There has been a significant response. I should say that Ann Duke, who Ann's law is named after, passed away at the weekend, and I would like to give my condolences to our family. We will move forward in Ann's law. I think that it has got cross-party support around getting this right for people as we move forward. That will be Ann's legacy. I pay tribute to our daughter Natasha and her husband, Campbell, for the efforts that they have made in getting it not only right for their own family, but right for everyone in the future. You wanted to put something on the record. My apologies for that last question on the theme of delayed discharge. I should have declared that I am a councillor at the city of Edinburgh. Minister, we will at least hear our last theme of questioning in this extended session with you, which is always going to happen when you come in front of us for the first time when we go through absolutely everything that is in your portfolio. Can I come to questions from Gillian Mackay? We heard from the panel last week about the role of golden hellos in recruitment. It was made clear that any such initiative would need to be funded across the board, otherwise some providers would not be able to afford it. Would the Scottish Government consider funding in the centre for people being recruited into social care? That is a question and a half because golden hellos, golden handcuffs, I think that that is a very difficult thing to do and it could end up creating more problems than it resolves. I will be honest with Ms Mackay and the committee. I am pretty pragmatic in a lot of things and I do not automatically shut doors and suggestions. It is something that we could look at, but in some regards I do not think that that is necessarily a solution. Gillian Mackay? I just have one other question particularly on social work. I feel that social workers have maybe been the one area that we have not discussed as front-line workers and, like many other services, social work has come under increased pressure during the pandemic. Yet we hear very little about the impact that it is having on social workers. Does the minister have a sense of wellbeing levels among the profession and how that might be impacting retention as we know that the average working life for a social worker is around seven years? I do not have the retention numbers off the top of my head, but we will furnish the committee with that information. I have spoken to a lot of social workers. I spoke to criminal justice social workers last week. I have spoken to social workers and children and families and adult services as well over the past few weeks and months. It would be fair to say that, like everyone else, there is a lot of pressure on them. It has been very difficult at points for them in terms of the way that they work. Particularly during the lockdown period. However, I think that folks have behaved admirably. They have done amazing things over the peace. In terms of conversations with social workers, one of the key messages from them is to empower front-line staff more. I think that we must do that. I think that social workers sometimes feel the poor relation to other professions. I think that we have to change that again. Part of the conversation and consultation that Derek Feeley suggests is whether we should move to a social work agency. I think that there is that to consider and we will look at the analysis there. One big bugbear of social workers is again eligibility criteria, where they feel bound, often by locally set eligibility criteria. Again, that is why, in the short term, we have to work with COSLA to eradicate some of that, because we are not doing good for people, either the professionals, the front-line staff who know or the individuals and families that they are serving. I thank colleagues for the questions this morning to the minister and to the minister and his officials for the time that you spent this morning. We will, of course, be seeing you many times over the next year. We will take you up in your offer to come back whenever you want to drill down into any particular aspect, but that has been an excellent overview for us to know what your priorities are for the coming year. We will suspend very briefly before we move on to our next item. I have a negative instrument on the National Health Service Pharmaceutical Services Scotland amendment regulations 2021. That instrument amends the National Health Service Pharmaceutical Services Scotland regulations 2009 to allow for the provision of dispense medicines at premises that are not a registered pharmacy. That is in line with the exception created by the regulation 248 of the Human Medicines Regulations 2012. The Delegated Powers and Law Reform Committee considered the instrument and raised no issues and no motions to annul have been received in relation to those instruments. Do you have any comments on that instrument? I propose that the committee does not make any recommendations in relation to that negative instrument. Any member disagree with this? We are all in agreement. At our next meeting on 23 November, the committee will take evidence on data and technology in health and social care. That concludes the public part of our meeting today.