 Good afternoon, ladies and gentlemen. If you could just take your seats that would be fantastic. I do hope you enjoyed your lunch and the tour of our committee rooms and all the exhibition space. For those of you who don't know me, my name is Alex Cole Hamilton, and I am the member of the Scottish Parliament for Edinburgh Weston. Can I just hear a show of hands? If I have any constituents in the room I can see a couple of friendly faces there. Lovely to have you here. I'll obviously direct all of my comments to you for the next couple of hours. It's lovely to have you here and thank you so much for bringing your gathering here today. It's important that this space is used in the way that you're using it as a gathering place, a place for exchange of ideas, but it's also very much a place where politicians such as myself and others present today can hear your views. I think that's absolutely key. I was speaking to Catherine, Mary and Eileen just a minute ago about how important it is to engage with voters, such as yourself, because you are voters and you have a stake in the democratic process, and without you, none of us would be here. Off your reflection, it's quite hard for Lib Dems to get elected these days and part of how I did that was by knocking 25,000 dollars. I'll give you one anecdote of just that kind of exchange that got me here. When I was a kid, we used to sail a dinghy in St Andrews. It was an otter-class dinghy. It was a beautiful thing. We loved it very much, but when we grew older, my parents didn't have time to use it, and we sold it. It was sad, but that's what happens. Then I was walking through Crammond, which is a coastal village in my constituency in March, and I walked into this driveway. Under this tarpaulin was a boat, and sure enough, it was an otter-class dinghy. It was not only that, but I was absolutely convinced. It was exactly the same dinghy that my parents had sold 20 years ago, and as it happens, the constituent was just walking out of his house at that time, walking his little dog, yapping at his heels, and I gave him my patter. I'm Alex Cole-Hamilton, I'm Lib Dem, running for the Scottish Parliament, but before I go any further, can I ask, is that an otter? He looked at me and he said, Are you quite mad? It's a Jack Russell. So I think that the moral of that story is that really everybody's got a story to tell, and it's important to hear them, and that's very much what we're here to do today. It is my great pleasure to be the vice convener of the Equalities and Human Rights Committee, and of course age is a protected characteristic in terms of the Equalities Act, and a lot of the concluding observations that we as a committee are looking at from various UN rapporteurs are connected to age, and I think that that's very much something I would like to explore with you this afternoon. In a minute, I'm going to invite questions about the work of our committee in the Equalities and Human Rights Committee, but I'm also very pleased to have David Cullum here, who's our Abel Clark from the health committee on which I also sit, and he and I will take questions and discussions about the work of that committee after this section. I think it's fair to say that we still have some way to go in Scotland to realise full equality, not least in terms of age issues, but also around disability, around children's rights, around a whole range of race relations and other things, not least the disparity in terms of men and women's equality within the workplace, something that I know a lot of people who are facing issues around pensions find particularly apposite at the moment. It's a very exciting committee to be on it, it's just had its remit expanded, and particularly at a time when there is a threat to things like the basis on which we form rights legislation within Scotland and the United Kingdom is in question, with the Conservative Government of Westminster talking about bringing in a British Bill of Rights. It really concentrates minds as to what we need to protect and what we need to do more of in terms of making rights real and equalities real for each community in our society. For the next 10 or 15 minutes or so, I'd like to invite your questions about the work of our committee, your own views about equalities, about how we can bridge those gaps that exist in our society. I'd like to hand over to you, and if we could go, as we did in the first session, if you could stand up, if you have a question, if you can stand, please do so. If you can't, that's fine as well. Make yourself known to me and wait for the red light to come on after I've indicated that I want you to speak, and then if you could give your name and where you're from as well, that would be really helpful, so I'm quite keen to hear what you have to say. Lady, in the second row, please. Good lad. Thank you very much. I'm Marlon Jones. I'm a member of the Scottish Board of Tenants organisation. The thing that worries me about benefits and healthcare is that senior citizens don't always like to ask for help, but a lot of Scottish Borders Housing Association has employed welfare benefits officers to help to fill in forms, to ask whether they have their rights. What worries me is what about home owners that don't have that service? What about private land lords? There's a lot of people out there that don't know where they go or don't even know if they're getting everything they should. Marlon, I think that that's an excellent question. When you were speaking there, it just reminded me very much of my own mother-in-law, my mother-in-law, Kez, for my father-in-law, who has profound MS, has done for 30 years. It never occurred to me that they weren't getting the help that they needed until she told me that, that afternoon, she'd had to flag down a passing motorist because he'd had a fall and she wasn't strong enough to lift him. I thought, my goodness, I had no idea that there was nothing there to help them. It was just because she never felt able to ask, because she was almost too proud to ask for help, and B didn't really know who to ask for that help. I think that that's a problem right across our society. It's a classless problem as well. It happens in all walks of life. People have worked all of their lives, provided for themselves all of their lives and done so with great pride. It's very difficult, I think, to put your hand up and say, actually, I might be struggling in this particular aspect of my life. I think that there's a responsibility on elected members, not just parliamentarians, but councillors as well, to make sure that people who come through their surgery doors know what rights they're entitled to and what state support they are. However, I think that there's a job of work as well in our councils to make that clear. I've just come from my surgery, working with a number of families facing different challenges, all of whom were unaware of the extent of the support that they could be getting from the council. It was only just from actually steering them towards that. Hopefully, they'll be able to access that. It shouldn't be like that, though. It should be readily available. It should be clear on billboards, wherever you go for advice, that there are telephone numbers to ring people to contact, and it shouldn't be that difficult. Is a follow-on comment from what I said earlier this morning? Helena Scott, Scottish mental health co-operative and age in mind. I want to go back on to the equality duty on health and social care integration partnerships. To me, it's something that I just can't let go, I'm afraid, because I'm still not very satisfied with the response that I'm receiving. What might be the objective justification by any integration board to age cap adult social care at 65? Secondly, how do you feel that equality cutting strands, particularly around age and mental health under the disability aspect, are being treated just now? I would exercise a certain degree of disappointment that, when I look at the way that equality impact assessments are being done, quite honestly, are they really addressing the equality duty that is incumbent in law? Well, I think the answer is no. Could you just give me the second about the cutting? Where you might have two equality strands that interface with each other, such as age and disability. I could argue on an age ground that to cap adult social care at the age of 65 would have to have an objective justification for doing that. It should not be discretionary on any one of the 31 partnerships in Scotland. Secondly, if I felt that I wasn't getting anywhere there, my approach would be through the disability. Why should people experience living with mental illness over 65 not receive the same service as someone younger than them? I think that that's an exceptionally important question and very well made, very well put. The state has always struggled with intersectionality, whether that's a confluence of protected characteristics that take supremacy and how we respond to them. Indeed, the objective justification, as you describe it, is a balance that we have still yet to find in the way we do it. A lot of it comes down to local authorities pointing to resources or what they're of, and they have to say, look, we have to put the cuts off somewhere. However, I don't think that that recognises the very human, very personal stories that come along with each and every case that you describe. I think that your sector, particularly in the mental health sector, is one that is lacking far behind. We are just now finally beginning to look at a refreshed mental health strategy after the last one expired at the end of last year. Now, I would want to see exactly those points that you've just articulated covered in that. It is not at the moment within the reach of that strategy. We're missing a trick. Sorry, did you want to come back in? I'll just add one further point, which is that the driver in social care is personalisation. Personalisation is about the person-centredness of service access and service delivery. In a sense, why do we have personalisation if we can't address the needs from an individual perspective irrespective of age? We should not be using age as a proxy to delineate who receives services at what point in their life. Life course was mentioned through some of the participants here today. It should be a transitional stage irrespective of a person's health. It should not be stopped according to a certain point in a person's life. I understand that there may be resource implications of how you manage services that can be better organised by using an age as a grouping. However, if you look at the transition of young people into adult social care and adult social care into old age psychiatry, it's not seamless. My argument is very strongly that we are not addressing the wider mental health needs of people over 65 that are non-dementia. I feel that that is a major gap. I think that you are right. That transition age is not keeping pace with the age of retirement. It's across the board. Personalisation is a word that we politicians like to use quite a lot. It's used in both the health and social care worlds. Those worlds are absolutely colliding right now, but we're still not matching reality with rhetoric. If you think about self-directed support, I'm sure that a lot of you are aware of self-directed support. Some of you may even be using self-directed support. It's a fantastic and it's a liberal. I find it a fantastic idea that it's empowering. It gives you as much control as you want to take over the direction of your care. However, if you live in Angus, for example, and I come from the children's social care workforce, in Angus there are 104 children who require respite support, and Angus would be desperate to get them all into self-directed support and start managing their own budget. However, there is one care home in Angus that covers all 104 kids. That's the only care home there will ever be in Angus because there's no business model there for a private provider to come in and set up a rival care home because it just won't be the custom. Giving parents control of those budgets to commission the service that they were getting anyway isn't choice. These are the symptomatic of the barriers that we're going to have to break down as a society to answer the needs around personalisation, but I think your point is exceptionally well made and thank you for making it. Gentlemen, in the middle, at the back in the green sweater. I'm Ian Clement. I'll wear my committee councillor and NHS patient hat of this question, and as an ex-member of the Christie commission, which is a terrible tragedy that it was not continued and its use used appropriately, but that's as it is. The problem is that we hear from politicians a lot of aspirational talk. We actually want things done. That's a big gulf. We are actually the people that pay for things, and sometimes this gets rather lost because healthcare integration is a great idea, but unless the foundation is secure, what you put in it is not going to hold up, and that's the major problem. It's a great thing in theory, but in practice it is not working well. The other thing is that I was on what's called the eye care integration strategy board. That was to make eye care and vision support more readily available to patients and communities. The last meeting was three years ago. I have no idea what's happened to it. There's no support from the Government. There's no support from health boards. You have NHS Lothian patient focus public involvement. They don't do it. They're not interested. They don't want the voice of the patient. We're just the awkward squad. Also, community councils. We're statutory bodies. I'm a community councillor. Where is the support for community councils? We're just ignored. The other thing basically is that we have the problem now, of course, where a certain party wants to centralise everything and we want to localise. How do you bridge this gap? The whole thing is that when people start, well, the state is essentially withdrawing from a lot of healthcare and handing it over to private companies. Now you go back 30 or 40 years, you knew the state was going to be there for you. Now the question is, it seems the state is not going to be there for you and that is really going to have a fundamental change and it doesn't matter whatever you politicians say, the people will realise that you're not there for us. Thank you. Wow. Firstly, I didn't catch your name there. Ian, can I thank you for your service both on the Christie commission, which I think was an exceptional body of work? I agree with you where it is sadly diminished over time in terms of the use that the Government has made of it. But also thank you for your service to the community council. The Christie commission I think came out with two of the most fundamental recommendations or approaches to public policy and that was first and foremost about prevention and then secondly by extension reduction of failure demand. The prevention side of things has always got my goat about politicians because I've always believed, and I can see this, I can see the seduction of this being an elected politician myself, that politicians rarely see beyond the date of their next election. There is a visceral desire in the political classes to see something pay off within the next four or five years. So you can point to it on a leaflet at election times that I did that, you know, we changed that, we improved that, whereas actually as you know from your work in the Christie commission that a lot of the social problems that we face across our society actually require investment now for a payoff that we may not see for 10, 15, 20 years, and that works in the criminal justice system, it works in the care system, it works in social care and in education right across the board. It's the political will that we now to connect up with the work that your commission did to make that a reality. That's in a way connected to the second half of your question, which is about subsidiarity, and I as a liberal obviously wholeheartedly endorse what you say about the desire to create, to move things closer to the people, move power and decision making closer to the people. I think that there is, I won't get party political about this because that's not what this event is about, but there is definitely a shift at the moment towards centralisation. We've seen that in the creation of Police Scotland, which is amalgamating police boards and I'll let you make your own mind up as to whether that has been a success or not. There is discussion within the health directorate of the Scottish Government about merging health boards, moving down from 14 health boards, potentially just three, and also slightly more controversially the idea that we could lose 32 local authorities and be reduced to a size smaller still. I think that that's completely the wrong direction of travel. If you take Police Scotland merger, for example, I think that we've now seen a situation where divisional commanders are facing operational control and applying tactics which work in Glasgow to the streets of Edinburgh, whereas actually the range of social problems that we face in Edinburgh is very different, and that's because we've lost that local decision-making element to it. I think that that works for community councils. We ignore community councils as parliamentarians at our peril. They are the source of greatest intelligence for us and they are the source of basically my entry, so thank you for doing what you're doing in the community council. I hope you'll continue to do so. I've been told that we only have time for one more question on the Equalities, Human Rights Committee. Lady in the green at the back in the middle there. In the middle—no, right—yeah, you, sorry. Thank you very much. I'd like to thank Sopa for inviting R&IB under entourage of eight along here today. There were a couple of points that I wanted to make. I wanted to resonate with the points that Helena Mates made about personalisation and the cap, arbitrary cap, on services to people over 65. If you were to look around the entourage that we have today from R&IB, not only are they elderly, which is a commonality with others in the room, there are also ethnic backgrounds and they also have sight loss. Seeing the person is hugely important to us as an organisation. I wanted to ask or get some comments with regard to digital technology and the digital by default that is very much the policy within the Scottish Government. As a national organisation, we are at the cutting edge of access technology to allow people with visual impairments to use the range of technology that is available to the wider population. However, it has to be noted that access technology comes at great expense and at great cost, and therefore in itself can create an inequality of access. I think that this is even more important in the devolving of powers to the Scottish Government with the social security, particular social security benefits, where we are looking potentially to an approach to put all of the applications online. I would very much like to hear your perspective from the Equalities and Human Rights Committee on making that access equitable. Alongside that, I would also like to speak a little bit about poverty. People who have sight loss are more likely to not be in employment, to require benefits and potentially not be able to access those benefits for a variety of reasons. Just within the backdrop of that in Scotland, we have huge income inequality anyway, so I would like you to make a recommendation about how we ensure equitable access for everybody across society in Scotland. I love it when you ask for one last question, and it is a massive basket of issues. I thank you for the question that I beautifully put. First, I think that the age of transitions that we have talked about is the same as the transition into adult services from children services at arbitrary cut-off at 18. Working as I have done over years with kids with profound autism, moving into a very different set of services at the age of 18 arbitrarily, when they are not ready to and not supported to, is a disaster. In the same way, why do we make it 65, because that used to be the pension age? That is changing too. It needs to be adaptable and flexible to people's needs on an individual basis. Digital inclusion is so inexorably linked to poverty. That came up in a debate in this chamber just last week in the fuel poverty debate that I spoke in. Right now, you get the best energy tariffs if you can sign up online. You get better deals as well if you can arrange direct debits through bank transfers online. There is something called the poverty premium, which I am sure a lot of people in this room are aware of. If you are in an income-deprived area, if you are in an area of multiple deprivation, you are far more likely to have an energy meter that you have to feed with cards to get your electric. That machine can have a voracious appetite when you have very little in the bank each week. It is far more expensive than if you were able to sign up online for a smart tariff. In Kirklessdon, a village that is just four miles from here—I see one of our residents there—we still do not have broadband speeds above two meg. This is our nation's capital and we do not have digital inclusion. That is far worse. If you go as you absolutely rightly say, you cannot afford the infrastructure, the terminal or the PC, to get you online in the first place, you have to go to your library, you have to make sure that there is a machine that is free and working. There is an amazing world of opportunity that the internet and everything around it brings, but we are leaving people behind and we are forgetting about them. I hope that I speak for everyone when I say that the constituency of people worst affected are those in the older generations. My kids are natives to the ICT world. I am an immigrant to it because I remember a time before the internet and I have had to learn it. I know that you all have had to learn it but there are those of us in particularly socially—that lack of digital inclusion walks hand in hand with social isolation. That has to be one of the foremost challenges that we address as a Parliament and as a public body. I know that you are working very hard on that as well. Right now, if it is okay, time is a pace, so I would like to introduce David Cullum, who is our very excellent clerk to the health committee. It is a pleasure for me to serve on that committee with David. He keeps us right. He can be very strict. That is necessary for me. David, if you want to come up and talk about the health committee, then he and I will answer your questions about that work. You can guess how difficult it is to keep the committee in line. Good afternoon and welcome again to the Scottish Parliament. I will be brief because this session is about hearing your views, opinions and suggestions. As Alex said, I am Clark to the Health and Sport Committee. The members of that committee would ask me to apologise because nobody was here to deliver this session to you. I know that Alex is now here. I am especially delighted to have him because it takes a little bit of the onus on me. I chased and chased and chased the members to try and get somebody to come. Friday is a constituency day for members. They are down here Tuesday, Wednesday, Thursday—they are not all local. I have a fantastic range of excuses or reasons why they cannot be here. It is brilliant. It is a case study on what MSPs do on a Friday. I am not going to go through them, but, believe me, some of them were very creative. You have got me. There is a good element to that. It may be that I will not talk as much. I know what you heard from the convener of the committee this morning, Neil Finlay. I am not going to repeat what he said, but I want to elaborate just before I pass it to you on a couple of areas. Neil gave some detail about work that the committee is undertaking in general. Can I just talk a little bit about the role of the committee in the Parliament? That applies to all the committees, I think. The committee's principal role is to hold the Government and other public bodies to account for what they do—their policies, their spending, and so on. The committee in exercising that is really exercising influence. That is quite important when it comes to thinking about your questions and how we are probably going to answer them. The committee is keen to hold people to account for what they do and what they achieve. The real reason I mention what the committee is about is to say what the committee does not do, and they do not deliver services themselves. I guess that, when you are making your comments, it is not our fault that the committee would say that they are doing their best and that they are working pretty hard. Lastly, I want to mention the committee's strategic plan. Neil mentioned that this morning, and the aim that is set out in the strategic plan is in your programme. When the committee agreed to strategic plan, it was the first committee ever in the Scottish Parliament to agree to a strategic plan, which is good. I got a couple of emails and phone calls from people saying, where is it? I said that it is online. They said, while we have seen it, that is it, the entire strategic plan. Where is the rest of it? I guess that the rationale for that is that, if you look at many businesses' strategic plans, it runs to 30 or 40 pages. That does not, it is short, it is concise. It says exactly what the committee is doing. I am just going to quickly just talk a little bit about it. The overriding aim that the committee has set itself is to improve the health of the people of Scotland. In all its actions, that is what they are aiming to do, to improve the health of the people of Scotland. I guess that everybody working in health would share that aim, at least we sincerely hope they do. The strategic plan then goes on to set out four principles that the committee will use and is using to test all activity that they undertake to scrutinise against. Four principles, the impact a policy, a practice, a service is having on health inequality. The committee are keen and are pushing people to answer that question. The extent to which activity has a prevention focus. We have got quite close to talking about prevention. We have been alluding to some of the Christy principles. Prevention is key. That is what drives the question that you were asked to consider for this afternoon. The committee are interested in the long-term cost-effectiveness and efficiency of activity that is taking place. I have sat in committees for a number of years now and I hear so many people talking about how effective they are, but it has to be coupled with efficiency. The committee are lumping the two together. Finally, it is not getting away from it in this place at the moment. The implications of the UK's EU exit is a matter of interest to the committee and that will grow. The focus of the committee is on outcomes achieved, outcomes being proposed, and they want to hear how activity adds value and the want proof of that. There is no point for people coming into this committee and saying that they are adding value, but they will just say how to prove it and give us some examples. That will continue throughout the next four or five years, I am sure. The strategic plan also makes clear the committee's desire—actually, it is a demand that the committee makes on the clerks—that we are inclusive of all sections of Scottish society. The committee wants to be accessible, it wants to get the views of service users. We are less interested in those at the top end of organisations who are running them. They want service users, those who are receiving services to speak to the committee. Essentially, that is why we are here today and that is why you have that question. The system is a golden opportunity to hear from a large number of service users. In giving your views and thoughts today, please look on it as giving evidence to the committee. It may not be directly in relation to a particular piece of work, but we will store it up, we will use it. We will consider it as evidence that the committee has heard. Evidence has different connotations in here to that in the courts. This place hears lots and lots of so-called evidence, which is generally, as I say to the committee, biased opinion designed to influence. That is fine. We know that it is that. We want to hear your opinion. We want you to influence the committee. Yes, some of you will be biased, but what heck—no, everybody else is in a way. That is enough for me. You are invited to consider what preventative activity could assist in reducing ill health and health inequalities. What we would like, I think, what would be really helpful are examples of good practice. Can I invite your views? Can I ask you to raise your hands? Alex will identify you. A couple of please. Please identify yourself and please, please, can you keep it brief? That way we can hear from a lot more people. I see quite a few hands here, so I see the lady to the right, yes, in the blue cardigan in the red shed. It will come on automatically. Diana MacKinnon My name is Diana quickly, and I am an individual—as we all are—as we all are, I am an individual. It is just a comment. In our local sports centre, the doctors are recommending people go and get exercise, and they send them there. The number of people whose faces fall when they realise they have got to pay £7 for this particular course, or £6, is maybe not a lot to some people, but to some people it could be a meal for that week. I do not know what you can do about that. David has just whispered in my ear that the health committee is launching an inquiry into this next year. This, I think, speaks to that discussion that we had earlier about the poverty premium, not necessarily that people who struggle with the £7 are in poverty, but they are close to it. It is also the fact that in our most deprived communities, there are often those who have least access to fresh vegetables and produce with which to prepare healthy meals. Why is it that, in our more deprived communities, you can only find an Iceland, whereas if you are in Stockbridge or Morningside, you have farmers markets and the rest of it? There is an inequality there. I think that we actually do ourselves as a society a disservice by not recognising the prevention aspect of investing in access to physical activity. If we as the state were to pick up your £7 tab for your exercise, we would probably be saving ourselves money down the line in terms of things that we have managed to stop or stopped you getting ill or kept you weller for longer, all of which have an exponential difference in terms of the cost that the state eventually meets out. That is all about prevention. Good question. Thank you. The gentleman here in the tie. Jan De Fries again from UC and East Kilbride. I was just talking to Donald McLeod during the break, and I was saying to him that something that has been happening today is getting closer to home, that quite a few people I know have been falling recently of our age. One thing I didn't know that there are some preventive causes, but you would stop yourself falling, so perhaps something that could be introduced or made more publicly aware. I wasn't aware that such things are available. That's the prevention of falling for elderly people who watch how you get up, so maybe that's a suggestion. A number of nurse practitioners have been trained in exactly that, and I think it's very important. Fools are a horrendous strain. Can we have the mic back on? Each of the people I've been talking about, there are three in particular in the last month. They've each broken a limb, a clavicle, an arm and a wrist, so we're talking about breaking of bones. Fools are the number one cause of hospital admissions in the over 65s, and in a large number of those cases, they don't actually lead to broken bones, but people are still admitted. That is just what happens. Largely, 999 is dialed, people are taken into hospital and then they stay there, and that leads to a set of circumstances which are also negative. For example, I had a constituent, and I raised this with the First Minister a couple of weeks ago, had a constituent who had a fall in March. He didn't break any bones, but was admitted to the Liberton hospital. He caught a small infection in the hospital, but was found fit to go home in June. However, because he was 83 and was still a bit frail, it was felt he needed a care package. It was the failure to install that care package, which meant that he spent his 150th night in Liberton hospital after being declared fit to go home last week, and that's the kind of delayed discharge, which costs tens of thousands of pounds, which prevents other people from accessing that resource and the rest of it. However, I think that you're absolutely right. If we can do things that empower people within their own homes to take basic exercise or techniques which can avoid falls or adaptations to homes, which are easier to come by, then we save a lot of grief, absolutely. The second person to mention was Kurt Liston in the parliamentary chamber. That may be the first time that's ever happened. I am Derek Young for the senior policy officer with Age Scotland. We heard in the morning session, Alex, when you weren't here about loneliness repeatedly. I know that was something that the Equalities and Human Rights Committee's predecessor in the previous session held a groundbreaking inquiry, the first ever in the world, as far as we know, to look at the issue of loneliness. I would encourage the Health and Sport Committee to pay attention to that in the rest of this parliamentary session, because what was revealed is that loneliness is an issue that doesn't specifically or exclusively apply just to age. It can apply to any age, so the Equalities issue isn't the main focus. What we know, though, is the profound impact that it has on people's health and wellbeing. It's a social determinant of health, but it's not often looked in that way as income or educational status poverty-poor housing are. We know that it doubles your risk of developing dementia if you have chronic loneliness. It is as bad as you as a 15-a-day smoking habit, and it increases by 10 per cent your risk of mortality. It has a huge profound effect on the way people live and the resources that they have to draw upon if they need that support from the health service. Living up to the ideal of prevention, this is something that could deserve attention. The Scottish Government is consulting on a strategy next year, and I would like to see the Health and Sport Committee look at that either during or after that process. That point is exceptionally well made. I should say that I mentioned the correct list in the First Minister's questions yesterday, so it's not the only time that it's been mentioned. No, the loneliness strategy has to be front and centre in the work not just of my committee in the Equalities in Human Rights Committee. I should say that our convener, Christina McKelvie, would be here today, but for family issues she's unable to, and she sends her best regards. That has to be front and centre in our work programme, as it does. I mentioned intersectionality earlier, but it has to be cross-cutting right across the committees of this Parliament. In literally every devolved area, there is an aspect of this through policy, through transport, even through justice. There are elements of that strategy that will permeate. It's a point that we do well to remember, and I know that I'll be agitating for that to be part of our agenda. The lady just in the middle there. We had this morning from Neil from the Health and Sports Committee that recruitment and retention in the NHS. Something like this has been spoken about for years. What will the committee do about it or what can they do? Because due to shortage of staff in the NHS, that's why we have been all these problems. You said the magic words, recruitment and retention. We face an existential crisis in our health service, bigger than anything that's ever come before. If you look, the Royal College of GPs tells us that, by the end of the decade, we will be 800 fewer GPs than we require as a nation to sustain our primary care services. Every aspect of the health care service, including paediatricians, psychologists, midwives, nurses, is beating a path to my door in the doors of the other committee members to say that we aren't training enough people. People are not coming on-stream fast enough. That problem is vastly accelerated with Brexit, potentially, because if we cut off recruitment from Europe, if we stop European migration into the workforce, we close off a very important tap in recruitment and retention in the NHS. Without that workforce planning, we are in real difficulty. Audit Scotland produced a report last week, which was quite scathing about where we are as a nation in the health force. It pointed out that we do our workforce plans every five years, but it takes seven years to train a doctor. That's an immediate disconnect that we should resolve. We should be looking not now, not just for the next five years but for the next 15 or 20 years, about what will the workforce look like, particularly considering that we are on the precipice of a massive generational time bomb where the ageing demographic is going to put an exponentially difficult demand on the health service. Workforce planning is key to that. There was a lady behind you that I promised to take next in the red cardigan. Thank you very much. I'm sorry to have to ask this question again, but I did ask it this morning of Neil Findlay, and he didn't answer it. I'm looking at your display up there how to overcome isolation and to improve uptake through more personalised and attractive support services. In fact, the home care service has been cut in the last year. The time has been halved for support to my husband, who had a stroke 10 years ago. He only has it in the morning, but it's very valuable and the workers are fine, but the admin is not. The question that I asked this morning is, what are you going to do about the illegal contravention of the European working time directive where the care workers only get 10 hours between shifts instead of 11 consecutive hours, which they should do, because it's not okay. Time off in the middle of the day doesn't actually compensate for it at all. I've asked this question several times locally. I'd like to know what the pattern is in the rest of Scotland. I'm sure that there are other shift work patterns that might serve the same purpose. When you look at overcoming isolation, for some people living alone, the visit of the care worker is the only human being that they see in the whole day, so it's really important to make sure that those workers are properly supported and not exploited. Thank you. Obviously, I'm feeling on the spot that you didn't have that answer earlier. There's quite a few things to unpack there, but I'll do my best. We, as a committee, met with some care providers or care workers earlier in this session. I think that it was one of the most moving sessions that any of our committee members had experienced before, hearing the first-hand testimony of people who are up against it, not getting the wages that they should be, being asked to perform intensely personal services for people, to offer compassion, support, friendship, physical assistance, and yet being paid less than they would if they did a nine-to-five shelf stacking job in Tesco. I think that that's an indictment of our system. I think that it's something that we have written as a committee to the Cabinet Secretary for Health and Welfare, and it's something that, because of that testimony, we will not leave wanting for the rest of this session. We will work on that repeatedly. Do you want to come in, David? Can we have David on the mic? Can I just add, in relation to the letter that the committee wrote, I gave a copy of that letter to my mother's carer, and she phoned me up the next day and said that she was moved to tears that, at last, somebody was taking notice of their position. We are awaiting the response. I think that it's due in the next week, and in line with all other exchanges with the Government, if the committee are not satisfied with the response, they will follow it up. I hope that answers your question. So quite a few hands here. I did see yourself in the pink cardigan. Is it Eileen? Eileen. I'm going to get a bit in here. My name is Wallace Eileen Wallace, and I'm from Stirling. I appreciate and like John, I actually lost a couple of dear friends in the last year from falls that happened at home. Could I maybe suggest, and you're going about the long term with health and support, that we have care standards? Why don't you look at falls standards in that situation? Again, there was terrific work done in Fife, and there was work done in Perth, and that sort of thing. It's actually been disseminated. The other side to take it from as a retired ex-professional myself. I know how important call handlers or nurse advisers on the end of a line would get a call from a relative or from the person themselves on the floor, and there's nothing they can do about that scenario if there isn't actually a break or a fall. It's very distressing, and they need support as well. So can I actually just say to you, have you ever thought about falls standards? Again, the statistics speak for themselves on that. I think it has to be front and centre, so thank you for that. We'll take that into the committee. I'm told we're only allowed one more question. I'm sorry, I can see a load of hands up. Can I take the gentleman on the end here? Rob Snodgrass from Grey Matters in Helensborough. Our group believes, and I'd be very surprised if you disagreed, that it's very important for health to keep all their people mentally active, to give them a reason to get up in the morning. But when I look at funding for active citizenship, I found over 20 funds between EU Westminster, Holyrood, all aimed at 16 to 25-year-olds. Don't we matter? Don't they want our 40 years of experience? It's not a good time to ask for more money, but maybe a readjustment of how it's distributed would help here. Again, how can you argue with that? No, it's absolutely right. There is a preeminence attached to young people. I think that for years and years and years, we're rightly wrongly, politicians and other stakeholders within public policy have focused resources towards those people who haven't translated into the workforce yet or are struggling to get into the workforce, the 16 to 25-year-olds you describe. I think that there is a rationale to that, that they would describe to you that because we have an ageing population that will require to be supported, we need that generation earning and contributing, otherwise we can't support that older generation. It doesn't mean that it's right, it doesn't mean that focus is right, and one of the reasons I was so pleased to come take the opportunity to chair this discussion this afternoon is because I don't think that I hear enough from older people. I think as we discussed in the very first question, older people are less likely to put their hand up and tell you and ask for help or to say they're not quite coping, and I don't think that's right. I think that we need to reshift that balance of focus, but this is about local democracy as well. I think that this is about making your voice heard by approaching your local parliamentarians, your community councils, your health boards and those who make the decisions about you and tell them that you require what your needs are, what your interests are and exert your stake at that table because without that then people are not going to offer it to you and for the reasons you described so. I think I will take one more question. Okay, lady in the middle at the back from my constituency, hello again. Sorry, that was quite a short one. My name's Marion Mitchell, we have met before, but my question is actually going back to falls and I know that every council provides a service where there's a little wristband which you press the button if you've fallen and you can't get off the floor then someone will come to your aid, but the problem is in Edinburgh they charge you £8 a week, in West Lothian they charge you £1 a week, neither is well means tested, so why is to describe the £8 a week for some households is actually our pensioners, especially single women, would be a lot of money? Well I described at the start the situation with my mother and father-in-law and they engage that service in their council which is Midlothian in their own Dalkeith and actually stopped it after a while because it was costing them too much money. We've kind of got them to reconsider that, but it shouldn't be a consideration you have to make, it should just be an entitlement. I think that's where having a strategy around falls and as you describe Eileen would actually see that front and centre. We have amazing technology now in the health and social care field, you're probably aware of something called telecare which is part of what you described, that's just one feature of it. There are many other very sophisticated techniques, so there are some sheltered living complexes which use telecare where they actually have pressure sensors on the floors so that they can detect if a resident hasn't been up and walking for a number of hours or during daylight hours or if there is a weight you know motionless in a certain part of the property and that will flag an alarm after a certain period of time so that they can A check if somebody can't get out of bed or B if they've had a fall. I think that these are not particularly expensive adaptations but with our ageing population we'll have to become a feature of modern life for Scottish residents. Given the statistics that we've already discussed, the pressure on the health service and the social care force, it's not can we afford to do it but can we afford not to? I'm going to read this note out just to see if I can decipher David's handwriting. Those who didn't get to contribute should write to David, my colleague from the health committee, David Cullum at the Scottish Parliament, and you can go through the website. If you go to the committee pages you'll find David and his contact details there. Please do feed them in. As he articulated very well, we will regard it as evidence for the committee that will fold into our continuing work in the fields that we're discussing and I'd just like to take this opportunity for thank you for being so welcoming to me and so forthright with your views. So thank you very much. I'm now going to pass over to Tom Burnie again who I think is going to conclude this afternoon. Thanks chair. Really we're now just in the final stage and we'll be winding up shortly but before I do could ask you, you've all been given an evaluation form so could ask you all to maybe while I'm speaking just now to start filling in some pretty simple questions and we'd like you to basically what we'd like is you to tell us what you liked, what you didn't like, so that we can do it better next time. I'd like to thank lots of people, I've got to thank this kind of event rather, this kind of event takes a lot of organising and so I'd like to thank some of the people who did that. Particularly of course the Scottish Government for the support that they've given us throughout the year, the Equartus unit of the Scottish Government for putting us on the committees and so on, the Scottish Parliament events team who you've probably seen around here leading you from room to room and helping with the catering and so on, thanks to all of them, thanks to Neil Findlay, Jeane Freeman, John McCormick, Eric Cole-Hamilton and David Collum for the contributions that they've made, thanks for that. Thanks to all the people who volunteered to help us today in Sopa, I'm among them, Rosa McAlpine, Gordon Fraser, Alison Gildia and all of the people who manned exhibition stands and of course all of the speakers along the front here who gave us, I thought, very interesting reports of the kind of activities that they were involved in throughout the year and thanks to all of you for asking your questions and even the ones who just came and didn't ask questions, thanks for being here anyway and I hope we've all learned something from it. I hope you've enjoyed today. One thing you should know is that you're all film stars now because all of this is being recorded and we will be looking at the recording and we'll be taking points that have been made from the floor and from the top table and we'll be using those to form Sopa's agenda of activity for the next year. Everything said today is recorded, we will be looking back to see what we can do to progress those ideas. In the meantime, have a look at the Sopa website. Everything we do, we're a very open organisation, everything we do is on the website, minutes of our meetings, notes of our meetings and that type of thing. It's all there, anything we're doing, look at the website, you can get it. We also produce a regular newsletter, again from the website, you can send us an email and we will put you on the mailing list and you'll get a copy of a newsletter. We do it by email so it doesn't cost us anything but it means that we can send out as many as we want to so anybody like to receive a regular copy of the newsletter ask for it and we'll arrange to get you one. I always think though that in these events, I think you're going, big mistake always trying to use technology, isn't it? I thought it'd be clever to use my iPad, wait a minute, I think you've had it with the poem. Basically though, I believe that old age is a benefit to community. We are the glue that holds society together, we keep families together, families with older people have less crime and we contribute something like 42 per cent of all the voluntary work done in Scotland that is done by older people and a lot of you are here today. So what I will say there is keep up the good work and have a safe journey home. Thanks for coming.