 The next item of business is a member's business debate on motion 5016 in the name of Jackie Bailey on Vale of Leven hospital GP out of our services. This debate will be concluded without any questions being put. Can those members who wish to speak the debate please press the request-to-speak buttons now? I call on Jackie Bailey to open the debate seven minutes earlier about this, Ms Bailey. Thank you very much, Presiding Officer, and I welcome the opportunity to discuss the future of GP out-of-our services in NHS Greater Glasgow and Clyde. I will, of course, focus my attention on the cuts proposed at the Vale of Leven hospital, but I am sure that other members will want to speak about the out-of-ours services in their own area. Make no mistake, this is an NHS Greater Glasgow and Clyde wide plan to cut back access to GP out-of-ours services. According to their recommendations in a paper sent to all health and social care partnerships in the Greater Glasgow and Clyde area, the services at the Vale of Leven hospital, Greenock health centre and Inverclyde royal hospital will be closed between Mondays and Fridays in the evenings and overnight. That will leave just five GP out-of-ours centres covering the whole of Greater Glasgow and Clyde during the week, putting even more pressure on NHS staff and causing some considerable concern for patients. The health board argues that the cuts are necessary due to staff shortages and financial pressure on NHS budgets. Those staff shortages have, in part, risen due to the reduction in medical training places made by the current Government. Since the beginning of the year, we have seen services withdrawn for hours at a time at the Vale of Leven hospital on at least eight occasions, with absolutely no notice given. Patients who have been sitting in the waiting room have been handed letters telling them that there is no doctor available to see them and they need to go to Paisley. The irony is that the vast majority of temporary closures at the Vale of Leven's out-of-ours service have happened during the weekend, yet the health board wants to act to the service during the week when they appear to have less difficulty filling staff rotas. What happens if the cuts go ahead but the health board still does not have enough staff to run the out-of-ours service on a Saturday or Sunday? If they were so concerned about staffing, why did the health board stop trainees doing shifts—something that is allowed to continue in Glasgow but not at the Vale? Local GPs believe that it is only a matter of time before the service is completely removed. There has been no consultation on the proposed changes. The health board has issued empty reassurances via the local media, while behind the scenes that its officials send out papers to the health and social care partnership recommending cuts to the service. Just ask the local GPs in Dumbarton, Vale of Leven or Helensborough, who met me and hospital campaigners last Friday. They are furious about the lack of engagement. Not only have they not been invited to share their unique insight to the needs of local patients, they weren't even informed about the proposals. One of the GPs in my area found out about the proposed cuts on Facebook, not from the health board but on Facebook. Family doctors should be at the forefront of shaping local primary care services, but NHS Greater Glasgow and Clyde simply treats them as an afterthought. Local GPs are responsible for the care of around 75,000 patients across the entire catchment area of the Vale of Leven hospital. They have issued a unanimous statement condemning the proposals and let me quote from it, because, in their words, they say that it constitutes an unacceptable clinical risk that will be felt most by disadvantaged patients, thereby widening health inequality and goes against both government and NHS Scotland advice. They made the point very clearly that GP out-of-hours is a core service that should be both local and accessible. It's not a specialised service. There's no clinical argument in favour of centralisation. Indeed, the GPs have said quite clearly that patient safety is at risk if those proposals go ahead. Emergency primary care is one of the most basic components of any local healthcare provision and it should be protected. Let me tell you about the practical implications for patients in the Vale if the service is centralised in Paisley. This is one example. I was told about a woman with a heart condition who turned up recently at the Vale on one of the evenings when the out-of-hours service was closed due to staff shortages. When she was told that she would have to make the 34-mile round-trip to Paisley to see a doctor, she decided to go home and wait until her local surgery reopened in the morning. Thankfully, in this case, her condition improved, but it could have been very, very different indeed. This example highlights how vital it is to protect access to local out-of-hours care. If the service is withdrawn permanently, many people from Dunbarth and Vale of Leven and Helensburgh, especially those without a car, will simply not be able to see a GP in an emergency. They might not see a GP at all because they don't want to bother anybody. My local GPs firmly believe that patients' lives will be put at risk. The health boards' own analysis of the footfall at out-of-hours centres shows that the service at the Vale of Leven hospital is well used. Dunbarth and Alexandria have the highest share of out-of-hours attendances of any postcode area in the whole of Greater Glasgow and Clyde. Yet, predictably, the health board singles out the Vale of Leven hospital for cuts once again. There are over 120 patients on average in my constituency used the service on Mondays to Fridays and they would be forced to travel to Paisley. In Helensburgh, remote communities on the Rose Neath peninsula in Arica would face even longer journeys if the service is centralised. Local GPs estimate that that would lead to in-excess of 500,000 miles of travel annually for Helensburgh patients alone. In West Dunbarthshire, we have some of the most deprived communities in Scotland and the lowest rates of car ownership. The last bus from the Vale to the RAH leaves at 10 minutes past 6. The patient transport service does not have the capacity to offer transport within one or even two hours. The poorest patients would be hardest hit and they would effectively lose access to emergency primary care. Whatever happened to the mantra of prevention and early treatment? If those proposals go ahead, patients will self-refer and end up in the wrong place at the front door of A&E further increasing waiting times. The provision of GP out-of-hours services was a key commitment in the vision for the Vale agreement signed by Nicola Sturgeon when she was health secretary. I welcomed the Vale vision back in 2009 because it offered stability and promised to retain a range of services at my local hospital. However, in recent years, the health board has started ripping up those promises. Maternity services under review, wards closed, hematology and a host of other clinics cut, 113 fewer nurses and midwives, bed numbers slashed by a third. Now even the most basic local service is under threat. Every time I raise the Vale of Leven hospital in this chamber, the cabinet secretary, the First Minister, they all tell me that they are committed to the vision for the Vale. However, if that is the case, why has not one SNP MSP signed my motion this evening? Not even Stuart McMillan, whose constituents in Greenock and Inverclyde will be directly affected. The message really is not understood by the health board either because if the health secretary is serious about the vision for the Vale and I believe she and her minister both are, will they tell the health board to take the cuts off the table? I hope to hear from her when she sums up this evening. Out of hours is a basic service. It is not specialist. It does not benefit from centralisation. If you remove it, you are putting patients at risk—not my words but the words of local GPs. On Thursday afternoon after FMQs, I have the pleasure of welcoming a delegation of local activists from the hospital watch campaign to the Parliament. Their recent demonstration at the Vale of Leven hospital was a huge success with over 5,000 people attending. Hopefully on Thursday they will get the opportunity to meet the cabinet secretary, to meet ministers and I encourage colleagues from all parties to join us at 1pm in committee room 4. The message that we want to convey is clear. Stop the cuts, protect local services. I call Stuart McMillan to be followed by Maurice Corry. Mr McMillan, please. Thank you very much, Presiding Officer. Jackie Baillie has raised many issues in her contribution and a lot of which I can agree with and we can find common ground. The issue before us today highlights the issue of the out-of-hours GP services. Previously, as a regional MSP, there were occasions where I highlighted issues on behalf of constituents regarding service delivery but also regarding the future of the Vale of Leven hospital and services in the Dumbarton constituency. The vision for the Vale document that Jackie Baillie touched upon was published in 2010, and inpatient and day case activity has increased by a third in that time. However, we should also remember that it was this Government that ended the decade of damaging uncertainty by delivering the vision for the Vale under the previous Labour Liberal Democrat Administration, in which Jackie Baillie served as a minister, the Vale's E&E was closed in 2002. The number of acute beds reduced in every year of the Labour-led Scottish executive. I highlight those points for a reason, because health service delivery is changing. The pulling together of transforming urgent care for the People of Scotland report, which was published in November 2015, highlights the need to think a new about what is best for urgent care for the People of Scotland. That would require transformational change across many sectors. That is not easy, and I have raised concerns about proposals that have come forward regarding Inverclyw Royal hospital, both publicly and also in correspondence with the Cabinet Secretary and the Health Board, and I will continue to do so. The tactic that I do not deploy is to run to the press for a story before I have all the information, and I am not accusing Ms Baillie of doing that. However, I am aware of the review, which clearly affects the Inverclyw area. That is also why I wrote to the chief executive of the health board on 10 May. I asked some questions regarding access to public transport. Due to the public transport not always being available during these hours, and the cost of a taxi to Paisley from Inverclyw will be prohibitive for many of my constituents, Jackie Baillie used the phrase of that the poorest patients will be the hardest hit, and that is certainly something that I absolutely agree with her on. I also raised the question regarding accompanying travel and the unsociable hours, if needed, to use the service, and thirdly I raised the question regarding patient safety and care and also the long-term future of the service. Now, I know that the review is taking place and I reply from the health board, and last week's Greenock Telegraph, in reply to someone else raising the issue, it was extremely informative in it that the review being led by the health and social care partnerships is considering how we can continue to provide an efficient responsive GP service out of hours that is sustainable in the long term. The recommendations from this review will be reported back to the six integrated joint boards and the NHS Greater Glasgow Clyde in due course. A spokesman for Inverclyw Council said that the service is wholly reliant on having enough GPs available to cover out of hours, and that this is proving difficult across the whole of NHS Greater Glasgow and Clyde area. A number of proposals will be put to joint boards, including Inverclyw next month for consideration and a preferred option identified. The issue of the out of hours service is something that is important to both Jackie Baillie's constituents and also to mine. The review that is under way is one of the recommendations from the Sir Lewis Richard review. However, the Scottish Government will be expecting meaningful engagement with the public to take place. There have been occasions where that has happened, but there are also other occasions where it has fallen short. That is also a point that I am sure Ms Baillie and I will agree on as well with some of the activities from NHS Greater Glasgow and Clyde. However, I will be looking at all the recommendations that come forward, and I will be encouraging all of my constituents to do likewise in Greater Glasgow and Clyde, and to make those recommendations heard loud and clear to not just the integrated joint board but also to the health board and to the wider public, because that service is crucial certainly to Jackie Baillie's constituents and also to mine. I thank Jackie Baillie for bringing forward this very important debate this afternoon. The future of the Vale and Even hospital that I concentrate on, because very much in my area, is vital to the constituents that we both represent in the Dabarton constituency and also across the wider West Scotland region, so it is right that we have a chance to debate our concerns about the future of the hospital here in Parliament today. The Vale is a central part of life in our area of Scotland, and for many of us, myself included, it is where we remember our children being born, where family members have gone to receive life-saving treatment, and, for some, it has also been the place where we have had to say our last goodbye to loved ones. That is why every time a reduction in services in the Vale is threatened to be implemented, it is followed by such passionate outcries by the local community and furious debate, because only local people can truly understand how important the Vale is to our community. The moving of the GP out of our services from the Vale to Paisley is another example of a threat against the hospital, and it would be detrimental to our area. Asking people in areas such as in Dambarton, Vale, Leven, Helensborough and Lomond, and including the Roseleys Peninsula, which Jackie Baillie referred to as well, to travel upwards of an hour or more to the Royal Alexander hospital in Paisley to access emergency primary care services is unfair, and I certainly do not believe that it will improve even patient care or, indeed, their ability to access that care. As Jackie Baillie correctly points out in her motion, the demand for out of ours GP services has not fallen in the areas that I mentioned above, but it is actually higher in those areas compared to others. This is not an underused service, wasting manpower and resources that could be better used elsewhere, but instead it is a vital need of our residents north of the Clyde in my west Scotland region. Alongside the other suggested cuts, removal of services at the Vale in recent months and years, such as the cuts from the pharmacy services have been mooted. This in itself, I believe, would have a detrimental effect on the care of patients. As would the suggested closure of the community maternity unit and also the reduction in hematology services at the hospital. Local people have been left questioning whether the Scottish Government and the NHS Greater Glasgow and Clyde board truly have the real dedication and commitment that is required to deliver on the promises they made in the vision of the Vale document. The service that we are debating today and the others that I have also mentioned is a vital part of our local hospital and they are required if a hospital is going to be able to successfully service local community just as the Vale of Leven has done for many decades. With the proposed expansion of the Vaslane naval base over the coming years, the population area will only increase. Service personnel and their families will be moving to the local area and many will be reliant on the services provided by the Vale of Leven hospital by getting rid of those services. We are discouraging people from living in our area and coming to settle in our area, which is very important. I welcome the calls and add my own to Cabinet Secretary of Health and Sport about the need for her to intervene in the matter. In conclusion, out-of-house services are not a centralised service. It is a basic service to our communities. The issue can be understood by local people who rely on the service and see the benefit of the Vale of Leven hospital. Moving out-of-house services to Paisley would incur travel times of over an hour plus and the personal costs involved. Young married couples who have come up to serve in the navy, whose wives may not drive, in the middle of the night they have a panic situation for one of the children, their face, there is no cash on the table to have a taxi, we have a problem there. Demand for out-of-service hours has fallen and it is actually higher with Dumbarton and Alexander residents. The Scottish Government should be delivering the promises made in the vision of the Vale document and services are needed due to the plans to increase the size of HM naval base Clyde. We have about 10 referrals per day from that base to the Vale of Leven hospital. Finally, it is vital that the Government steps forward and protects the services and keeps the promises that it made to local residents, patients and NHS staff in the vision for the Vale report. Deputy Presiding Officer, I hope that you will give me permission to first of all start by thanking all staff at the Wishaw general hospital, who have responded very quickly to what is believed to be a bomb threat at the hospital in terms of evacuating and very quickly getting the situation back in control and the patients and staff back to work. I want to put on record my thanks to all our wonderful NHS staff, particularly those working at the Wishaw general hospital. I can also thank Jackie Baillie for bringing forward this important debate today. It is no secret that Jackie Baillie is a strong defender of the Vale of Leven hospital and has been a strong advocate for local services in her constituency. He has worked closely with local people, including hospital watch, to focus on the services there. I look forward to accepting that invitation and meeting the campaigners from hospital watch on Thursday. I also put on record my thanks to them for their on-going commitment to the Vale of Leven, to the staff at the Vale of Leven and to protecting services at the Vale of Leven hospital. It is also important to recognise the debate in the context of the on-going concern around the maternity services unit at the Vale of Leven hospital, which is currently under review and has been recommended for closure by Greater Glasgow health board. I hope that the Scottish Government takes the earliest opportunity to provide clarity to the service users at the Vale that the maternity service will be protected and will end the uncertainty there. It is also important to recognise that this debate and the pressure on the out-of-hours service as the result of two key factors, one being resource and resource not meeting demand in the NHS, and secondly, and perhaps more concerning, the on-going workforce crisis that we have in the NHS. Let's not forget that our health boards are being asked to make £1 billion of cuts over the next four years, and that is directly going to impact on services and direct impact on patient care and impact on our staff. That is perhaps an early indication of what the results of those cuts will be. Secondly, in terms of the workforce crisis, we have seen a mismanagement of the workforce for the last 10 years, where we have seen our NHS staff left overworked, undervalued, under-resourced and, I believe, underpaid to. That is a situation that needs to be addressed with urgency. There is also an on-going GP crisis. The Royal College of General Practitioners tells us that we are 830 GP short or projected to be 830 GP short by 2021. Again, that is a concern particularly around the available service, and I hope that the minister in response will address the opportunities that will come from the GP contract process to provide more support to general practice, firstly in terms of more auxiliary support to other support services around the GP, for example, specialist advanced nurse, physiotherapists, a mental health nurse, et cetera. What further support that pharmacies can give to try and take pressures off GP practices and also out of our services. What role out of our services will play in terms of their relationship with primary care, because any closures out of our services will only pile on pressure even more on existing GPs and pile more pressure on to our already overstretched A&Es. I also want to thank all those GPs in the local area around the Vale of Leven hospital, who have signed a joint statement saying what they think will be unacceptable clinical risks to patients if this out of our service proposal goes ahead. I think that the minister must listen very carefully to the concerns of general practitioners in the region. Just in closing, there are some direct impacts. The loss of a lifeline service, more pressures on GP practices, adding pressures on already existing over-pressured GP practices and surrounding A&Es. The continued centralisation of services, the longer travelling times for people around the Vale of Leven, particularly impacting those people who are from the most deprived communities. The fact that we have poor transport links to other hospitals around the area, the impact will have wider health inequalities on the area, the further pressure that I will put on existing staff in other areas. The downward slope in taking services away from the Vale of Leven hospital will be a huge concern to people around the area of Vale of Leven. It is also important to recognise that this is not just the Vale of Leven that is impacted on those changes but those in Greenock, around the Greenock health centre, and service users who are un-reclied with the pressures around the un-reclied royal hospital. I hope that the minister will take the opportunity to give clarity to the local people and to say that local services will be protected, which was a manifesto commitment and will instead invest in our NHS and take pressure off our hard-working NHS staff. Thank you, Mr Sauer. I see that you have localised it. You are a bit general to start with, but you are an astute speaker, and I realise that you are to bring it back to the motion in hand. I compliment you for that. Ross Greer followed Brian Whittle. Mr Greer. I should start by apologising if I have to leave early, as I notified your office in Jackie Baillie last week, on an event that I am hosting that has had arrangements changed due to the security issues. I also thank Jackie Baillie for having tabled this motion and brought it to debate in the chamber. I know that it is an issue that she quite rightly cares deeply about, and indeed it is an issue that we should all feel strongly about. Certainly every representative of the west of Scotland. Access to healthcare in your local area is of vital importance to everyone. That local connection, the accessibility, should not be underestimated. When it comes to primary care services, they should be available in your community from a GP that you know that you trust. That is exactly what is under threat at the Vale of Leven. Year on year services have been chipped away—hematology, pharmacy—and now out-of-hours GP services under threat of being cut. Already out-of-hours GP services have been temporarily closed at weekends due to staffing shortages. As Jackie Baillie has stated, a report by NHS Greater Glasgow and Clyde recommends the withdrawal of out-of-hours GP services on weekdays. Alternative out-of-hours services would involve travelling all the way to Paisley to the Royal Alexandria, which should be more than an hour away by bus. I do not see how forcing people with a health issue to travel all the way to Paisley will deliver better care. Particularly for those with disabilities or parents with young children, access to healthcare will suffer from restrictions on out-of-hours GP services. Local residents certainly do not think that it will improve the service, and they are its users. We will have on Thursday, as Jackie Baillie mentioned, those who have campaigned to save local services in the Vale of Leven. Hostel Watch has been campaigning for, I believe, 13 years now. They will bring with them a bedsheet signed by thousands of their supporters, some of whom attended the vigil last week. It is to be presented to the cabinet secretary for health to demonstrate the strength of local support. Particularly for those further north, as Jackie Baillie highlighted, those who will be most affected by having to travel further south to Paisley. I hope that the cabinet secretary will consider the impact that that cut would have on people in and around the Vale. After all, the Scottish Government's own independent review in 2015 of out-of-hours primary care services states that they should be person-centred, intelligent side and fair and accessible for all. Restricting out-of-hours care at Vale of Leven will not achieve that. It will, instead, exacerbate health inequalities that are already a serious problem across this country, but particularly in western central Scotland. I respect that it is NHS Greater Glasgow and Clyde to make that proposal, but, as Annas Sarwar said, it makes it in a context, in a financial context. If the cabinet secretary for health will not step in to protect local services, how many more hospitals will face the same problems as Vale of Leven? It is deeply worrying to see staff shortages drive the need to cut back on local health services. The public sector pay cap is now preventing hospitals from getting the professionals and keeping the professionals that they need to deliver healthcare. As my colleague Alison Johnson said earlier this month, it is clear that public sector pay freeze is negatively impacting staff retention. The NHS in Scotland is facing severe workforce shortages, and with the retirement boom on the horizon, pressures on healthcare are only going to increase. It is imperative that funding in this area does not only increase above the rate of inflation but that it actually keeps up with demand. Anything less is completely unacceptable. That way, we can ensure that services such as out-of-hours GP services that should be locally accessible remain locally accessible, and that is certainly what we will be fighting for at the Vale of Leven. I thank Jackie Baillie for bringing this debate to the chamber this afternoon. It is a debate that has far-reaching implications, not just for the Vale of Leven hospital, but also for how this Parliament approaches healthcare needs across Scotland. First, I can completely empathise with the stance that Jackie Baillie and Maurice Corry and, indeed, Stuart McMillan are taking with this motion. Protecting local services within their own area and supporting the constituents is entirely right. I know that the subject of the proposed changes at the Vale of Leven hospital and the on-going review is one that has been raised often in this chamber, and I have spoken in a debate in this subject before. My position is, as it was then, that it is an unsustainable position to have a blanket policy that states that no services can change or move ad infinitum. It is still my view and the view of the Scottish Conservatives, however, that a significant change in the services provided within a community should be brought to the cabinet secretary's office, and that decision should rest with them. We have a rapidly changing health need, which we are struggling to keep up with. With reference to the Vale of Leven, as with other similar situations, I suggest that we need to consider community services in the round and not through a narrow prism. It is time that we consider the long-term future of hospitals and how they fit into the package of community care. Should there be places for acute services such as A and E and neonatal units with once-in-a-lifetime treatments and operations such as hip replacements in area hospitals where specialists are working, primary care within the Vale of Leven is the subject of this motion, however. I would ask that other provisions are available outside the hospital to complement or supplement the specific needs highlighted. The truth is that there are others in this chamber who know better than me. However, investment in primary care is absolutely essential if we are to have a sustainable NHS service. The Scottish Conservatives have called to the increased funding to be invested directly with GPs to help alleviate the very issue of the motion highlights. I suggest that the RCGP has said that 7.2 per cent of the healthcare budget is currently spent in general practice in Scotland. That is less than in the rest of the United Kingdom. Even then, throughout the United Kingdom, I would also suggest that that is not enough at all. We have to make primary care an attractive proposition for doctors, not only as a good career option when graduating from medical school but also as a working lifetime option. GPs, more than any other healthcare professional, can build up a trusting and knowledgeable relationship in communities over years of service to those communities. Continuity of care is an essential element to the effectiveness of our front-line NHS staff. In Jackie Baillie's motion, she highlights that that is sadly lacking. Whether that is through poor workforce planning and has often been discussed and debated in this chamber or the lack of GP training and recruitment or even the general running down of the services in the Vale of Leven, I am not able to say. Alone investment in primary care is supposed to alleviate pressures on hospitals. In this case, we have a primary care delivery from a secondary care site. However, what is clear is that there is a breakdown in the GP services that the hospital is able to provide, which has to be to the detriment of patients requiring out-of-hours care. I have not supported that motion mainly due to a lack of knowledge in that particular case. However, I can certainly support the overarching issues in the lack of proper investment in primary care, specifically GPs, the lack of cohesive workforce planning and the lack of long-term planning through our NHS services. Thank you, Mr Whittle. I call on Aileen Campbell to close with the Government. Minister, seven minutes are there abouts, please. I thank you, Presiding Officer, and I, too, echo the words that Anna Sarwar said at the beginning of his remarks about the staff response to the incident at Wishaw General. Wishaw has of course been one of the hospitals that services my constituency, where I had my two children and certainly commend the dedication of the staff that work there on our behalf. Again, like others, I thank Jackie Baillie for raising that motion. Let me first begin by setting the scene nationally for out-of-hours provision in Scotland before returning to the points raised by Jackie Baillie and others through this debate. Daytime general practice and GP out-of-hours services across the country, like those in Glasgow and at the Vale of Leven hospital, are facing challenges, including increasing demand for services. That is why, in February 2015, the Scottish Government commissions Professor Sir Lewis Ritchie to undertake a review of GP out-of-hours services. It was commissioned precisely because we recognised the importance of primary care as the first point of contact in healthcare. That should also be the case during out-of-hours services. His report, Pulling Together, Transforming Urgent Care for the People of Scotland, published in November 2015, made 28 specific recommendations focusing on the delivery of a model of care that is GP-led with a multidisciplinary team working together at urgent care resource hubs across Scotland. Sir Lewis's report received full cross-party parliamentary support, as well as broad consensus for its key recommendations from key professional groups such as the SGPC, the BMA, the RCN, pharmacy services, GP out-of-hours services, NHS board chief executives and patient representatives. Crucially, the report recognised that delivering the new model would take time, however, and would require transformational change across the health and social care landscape. That is a journey that has begun. In 2016, we asked IJBs to work with their delivery partners to set out how they will deliver reports' recommendations locally. We provided £10 million of funding in 2016-17 and will provide a further £10 million in the current financial year to support that work. As part of the on-going peer review process, Sir Lewis Ritchie has recently led a national engagement programme in each IJB area, bringing together key stakeholders, including staff in the public, to discuss progress. We are now starting to see a number of areas progress, but, as I mentioned earlier, it will take time to embed transformational change of this nature. That review that is taking place in Glasgow is being carried out in line with Sir Lewis Ritchie's report recommendations. I should make it clear that it is being led by Glasgow City Health and Social Care Partnership on behalf of the six greater Glasgow and Clyde integration authorities. The IJBs are in the initial stages of exploring options for the service as a whole across greater Glasgow and Clyde, and we should also be clear that these are only options at the moment and that no decision has been made and will not be made until wider consultation is concluded. We have been assured by the IJB that it will now be undertaking extensive engagement with the local community to help them to shape a service that meets the needs of the local communities and is safe and sustainable both in terms of human resources but also financially, and we would expect nothing less than meaningful and robust engagement. The IJB will be organising a number of half-day events in the first instance, the first of which is to take place by the end of June this year. That is why the point that Stuart McMillan raised in his remarks is so important. MSPs should actively seek to use the opportunities presented in this consultation process to ensure that the IJBs and the health boards know exactly what the local challenges are. Jackie Baillie raised legitimate points about car usage. She raised relative points about public transport, and, likewise, Ross Greer made and raised legitimate issues around barriers faced by those facing disabilities. The important impact that those decisions can have on our most vulnerable groups in our society if they are not adequately engaged with, and I know that Jackie Baillie will continue to engage in the consultation process. I am encouraged by the minister's comments on consultation, but does she share my concern that local GPs who are responsible for delivering the service weren't consulted and were found out from Facebook? I would expect the IJBs and the board to make sure that GPs are adequately given the opportunity to feed in with their specialist knowledge, their in-depth knowledge of the communities that they serve into the process. We would actively seek the consultation process to engage with GPs and to ensure that they get their opportunity to feed into the options consultation. Services require to provide a quality and safe service to patients. That is the case across the country. The number of GPs who are willing to work in our periods is challenging. We need to work through those challenges to ensure that the right complement of staff and professionals are able to give the support to the people who need it when they need it, because patient safety cannot be compromised and the onset of illness and the need for services does not recognise the clock. We are taking action to deal with the challenges of GP recruitment, which is not an issue that has solely been felt in Scotland. Our manifesto made clear that we are committed to increasing the number of GPs working in Scotland. Last year, we increased the number of general practice training places in Scotland by a third, and for the first time we made a recruitment bonus of 20,000 available to attract trainees to traditionally harder to fill posts. However, such measures only go so far in helping to increase GP numbers in the out-of-hours service. That is another reason why we published the national out-of-hours report in November 2015. As many others members have raised, that is around workforce development issues. That is why 11 out of the 28 recommendations related to workforce issues. The recommendations cover the specific future contribution of not only the GP workforce but, also, importantly, the nursing, pharmaceutical, paramedic and other ILIs, health professionals and other services workforces. The current out-of-hours review being undertaken across Glasgow is taking all those workforce recommendations into account. For example, pilots are taking place to deploy advanced nurse practitioners in home visits. With all that in mind and in order to stabilise the services, the IJBs are required to explore options to deliver a sustainable and safe model of care. As I have said before, patient safety cannot be compromised. However, the continued provision of out-of-hours primary care services across the Clyde area, including the Vale, is a key priority for the Government, because we want high-quality out-of-hours services that fully meet patient needs. That is why we are investing £20 million over two years into delivering the report's recommendations to create a multi-disciplinary team approach, utilising the skills of a range of highly trained professionals in the NHS and ensuring that patients are seen by the person best able to address their needs. There were many other points that were raised. However, the debate is of such importance that I do not want to descend into some of the political points scoring that often happens in such debates, such as trading blows around who said what in manifestos. I could say that we had much more willing to invest in the NHS to support our NHS than the other parties here. I could also say that it was our party that decided to end the uncertainty to the Vale and leave, despite the previous administration being the one that shut their A and E. However, that is of such importance. I think that what we want to do and what we should do and unite as a Parliament is to make sure that we can support our NHS staff, support the GPs, support the process of consultation to make sure at the end of it that what we have is a sustainable service that meets the needs of people that we all care about. Those who are most vulnerable are most furthest away from some of those consultation exercises and make sure that they can adequately shape the service delivery of the NHS in their area. Thank you very much. That concludes the debate and I close this meeting of Parliament.