Neil Gray
Scottish National Party · Scotland
“I welcome the fact that, through the police and the courts, our justice system is ensuring that justice is done. Victims show enormous bravery and trust in our legal system in reporting crime, and I want that to continue.”
“The Scottish Government-funded Caledonian system is a good example of a community-based programme that aims to address the behaviour of men who have been convicted of domestic abuse, alongside providing support to affected women and children.”
“On the day after my appointment as justice secretary, I visited HMP Edinburgh to see the level of pressure that the Scottish Prison Service is facing due to an increasing prison population. It is clear that staff want to focus on rehabilitation and reducing reoffending but that it is increasingly difficult for them to do so.”
“Scotland shows a clear and persistent trend of increasing the length of average custodial sentences, including a 37 per cent rise between 2014-15 and 2023-24.”
“However, although the operational impact that will result from the changes is expected to be minimal, I still advise the Parliament to give legislative consent to the relevant sections of the bill.”
“I note my thanks and appreciation to the Parliament for expediting consideration of this legislative consent motion. It is regrettable that we are having to expedite scrutiny on an LCM, which is due to the UK Government’s timetabling for the National Security (State Threats) Bill.”
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“I take this opportunity to update the Parliament on progress regarding the implementation of the medication assisted treatment standards and the wider work of the national mission. First, I acknowledge the suspected drug death figures that were published as part of Public Health Scotland’s latest rapid action drug alerts and response—RADAR—surveillance report, which highlighted that there were 215 suspected drug deaths between September and November 2024. The 10 per cent reduction on the previous quarter is welcome, but the number of drug deaths remains much too high and serves as a stark reminder of the work that remains to be done. Behind every statistic is a person and a life that has been lost needlessly. Those people leave behind grieving loved ones, who bear those tragic losses. To them, I offer my sincerest condolences.”
“Michael Marra: Week after week, the First Minister says that things are not really that bad, but admissions of crisis are wheedled out of him in moments of weakness. Daily, he denies the reality experienced by so many people who have come into contact with our NHS, our schools and our justice system. Scots are paying ever more, and getting less in return. Every institution is weaker after 18 years of John Swinney and the SNP. A Government that will not admit when things are going wrong is never going to turn things around. Our country needs a new direction. We need a Government that is invested in making things better, turning things around, and doing the hard work of fixing what the SNP has broken. This is not as good as it gets. Our country desperately needs a new direction. 15:07”
“Can Michael Marra set out anything that the Labour Party asked for in relation to the health service in the budget negotiations? Is it not true that it asked for precisely nothing, and therefore got nothing in return? Michael Marra: In all the meetings, we asked for the Government to take a new approach to our NHS. [Interruption.] We asked it to clear the backlogs and reform the NHS so that it is actually able to deliver. [Interruption.] Just last week, the First Minister republished his previous plans that he failed to deliver anything of. This is a tired Government that has lost its way and run out of ideas. Week after week— [Interruption.] The Deputy Presiding Officer: There is a bit too much noise, members. We need to hear from Mr Marra.”
“Further, our wellbeing services include a 24/7 compassionate listening service through the national wellbeing helpline; self-guided resources via the national wellbeing hub; confidential mental health care through the workforce specialist service; and access to psychological therapies.”
“What measures in the Scottish budget will help in that regard? Neil Gray: I absolutely echo the compliments for our Scottish Ambulance Service staff, as I set out in my answer to Kevin Stewart’s first question. If the 2025-26 Scottish budget, which we will hear about shortly, is agreed by the Scottish Parliament, it will provide record funding of £21 billion to health and social care. That includes an increase for the Scottish Ambulance Service of more than £88 million, taking its baseline funding to £437.2 million for 2025-26. That will help the service to continue to develop, enhance capacity and deliver high-quality patient care across Scotland.”
“The central aim is to improve patient flow through the system, from the Scottish Ambulance Service into NHS Grampian’s acute sites and back into the community as soon as patients are fit for discharge. The Scottish Ambulance Service and Grampian’s health and social care partnerships have been collaborating to implement their unscheduled care improvement plan. The centre for sustainable delivery is also providing support to NHS Grampian; it has identified opportunities within its acute system for more efficient use of in-patient capacity and learning from best practice elsewhere. Kevin Stewart: People who I have talked to in the past few days have been highly complimentary of our paramedics and the job that they do. What more can the Government do to ease the strain on and improve the wellbeing of ambulance crews?”
“Since 2019, the Scottish Government has invested more than £480,000 in the development and implementation of the national Lifelines Scotland programme. Kevin Stewart: Ambulance stacking at Aberdeen royal infirmary has caused a great deal of stress for ambulance crews, according to a paramedic who I listened to yesterday. That, of course, has consequences. What is being done to improve patient flow at ARI to improve the situation? Has best practice from elsewhere been brought into play in Aberdeen? Neil Gray: I absolutely recognise the scenario that Kevin Stewart outlines and the impact that ambulance stacking has on staff across the system, but in particular on paramedics. Officials have been meeting the executive team at NHS Grampian to discuss actions that can be taken to ease pressures.”
“I take this opportunity to put on record my thanks to all national health service and social care staff for their incredible service. In this case, we are discussing issues that paramedics are facing, which I absolutely recognise from the meetings that the First Minister and I held over Christmas, as well as from the visit that I paid to the Scottish Ambulance Service in Edinburgh before Christmas. Healthcare services are under significant pressure, and we must ensure that support is sustainable and aligned with staff needs. We will continue collaborating with healthcare leaders and staff to identify and address areas of stress and take actions to provide support. Staff wellbeing is absolutely paramount. From 2024-25, the Scottish Government is dedicating more than £2.5 million annually to support staff wellbeing.”
“Nevertheless, I absolutely take the point that Roz McCall makes regarding the evidence that she points to from elsewhere, and we will continue to consider that.”
“Does the Scottish Government agree that an extended testing programme should be considered? Will the cabinet secretary report back to Parliament with the results of any in-depth studies regarding that public health issue? Neil Gray: Vision is one of eight developmental domains that are assessed by a health visitor during universal child health reviews at 13 to 15 months, 27 to 30 months and four to five years. Health visitors can provide appropriate intervention in response to any concerns at those stages. In addition, in 2023, we launched our early child development transformational change programme, which supports the provision of oversight and better integration of policies that contribute to early child development, with a focus on prevention to emphasise the importance of pre-birth and early years.”
“Roz McCall: Again, I thank the cabinet secretary for his response and for the tone that he has taken on the matter so far today. The study that I mentioned is wide ranging and has found a clear link between shortsightedness and living in urban areas with a large number of flats. For example, children who are living in the Greater Glasgow and Clyde and Lothian health board areas have been found to be twice as likely to be myopic as those in the Highlands and in Ayrshire and Arran. International studies, such as those conducted in China, where lockdowns were particularly strict, also show a sharp increase in myopia among seven and eight-year-olds. With all those worrying trends, there is now a louder call for a sustained and repeated testing programme to be rolled out for slightly older year groups, including seven and eight-year-olds.”
“Of course, we wish to do everything that we possibly can to prevent myopia from occurring and, where it has occurred in the population, to address that through the availability of optometry services and the expansion of those services in the community. All children aged under 16, and those who are aged between 16 and 18 and in full-time education, are entitled to NHS- funded help with the cost of glasses and contact lenses. I encourage any parent—I declare an interest, as a father of four—who has concerns about their child’s vision to arrange a free NHS eye examination with an optometry practice, and I strongly encourage children to undertake as much outdoor play as possible, as those areas have been assessed as assisting in preventing myopia from happening in the first place and in its rehabilitation.”
“Roz McCall: The analysis that was carried out by Ninewells hospital and the University of London, following a study that compared results from eight Scottish health board areas for three years before the pandemic with results after the pandemic, should be deeply concerning to us all, because it found that there has been a 42 per cent increase in shortsightedness, or myopia, in the wake of the pandemic lockdowns. Given that it is so unusual for conditions such as myopia to set in at such a young age, those results are concerning. The Scottish Government’s see4school campaign is very successful in picking up vision issues in preschoolers, but what information does the Scottish Government currently have on sight and vision standards for primary and secondary pupils? Neil Gray: I agree that the findings are concerning.”
“The Covid-19 pandemic was the greatest shock to our health and social care system since the establishment of the national health service. The lockdowns were a necessary public health measure to protect life. There is evidence that there is a global rise in shortsightedness, otherwise known as myopia. That is caused by a range of factors, including more screen-based activities. However, it would not be appropriate for me to speculate on precise causes, although it is possible that the pandemic has exacerbated those.”
“We recognise the link between patient safety and capacity; those questions are incredibly important, and we continue to work with health boards on them. It highlights the importance of passing the budget, as it will allow measures to be taken forward to reduce demand on the system and free up capacity.”
“For a start, the pressure of overcrowding has forced staff to care for patients in unsafe and inappropriate areas. Corridor care compromises patient privacy and dignity, and it should not be accepted as the norm. To show that the Scottish Government recognises that staff across health and social care are at breaking point, I ask the cabinet secretary to commit today to publishing regular data on corridor care. Neil Gray: I recognise the pressure that there has been on staff, and I thank the RCN for its report. It was a snapshot that was taken during the peak of demand over the Christmas period, when we had an exceptional level of flu prevalence, but I do recognise that staff members who worked during that period were also feeling pressure before that and outside of the period when flu was prevalent.”
“Health boards operate their own escalation policy for the management of in-patient capacity, which includes well-established processes with locally agreed trigger points for maintaining a safe service and ensuring patient safety. Capacity challenges can necessitate the provision of care in non-standard areas for some patients. That decision is not taken lightly and is made to relieve pressure on other parts of the system, in particular to prevent ambulance stacking and to allow crews to respond promptly to the most serious incidents. Every effort will be made to accommodate patients in an in-patient ward, and we are working with boards to free up capacity in acute sites. Carol Mochan: The Royal College of Nursing’s corridor care report revealed harrowing truths about the current realities of NHS patient care.”
“On a point of order, Presiding Officer. I apologise that I do not have quite as elaborate an explanation as Jackie Baillie does, but my phone would not connect. I would have voted yes. The Presiding Officer: Thank you, Mr Gray. We will ensure that that is recorded.”
“Furthermore, it will enable use of innovation—digital and technological—to improve access to care. Our NHS workforce is central to delivering all those improvements, and we simply cannot afford to underestimate the role that social care staff will play in enabling and realising the ambitions.”
“Looking ahead, I believe that the draft budget provides strong foundations for the improvements that we all want and need to be delivered, including our commitment to providing funding to enable social care workers to continue to be paid at least the real living wage. The budget represents a package of investment to reduce the immediate pressures across the NHS and to speed up the rate at which individuals can be treated by delivering an additional 150,000 planned care procedures over the coming year. The investment will also shift the balance of care from acute services to the community by expanding the hospital at home service, opening more frailty units and ensuring that a greater proportion of new NHS funding goes to primary and community care.”
“Does the cabinet secretary share my concern that the national insurance rise has been described by the British Medical Association as presenting an “existential threat” to general practice? Neil Gray: Yes, I do, and I could list the names of those who signed the letter on that subject that was sent by the First Minister and the president of the Convention of Scottish Local Authorities. The wealth of experience and dedicated commitment of those signatories from civic Scotland underline the need across health, social care and all elements of public service to see the issue being resolved at source.”
“More recently, the decision that has been made by Jackie Baillie’s colleagues in the UK Government to increase employer national insurance contributions is expected to cost the NHS alone more than £191 million, with those costs rising to around £315 million when we take account of NHS contractors including GPs, dentists, optometrists and pharmacists, as well as the adult social care workforce. It is therefore vital that the UK Government fully funds the increase in order to avoid Scotland being punished for investing in key public services. I give way to Clare Adamson. Clare Adamson: I should have waited, as the cabinet secretary has almost answered my question.”
“Our efforts to recover have certainly not been helped by decisions that have been taken at Westminster. A decade and a half of austerity, coupled with the shock of inflation, has meant that our already stretched resources have been able to deliver less. Furthermore, Brexit continues to impact on staffing in our social care sector and will, coupled with the UK Labour Government’s decision to continue the Tories’ cruel policy of preventing care workers from bringing dependants to the UK, have deep and lasting consequences. Home Office statistics show a staggering 82 per cent drop in health and care worker visa applications between April and December 2024, compared with the same nine-month period in 2023. Clare Adamson: Will the cabinet secretary take an intervention? Neil Gray: I will make some progress, first.”
“People are waiting too long for treatment and there have been periods of real crisis in recent weeks linked to the unusually high flu prevalence that we have seen. I want to record my thanks to staff and my admiration for their resilience in the face of those extreme pressures. We are all grateful to them for their efforts. We must also acknowledge that the sustained and significant pressure that the system has faced, and continues to face, places real pressure on staff. Change is clearly needed. Although a shift in demographics and changes in the burden of disease mean that reform of our health and social care services would always have been necessary, the pandemic has undoubtedly impacted on the scale of change and pace of change that are required.”
“I welcome this debate, which is very timely in the light of the speech that was given by the First Minister on Monday on protecting and renewing our health and social care system—a plan of substance, and that is to deliver. In his remarks, the First Minster acknowledged the central role that those most cherished of public services play in all our lives, which is why we, as a Government, attach so much importance to supporting our health and social care system and the people who work in it. I agree with Jackie Baillie that staff are the backbone of our health and social care system. Without their skills, expertise and endeavours the system simply could not operate. I have been privileged to witness at first hand their dedication and professionalism in my role as health secretary. We also know that services are struggling.”
“Although the increase in funding from the new UK Government’s autumn budget is welcome, after inflation, it equates to only around 1 per cent growth in our resource budget—the budget that is used to pay for our public services. Therefore, significant financial pressures and challenges remain. At the same time, the chancellor has announced an increase in employer national insurance contributions, which will increase the cost of delivering public services. We estimate that this change could add over £500 million in costs for directly employed public sector staff in Scotland and, if we include the costs of wider staff who are delivering public services, such as general practitioners, dentists and those working in hospices, that figure increases to over £700 million.”
“This Government is proud of the successes in Scotland’s public services, including the best- performing core accident and emergency departments in the United Kingdom, record levels of young people progressing to positive destinations, and police-recorded crimes at one of the lowest levels since 1974, to name but a few. This Government is also clear about the challenges that our public services face. In recent times, our nation has faced an unprecedented range of challenges, including the Covid pandemic, prolonged Westminster austerity, Brexit, the war in Ukraine and high inflation. Those difficult challenges have all put our hard-working public services staff under significant and prolonged pressure.”
“Our approach ensured that the budget that was presented on 4 December not only delivers on those requests but, above all, fulfils the expectations of the people of Scotland. Since the draft budget was presented in December, the Cabinet Secretary for Finance and Local Government and the Minister for Public Finance have continued to engage constructively with all parties. I am pleased to say that, as confirmed in the finance secretary’s letter to the Finance and Public Administration Committee this morning, the Scottish Greens and the Scottish Liberal Democrats have indicated their intention to support the Budget (Scotland) (No 4) Bill throughout its parliamentary passage.”
“From emergency services to health and social care teams, their dedication and co-ordination ensured that individuals were supported and that essential services continued to operate. I extend our deepest thanks to all those who worked relentlessly to keep us safe during the storm. That is exactly why, in June last year, the Parliament recognised the importance of maintaining high-quality services and the need for public service investment. I am proud that the 2025-26 Scottish budget does exactly that, including investing £21.7 billion for health and social care and more than £15 billion for local government. The Government committed to listening to the priorities of Opposition parties as we shaped the 2025-26 budget, to offer a budget by Scotland for Scotland.”
“Scotland’s public services are the foundation of our society. Through our public services, we ensure that all individuals, regardless of their background or circumstances, have access to essential resources and support. Our front-line services play a vital role in all our lives, providing quality education to our children and young people, supporting our most vulnerable people through social care services, and improving the wellbeing of the people of Scotland. We saw a key example of that this past weekend. Our public services were critical in responding to the challenges that were posed by storm Éowyn. The role that they played in protecting the wellbeing of our communities cannot be overstated.”
“We will also continue to build on the good work that is under way in many boards, including by ensuring that every core accident and emergency department has a frailty unit or frailty team that is linked to community re- enablement and by optimising our flow navigation centres to create more alternatives to accident and emergency. We want to make progress on improving our health service. That is why, by 26 March, we expect nobody to wait longer than 12 months for a new out-patient appointment, in-patient treatment or day-case treatment.”
“Neil Gray: I absolutely agree with Annabelle Ewing’s assessment, which is why the prioritisation that we have set out through the budget aims to tackle those very issues. In relation to GP appointments, we continue to work together with all relevant partners to effectively implement the general practice access principles that were established in 2023, including through our commitment to the on-going recruitment of primary care multidisciplinary teams, as well as 800 more GPs. As Annabelle Ewing will be aware, our draft budget sets out a clear plan to reduce waiting times and delayed discharges, which is supported by the provision of £200 million of targeted investment, and shift the balance of care from acute to community.”
“Both ministers and Scottish Government officials regularly meet with representatives of all health boards, including NHS Fife, to discuss matters of importance to local people. Senior health officials met with the NHS Fife chief executive earlier today as part of the national health service executive group, which discusses key operational matters and supports NHS boards and senior leaders to work co- operatively, regionally and nationally. Annabelle Ewing: The cabinet secretary will be aware that timely access to medical treatment— whether via a general practitioner appointment or hospital intervention—is a worry for an increasing number of my constituents. What action is he taking to deal with those concerns?”
“We have been working with people in the area on how we can support the whole system to respond, which includes providing support to maintain some care home provision that would otherwise have been put to closure. That is clear in evidence around Moss Park, on which we have engaged previously. We are working with partners on further interventions, which I hope will help to improve the situation, as we are starting to see from the data.”
“Rhoda Grant: Since 2022, Highland Council has lost 161 care home places, due to eight care homes closing. On top of that, care at home has declined significantly, which increases delayed discharge. Last October, NHS Highland reported that it had to reduce delayed discharge by 65 per cent just to meet national targets. What interventions are being put in place that are specifically tailored to the Highlands and Islands to provide more care places and packages so as to meet that challenge? Neil Gray: I thank Rhoda Grant for raising the issue. As she will understand, Maree Todd and I are both heavily engaged with areas facing the most significant challenges regarding delayed discharge, as are senior and other officials across Government—and Highland is absolutely at the top of that engagement.”
“Since last June, the collaborative response and assurance group that I chair jointly with the Convention of Scottish Local Authorities has met weekly with leaders from across the health and social care system, including leaders from Highland and Islands health and social care partnerships. Our most recent meeting took place on Monday. We have been working to support areas with high levels of delay, including in Highland, to understand their challenges and to support them to deliver the changes that will improve people’s journey from hospital to home or to the care setting that is right for them. Our planned budget for 2025-26 includes investment of a further £200 million to reduce waiting list backlogs, improve capacity and remove barriers that keep some patients in hospital longer than necessary.”
“We therefore established a standing committee on pandemic preparedness, which published its full recommendations on 26 November last year, and the Government has accepted those recommendations in principle. We are committed to responding to both the UK and Scottish Covid-19 inquiries, and we have established governance arrangements within the Scottish Government to deliver a cross- Government programme of work to improve our pandemic preparedness, with ministerial oversight at the heart of that.”
“Alexander Stewart: Although it is not the same as Covid, there has reportedly been an increase in HMPV in the United Kingdom, which could have implications for overwhelming the national health service. The UK Covid inquiry showed that the Scottish Government was inadequately prepared for the Covid-19 pandemic and that there was not a sufficient level of urgency. Cabinet secretary, could you outline what steps the Government is taking—if Scotland were facing a looming pandemic tomorrow, for instance—to ensure that proper planning is put in place? The Deputy Presiding Officer: Speak through the chair, please. Neil Gray: We are working to ensure that the lessons identified from our policy response to the Covid-19 pandemic are put in place and that policy across Government can respond to the next pandemic.”
“HMPV is just one of the respiratory viruses that Public Health Scotland routinely monitors through our national respiratory surveillance programmes. The latest data shows that the national incidence rate for HMPV remains at a low activity level overall and is normal for what we would expect at this time of year. HMPV typically causes mild disease, and the current threat level is assessed as low. Public Health Scotland continues to monitor trends and indications of the severity of viruses or diseases such as HMPV, as well as other respiratory diseases, and any action that is taken as a result will be proportionate and based on evidence gathered.”
“Under rule 16.2 and the provisions of the guidance on correcting the record, members have 20 days to make any correction to the Official Report. Unfortunately, that time has passed, so I seek your guidance on how I can best make members aware of the position that I have set out today.”
“In it, I said that I believed that there was a note available for “all” meetings, but I was explicitly clear in saying that “I will need to double check”.—[Official Report, 14 November 2024; c 53.] I believe that both my formal statement to the chamber and my answer to Mr Bibby are unambiguous and accurate. However, I have also reviewed my answer to Stephen Kerr. In it, in relation to the summaries of the meeting, I stated that “those summaries will be available for all the engagements that I have been participating in.”—[Official Report, 14 November 2024; c 57.] Despite being clear earlier in the session that I would need to check, I recognise that I asserted that there would be summaries available for all the engagements. It has since come to light that that is incorrect, and I am sorry for that inadvertent error.”
“On a point of order, Presiding Officer. I make my point of order under rule 16.2.3. I have today written to you in light of the points of order that were raised today by Stephen Kerr and Neil Bibby. I did so after reviewing the Official Report of my statement on 14 November last year. In it, I was explicitly clear that not all meetings required to be minuted but that summary notes are often available and that notes would be available for the majority of the engagements that had been reported on. I have also reviewed my answer that day to Mr Bibby.”
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“I am committed to driving the reform that we need in order to secure sustainable services now and in the future, across our communities—whether they are rural, island or urban—and to improve the outcomes for our population nationwide. The Deputy Presiding Officer: That concludes the debate. I thank members for their co-operation in allowing so many members to participate in the debate. Meeting closed at 18:21. This is the final edition of the Official Report for this meeting. It is part of the Scottish Parliament Official Report archive and has been sent for legal deposit.”
“I am sorry that I cannot respond to everybody’s contributions today: they have been extensive, and based on the real-life experiences of constituents and members’ own experiences of the health and social care services in our communities. I want to give the assurance that the Government continues to take the needs of rural and island communities seriously. I have set out the areas that we are seeking to invest in, which I hope colleagues can get behind. Colleagues will know that all the ministerial team’s doors are open to members to discuss any ideas or issues that are prevalent in their communities, and we will continue to work to make sure that we improve public services in rural and island communities.”
“That conundrum of ensuring both that we deliver services as close to people’s homes as possible and that those services meet a patient- safety test has been at the heart of everybody’s speeches: I know that colleagues are all well aware of it. I want to touch briefly on some speeches. Colleagues referenced maternity services. I am more than happy to get back to members on the matter, as will Jenni Minto, who is the Minister for Public Health and Women’s Health. There is on-going work in Dumfries and Galloway, Caithness and other areas on making sure that we meet the needs of patients. On Mr Ross’s point about the Burghead and Hopeman practice, Ms Minto continues to engage with the health and social care partnership. Another meeting on that very point is due later this month.”
“On the point that Mr Whittle has put to me, it is exactly about ensuring that we are freeing clinical capacity and time for our staff to deliver the aspects that can be delivered only by humans—the caring, loving and compassionate approach that we need. Some of those innovations are already in development. NHS Near Me and the work around hospital at home are areas in which technology has been used to provide exactly that approach. I would be happy to engage more with Mr Whittle on how we could go further. As part of that work, we are seeking to define the core services that should be delivered in our communities and to balance them with the need for specialised care, which might be provided outside the local area when it is clinically appropriate in order to ensure the best outcomes for patients.”
“As I set out in the debate in December, we have— Brian Whittle: Will the cabinet secretary give way on that point? Neil Gray: I will give way very briefly. The Deputy Presiding Officer: I can give you additional time. Brian Whittle: I really appreciate the cabinet secretary taking this time. Currently, we are told that we are 1,000 GPs short. By adopting the technology that I was talking about, might you not find that we are not 1,000 GPs short and that we could be more effective in how we deliver healthcare? The Deputy Presiding Officer: Again, I ask members to speak through the chair. I will give you that time back, cabinet secretary. Neil Gray: Embracing innovation and technology is a central theme of the reform and improvement that I am seeking to take forward.”
“Looking to the future, I note that the primary care route map will set out how the system operates across rural areas and fits with wider reforms. We have invested in the national centre for remote and rural healthcare, which is hosted by NHS Education for Scotland, in order to bring in a co-ordinated approach, which includes working to improve recruitment and retention and to grow skills and access to training, and to develop new models of service delivery, all of which are focused on improved outcomes for rural and island communities. Furthermore, in partnership with NES’s centre for workforce supply, we will deliver a sustained model of direct support that will provide rural and island employers across health and social care with the whole-system approach that is necessary in order to improve recruitment and retention.”
“To further support GPs, we have significantly expanded the primary care multidisciplinary team workforce, with more than 4,900 staff working in such services, funded through the primary care phased investment programme. I understand the call that is coming from some, although not all, general practices for people in those roles to be directly employed by practices. That is something that we continue to consider. In recognition that barriers to implementation can be exacerbated in rural and island settings, we are partnering with a number of areas, including in the Borders and Shetland, through the primary care phased investment programme to demonstrate what a fully functional and effective multidisciplinary team model looks like in practice.”