Gillian Mackay
Scottish Green Party · Scotland
“There are lessons to be learned from this situation, but that will be of little comfort to the staff and patients who are dealing with an old hospital. Right now, it is 30°C in some parts of Monklands hospital, wall trims are held on with duct tape and there are historical issues with asbestos in the building.”
“Since we raised the issue of hyperscale data centres with the First Minister last week, more than 6,000 people have written to him to back the Scottish Greens’ call for a moratorium. Hundreds of those people gathered outside the Parliament yesterday to make their voices heard.”
“I am more than happy to meet staff and union representatives. In the interest of expediency and time, I will write to the member in more detail, because there are detailed concerns here and now about Monklands, and they need to be addressed.”
“Facts and figures are important and help us to understand the issue, but the finance secretary will forgive me for a moment for highlighting the human costs, because I know that she already gets the impact on people. Gillian Mackay is right. Our offices across Europe and elsewhere have done a fantastic job.”
“We all know how damaging Brexit has been to our economy and our democracy. I am pleased to hear the minister highlight the human costs, because I think those are tangible things that everybody can realise we have lost. At a time when global relations are so unstable, we need to work more closely with our European allies.”
“I follow others in wishing Steve Clarke, the Scotland men’s team and the tartan army a safe and productive journey in the US. The racist violence that we have seen on the streets of Belfast, as well as in Glasgow and elsewhere in Scotland this week, has been utterly shameful.”
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“The BMA highlights its on-going frustration with Scotland’s workforce plans, which in its opinion have lacked the necessary detail and long-term solutions. It continues to call for a comprehensive plan that sets out the required number of doctors in both primary and secondary care, along with clear strategies to improve recruitment and retention at every stage. Alcohol Focus Scotland is calling for urgent action, as many feel undervalued and at risk of burnout. The alcohol and drug workforce survey highlighted high workloads, large case loads and heavy performance-reporting burdens. Among respondents from statutory services, 63 per cent reported feeling under pressure most or all of the time.”
“However, the royal college stresses that the plan must be adequately resourced and effectively implemented, as must other plans. Workforce and workload data for Scotland’s GP workforce remains poor. The number of GP practices in Scotland has already decreased, reflecting a concerning trend towards fewer practices overall. Evidence consistently shows that countries with strong primary care systems have better health outcomes and lower rates of unnecessary hospitalisations. The RCGP has also welcomed the First Minister’s recent speech on renewing the NHS, and his commitment to increasing the proportion of new NHS funding that is allocated to primary and community care. However, we need that to be progressed at pace.”
“The single most impactful outcome for primary care would be an increase in the number of general practitioners—and that needs to be measured by whole-time equivalent rather than by headcount. Data shared by the royal college, which originated from the GP workforce survey, reveal that the number of WTE GPs has decreased, with a reduction of 0.7 per cent between 2023 and 2024. Since 2015, the WTE GP workforce has declined by 4.2 per cent, while the number of WTE medical and dental consultants has increased by 21.2 per cent. The divergence is particularly concerning as GPs carry out 90 per cent of NHS patient consultations on any given day. It must be recognised that some progress has been made, and the royal college welcomes the Scottish Government’s general practitioner recruitment and retention action plan.”
“In the 2021 programme for government, a commitment was made that, by 2026, every GP practice would have access to a mental health and wellbeing service, which would be backed by funding for 1,000 additional dedicated staff. That was to be supported with an annual investment of £40 million by 2024-25. However, it is disappointing that the commitment has been paused due to financial pressures. I hope that, with additional money coming from Westminster, we will see it restarted. As at March 2023, 17 per cent of GP practices in Scotland reported having no access to mental health workers. The need for investment in primary care is clear, and we must ensure that people can access the mental health support that they require at the first point of contact. The Royal College of General Practitioners has shared important information on GPs.”
“The Scottish Government’s mental health and wellbeing workforce action plan sets out some priorities that are generally welcome, including a commitment to evidence-based workforce planning. However, SAMH points out that there are clear gaps that need to be addressed. The plan does not provide essential benchmarking or mapping, nor does it set out targets or an assessment of workforce needs. It also fails to fully recognise the third sector’s vital role in delivering mental health treatment and support. SAMH poses the question to the Scottish Government whether it will conduct a needs assessment of the mental health workforce, including the third sector, to establish clear targets. In addition, we need to see the Government guaranteeing sustainable funding for third sector mental health providers, which are doing huge amounts of work.”
“I thank Scottish Action for Mental health for the support and briefing provided ahead of this afternoon’s debate. We know that access to timely mental health support remains a serious concern in Scotland. The on-going lack of meeting the 18- week waiting time for NHS psychological therapies and child and adolescent mental health services points to a system that is struggling to meet demand. Although there has been a 69 per cent increase in the NHS psychological services workforce over the past decade, and a 128 per cent increase in the CAMHS workforce since 2006, demand continues to outstrip capacity. That is particularly evident in the lack of community- based mental health provision and the vacancies in some health boards, including in NHS Forth Valley in my region, which has a significant number of unfulfilled psychiatrist roles.”
“I will start by apologising to the chamber. My Surface has had a moment with Zoom over the past five minutes, so I currently have my phone propped up while I try to make this speech. I hope to get the issue fixed ahead of my closing speech. I thank Labour for bringing this important debate to the chamber. I hope that, together, we can recognise the importance of our health and social care workforce. Despite the workforce’s dedication, it continues often to face significant challenges that require not only urgent attention but concrete action. I hope that we can use this opportunity to highlight the key issues raised by those working on the front lines and to discuss the steps needed to ensure a sustainable and effective workforce for the future. I will start by talking about mental health.”
“I move amendment S6M-16237.4, to leave out from “notes the importance” to “sustainability” and insert: “further calls on the UK Government to fully fund the increase in employer national insurance contributions in commissioned services and arm’s-length external organisations; notes the importance of the public service reform programme to drive future financial sustainability; further notes the success of the four-day week pilot trialled by South of Scotland Enterprise, and calls on the Scottish Government to expand the four-day working week within the public sector workforce”. 15:41”
“That is about protecting vital third sector organisations, sustaining our hospices and ensuring the resilience of the entire health and care system. I sincerely wish that the chancellor would show more willingness to listen to the concerns of third sector organisations in the same way that she seems to have listened to and acknowledged the demands of the non-dom community recently. At the same time, I reiterate my call on the Scottish Government to tackle the harms that we see across public services and to ensure that health and social care services are properly funded, that we have the plans to tackle the on-going issues that we are seeing and that we have Scottish public services that generations to come can be proud of.”
“It is important to recognise the scale of the challenges that we face and to double down on efforts to safeguard Scotland’s health and social care systems, and public services more generally, for generations to come. The investments that we welcome today are a step in the right direction, but they must be met with concrete action. We need sustained, focused funding that prioritises prevention, supports overstretched services and ensures equitable access to care. That means shifting from a system that reacts to crises to one that proactively supports good health and wellbeing. I echo the cabinet secretary’s calls on the UK Government to do its part by fully refunding the additional costs of employer national insurance contributions for the public sector.”
“Some said that the additional cost of the national insurance contributions could be £300,000 per care home and some expressed doubt about whether they could weather the additional cost for more than a year. What happens if we lose some care homes should be a real concern to us all. The impact that that could have on our local authorities and the individuals who support the care homes is staggering, and we need a resolution to that. That is without even talking about the impact on GPs, councils’ arm’s-length organisations and commissioned services within local authorities. The Labour Government’s decision to prioritise a national insurance contribution increase over other tax reform exacerbates those issues. Aligning UK income tax rates with Scotland’s progressive system could raise an additional £11 billion.”
“Hospices have also opposed the increase, and a joint letter from 14 Scottish hospices warned the Chancellor of the Exchequer that rising costs could force them to turn people away from their essential services. It is the same story for social care providers. The increase is projected to cost organisations such as Turning Point Scotland £1.1 million annually, pushing them further into deficit. Nearly 48 per cent of care providers that were surveyed reported that service closures are a real possibility without additional support. I was grateful to attend the Scottish Care care home conference, along with Brian Whittle, Jackie Baillie and the cabinet secretary, where we heard about the impact on individual care homes.”
“There are several estimates that the increases will cost Scottish third sector organisations an additional £75 million in 2025-26. Hospices, homeless shelters and care providers could be hit the hardest. Several charities have highlighted and described the devastating impact that additional cost will have. The Health and Social Care Alliance Scotland has pointed out that 62 per cent of its members anticipate needing to cut services, with 58 per cent expecting to reduce staff. It has reiterated the calls to exempt third sector organisations from the national insurance contributions increase, and it has pointed out that several providers have noted that such relief could be game changing.”
“I do not do that particularly often, but he is correct that reform in the NHS urgently needs to be worked on. If I have time, I will come back to that. Many members have referred to the UK Government’s decision to increase employer national insurance contributions. The impact of that move cannot be overstated, especially in Scotland, where public services depend on the hard work of more than 600,000 people, who make up 22 per cent of our total workforce; that is higher than the UK average of 17 per cent. The UK Government’s increase in employer national insurance contributions poses a very serious threat to third sector organisations, care providers and charities across Scotland, many of which are already grappling with surging demand and escalating costs as well as declining funding and declining certainty in that funding.”
“I recognise that there are pressures, but striking a balance between those financial constraints and the consequences of reducing spending on critical services remains an immense challenge. Scotland’s public finances face significant pressure, which must be met with bold action to ensure the sustainability and long- term stability of our public services. I would also like to point to the role that the Scottish Greens have played in securing progressive income tax reforms in past budgets, ensuring that lower earners in Scotland pay less tax than those elsewhere in the UK. That progressive approach underscores our commitment to fairness and equity in public finance and a commitment to bring about transformative change. I agree with one of Michael Marra’s points.”
“I welcome the commitment to investing in our public services, particularly in my portfolio of health and social care. Far from being a burden on the economy, growth in public spending as a proportion of the economy has had a persistent positive link with gross domestic product for more than a century. The mechanisms that link public spending and economic growth include investment in and maintenance of infrastructure, supporting an educated and healthy workforce and redistributing income. There can be no sustainable economic growth without prioritising and properly resourcing our public services. That is why the increased investment across public services is very welcome. However, the investment must be strategically deployed to address key challenges, including workforce capacity, service accessibility and a focus on preventative care.”
“I am happy to speak with Gillian Mackay about independent advocacy as the bill progresses. She is correct in saying that the changes that we are making to the bill will change where that links into it.”
“I hope that the announcement by the Government will allow us to make small but positive changes to social care, even if we know that much more needs to be done. The minister rightly highlighted how traumatic it can be for people to repeat their stories. Will she outline how the work of lived experience groups will be retained, how it will contribute to the on-going reform of social care and whether the right to information and advocacy that was originally contained in part 1 of the bill will be put elsewhere? Maree Todd: I recognise that the voice of those with lived experience is vital. Gillian Mackay and all Green Party members are committed to listening to those with lived experience. The various stakeholder groups that I interact with are extremely important in helping me to find a way forward in a complex and contested area.”
“I mentioned that the pandemic preparedness group that was established published its recommendations last year. Many of those recommendations are similar to those of the chair, and we have already made significant progress on those recommendations. Much of what we have responded to is already in train. The areas that require four-nations responses are probably the items that are new in this response.”
“This is the first module of 10 that will complete over the next few years. The inquiry is essential and it cannot be rushed, but the recommendations should be worked on at pace. I am grateful to the Deputy First Minister for setting out how that is being done at the moment. However, pandemics do not wait for us to complete work, learn lessons and then implement them before they happen. How confident is the Deputy First Minister that, if we were to have another pandemic in the short term, we would be ready, without the full learning from the inquiry? Kate Forbes: As the member said, we cannot afford to wait. In my statement, I set out a number of steps that we have already taken in advance of the chair publishing the report and of our response to the recommendations.”
“I reiterate the point that I made in my statement about ensuring that people access the right care in the right place and that they utilise the services that are available through NHS Inform and NHS 24. I hear the point that she has made about minor injuries units. Such a decision would be for NHS Forth Valley to take, and I would be more than happy to facilitate a discussion between it and Gillian Mackay on that potential option.”
“In the past few weeks, winter pressures have meant that we have heard several warnings from health boards not to come to A and E departments unless it is an emergency. For many people, the alternative minor injuries unit is not as close as their local A and E department. That includes my constituents in Falkirk, for whom the nearest minor injuries unit is in Stirling. For some people, going to that unit means their passing two hospitals, including an A and E department. For many people, that is just not an option. Has the cabinet secretary assessed what benefit there might be in opening a minor injuries unit in Falkirk to help to relieve pressure, especially during the winter months? Neil Gray: I thank Gillian Mackay for raising that point.”