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There are frameworks in place around the integration of health and social care that should allow for some of those discussions to take place. Where there is an understanding on the part of IJBs and health and social care partnerships that there are particular workforce challenges in the communities that they are looking to serve, those discussions can start there and spread to other forums. However, of course, where we have that convening power or, indeed, where we can provide that guidance, we will continue to do so. There are good examples of some of that work being done already, and we need to build on those and try to provide that advice on a wider basis.

I am happy to share that with the committee.

To answer some of your other questions and bring it back into one answer, for the strategies and plans to be effective, stakeholders have to be consulted on them. In order for us to have an effective and sustainable health service and if we are to have a workforce strategy that means anything, the workforce and trade union representatives must be consulted and must be part of the discussion. They will absolutely be part of the discussion.

I have nothing further to add than what was discussed in the debate.

I move,

That the Health, Social Care and Sport Committee recommends that the National Health Service (Scotland) Act 1978 (Independent Health Care) Modification Order 2024 be approved.

That the Health, Social Care and Sport Committee recommends that the Healthcare Improvement Scotland (Inspections) Amendment Regulations 2024 [draft] be approved.

No—I have not said that. I was talking about the issues that we face regarding the workforce challenge. It would be remiss of anybody not to acknowledge the impact of making migration to the UK harder and the impact that Brexit has had. Indeed, I think that Mr Macaskill, who represents social care providers, would make those very points, too. Of course we have a responsibility to continue to deliver for social care, and we will continue to do all that we can, which is why we are looking to implement the national care service so that standards can be raised and can become more consistent—both for those working in the service and for those we are providing it for.

When decisions are made for us that are not in our interests and that are detrimental, of course I have to point those out, and Mr Gulhane will understand why I would need to do so. There was a 10 per cent drop in our workforce off the back of Brexit, and the new migration rules will make it much harder for social care providers to employ social care staff. It is understandable that I would wish to make such a comment.

We are working with the specialist advisory group at the moment on the stage 2 amendments, and we will be providing them to the committee as soon as we can.

I have already given the example of ScotGEM, where we have people coming through a training system that is dedicated to serving remote general practice. We are improving the situation with regard to GP numbers, which I think are up by 256, or 257, in recent years, and we have a record number of GPs—1,200—in training. I recognise that we need to go faster in order to meet the target. That is why, over recent years, we have added new GP training places to the system. I hope that, through the record level of GPs in training and the work that we are doing with ScotGEM—as Stephen Lea-Ross and Paula Speirs outlined, and as I highlighted—a large number of those new GP entrants will go into the rural communities that we wish to see continue to be sustainable.

I would be very interested in hearing more about the direct experience that you have been able to pick up. I presume that that will come through in the report, but if there is anything that the practitioners in Broadford would be able to feed straight in, I would be keen for us to look at that as part of our reform and improvement work. We are keen to look at how we can blur the lines of health boards and ensure that we maximise the operational capacity through better working arrangements for our staff.

However, I am cognisant of the fact that, although such an arrangement might work for many people, there are others who would prefer to have a fixed-point contract that involves working in a fixed-point place. Therefore, we would need to handle that carefully, but I would be very interested in hearing more about the experience that you picked up in Broadford.

That is a major concern for me. Since coming into post, one of the areas that I have had the greatest concern about is the rise in agency and locum costs. In some areas, that cost is unavoidable, and we need to invest to ensure service continuation. However, I want to take a longer-term approach, and I hope that some of the reform discussion that we will have later this month and, going into the rest of the year, the reform and improvement work can focus on how we make sure that we have the culture and management structures in place that allow greater flexibility for workforce so that we are attracting and retaining staff.

We have a number of areas of intervention including bursaries and golden hellos to try to attract people to rural and island areas in particular on a sustainable basis, so that we can avoid the need for locum and agency cover. That cost increase over recent years is a major concern for me and one that I wish to tackle.

It increasingly sounds as though the session on Skye was incredibly productive, and I am ever more regretful that I was not a part of it so that I could hear directly from the colleagues that Ms Mackay refers to.

We are in a situation where we do not have the luxury—although I do not think that it is a luxury, actually—of being siloed; we cannot afford that. We need to use the capacity that is available, regardless of where it comes from. There must be much greater collaboration between public sector agencies. The integration agenda is about much greater collaboration between our health and social care partnerships, or IJBs, and our statutory partners, as well as the community and the voluntary sector. As Ms Mackay rightly said, that sector often provides services that statutory providers cannot provide to the same level of funding. We have to see much greater collaboration there.

We must also utilise the expertise and innovation that are coming through from the private sector. If we can harness that, we have an opportunity to stay true to the principles of the NHS being publicly owned and free at the point of need and delivery. We need to harness some of the products that are being delivered by the academic and private sector to free up clinical capacity for the care that clinicians and health service staff give. We have an opportunity to take forward much greater collaboration, if we can, to continue to improve and reform our health service for the better.