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It is absolutely central, because we cannot have a sustainable and improving health service without a sustained and improving workforce. I am very proud of our incredible workforce. In the past 14 weeks, I have been able to see some of it in action. As health secretary, and previously as a user of the health service, I have seen the fantastic work that our workforce delivers.

On interaction with the workforce around reform, I am keen to hear directly from the workforce, its representatives and the trade unions on setting out how we move forward in a sustainable way and how we make sure that we continue to see improvements. I am keen to hear from the workforce about its ideas for changing how the health service works to make it more responsive to the needs of the people of Scotland and to make sure that it continues to be sustainable.

Having discussed the issue with people over the past few months, I know that that must be about making sure that we prevent ill health. The public health work that we are doing is of critical importance in making sure that we have a healthier population, in stopping the continued escalation in demand that we have on our health service and in making the shift on the flexibility of our employment patterns. We have seen some of that in the implementation of changes under agenda for change over recent weeks. That is where we will need to go, but that has to be informed by discussions with the workforce, which I am committed to having as part of the reform discussions.

The orders do not cover that area, but we are looking to introduce legislation that would cover it, because I share Dr Gulhane’s concern about it.

The orders will widen the scope of regulations that are already in place, but we are looking to expand what is covered through legislation, as my colleague, Jenni Minto, has already outlined to Parliament.

The Scottish cosmetic interventions expert group’s phase 2 recommendations include the introduction of legislation to regulate the administration of non-surgical cosmetic procedures. Following the 2020 consultation on the regulation of those procedures, our initial priority, from a clinical safety perspective, was to consider regulating the administration of dermal fillers. As we are aware, if they are administered incorrectly, they often cause long-term damage that can be reversed or limited only by the urgent administration of specific prescription-only medication.

Because of the number of non-surgical cosmetic procedures that are now available, we are working with our stakeholders to consider the potential scope of further regulation that is needed within the area. The stakeholders include: healthcare professionals who represent the British College of Aesthetic Medicine and the British Association of Cosmetic Nurses; hair and beauty industry representatives; environmental health officers; and HIS. Their input is hugely valued.

It is also worth noting that part of the phase 3 recommendations of the interventions expert group was to consider independent services that are provided by other healthcare professionals who are not currently included in the “independent clinic” definition. Our work today to add pharmacists and pharmacy technicians is an important step forward, but I absolutely share Dr Gulhane’s concern. We are working to expand some of that regulation to take in the areas of concern that he set out.

That goes beyond what is in the orders that are before us today, but I would be happy to have a further conversation with Dr Gulhane about the on-going work that we are doing on expanding regulation of cosmetic procedures, including the detail that Dr Gulhane is looking for, which is part of the consultation and discussions that we are having with stakeholders.

That points to some of what I was referring to in response to Ms Mackay.

The use of innovation in our health service is going to be critical. Some of that is already in place—Ms Harper spoke about Near Me, which is currently in use—but there is more that we could do to ensure that we continue to utilise some of that innovation to a greater extent.

We also need to look at some of the innovations with regard to digital technology and the advances—if they are ethically used—in artificial intelligence. Critically, we need to ensure—as Ms Harper was driving at in her question—that that is done in not only an ethical way, but an equitable way, so that those who are in remote and rural areas can benefit from such innovations if they choose to do so, and take advantage of that way of working.

I am very keen to use innovation—as I have set out, it will be central to our being able to see reform and improvement in our health service in a way that maintains capacity and the opportunity for caring by those—the medical professionals and staff who work across our health service—whom we task with supporting patients coming through the system.

Like Ms White, my thoughts are with the family of the little girl to whom she referred. Those incidents are tragic examples that we wish to avoid, and everything that we do as a Government, and as health boards and services, is to try to prevent such situations from happening.

Ms White is correct about the pressures on the Ambulance Service and about those pressures not being unique to Scotland. Unfortunately, we have seen the type of ambulance stacking that we saw at Aberdeen royal infirmary elsewhere in the UK, too. That is partly due to the significant increase in demand that we have seen. We are seeing a clear increase in demand on our ambulance services. We also need to have those services in the right place to respond to incidents such as those that Ms White spoke about.

We have made a significant investment in our Ambulance Service to support an increase in the number of practitioners and paramedics working within it to respond. We are also working with boards on how they can make sure that the flow at their hospitals is working better.

That goes back to the point that I mentioned about the importance of social care to our health service. It is important that we get our social care services working for the people who need them, but delays in social care also have an impact that goes all the way back through the hospital, right up to the front door, where ambulances are stacked outside because of the pressure in the hospital. That pressure is not necessarily in accident and emergency, although that is sometimes the case; it might be about accessing beds in the hospital.

We are making investments in all areas of the system to relieve that pressure. We can see that that is working, but it needs to move faster in order for us to see continued improvement in the services that we have available to us.

A significant number of people who would be considered to be in the delayed discharge category are adults who have incapacity, which is an incredibly complicated area. I will take up Ruth Maguire’s invitation and encourage people to ensure that they have power of attorney arrangements in place, as well as arrangements that allow for people to get access to the health and social care services that they need. As a Government, we are looking to introduce legislation on adults with incapacity in order to make sure that we are improving the system and the services for it. My colleague Jenni Minto has responsibility for that bill and we are looking at it during this parliamentary term.

I am happy to reiterate what I set out earlier: I share Dr Gulhane’s concern and the work is on-going. The regulations take us a step forward, but it is imperative that we continue our work to widen regulation of that area. I am happy to come back to the committee with more information on the on-going work on that.

Motions agreed to,

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.

I recognise that we need to ensure that our skills landscape is supportive. As I said in previous remarks to Maggie Chapman and Kevin Stewart, we need a good skills landscape to ensure that we are providing the labour market with opportunities. That allows businesses to grow and it allows people to get on with taking advantage of the just transition that we see in the energy sector, for instance.

The figure that you point to on higher education places was, of course, a temporary investment off the back of Covid. The current figures are returning to pre-Covid levels, but we will of course continue to work with our university sector. Indeed, I have a meeting next week to discuss how we can take full advantage of the innovation that is going on in the sector and the investment that we are making in entrepreneurial campuses. At the University of Strathclyde last week, I saw incredible work on the entrepreneurial support that it is providing to its students; I saw the benefits from that, not just to business start-ups but in the income potential that it can achieve; and I saw the collaborative work that is going on with our universities to see the level of investment grow.

We have big opportunities. I recognise the challenges, but we will continue to work with our skills colleagues. As I have said, Graeme Dey is incredibly energised to make sure that our response to the Withers review will result in a supportive skills landscape. We will make sure that the resource that we put behind it is as much as we possibly can provide in order to ensure that we have a landscape that is as supportive as possible, not just for our employers but for our workforce.

The Fraser of Allander assessments have been helpful in demonstrating some of the positive elements of the small business bonus scheme in terms of its ensuring that some businesses continue to be viable, as well as in demonstrating that other elements are more challenging, as you pointed out, convener.

I think that it is fair to say that, across the Government, Tom Arthur is, as part of the new deal for business group, looking at what we can do to bring forward longer-term non-domestic rates reform. Some of that work is challenging, because where we make changes, there will be winners and losers, and there is a potential cost to be borne either by the Government or by the business sector. We are developing a long-term evidenced-based approach to non-domestic rates reform.

Part of the discussion with the hospitality industry last week was about what might be helpful for it and what barriers to growth there might be in the current set-up. The discussion also considered whether there are ways of reforming that would not have wider unintended consequences. Part of that assessment will be informed by the work that has been done by the Fraser of Allander Institute.

I will find out exactly where the budget line is, but we are starting with an investment of £1.5 million in implementation. I will shortly bring in Aidan Grisewood to point you to the exact place where it is held. As I set out in the letter to you and the committee—I think that it was on 19 December—the “Pathways: A New Approach for Women in Entrepreneurship” review by Ana Stewart, alongside Mark Logan, considered a dedicated women’s business centre, consulted widely on it and concluded that it is not necessarily the best way of encouraging female participation in business. There will be differing opinions on that, but based on that wide-ranging consultation and feedback, we have decided to accept Ana Stewart’s recommendations that the likes of pre-start centres and pop-up centres will be the most advantageous way of progressing greater diversity in business start-ups and encouraging more women into business. This year, £1.5 million will be used to start expanding that. I will happily bring in Aidan Grisewood to provide greater detail.