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It is very important to come back to what the petitioner said. I do not want there to be any illusion that we do not think that bereavement support can be improved, because the petitioner made it very clear that they do not feel that such support was there for them or their family. Although there is support—we can give details of that—I do not want there to be any misunderstanding that we do not think that that support can be improved.

Convener, we will go through you to give the committee some of the information that members—David Torrance in particular—have asked for, and it can be cascaded to other committee members.

I started my opening contribution by thanking Karen McKeown for her bravery. I have not met her, but I would be happy to speak to her directly if Monica Lennon wishes to get in touch with my office about it.

I want to give the committee and, I hope, Karen an assurance that nobody in Government, certainly not me as the Cabinet Secretary for Health and Social Care, comes to the issue with defensive walls up and saying, “This is all the great stuff that we are doing.” That said, a lot of good work is being done by the workforce. For example, child and adolescent mental health services is seeing more people than it has ever seen before, but the demand is huge.

Nobody is coming up with defensive walls and saying that we have got it all right, that it is fine, and that people are only being failed here and there as a result of the odd exception. We are saying that there are some serious systemic issues, some of which were there before the pandemic and have been exacerbated by the pandemic, and joint work is being done across the Government to address some of those issues. It will take time but I do not want anybody to have the experience that Luke did, and we will do everything that we can through the implementation of our suicide prevention strategy to make sure that we reduce the number of suicides in Scotland in the years to come.

As I said, convener, I am happy to follow up in writing some of the issues that have been raised that we have not been able to give additional detail on today.

I will perhaps hand that question over to clinical colleagues and others. We have certainly had that discussion. It is very difficult to say and, given that we are still not quite out of the pandemic, it is challenging to do so.

In relation to mental health, one of the key concerns that I and, I think, every member at table had was about access, or lack of access, to services during the pandemic. We have put a lot of work into suicide prevention. Even at the most difficult times during the pandemic, when we were under significant legal restrictions, we still tried to ensure that vital services—in which I include suicide prevention and mental health services—were as accessible as possible.

Of course, suicide prevention has been a mission of this Government for many years, and we see some positive signs that things are going in the right direction, if we look at recent trends, but we are nowhere near where we want to be, which is why we have the suicide prevention strategy that was co-designed with the Convention of Scottish Local Authorities. Alastair Cook might want to come in on that.

You are right to suggest that we need to wait for the figures, and I do not disagree with your assumptions around the issue. We will always set ambitious targets to stretch ourselves in order to ensure that we are going as far as we can.

I commend to you the most recent strategy that has been developed in conjunction with COSLA. I am certain that Paul Sweeney will, if nothing else, have seen and skimmed through it. “Creating Hope Together—Scotland’s Suicide Prevention Action Plan 2022-2025”, which is the long-term suicide prevention strategy and action plan, looks at the trends over past years and asks how we can improve. We have a goal in the plan to reduce the number of suicide deaths in Scotland while, importantly, we tackle the inequalities that, as Dr Cook mentioned, contribute to suicide rates. That is why we were so keen to produce the strategy alongside COSLA.

We have not managed to go as far as we wanted on reducing suicide deaths, but there has been positive progress. The new strategy takes into account the good that we were doing, and says where we need to go further, how we can work with local partners and, importantly, how we can further reduce inequalities, because we know that disparities and inequalities are, beyond a shadow of a doubt, disproportionate contributing factors in respect of deaths by suicide.

I will address the general issue and come back to the specific question.

It has been my view since I came into post that, although we have a suite of quality standards for measuring and monitoring outcomes for child and adolescent mental health services, we do not have similar for adult mental health services, so there is a gap. A range of work is on-going to develop that suite of quality standards to improve the quality and safety of mental health care and support, which definitely includes adult secondary mental health service standards and the delivery of psychological therapies, interventions, eating disorder standards and so on.

Hugh McAloon might have the specifics with regard to the dates and our intentions in relation to the outcomes framework. Because we have co-designed the strategy with COSLA, we are trying to ensure that anything that we do in that space is done collaboratively with COSLA and local authorities.

Hugh McAloon will come in on some of the specifics. We will, of course, evaluate the projects that Alexander Stewart rightly cites and look to see how we can upscale them.

I am the first person to say that, far too often within Government, we suffer from pilotitis—the inability to go from a pilot to upscaling. We have to be better at that, and I think that we are getting better at that. If the pandemic taught us anything, it is about the need to have a slightly bigger risk appetite in relation to upscaling things. Not everything will work when you upscale it, but the desire for perfection should not get in the way of progress. There may well be faults and glitches that we will have to work through, but, generally speaking, we should be able to upscale far more quickly than we currently do when things are going well.

On the other matters that you raise, a lot of that is within the strategy that we referenced. Can you remind me of your very last question?

We have positive data on the increase in intake of student nurses and midwives, and that data speaks for itself. It might be difficult to say that the bursary has caused that increase but it would be fair to say that the package of support that we give to students, including bursaries, has been a factor in that.

There are also challenges, and the paramedic bursary is a really good example of that. There was an excellent campaign that was run by a number of student paramedics, and when I met them, they were very clear that, without the bursary, they did not think that they could continue. The anecdotal data is there. The workforce numbers that we have on the student intake are positive.

There are also some well-known and well-rehearsed areas where we have struggled with intake. We know and have often talked about the level of vacancies in our nursing cohort in particular, and we will work hard to fill those. However, we are in a competitive place because people in health systems around the world are looking to do the same thing. I think that Scotland is an attractive proposition, with the best-paid staff in the UK. Scotland offers an excellent lifestyle and remote, rural and island Scotland, in particular, offers a lifestyle that many people seek. We are going to have to maximise every one of those potential avenues to meet the ambitions of our plan.

The committee could have a whole separate session on screening. I want to commend, on the record, our colleague Edward Mountain MSP, who I thought spoke very bravely and with great humour about his bowel cancer journey. I managed to speak to him privately to share my admiration for that. He reminded people about the importance of returning the screening kits, because early diagnosis can save lives. Of course, we wish him all the best with his recovery.

Our work on screening is hugely significant and our decision to pause screening for a few months, which we took early on in the pandemic, was one of the most difficult decisions that the Government had to make during the pandemic. The recovery of screening is an important part of our recovery plan. There are some elements of it that are not yet fully recovered. We are working on recovering self-referral for breast cancer for women who are 71-plus by September this year, but there is still work to do.

The use of digital is, of course, important, but we also need to make sure that screening is accessible as close to people’s homes as possible. That is really important in our remote rural and island communities. In relation to cervical cancer screening, it will be really important to have mobile screening units of the kind that are used for breast cancer screening around the country. That will enable us to ensure that such screening is as accessible as possible as close to home as possible, which will be key to helping us with our recovery.

I spoke to Jaki Lambert of the RCM yesterday, and we had a good and detailed discussion about the very points that Ms Webber has raised. I do not know whether the staff survey has been published yet, so I will refrain from going into detail on it, but, as I understand it, one of the best things that we can do to alleviate some of the concerns is to control Covid transmission. It is very clear from staff responses that the pressure of the pandemic has been unlike any other pressure that they have faced before, and if we have can control the pressure of Covid, it will stop midwives feeling anxious every day they go on shift about whether they will be moved to a different ward or whether any given unit at any given time will have the appropriate number of midwives and nurses. Controlling Covid transmission will help to alleviate that significant pressure.

Investment in wellbeing will also be important, as will as giving our midwives and, of course, other NHS and social care staff the time to access those wellbeing resources. I therefore made a commitment to the RCM that we would continue to invest in wellbeing.

The third point, which was made quite strongly to me, was on the importance of time for training and educational and professional development, which, again, have been impacted by the pandemic. Controlling the pandemic and community transmission will allow us to begin to alleviate some of that pressure, so that our midwives can dedicate more of their time to training and competency.

A number of bottlenecks are the result of the pressures of the pandemic. Some people will say to me that they find accessing primary care a challenge, and we know that there can be challenges in that respect. I believe that you used the example of a patient waiting for an X-ray, but access to diagnostic testing, waits for elective procedures and screening that we have previously talked about have all been impacted by the pandemic.

There is no doubt that there were challenges with waiting lists before the pandemic. I am not suggesting that you are saying so, but any suggestion that the pandemic has not significantly exacerbated those problems would be inaccurate. Unfortunately, because of the pandemic, there are bottlenecks across the system.