A doctors' union has called for a "fundamental shift" away from an "over-reliance" on targets in the NHS.

Peter Bennie, chairman of the British Medical Association's Scottish Council, said there was too much focus on "crude" measurements.

He said targets created a culture of blame, and that the focus should be on delivering the best care for patients.

Health Secretary Shona Robison said targets had a role to play - but should not be an end in themselves.

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Scottish government director for health and social care integration Geoff Huggins says most integration authorities have different starting positions.

This means some areas will really struggle to meet targets, he says.

SNP MSP Ivan McKee suggests the current environment is cluttered and confused due to too many overlapping targets.

The health secretary suggests having a number of indicators can be useful, suggesting for example that hospital discharge rates can be used as a barometer for overall performance.

She adds targets ensure individual NHS executives are aiming towards the same outcomes as the NHS as a whole.

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The number of people waiting more than four hours in Scotland's accident and emergency units reached record high levels in the last week of the year.

The latest weekly figures show that just 78% of patients across Scotland were seen within the target time.

This was well below the Scottish government's 95% target, and the lowest since the weekly figures began in February 2015.

In the same week in 2016 there were 92.5% were treated within four hours.

Read more here.

Health Secretary Shona Robison highlights some targets, including cancer and A&E targets, will remain in place but different approaches are needed elsewhere.

She notes better community-based care will likely lead to fewer patients presenting to A&E.

Ms Robison agrees with Sir Harry Burns's report's recommendation that targets must be taken forward with a broader scope to create more balanced care and better outcomes.

Former chief medical officer Professor Sir Harry Burns published 'Targets and Indicators in Health and Social Care in Scotland - A Review, external' in November.

He concluded the following:

Image source, Scottish government

Image source, bbc

The committee will now discussing the Targets and Indicators in Health and Social Care in Scotland Review with:

• Health Secretary Shona Robison

• Scottish government director for health and social care integration Geoff Huggins
• Scotland's chief medical officer Dr Catherine Calderwood

Image source, bbc

Last June we reported here had been a sharp drop in nurses registering to work in the UK since the EU referendum, figures suggested.

Last July, 1,304 nurses from the EU joined the Nursing and Midwifery Council register, compared to 46 in April this year, a fall of 96%.

The Health Foundation said the findings could not be more stark and said they should act as a "wake-up call".

But the NMC said the introduction of English language testing for EU nurses is also likely to have played a role.

Read more here.

Tory MSP Brian Whittle raises the impact of Brexit on health and care.

The health secretary says she meets regularly with Brexit Minister Michael Russell and stakeholders to discuss staffing concerns.

She says nursing homes in particular are feeling an impact already.

A trial programme on Dumfries and Galloway on providing a locality based response for staffing nursing homes is referred to.

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Tory MSP Miles Briggs raises the issue of agency and bank staff in the NHS.

Mr Briggs asks what has gone wrong over the last year as the 25% reduction target was not met.

Ms Robison says bank staff are NHS staff whereas agency staff are not.

She highlights £16.7m funding for new nurses and midwives and says there has been a reduction in the use off agency staff.

Image source, SNS

Last year, sport funding faced a 20% reduction over a three-year period, a move described as "heartbreaking" by the national agency.

The cuts were blamed on reduced government spending and a drop in National Lottery ticket sales - a major contributor to sports backing.

About 60% of funding is made up from Scottish government money, with lottery sales making up the rest.

Read more here.

Tory MSP Brian Whittle says there have been concerns about the lack of transparency in the budget for sport.

Ms Robison says the sport budget has been integrated with the health budget to make it part of the health response.

She says the active programme is about doing prevention work.

Image source, bbc

Mr Whittle says the extra £2m coming to Sport Scotland only brings it back to the level of two years ago.

Sport delivery is done through councils as well, he says and he highlights the increased pressure on local authorities.

The health secretary says the decision to continue business rates relief for sports facilities will help.

"We have a drugs disaster on our hands", says Convener Neil Findlay.

He wonders whether the funding is enough.

Shona Robison highlights the 'seek and treat' approach which will attempt to engage with hard-to-reach people.

She also notes work in collaboration with the justice portfolio on prisoners.

Mr Findlay says there is a whole new generation experiencing drugs like cocaine and says the streets are awash with it.

He says he will write to the health secretary on this issue.

The number of drug-related deaths in Scotland last year totalled 867, a rise of 23% on 2015.

Numbers have been steadily increasing since 1995, when 426 fatal overdoses were recorded.

The latest statistics from the National Records of Scotland, external showed more than 70% of deaths were among people aged 35 or over.

Critics say the continuing rise calls into question the effectiveness of the Scottish government's drugs strategy.

However, Public Health Minister Aileen Campbell, said "unfortunately" the figures for Scotland were representative of a general trend of increasing drug deaths "across the UK and in many other parts of Europe".

Read more here.

SNP MSP Sandra White says there is a lack of transparency around Alcohol and Drug Partnerships budgets.

Ms Robison says the government will look to publish information to address this.

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Ms Robison says the £20m is exceeded in spend by health boards on APD.

The health secretary says there are discussions about the priorities for the £20m spend.

There is an element of the fund for transformation and creating new services, she says.

Lib Dem MSP Alex Cole-Hamilton seeks clarification on the breakdown of £17m of mental health funding for pay increases, new staff and CAMHS.

Shona Robison says the pay increases will not come out of that funding pot.

Increased spend from the Scottish government does not always translate to the intention at a local level, she adds, noting it is important this funding be visibly for the purpose of mental health.

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Three Scottish NHS boards are spending less on child mental health services than last year despite failing to meet waiting times, the BBC has learned.

The 18-week waiting time standard was met by six of Scotland's 14 NHS boards in the last quarter.

One of the health boards that cut funding - Grampian - met the target in just a third of cases and had an average wait of 21 weeks.

Tayside and Lothian also reduced the amount spent on child mental health.

Read more here.

Image source, Thinkstock

SNP MSP Jenny Gilruth raises CAMHS waiting times and funding for health boards to tackle them.

Ms Robison points towards funding to increase the CAMHS workforce.

She says it is important the money is followed by appropriate decisions by health boards and integrated joint boards.

It is important that mental health is "visible and seen" when setting resources priorities, she adds.

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Health Secretary Shona Robison says over half a billion pounds is already in the system to improve social care provision.

Ms Robison says she believes local authoriteis will live up to their obligation to pay the living wage to social care workers.

The Scottish government backs the "real living wage" of £8.75 an hour, as promoted by the Living Wage Foundation campaign group.

It is a voluntary rate, which is higher than the statutory national living wage of £7.50 for those over 25.