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That's all from Holyrood Live on Thursday 6 December 2018.

MSPs unanimously backed the general principle of the Health and Care (Staffing) (Scotland) Bill.

The proposed legislation seeks to place an existing workforce planning tool onto a statutory footing.

It will also see staff planning methods be used on social care settings, such as care homes.

Health boards are responsible for assessing the needs of their own populations using a set of 12 tools, which have existed since 2004. These are focused on nursing and midwifery.

Should the legislation pass, the tools will become mandatory for health boards and social care providers to use - though it is not yet clear what would happen if they did not meet their duties.

At decision time, MSPs unanimously back the Health and Care (Staffing) Bill at stage one.

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Health Secretary Jeanne Freeman says she has listened very carefully to all the issues raised during this debate.

Ms Freeman insists that she is certain MSPs will want to bring forward stage 2 amendments and offers to discuss any proposals for amendments in advance.

She says this is a piece of legislation whose principles we all agree on.

Ms Freeman explains the bill, if passed, will add to the 1978 NHS Scotland Act which will make health boards and the Care Inspectorate accountable.

The health secretary concludes calling for the general principles of the Health and Care (Staffing) (Scotland) Bill to be agreed to.

Tory MSP Brian Whittle emphasises the need to look after staff welfare.

He agrees with Mr Stewart that we need to ensure we are looking at outcomes rather than the process, and he welcomes the cabinet secretary confirming amendments will be brought forward to clarify this.

Mr Whittle highlights calls to ensure the bill does not focus solely on nurses and midwives, given the importance of, for example, allied health professionals within the health service.

If the bill is to succeed, there is work to do and the elephant in the room is the shortage of staff across all medical professions, the Tory MSP concludes.

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Labour MSP David Stewart, closing for his party, says this has been an "excellent debate" and reitrates its backing off the general principles of the Heath and Care (Staffing) (Scotland) Bill.

Mr Stewart does however highlight areas of concern and room for improvement in the proposed legislation.

He says perhaps the bill currently is too focused on process.

The Labour MSP says the key is getting the right balance of skills and experience.

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The number of NHS Scotland consultant posts vacant for over six months rose by almost a quarter in the last year, according to official figures.

The NHS Scotland workforce report, external shows there are 422 unfilled posts across the country.

More than half of those have remained vacant for more than six months.

Then Health Secretary Shona Robison said NHS Scotland's workforce had increased to "historically high levels" under the current government.

Read more.

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The Health and Care (Staffing) (Scotland) Bill seeks to place an existing workforce planning tool onto a statutory footing.

It will also see staff planning methods be used on social care settings, such as care homes.

Health boards are responsible for assessing the needs of their own populations using a set of 12 tools, which have existed since 2004. These are focused on nursing and midwifery.

Should the legislation pass, the tools will become mandatory for health boards and social care providers to use - though it is not yet clear what would happen if they did not meet their duties.

Read more about the bill in the SPICe briefing., external

Lib Dem MSP Alex Cole-Hamilton says financial targets have often had priority over patient safety, but it is important we have the right skills mix.

We need more on the face of the bill to link the tools to the outcomes, he argues.

Mr Cole-Hamilton says we need to trust the expertise of our staff.

There is a link between staff welfare and patient safety, he adds, and that is why we must ensure staff are supported themselves.

The bill will not end staff shortages but it is one step towards improving the culture, he says.

Image source, bbc

Green MSP Alison Johnstone says it is not surprising that better staffed hospitals have better outcomes.

Ms Johnstone points out that 30% of midwifery and allied health professional vacancies remain open for three months or more.

She raises concerns about staffing in the NHS across the boards.

The Green MSP encourages the Scottish government to continue to liaise with professional bodies.

She argues it is important the provisions in the bill will only play a small role in ensuring staffing levels are right.

Ms Lennon highlights warnings that the NHS is not financially sustainable, pointing to an Audit Scotland report.

Ms Freeman says the Audit Scotland report did not take account of the medium-term financial framework.

While welcoming this framework, the Labour MSP says there is no denying the seriousness of the report.

This bill is hopefully part of a new approach to staffing in the NHS which is person-centred, Ms Lennon adds.

She points to concerns that the bill may undermine the care sector however and says we must be alive to these issues.

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Labour MSP Monica Lennon agrees the Scottish government should remain open to improving the bill.

The Labour MSP says under this government, we are not yet seeing health inequalities resolved.

She adds: "Our health and social care services are struggling to cope."

"Our focus has to remain on outcomes and what difference this bill could make to the health and wellbeing of our constituents and our loved ones."

Mr Briggs says there is a need for clarity on where accountability will sit.

The bill should empower nurses and other staff, he argues.

On social care, the Tory MSP notes it had no single governance structure which means this bill could be a significant challenge.

He concludes by calling for progress to address staffing shortages since the bill will not create more staff.

Image source, SPL

The public are being urged to back a campaign for tougher legislation to ensure there are enough nurses to deliver high-quality patient care.

The Royal College of Nursing (RCN) Scotland said the latest NHS workforce data, external showed the highest number of nursing vacancies ever reported.

It said its members were at "breaking point" and it was "time for change".

The Scottish government said the number of nurses and midwives had increased by 5.7% since 2007.

The "Ask for more" campaign is being run by the RCN throughout the autumn as MSPs undertake their initial work on the bill.

Read more.

Tory MSP Miles Briggs says the most valuable resource of the NHS is its people and he asks what this bill will do to help them.

Mr Briggs points to concerns raised in by the RCN Scotland staff survey.

He argues the statements from NHS staff were the most important elements of the survey and he quotes three.

The Tory MSP calls for the bill to be improved in terms of the guiding principles, which he cites as too general.

Douglas Fraser
Scotland business & economy editor

The NHS has turned 70, well past the age of having its own bus pass.

While most others can retire at that age, the National Health Service is still working. Indeed, it's having to work flat out, and it's feeling the strain.

Some of that strain comes from more demands being placed on it. Expectations of what it can achieve are completely different to 1948.

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And it has to put up with patients, many of whom do a poor job at looking after themselves. A lot of the strain comes from budgets that keep rising but struggle to keep up with numbers of patients and expectations of what can be done.

But even with lots more money, there's a shortage of people to do the jobs necessary. So-called workforce planning is one of its biggest headaches. I've been looking at many different facets to that workforce planning challenge.

Read Douglas Fraser's analysis.

Mr Macdonald highlights concerns from staff about getting enough time to continue training.

There were questions raised over whether a workforce tool was necessary for the care sector, he adds, though the committee ended up agreeing care should not be treated differently from health.

He insists there must be appropriate staff numbers to deliver care.

We also need to know what would follow if the requirements cannot be met, the health committee convener says.