SCOTTISH EXECUTIVE
Health and Community Care
Question 1 has been withdrawn.
Accident and Emergency Units (Lanarkshire)
To ask the Scottish Executive whether it is satisfied that there is sufficient accident and emergency unit capacity in Lanarkshire. (S2O-11813)
We are satisfied that A and E capacity in Lanarkshire is sufficient at present, but we believe that fundamental changes are needed in order to provide the type and level of service that will be required in future. Those changes will include the streaming of emergency and planned care, the creation of five new community casualty units and the expansion of specialist emergency teams and physical capacity for A and E services at Wishaw and Hairmyres.
I draw the minister's attention to the fact that, over the past three months, Hairmyres and Wishaw accident and emergency units have regularly, usually at weekends, had to refer people to another accident and emergency unit because they have not had sufficient capacity and have been unable to cope. In the light of that, is not it lunacy to close Monklands A and E unit when we urgently require to retain capacity at Monklands?
The very fact that there is pressure on existing services demonstrates beyond any question the need for modernisation and change in the provision of A and E services. That is why expanding the services at Wishaw and Hairmyres will deliver benefits for patients throughout Lanarkshire; it is why moving two thirds of all the cases seen at all three hospital A and E units out of A and E and into community casualty units will bring benefits to all patients; and it is why the development of the excellent new hospital at Larbert, which will serve part of the Lanarkshire population, will bring benefits right across the area.
Will the minister give an assurance that my constituents in Cumbernauld and Kilsyth will be able to access accident and emergency services in Glasgow and at the new hospital at Larbert when it is opened? Will he give an assurance that he will continue to put pressure on NHS Lanarkshire to hasten the development of the minor injuries unit at Cumbernauld health centre?
Indeed I will. I offer a clear reassurance to all members that the new provision of community casualty units and the necessary upgrading and expansion of the A and E units at Wishaw and Hairmyres will take place before there are any changes to A and E provision at Monklands.
NHS Lanarkshire (Transport Impact Assessment)
To ask the Scottish Executive whether NHS Lanarkshire has carried out the transport impact assessment that it stated it would undertake after the decision was taken to close Monklands hospital's accident and emergency department and, if so, what the results were of the assessment. (S2O-11832)
I understand that NHS Lanarkshire is in discussions with its partners in the west of Scotland transport partnership and that it will develop its transport impact assessment in the context of those discussions as part of its development of the business case for future hospital services over the next three years.
Does the minister share my concern that that important study, which includes the impact of hospital development on roads, junctions and car parking and which was required as part of the business case to support the board's decision to close Monklands A and E unit, has not been completed to date? Does he agree that, in view of the pressure on Hairmyres and Wishaw A and E over the festive period, which resulted in ambulances and patients being redirected to Monklands, it is time for the Minister for Health and Community Care to act decisively, as he did in the case of NHS Argyll and Clyde, by reviewing the membership of the board of NHS Lanarkshire and ensuring that the new membership listens to Lanarkshire people, is sympathetic to their justifiable concerns and their opposition to reconfiguration and acts accordingly?
No—it is time that Opposition parties got behind the proposals for better health services for the people of Lanarkshire. If they did that, they would gain credit. The proposals are progressing on the basis that they will provide a better quality of service for serious emergency cases and for cases of lesser urgency. Streaming emergency care and planned care will bring benefits to all. If Margaret Mitchell had listened to my first answer, she would understand that the development of the business case for the improved hospital services, and the transport impact assessment that is part of that, will take place in the next three years as proposed and agreed so that, when the configuration of hospital services in Lanarkshire changes, the current transport situation will be taken into account and the best possible provision will be made.
Motor Neurone Disease Clinical Specialists
To ask the Scottish Executive what financial contribution national health service boards are making towards the funding of motor neurone disease clinical specialists. (S2O-11810)
That is a matter for individual boards, but we encourage them to work with the Scottish Motor Neurone Disease Association to ensure that the needs of those in their area with the condition are met.
Given that the work that the specialists do dovetails well with NHS strategy, does the minister concede that a real case can be made for establishing a permanent, rather than a project-based, funding contribution from the Executive to assist the motor neurone disease team?
The Scottish Motor Neurone Disease Association, which acts and works on behalf of patients, has an opportunity to make that case. My officials have worked with the association to encourage it to do so and to make the case for the development of a managed clinical network, which would deliver many of the benefits that I am sure Mr Morgan is keen to have. Given the numbers that are involved, a clear case can be made for doing that nationally, rather than locally or regionally, but I look to the association to work up an application for the national services advisory group to consider in due course.
Consultant Contract
To ask the Scottish Executive what action it is taking as a result of the response by the chief executive of NHS Scotland on 17 January 2007 to the Audit Committee's report "Implementing the NHS consultant contract in Scotland". (S2O-11817)
It is important to recognise the potential that the consultant contract gives NHS Scotland to remunerate fairly that important group of staff and reward them appropriately for their service to the national health service, and to act as a driver for change and improvement in services to patients. That was acknowledged in the Audit Committee's report on the contract. The Executive is committed to turning the potential benefits that are associated with the new contract into actual benefits for patients, staff and the NHS. We have always maintained that realising the benefits fully will take time and we already have in place a process for planning and delivering the changes locally. We have recently emphasised to boards that their plans should demonstrate increased patient benefits and increased consultant-related productivity from service redesign.
Is the minister aware that, in Dr Kevin Woods's response to the Audit Committee's report, he agrees with the committee conclusion that the consultant contract
I must say that that question is somewhat naive. The new contract for consultants is the first such change in more than 50 years and we have never said that the benefits would arise overnight. Before the changes, we heard from members, including Shona Robison, about the recruitment and retention problems in the NHS. The new contract has secured recruitment and retained much-valued staff in our health service and we now have local job planning.
Does the minister agree that, notwithstanding the long-standing problems with getting the best value out of the contract, it would be unacceptable to pay our consultants less than they would be paid down south, as the consequence of that would be that we would lose further precious clinical staff?
We need to ensure that pay rates in Scotland for such a highly specialised and—to acknowledge what Duncan McNeil says—highly mobile workforce are consistent with those throughout the United Kingdom. Nonetheless, I want our pound of flesh from the consultants, who have better terms and conditions as a result of the new contract. I suggest that the productivity that we are achieving and that we will achieve tomorrow and further in the future will ensure that patients get a better service from our national health service.
How will implementing the contract affect the critical situation in the Oban and Fort William hospitals?
The combination of improved recruitment and retention, which I mentioned, the new training regime that modernising medical careers has introduced in Scotland, the focus of the royal colleges on reducing specialisation and increasing generalisation in health care and our ability to attract internationally qualified graduates into medicine in Scotland and to grow the workforce will enable our community hospitals strategy, which the Deputy Minister for Health and Community Care launched, to pay back in the recruitment and retention of much-valued skills in Scotland, thereby contributing to the success and turnaround of the hospitals to which Dave Petrie refers.
National Health Service (Targets)
To ask the Scottish Executive whether it has considered the impact of abolishing all targets for the NHS in Scotland. (S2O-11876)
The Executive has not considered the impact of abolishing targets for the national health service in Scotland as there are no plans to do so.
I thank the minister, who announced investment of £10 billion in the NHS in Scotland today, for that assurance. Does he agree that we must continue to set rigorous targets that are aimed at providing the best services for all NHS patients? Does he agree that a return to the system that obtained under the previous Tory Government, in which there were no targets, would lead us back to waiting times exceeding 18 months?
Absolutely. I will relate that question to the previous one. Because we are investing £10.3 billion in our health service, in the skills of the workforce and in what we pay them, the taxpayer has every right to set targets for the national health service's performance and productivity. I do not want to return to the long waiting times to which Michael McMahon refers or to the two-tier health system that we had under the Tories. Scrapping the targets would take us back to those longer waiting times which, I recall, were as long as three years. We must understand that the targets that we have set in the national health service not only drive a good bargain for patients but drive sustainable change to create a better health service for the future.
The minister already knows that I disagree with his top-down, target-driven approach to the NHS, which is driving down morale among the clinicians, who are trying hard to look after the patients who are under their care. Why will he not pay attention to the chairman of the Scottish council of the British Medical Association, Dr Peter Terry, who called this week for the Executive to scrap its waiting time targets, as there are serious concerns within the medical profession that patient care throughout the NHS is being compromised because doctors are forced to achieve the minister's political objectives rather than meet patient need? Does he agree that it is time to set the health professionals free to deliver the health service that Scotland needs, not the health service that he wants to control?
Is that free as in the way in which we were free under the Tories to have three-year waiting lists for treatment? That is not acceptable to my community or any other community in Scotland.
Wet Age-related Macular Degeneration
To ask the Scottish Executive how many people are currently diagnosed as suffering from wet age-related macular degeneration. (S2O-11830)
Work is being done to collect that information by national health service boards and as part of the Scottish medicines consortium's forward look financial planning programme. Early modelling has estimated that 16,000 patients in Scotland have wet age-related macular degeneration.
In correspondence that I had with the Greater Glasgow and Clyde NHS Board on behalf of a constituent, the board confirmed that the SMC issued positive guidance on the medicine Macugen in July 2006 and that the board agreed with and supported that guidance in August 2006. However, in its letter, the board also says:
I am interested in the correspondence to which Mr Maxwell refers. If he wishes to copy that to me, I will be happy to read it.
Minor Injury and Illness Units (NHS Tayside)
To ask the Scottish Executive whether it is satisfied that NHS Tayside made the correct decision in respect of the number and location of minor injury and illness units in its area. (S2O-11854)
In the framework of national priorities, it is for NHS Tayside to assess local service needs and to provide appropriate services to meet those needs. That applies to minor injury and illness facilities in the same way as it does to other services.
For obvious reasons, my interest lies in the provision in Perthshire, which has MIIUs in Blairgowrie, Pitlochry and Crieff. Auchterarder, which has a community hospital, is denied such a unit, despite having a growing population. Is the minister aware that that has resulted in patients in Auchterarder and its surrounding areas putting increased pressure on the accident and emergency facilities at Perth royal infirmary and probably also at Stirling? Does he agree that the success of MIIUs depends on their being available to natural communities? Will he consider whether the network should be extended?
I considered the issues carefully when the question was lodged. First, I expect all boards—including NHS Tayside—to keep all their services under review. If the pressures that the member describes create difficulty for patient care, the board will need to examine that. Information is also available to me about out-of-hours services in Crieff, which is some 7 miles away, and about the emergency centre in Perth that the member mentioned, which is 12 miles away.
Question 9 is from Duncan McNeil.
Midwife-led Maternity Units
Sorry, you caught me sleeping there—not for the first time. I blame Frank McAveety. My apologies, Presiding Officer.
Community maternity units have been endorsed as part of a network of maternity care in the overview report of the expert group on acute maternity services. We expect such units to continue to play a key role in delivering maternity services in Scotland.
If midwife-led units have a role to play, is it not essential that work is done to reassure sceptical expectant mothers that such units are perfectly safe and, where appropriate, offer the best care? How will the Executive work to boost public confidence in the units, which is essential to their long-term viability?
The Executive is happy to work both nationally and in partnership with health boards locally to ensure that people understand that the quality of care provided throughout our network of maternity services is second to none.
Environment and Rural Development
Climate Change (Hydrogen)
To ask the Scottish Executive how CO2 emissions can be reduced and climate change targets met by the use of hydrogen. (S2O-11873)
Hydrogen is a carrier of energy and will reduce carbon dioxide emissions only if produced from renewable energy. That green hydrogen will allow for excess amounts of renewable energy to be captured, stored as hydrogen and used at a later stage. The technology is still largely embryonic, and the Executive is encouraging the growth of the sector through the renewable hydrogen and fuel cell support scheme.
Is the minister aware of the recent award of £2.7 million to the hydrogen office project in Methil to demonstrate the potential of hydrogen derived from wind energy to reduce CO2 emissions and help businesses to meet climate change targets? How does the minister intend to let wider industry and business interests know about the potential of hydrogen? Does he believe that all businesses should be encouraged to examine that very real potential? Although I have not yet invited him to visit the hydrogen office project, he is more than welcome any time he is in Fife.
I am always grateful to Christine May for so willingly filling my diary with such regularity during environment questions.
In addressing the fledgling hydrogen economy that we all hope will exist, does the minister envisage any difference in treatment between hydrogen created through renewable means and hydrogen generated as a by-product of hydrocarbon carbon capture?
The only promotion scheme we have is that to which I have just referred. We would like that project to get rooted and to see how it develops. We recognise the member's point. There are two aspects to the issue, both of which can play an equally valuable role in developing our interest in hydrogen. The issue is at an embryonic stage and we are keeping it under review. My colleague, the Minister for Enterprise and Lifelong Learning, will be taking it forward.
Flood Defences
To ask the Scottish Executive what steps it is taking to review the approach to minimising flooding risks to communities, in light of recent incidents highlighting the failure of hard engineering flood defence schemes. (S2O-11894)
The flooding issues advisory committee is providing advice to the Executive on the implementation of a more sustainable approach to flood risk management. We plan to launch a public consultation on the issue later this month.
The minister will be aware of the manifest failure of hard flood defences at Milnathort. Will she commit to reviewing what went wrong at Milnathort, focusing not just on those hard flood defences, but on the approach that was taken by Perth and Kinross Council to sustainable flood management? In particular, will she focus on whether part of the problem that we saw at Milnathort recently was the result of planning decisions that may have led to flood waters being pushed away from new housing—built on flood plains—simply for it to appear in another part of the catchment, causing devastation?
We need to be able to speak authoritatively on the exact cause of that incident, which is something that I am very concerned about. My predecessor met George Reid, the constituency member for the area, before Christmas. I have spoken to George Reid since then, and I know that he has been trying to keep local colleagues up to speed with the issue. The key thing is that Perth and Kinross Council has produced a preliminary report on the incident and it will now commission a more detailed report, on which we will all need to reflect. There may be lessons to be learned throughout Scotland, and there will definitely be lessons for residents and businesses in Perth and Kinross.
Does the deputy minister accept that an important factor in minimising flood risk for communities is timely decision making? Does she accept that it is high time that the Executive ruled on the City of Edinburgh Council's flood prevention scheme, which received planning permission in 2004? Although I recognise that the deputy minister cannot be involved in the decision, as it affects her constituency, will she urge the Minister for Environment and Rural Development to make a decision quickly? Will she also ensure that he puts the interests of my constituents in Stockbridge and Bonnington before the self-serving interests of the Scottish Rugby Union?
Malcolm Chisholm is absolutely right about my long-term interest in the issue. Having seen the impact of a flood on constituents' businesses and houses, I assure him that it is a matter of great concern to the Executive that it has taken so long for the issue to be resolved. I acknowledge the point that he makes about timescales. It will be my colleague, Ross Finnie, who decides the issue, because of my previous interest. He has reassured me that he will complete his consideration of the matter as soon as he can.
Is the minister aware of the study that is being undertaken as a joint venture between Network Rail and Perth and Kinross Council, in my constituency, to examine how to deal with flooding in the Dalguise area, where homes and the main rail line between Perth and Inverness are severely affected by the implications of flooding? Given her response to Mr Ruskell's earlier question about the need to examine these issues in a more comprehensive way, is she able to say what further initiatives could be deployed by the Executive to ensure that a wider flood prevention study is undertaken in the whole of the river Tay catchment area? Flooding is now a serious issue in the western part of my constituency.
There is obviously the work that will be carried out by the local council, which is taking the lead in such matters. It is for the Executive ministers to work with local councils, once they have worked their schemes up, to find appropriate funding mechanisms. I know that, in his previous conversations with the minister, John Swinney has raised some practical thoughts as to how we might expedite some of those procedures and consider the funding issues. If John Swinney was prepared to put some of those thoughts down in writing, I would be keen to take them forward as I think that they are constructive ideas.
It is the belief of many living in areas—such as Perthshire—that have been affected by flooding in recent weeks that the discontinuation of the traditional practice of gravel extraction from river-beds has exacerbated the problem by raising water levels. Given that the practice has effectively been outlawed by the Scottish Environment Protection Agency, will the minister instruct the agency to reconsider the issue and review the impact that river dredging would have on river levels and on the propensity to flood?
I own up to not being an expert on that, but I would be more than happy to ensure that that question is included among the other issues that we are considering, such as using reservoir storage and natural flood attenuation, in examining the implications of different techniques. If Murdo Fraser wants to put a note to me, I will ensure that it goes to the flooding issues advisory committee so that that that issue is taken on board.
Chernobyl Incident (Restricted Areas)
To ask the Scottish Executive what the extent and current status are of the restricted areas arising from the Chernobyl incident. (S2O-11850)
Seven farms in Scotland, comprising approximately 1,030 hectares per farm, are still subject to restrictions as a result of the Chernobyl incident. Sheep from those farms are required by the Food Protection (Emergency Prohibitions) (Radioactivity in Sheep) Order 1991, as amended, to be monitored for radioactivity prior to being moved off farm.
Does the minister agree that, when more than two decades after a nuclear incident as far away as Chernobyl we still have restricted areas across Scotland, including within the area that I represent, and when the Food Standards Agency and the Scottish Environment Protection Agency are still carrying out such monitoring, it would be absolute folly to allow the siting of any further nuclear power stations in Scotland?
The one thing that I can safely say is that it would be absolute folly to build anywhere, at any place and at any time, a nuclear or any power station that was as badly designed as the Chernobyl station. That is the one thing on which we can all agree. It is not for me to enter into the debate, although I have my private views about the undesirability of nuclear power. [Interruption.] What did I say? I said only that I had my private views on the undesirability of nuclear power.
Food Miles (Young's of Annan)
To ask the Scottish Executive what contribution Scotland is making to reducing its carbon footprint in respect of food miles, in light of the decision by Young's of Annan to send prawns to Thailand for processing. (S2O-11825)
The Scottish Executive is seeking to reduce Scotland's carbon footprint in respect of food miles by working with the industry to ensure that more Scottish food is processed in Scotland, by encouraging localised food distribution systems, and by supporting local marketing schemes. For example, we have provided more than £60 million to support investments that add value to Scottish primary produce within Scotland.
As the Carbon Trust has identified that 82 million tonnes of carbon dioxide is generated by the food and catering industry, including a large proportion generated by food miles, and as the Scottish Executive has stated on several occasions that it is committed to playing its part in implementing the Kyoto protocol, can the Executive give an assurance today, ahead of environment week next week, that the situation will never occur again and that we will adhere not only to the Kyoto protocol but to the proximity principle in food processing? Will the minister also meet the workers from Young's of Annan to explain to them the situation that they find themselves in?
Obviously, I cannot give an undertaking on how commercial operations function. However, the biggest pressure that we can bring to bear on those who process and sell food is through our power as consumers. It is helpful that there is increasing demand from consumers for the labelling of food that has been subject to excessive air miles. There are calls for such information to be given to consumers, who can then exercise their discretion. If they do so, that will play a big part in commercial decisions, because if the consumer ain't buying, those who process and sell food will have to change their habits.
Declaration on Climate Change
To ask the Scottish Executive how it will monitor the success of the declaration on climate change, signed by all of Scotland's local authorities. (S2O-11874)
One of the commitments in Scotland's climate change declaration is for each local authority to publish an annual statement on the monitoring and progress of its climate change response. That will enable the Executive and the public to assess each local authority's performance.
I welcome the signing of the declaration and the commitment to tackle climate change. Local authorities are critical to reductions in greenhouse gas emissions in Scotland. Although 10 of Scotland's local authorities have developed carbon management plans with the Carbon Trust, 22 local authorities have not put together a full plan. Will the minister ensure that, in time, all Scotland's local authorities develop carbon management plans?
I hope that that will be the case. Our document, "Changing Our Ways: Scotland's Climate Change Programme", was not intended to be exclusively for the Executive. We intended it to be adopted by all of Scotland. It is important that all local authorities sign up to it and that we are all committed to meeting the objectives. I hope that the other authorities will follow the lead of the 12 authorities that have already produced plans.
Recycling (Household Waste)
To ask the Scottish Executive what progress has been made in improving the recycling of household waste by local authorities. (S2O-11880)
Good progress has been made. The latest figures from the Scottish Environment Protection Agency show that, from April 2005 to March 2006, Scotland recycled or composted 24.4 per cent of its biodegradable municipal waste. That compares with just 8 per cent in 2002-03.
The minister will be aware that West Lothian Council has increased its recycling rate from a low single figure to an expected 30 per cent this year and plans to increase that to 37 per cent with support from the Scottish Executive's strategic waste fund.
On the first point, I am happy to look into whether the statistics that we use are comparable. I will certainly investigate that.
Flooding
To ask the Scottish Executive what measures are being taken to reduce the risk of flooding in Moray and across Scotland. (S2O-11836)
In the first instance it is for the local authority to bring forward flood defence schemes to the Executive. In addition to a scheme it promoted at Lhanbryde, which has been confirmed by the Scottish ministers, Moray Council is also in discussion with the Executive about a further three schemes in Forres, Rothes and Elgin. For our part, we are committed to helping authorities increase protection of communities affected by flooding through investment in flood alleviation measures and flood defences. The Executive is also pursuing a wide range of initiatives under its national flooding framework to improve and strengthen flood arrangements in Scotland.
I thank the minister for her detailed answer. She might be aware that in Elgin, the proposed biggest flood prevention scheme in Scotland, which will cost more than £95 million, has at long last passed the approval stage at Moray Council and will be passed to her office to go through the next stage of the process. Will she undertake to ensure that the scheme goes through the next stage of the process as soon as possible, given that the people of Elgin have been waiting many years for it to get off the ground?
I reassure Mr Lochhead that the Executive will deal with the Elgin proposal as soon as possible.
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