Meeting of the Parliament (Hybrid) [Draft]
Meeting date: Wednesday, October 5, 2022
Agenda: Portfolio Question Time, Urgent Question, Committee of the Whole Parliament, Cost of Living (Tenant Protection) (Scotland) Bill: Stage 2, Meeting of the Parliament, Business Motions, Parliamentary Bureau Motions, Decision Time
- Portfolio Question Time
- Urgent Question
- Committee of the Whole Parliament
- Cost of Living (Tenant Protection) (Scotland) Bill: Stage 2
- Meeting of the Parliament
- Business Motions
- Parliamentary Bureau Motions
- Decision Time
Portfolio Question Time
Rural Affairs and Islands
The first item of business is portfolio question time. If a member wishes to request a supplementary question, they should press their request-to-speak button or enter the letter R in the chat function during the relevant question. To get in as many members as possible, I would appreciate succinct questions and answers to match.
Energy Price Cap (Impact on Farmers)
To ask the Scottish Government what assessment it has carried out of the impact on farmers in Scotland of the United Kingdom Government’s energy price cap. (S6O-01412)
We welcome any intervention that can help in this crisis, but the UK Government’s energy bill relief scheme is too little, too late. From my on-going engagement with farmers, I am aware that they face a range of increasing costs, including those for animal feed, fertiliser and fuel. The general increases in costs that businesses are facing across the board are all having an impact, and the scheme comes too late for many agriculture businesses that are struggling to pay bills. The scheme is also only in place for six months. I have written to the new Secretary of State for Environment, Food and Rural Affairs to request a meeting, and we will continue to press the UK Government to do more to ease the pressures that farmers and the wider food supply chain are facing.
NFU Scotland is working with its members to gauge how the energy price cap will benefit hard-pressed food and farming businesses. I understand that farmers who were paying under 20p per kilowatt hour are now being quoted 83p per kilowatt hour, which is a 315 per cent increase.
Scotland’s farmers are crucial to ensuring that we have access to nutritious food, and local farmers have told me that they are being hammered by rising production costs. Does the cabinet secretary agree that the UK Government needs to go further than the six-month cap and provide more financial certainty and stability to our farmers? Otherwise, food security will continue to be undermined and the prices on shop shelves will continue to climb.
I absolutely agree. As I said in my initial response, I have written to the new secretary of state at the Department for Environment, Food and Rural Affairs, Ranil Jayawardena, to request a meeting to highlight my concerns about food security. I will also continue to press the UK Government to do more to ease the pressures that we know that farmers and the wider food supply chain are facing.
We are seeking clarity from the UK Government on what plans for protections, such as the energy bill relief scheme, will look like after 31 March 2023, to ensure that businesses have the certainty and security that they need to operate with confidence. The work that we did with the food security and supply task force produced some recommendations that only the UK Government can act on and deliver. We will continue to press it to act and respond to the task force asks.
Rural Visa Pilot
To ask the Scottish Government whether it will provide an update on the proposals for the rural visa pilot. (S6O-01413)
Last week, the Scottish Government’s rural visa pilot proposal gained cross-party support in the Scottish Parliament. The proposal has been issued to the United Kingdom Government and we await its response.
We call on the UK Government to accept the recommendation of its own Migration Advisory Committee to deliver a migration pilot for rural areas. The proposal that was endorsed by this Parliament was co-developed by the Scottish Government, local authorities, rural employers, academic experts and partners. Our ask of the UK Government is clear—for it to work with the Scottish Government, local authorities and employers to establish migration pilots to meet the needs of Scotland’s rural and island communities.
In August, the National Farmers Union estimated that more than £60 million-worth of food had been wasted because of workforce shortages. Farmers are doubly feeling the effect of Tory policy through not having the workforce available to help them, and now farmers, like most in the country, are suffering from inflationary pressures that have been exacerbated by Brexit, which the Tories forced on Scotland. Does the minister share my view that, unless the UK Government considers Scotland to be beneath its contempt, the very least that it can do is urgently agree to proposals for a rural visa pilot?
Yes—I do. It is notable that the chief executive and the president of NFU Scotland have publicly called for the rural visa pilot proposal to be implemented. Scott Walker stated that it must be delivered
“in tandem with UK Govt expanding number of seasonal workers visas & a review of shortage occupation list.”
The Conservatives are the only party in this Parliament yet to support the proposal. Donald Cameron asked for more time to consider it in detail, and I know that he and his colleagues will look to engage constructively. I hope that they can do that and that the Parliament can speak with one voice on this critical issue that our rural and island communities face.
Food Security (Brexit)
To ask the Scottish Government what its latest engagement has been with the United Kingdom Government on the impact of Brexit on Scotland’s food security. (S6O-01414)
The Scottish Government takes food security in Scotland seriously. Along with my fellow Scottish ministers, I have repeatedly highlighted to the UK Government our concerns about the effects of its bad Brexit deal.
On 26 August, I wrote to the UK Government to highlight the cumulative impact on the food and drink sector of labour and skills shortages and of rising costs. I have yet to receive a response. The Scottish Government will continue to use all the devolved powers that are available to it to support the sector, but the UK Government needs to do more now to protect our food and drink businesses.
I agree that the UK Government should be doing more as soon as possible. The Green Alliance’s recent letter to Kemi Badenoch noted that
“The recent lifting of tariffs and quotas without any equivalence on animal welfare or environmental standards for Australian producers means that UK farmers will now compete with imported food produced to standards that would be illegal in the UK”.
Does the minister share my view that Brexit continues to be a monstrous betrayal of farmers, growers, food producers and the sector in general, for which the Tories should be beyond ashamed?
I do not think that there is any doubt that food and drink businesses and the sector in Scotland have borne the brunt of the hard Brexit that the UK Government has pursued. We have seen the UK Government sign up to trade deals with Australia and New Zealand that, as the UK Government’s own modelling shows, will be damaging to Scotland’s farmers and crofters.
We have worse deals with those countries than those that the European Union negotiated with them. It is really important to highlight an example of that. Although the UK Government has agreed to allow unlimited quantities of tariff-free beef into the UK after 15 years, the EU-New Zealand free trade agreement will maintain quotas permanently and apply a 7.5 per cent tariff. In addition, the quotas that New Zealand has secured in its FTA with the UK are much higher than those in its agreement with the EU. In the first year of the FTA, the UK will allow 12,000 tonnes of New Zealand beef into the UK, while the EU will allow only 3,333 tonnes into the entire EU27. I really look forward to a time when the Scottish Government can work with the EU and others to develop and deliver a trade policy that works in the economic and other interests of the people in Scotland.
It is no surprise that, on Wednesday 2 November, from Shetland to Stranraer and from Kirkwall to Kelso, and here at Holyrood, farmers and crofters will send a message to the Scottish National Party Government that they need clarity and that food production needs farmers. That rally will not be a celebration, as the civil servant accompanying the cabinet secretary described it at the Rural Affairs, Islands and Natural Environment Committee this morning.
It has taken six years for the SNP to launch a consultation on agricultural policy. Now farmers are being asked to discuss massive issues in an information vacuum. Despite numerous requests, the cabinet secretary’s department has failed to give clarity on how the new powers in the proposed agriculture bill would put food production at the heart of delivering the Government’s expectations.
The rally will take place in four weeks’ time. The Scottish Conservatives will be there to support farmers and crofters. Will the cabinet secretary be there to apologise for her lack of clarity? Will she commit to fully addressing farmers’ concerns?
One thing that I will not be apologising for is continuing to support food production in this country, unlike other parts of the UK. That is one of the central pillars of our vision for agriculture, which we published earlier this year, in which we committed to supporting food production, while looking to tackle the climate and nature emergencies. They are the three key pillars of our support. That is also why we have committed to maintaining direct payments, to recognise the importance of food production. That is now more important than ever, given the increasing food security risks that we face.
To ask the Scottish Government what action it is taking to address the issue of absenteeism in crofting. (S6O-01415)
In 2022-23, the Crofting Commission received an increase in budget that enabled it to expand its residency and land-use team in order to increase its work in addressing absenteeism and bringing crofts back into productive use. Through the Crofting Commission’s development officers, work is under way to implement actions that are contained in the Scottish Government’s national development plan for crofting, including bringing more crofts back into active use. As crofting landlords, the Scottish ministers are considering what action can be taken on their crofting estates to increase the active use and occupancy of crofts and to look at opportunities for new entrants.
The cabinet secretary is aware of the importance of crofting to the Highlands and Islands. Crofts falling into disuse as a result of absenteeism represents a barrier to young people acquiring a tenancy to use the land and thereby remain in their communities. Will she say more about how the Government’s legislative ambitions will create more active crofts and ensure that people who wish to productively use a croft can access land?
I use this opportunity to reaffirm our commitment to modernising crofting laws, as we set out in our programme for government this year. The crofting bill group was reinstated in May to consider crofting legislation, including provisions pertaining to the enforcement of the duties of crofters on owner-occupier crofts, such as the residency duty and the duty to cultivate the croft or put the croft to another purposeful use. A number of meetings took place between June and September, and more are scheduled. I look forward to the further development of that work, so that we can really tackle the important issues that Alasdair Allan raised.
Retained EU Law (Revocation and Reform) Bill (Food Safety and Quality)
To ask the Scottish Government what discussions the rural affairs secretary has had with the public health minister regarding how it will ensure the safety and quality of food sold in Scotland in the event that the United Kingdom Government proceeds with its Retained EU Law (Revocation and Reform) Bill proposals. (S6O-01416)
That is an area that causes us significant concern. Scottish ministers are advised on food safety and standards matters by Food Standards Scotland. The Minister for Public Health, Women’s Health and Sport and I meet regularly with the chief executive officer of FSS to discuss a range of issues. The bill will, of course, feature in our on-going discussions with FSS.
The Scottish Government considers the bill to be reckless. I cannot emphasise enough the impact that it will have on the areas that the member has mentioned, as well as more broadly across my portfolio and others.
Independent of the Scottish Government, the FSS considers that the bill will undermine our ability to ensure the safety and quality of food that is sold in Scotland, because unless existing legal protections that are set out in retained European Union law are preserved, they will be removed from the statute book by the end of 2023. The sheer volume of food and feed legislation is significant, the timescales that are proposed by the UK Government are ridiculous and the current protections for consumers are put at risk by the bill.
It goes much further than food safety, because the bill also dismantles our environmental and biosecurity protections, as well as affecting many other areas of devolved competence. We will do everything within the powers that are available to us to prevent the progress of the bill in its current form.
I thank the cabinet secretary for that detailed answer. As she is well aware, Food Standards Scotland has already warned about the risks to consumers here. The UK bill will result in removal of consumer protections related to food that have applied in Scotland under the protection of this Parliament for years. Does she agree with me that the bill is another example of the UK Government interfering with and grabbing the powers of this Parliament? What can the Scottish Government do to prevent a race to the bottom in food quality standards and to uphold the high safety and quality of food that we have enjoyed in Scotland for many years?
As I have outlined, the bill carries an unacceptably high risk that vital law will simply drop off the UK statute book towards the end of next year. My colleague Angus Robertson, the Cabinet Secretary for the Constitution, External Affairs and Culture, is pressing the UK Government to reconsider the bill in the light of its implications for the devolved Governments. Unless it is changed, and unless current standards remain on the statute book, Scotland’s reputation for high-quality food and drink is very much at risk.
It is also worth bearing in mind some of the comments from Food Standards Scotland that highlight the significance of what the bill will mean. FSS has advised of
“major risks and impacts to Scottish consumers in relation to food safety and standards if the ... Bill is progressed in its current form.”
It added that
“Even if high legal standards continued to apply in Scotland, the Internal Market Act ... means that there would be no way of stopping goods from elsewhere in the UK being sold in Scotland produced under lower legal standards.”
The Scottish National Party-Green Government has already shackled Scotland’s farmers to European Union law—for example, on the issue of gene editing—and it is not interested in building a farming policy that is aligned to Scotland’s need. The UK Government offered to extend powers in the UK Agriculture Act 2020 to help the devolved Administrations to create their own farming support systems. Although Wales and Northern Ireland accepted that offer, the SNP Government declined. NFU Scotland president Martin Kennedy says that he remains frustrated that
“despite several requests from NFU Scotland and other stakeholders”,
they have yet to receive clarity on the new agriculture bill. When will the cabinet secretary start prioritising farmers ahead of constitutional grievance?
That is a completely nonsensical comment from Finlay Carson with which I completely disagree. We are, of course, putting our farmers and crofters at the forefront of our policy, and we are co-developing it with them, to ensure that we have a policy that works.
Rural Economy (Population Decline)
To ask the Scottish Government what plans it has to support the rural economy in areas impacted by long-term population decline. (S6O-01417)
We are investing £8.3 million this year to deliver the national islands plan, and we are developing an addressing depopulation action plan to provide the policy framework to support population retention across rural communities.
We are also investing £11.6 million through our rural community-led fund; developing a remote, rural and islands housing action plan; and investing in digital infrastructure, despite the fact that responsibility for broadband is reserved to the United Kingdom Government. Additionally, Parliament has recently endorsed a bespoke rural visa pilot scheme. That employer-based migration proposal has been developed with representatives from employers across island and rural communities.
Can the minister confirm that the £5 million for the now-abandoned islands bond is still ring fenced for tackling depopulation? Can he advise whether plans for utilising that resource will be set out in future financial plans?
Obviously, we are working with our island communities to develop proposals to ensure that we address depopulation. At the moment, all financial issues are going through the lens of the emergency budget review—details of which will be published as soon as possible.
Depopulation is often a multifaceted problem that requires a range of levers to address it. Many of those levers, such as on matters pertaining to immigration, are reserved. The Scottish Government has clearly set out a case for charting a different course from that of UK immigration policies, which, frankly, do not take into account Scotland’s unique circumstances and are therefore harmful to our communities. What does the minister think is the basis for the UK Government’s opposition to initiatives that are essential to Scotland’s wellbeing, to supporting economic growth, to delivery of public services and to enhancing and sustaining our communities?
The basis is lack of understanding of Scotland’s rural needs. Depopulation is a complex issue, so there are no simple solutions. Therefore, it is essential that we work with regional, local and community partners to develop a sustainable approach to enhancing and sustaining our communities. In Scotland, we are proud to have legislation such as the Islands (Scotland) Act 2018, which ensures that we take into account the unique nature of communities and that we develop solutions in a collaborative manner. Without that close working relationship, I struggle to see how the UK Government can understand the needs of our communities and profess to know what is best for them.
Island Communities (Resilience)
To ask the Scottish Government what steps it is taking to improve the resilience of island communities. (S6O-01418)
By considering population levels, promoting sustainable island economies, supporting wellbeing and health and focusing on reducing fuel poverty, the national islands plan is critical to improving outcomes for island communities and, ultimately, resilience.
I frequently engage with my colleagues across all portfolios to ensure that we respond in real time to issues as they arise, and to ensure that reporting on island resilience matters is timely and effective. That provides me with the assurance that I need on concurrent risk and allows us to explore potential mitigations. My islands officials also correspond with island communities to provide on-the-ground information regarding any major issues.
I welcome the work that is on-going, but it appears that ministers, having abandoned—for which I am thankful—the ill-conceived and overly simplistic proposal for islands bonds, now intend to spend the money, which is £300,000 this year, on practical policy tests to inform a future action plan. That is unlikely to have people dancing in the isles. It will also do nothing to improve transport links, broadband provision or the availability of affordable housing.
Will the cabinet secretary agree to ditch the tests and focus the limited resources on, for example, expanding inter-isles air services in Orkney or providing additional support to students who wish to come to our islands to study? In the past, such students have often stayed on the islands to build lives and careers.
The detail of any proposals is still to come forward; it is not right for the member to encourage me to ditch something before he has seen the detail. What we propose will be based on feedback from island communities that we received through the extensive consultation that we undertook. I am more than happy to have more discussion with Liam McArthur about what such projects might look like. Any work that we take forward will be based on the needs of our island communities.
I draw attention to the fact that help for our island communities does not come only from the rural affairs and islands portfolio. We should consider all the funding that is being channelled through our housing and transport programmes. A number of interventions that are either planned or under way will help with the overall resilience of island communities.
Island and rural communities are among the most vibrant, but the cost of living crisis poses a threat to many of them. It has been reported that households in Argyll and Bute will need to earn more than £72,000 per year to avoid fuel poverty this winter.
The key levers to address the crisis rest with the United Kingdom Government. Does the cabinet secretary share my view that the best way to ensure the resilience of island and rural communities is for them to be rid of the chaos of Westminster and the callous politics of the Tories?
I agree with the points that the member made on both counts. Time and again, we have seen that decisions that are taken in reserved areas simply do not take into account the unique circumstances that rural and island communities face.
I will give one example of that, which relates to the shared prosperity fund, but there are many more. We discussed that when I appeared at the Rural Affairs, Islands and Natural Environment Committee this morning. The Highlands and Islands were recognised as one of the highest-priority areas that were earmarked for European structural funds, but the opposite is the case in relation to the UK Government’s levelling up agenda. Every year, £183 million is required to replace European Union funding. That equates to £549 million over the three years that the shared prosperity fund covers. However, instead of receiving £549 million, Scotland will receive just £212 million over the three-year period. That equates to a 60 per cent real-terms reduction in funding. As a result of that lack of regard by the Tories, the Scottish Government continues to press them to take further action to support our households through the cost of living crisis.
Proposed Agriculture Bill (Stakeholder Meeting)
To ask the Scottish Government what its response is to the emergency stakeholder meeting on 12 September regarding its proposed new agricultural bill. (S6O-01419)
Our public consultation—“Delivering our Vision for Scottish Agriculture: Proposals for a new Agriculture Bill”—is open until 21 November this year. It will inform the next steps in our commitment to co-design via the agriculture reform implementation oversight board, so I encourage everyone to engage in the consultation to ensure that their views are captured.
It is important that stakeholders, the Government and wider society come together to discuss issues and work towards shared outcomes as part of the Scottish Government’s co-development approach. I trust that the new industry group will feed back to enable discussion with stakeholders representing the wider rural economy in the agriculture and rural development stakeholder group.
I think that co-design refers only to the relationship between the Government and the minority party that is propping it up, because senior NFU Scotland figures describe the proposed agriculture bill as reading more like a Green Party manifesto than a true agriculture bill. There is very little mention of food security and food production, which should surely lie at the heart of any such bill. Relationships between the farming community and the Scottish Government are at an all-time low, in the eyes of many people in the industry. Given that the Scottish National Party Government has had years to come up with a plan for the future of Scottish farming, why does the cabinet secretary think that so many farmers are being so vocal in their disappointment and anger about the Government’s proposals for their future?
I do not know whether Jamie Greene has been through the detail of the consultation. It sets out the framework that we are looking to establish and the enabling powers that we will need in any future legislation in which we discuss the importance of our food production and food security. As I have said, that is an area that we identified and highlighted in our vision for agriculture, which we are intent on delivering.
The cabinet secretary will know that, even when the proposed agriculture framework bill is passed, it will not provide the detail that farmers are looking for on agriculture support. Does she accept their need to see the detail, even before the bill is passed, to allow them to plan the future of their business?
I absolutely accept that, and I will be working to deliver that. More information on that will be available in due course.
Health and Social Care
The next portfolio is health and social care. I remind members that questions 3 and 4 are grouped together and that I will take any supplementaries on those questions once they have both been answered. If a member wishes to request a supplementary question, they should press the request-to-speak button during the relevant question or indicate as such in the chat function by pressing the letter R. I press members for succinct questions and answers to match, in order to get in as many questions as possible.
Waiting Lists (NHS Boards)
To ask the Scottish Government what its advice is for patients who move from one regional national health service board to another while on a waiting list for essential surgery. (S6O-01420)
Patients who move to another health board area will join the waiting list of the receiving health board. Although waiting times vary across health boards and specialities, I would not expect that to have a negative impact on the length of time that a person should expect to wait.
Clinicians in the new board might wish to reassess the patient to ensure that it is safe to go ahead with the procedure, especially where there has been no prior assessment or some time has elapsed since an assessment was carried out. Again, I would not expect that to be done routinely without good clinical reasons.
Patients with an urgent clinical need will always be prioritised. In all cases, I expect health boards to make every effort to ensure equity of care and to minimise any disruptions to the patient’s journey.
A constituent of mine, who was first referred in October 2019, has been waiting—all the while in pain—for surgery since March 2020. They recently had to move—fortunately, still in the north-east region—which required a transfer from NHS Grampian to NHS Tayside. To get on to the Tayside waiting list, they have to undergo a fresh assessment. Will the cabinet secretary outline how patients can ensure that they do not have to redo assessments, at the cost of time, energy and resources to both themselves and the NHS, in order to get on to their new health board’s waiting list? What guidance can we give patients who might be willing and able to travel to another health board that has available capacity so as to expedite their surgery or other treatment?
My thoughts are with Maggie Chapman’s constituent at what is a difficult time for them.
There should not be any detriment to patients who move to a new health board area. Obviously I do not know the full details of Maggie Chapman’s constituent’s case but I am happy to receive them. As I said in my answer to the first question, reassessments are not done routinely or necessarily, but there might be a good clinical reason in this case—I do not know because I do not know the details. However, I would expect there to be no undue impact on the time that her constituent has to wait for the procedure, and I will ask my officials to liaise with the two boards.
On Maggie Chapman’s second question, a review of NHS waiting times guidance will be undertaken. The working group has been established, and I am happy to keep her and other members updated.
On the final point about whether there is the possibility of moving to another board for a procedure to take place, that can be a board-to-board discussion. In certain cases, financial help is available for travel and accommodation.
Will the minister guarantee that any patient who moves from one regional NHS board to another while waiting for any out-patient or in-patient services will have their current length-of-wait time taken into account in their new board’s scheduled treatment, and that such patients will not simply be moved to the foot of a waiting list?
That would not routinely happen—the clock would not routinely be reset to zero. However, as I said in my answer to Maggie Chapman, an assessment may be necessary, particularly if time has elapsed since the original, or most recent, assessment.
Patients would not routinely have their clock reset to zero. I would be concerned if that was happening routinely in any health board.
Access to Care at Home (Hospital Patients)
To ask the Scottish Government what work it is undertaking to ensure that patients have access to care packages to help aid recovery at home as soon as possible after a hospital stay. (S6O-01421)
The Scottish Government is committed to ensuring that people receive the right care, in the right place, at the right time, avoiding delays in discharge wherever possible. To support that work in 2022-23, we have issued a range of funding packages, including £124 million to enhance care at home; £200 million to increase the hourly rate of pay to £10.50; £20 million to support interim care arrangements; and £40 million to enhance multidisciplinary teams.
We are also investing a further £3.6 million in the development of hospital at home, which can provide acute hospital-level care at home, thereby avoiding the need for an acute admission and a length of stay in hospital. That funding is in addition to the £4.5 million that has already been invested, which takes our total investment to more than £8 million.
I have recently written to NHS Tayside, the integration joint board and the Cabinet Secretary for Health and Social Care, Humza Yousaf, about a constituent of mine, whom I will not name, who has been waiting an excessively long time for his wife to be returned home after having a stroke. She has all the equipment in place, but it does not seem to be possible to put a care package in place for her. The challenge appears to centre on staffing capacity, which has clearly been impacted by Brexit.
Will the minister set out what action the Scottish Government is taking within its powers to support health boards and IJBs to recruit the staff they need?
I thank Mr Fairlie for raising that distressing case. I understand that he has written to the cabinet secretary, who will respond shortly. I will ask my officials to investigate the situation, if Mr Fairlie could provide us with more detail.
It is absolutely vital that we continue to make every effort to maximise the capacity of the social care system. In addition to the financial investment of £528 million that I outlined, we have, as part of our winter planning preparedness, been working with the Convention of Scottish Local Authorities to develop our joint plan for winter.
The Government has a long-standing commitment to implementing the principles of fair work for the social care sector. We are fully committed to improving the experience of the social care workforce, including by increasing levels of pay and delivering consistent fair work conditions to staff who work with the more than 1,200 employers that deliver social care in Scotland.
On that basis, we have just extended the staff support fund, to ensure that social care staff who are required to isolate if they test positive for Covid receive their full pay over the winter months. We will continue to work in partnership with local government and health and social care partners to do all that we can to support them to ensure that we recruit and retain staff, so that we do not have situations such as the one that Mr Fairlie identified.
Cases such as the one that Jim Fairlie has highlighted are replicated across the country. As of 26 September, 90 people in North East Fife were waiting for a care package, either stuck in hospital or stuck at home. That needs to change.
The trouble is that the minister has been saying what he just said for years, ever since Shona Robison promised that she would get rid of delayed discharge altogether. Why are the plans that he set out making absolutely no difference?
I think that the work that I have laid out is making a difference. Willie Rennie fails to understand the huge impact that the pandemic has had on our health and social care systems. Some folks forget that we are still in the midst of that pandemic and that there will be situations in which staff are off ill with Covid or for other reasons.
Of course, as Mr Fairlie rightly pointed out, our health and social care system has faced a Brexit shock, with one care organisation that I have spoken to losing 40 per cent of its staff because of Brexit.
We will continue to put in place our winter planning. We will co-operate with local authorities and health and social care partnerships. The cabinet secretary and I are in a constant round of discussions with service providers across the country, so that we can help them as best we can. What we cannot do, unfortunately, is bring back all of the folks who we lost because of the Brexit situation.
New research by YouGov has revealed that only 28 per cent of Scots have considered a career in the care sector, with about 40 per cent citing low pay, stress and a perception that the sector is physically demanding. More shockingly, nine out of 10 care workers describe their place of work as understaffed.
I heard what the cabinet secretary said in his statement about winter planning yesterday. However, the headline that we heard on social care was a repeat of the announcement of the £10.50 per hour wage, which equates to a derisory pay rise of 48p. When will the Government get serious, engage with staff and unions on the ground, and respond to the call for £15 an hour?
Mr O’Kane fails to say that if we were to raise pay to £15 an hour at this moment, that would cost £1.75 billion. Mr O’Kane knows that we are already in a stressed situation when it comes to budgets, because of the continued cuts of the Tory Government. We will continue to do all that we can—[Interruption.]
I do not want all this shouting from sedentary positions. Minister, please resume.
We will continue to raise pay and support our social care staff. We have raised pay twice in a year. We keep pay under constant review and will continue to do so.
On the point about career progression and attracting people to the profession, that is one of the key planks of our national care service proposal. We want to ensure not only that we get pay and conditions right, but that there are career pathways for folks who enter the profession. That is what young people want to see, and those are the folks who we need to enter care. We need to grow our own workforce, thanks to the fact that we have lost so many folks because of the Brexit situation.
I point out to members that we are now 13 minutes into this question time session and I have another six questions to take. I think that everybody can do the maths on that.
Out-patient Appointments (Waiting Lists)
To ask the Scottish Government whether it will provide an update on its target to eliminate two-year waits for out-patient appointments in NHS Scotland. (S6O-01422)
The first of those targets, which were set in July to address the impact of the pandemic on planned care, was to eliminate two-year waits for out-patients in most specialities by the end of August. Public Health Scotland data shows that, by 31 August, a majority of specialities had no patients waiting more than two years. In fact, 76 per cent of specialities had fewer than 10 patients waiting more than two years, and 71 per cent of territorial health boards had five patients or fewer waiting more than two years.
Boards are working hard to reduce the number of out-patients waiting more than two years as quickly as possible. I am grateful to our national health service staff who have helped in that effort.
Back in June, the health secretary set a series of targets on long waits for NHS Scotland. He pledged to eradicate two-year out-patient waits only in most specialities, rather than altogether. The fact is that we now find that more than 2,000 Scots have been languishing on out-patient waiting lists for more than two years. That means that the long out-patient waiting lists are seriously far from being eliminated.
Does the cabinet secretary concede that the original targets have failed? When can we expect to see two-year out-patient waits eliminated for good?
I am not sure how Alexander Stewart can stand there and repeat what the target was, which was to eradicate two-year out-patient waits in most specialities, agree with me that that has happened in most specialities, and then ask me whether the target has failed. That does not make any sense to me.
I am surprised that, when those statistics were published, neither Alexander Stewart nor any member of the Opposition uttered a word—or even a syllable—of thanks to NHS staff who have worked so hard to reduce those two-year outpatient waits in the majority of health boards.
Two health boards account for 90 per cent of the two-year outpatient waits—NHS Ayrshire and Arran and NHS Grampian—and I assure the member that we will work intensively with both those health boards to ensure that they get extra support. That does not take away from the fact that we have seen remarkable progress across health boards in the 60 days after those targets were announced, and I hope that the member will join me in thanking NHS staff for their incredible efforts in that regard.
To ask the Scottish Government whether it will provide an update on what new steps it has taken to tackle national health service waiting lists. (S6O-01423)
I will not repeat what I said in my previous answer.
We are working intensively with the national centre for sustainable delivery, which Pauline McNeill will know. We are working with boards to accelerate the implementation of high-impact changes, including active clinical referral triage and patient-initiated review. Those improvement programmes will support the delivery of the targets that I mentioned and provide sustainable solutions for the future.
We are also working with the national centre for sustainable delivery and boards to embed regional and national working, to ensure that long-waiting patients can access treatment quicker, even if that means that they have to travel to do so.
I want to ask about internal waiting times. Last week, an NHS Greater Glasgow and Clyde oncologist raised with my office concerns that cancer-related scans now take up to eight weeks to be returned, when they should normally be returned within one week. The fact that oncologists are waiting for the results of important scans will clearly have a knock-on effect on patients in a priority area of treatment.
Is the cabinet secretary aware of that situation and is he acting on it? What assurances can he give oncologists in Glasgow and the health board area that the scans of worried patients will be returned in a much-reduced timescale?
We are aware of that issue, and the member is right to raise it. I have spoken in the chamber previously about our challenges around the medical oncology workforce. I am happy to give Pauline McNeill more detail off table about some of the actions that we are taking with NHS Greater Glasgow and Clyde in relation to cancer and other key diagnostics.
We have invested particularly in areas in which we know that diagnostics can take much longer than any of us would want them to take. For example, we have taken actions in relation to endoscopy and neurology, on which I will give Pauline McNeill more detail.
If the member is concerned about a specific constituency case, I will be happy to follow it up with the appropriate board.
I welcome the latest statistics, which show an increase in the number of patients who are seen within target times. What work is going on to ensure that that upward trajectory continues?
We know that we are entering a really challenging period—we already are in a challenging period, but the winter months will present significant challenges on top of those that we currently face. The work that we are doing with boards is to try to ensure that we can protect some of the capacity for elective care as much as possible. We know that elective care has taken a real hit because of the pandemic over the past two and a half years, so we are maximising theatre productivity and considering how we can ring fence that capacity.
The centre for sustainable delivery is moving forward with its national elective co-ordination unit, which will help to ensure that we make the best use of theatre capacity across boards, where possible. We are also funding boards to the tune of around £8 million over the course of the winter to help to recruit 750 additional nurses, midwives and allied health professionals, which I hope will boost our workforce over the winter.
NHS Borders (Meetings)
To ask the Scottish Government what recent discussions it has had with NHS Borders. (S6O-01424)
I last met with NHS Borders on 22 September and discussed matters of public health that concern the local population.
Will the cabinet secretary join me in congratulating all staff at NHS Borders on the recent announcement that 100 per cent of patients who were diagnosed with cancer were treated within the Scottish Government target of 31 days, and almost 97 per cent of eligible patients who were given an urgent suspicion of cancer referral received their first treatment within the Scottish Government’s 62-day target? That is excellent work on the part of the staff at NHS Borders.
I agree whole-heartedly with Christine Grahame, and it is right that we congratulate and pay tribute to our NHS staff, who have had the most difficult and challenging two and a half years of their professional careers. It is right that we congratulate NHS staff when we see progress.
Notwithstanding that excellent progress in NHS Borders, I am not satisfied with our current levels in relation to our 62-day target across the board. I have asked officials to explore closely whether other boards can learn from the boards that are doing well and accelerating, such as NHS Borders, and implement what they are doing.
To ask the Scottish Government whether it will provide an update on the provision of maternity services. (S6O-01425)
The Scottish Government continues to improve provision of maternity and neonatal services through implementation of “The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland”.
Following a pause due to Covid, we have now received implementation plans from all boards, which show an on-track trajectory for completion by the revised end date of 2024 for the majority of the recommendations and 2026 for continuity of carer.
In a recent letter to the Galloway community hospital action group, the minister wrote:
“We expect all boards to provide maternity services that are delivered as close to home as possible.”
People in my constituency have waited for four long years, with mothers giving birth on the roadside, but there is still no serious discussion from NHS Dumfries and Galloway on the return of maternity services in Wigtownshire. What reassurance can the minister give expectant mothers in that part of my constituency, Galloway and West Dumfries? I know that she is very aware that there is an undeniable need for a midwife-led maternity service at the Galloway community hospital in Stranraer, to prevent a 150-mile and three-hour round trip. Will the minister outline what the Government can do as a matter of urgency to reinstate such a service?
The member is aware that Scottish Government officials and professional leads, including the chief midwifery officer, are in regular contact with the head of midwifery at NHS Dumfries and Galloway to discuss those issues and explore what support the Government might provide.
The member is also aware that Dumfries and Galloway integration joint board, which is responsible for the planning and delivery of the vast majority of health and adult social care services in the region, has asked the health board to consider options for the delivery of maternity services in Galloway and to report to the IJB. I understand that the matter is to be discussed next week, on 13 October, and I have asked to be kept informed of progress and the outcome of that process.
I plan to visit Galloway community hospital towards the end of the month, on Monday 31 October; I will meet the Galloway community hospital action group at that time and I hope to discuss the issues with it.
To ask the Scottish Government what action it is taking to address the reported prevalence of alcohol-related cancers in Scotland. (S6O-01426)
The recently published Scottish Health Action on Alcohol Problems guidance for health professionals highlights that the risk of developing a range of cancers increases as alcohol consumption increases. We are working with SHAAP to promote the guidance.
We are investing £10 million to improve how cancer, including alcohol-attributed cancer, is treated in Scotland, and we will launch a new 10-year strategy in April that will take a comprehensive approach to improving patient pathways. We are taking action to reduce alcohol consumption across the population, including consulting on potential alcohol marketing restrictions in autumn and continuing our evaluation of minimum unit pricing.
The SHAAP guidance highlights that one in four alcohol-attributed deaths in Scotland is due to cancer, so it is important that we do everything that we can to highlight that to the public. The report that the minister mentioned makes a number of recommendations for intervention; can the minister say more about what the Scottish Government plans to do to make health professionals and the public more aware of the risks? I welcome the comments that the minister made on advertising.
The Scottish Government works closely with SHAAP, and health professionals across Scotland have been issued with SHAAP’s guidance, which highlights the link between alcohol and cancer and suggests that professionals can reduce alcohol-related cancer risks by helping patients to reduce their intake.
We are developing a new, 10-year cancer strategy, to launch in spring 2023, which will take a comprehensive approach to improving patient pathways, from prevention and diagnosis right through to treatment and post-treatment care. That will include alcohol-related cancers.
I welcome the member’s focus on the issue. As all members in the chamber will know, this year, deaths that were directly attributable to alcohol rose to 24 a week in Scotland. That is an absolute tragedy and it is the tip of the iceberg, because that number does not include the people who die from cardiac-related illnesses and cancer, in relation to both of which alcohol is a major contributory factor.
Universal Free Prescriptions
To ask the Scottish Government whether it will provide an update on its commitment to universal free prescriptions on the national health service. (S6O-01427)
The Scottish Government has no plans whatever for the reintroduction of prescription charges. We have been absolutely clear that prescription charges are a tax on ill health and that any medication prescribed to a patient should be dispensed free of charge, unlike the situation in England, where charges apply and patients pay £9.35 per item—not per prescription but per item.
The minister agrees with me that free prescriptions are a significant investment in improving health, especially when prescriptions cost £9.35 in England, during a cost of living crisis. People should not be deterred from accessing the vital treatment and medicine that they need. Does the minister share my astonishment that the leader of the Scottish Labour Party refused to back the suggestion that the abolition of prescription charges should be Labour Party policy when he was invited to do so by the First Minister in Parliament last week?
I absolutely share the member’s astonishment. Let me be clear: prescription charges are a tax on ill health and a barrier to better health for many people. Charging for prescriptions would mean that many people who have chronic conditions—even people receiving treatment for cancer—could be liable to pay an enormous charge. Having to choose between food shopping or vital medicines is not a position that people in Scotland are faced with, unlike in England, where patients are charged £9.35 per item.
We continue to demonstrate our commitment to the provision of free healthcare advice and treatment when needed, with the introduction of the NHS pharmacy first service, which is available at all community pharmacies. The service is available to everyone who is registered with a general practitioner and who is ordinarily resident in Scotland.
I have to say, in relation to Labour policy, that even the Scottish Conservatives dropped their opposition to free prescriptions in 2017 because they recognised the popular support for the policy, which was introduced by the Scottish National Party Administration in 2011.