Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business is portfolio questions, and the first portfolio is rural affairs, land reform and islands.
I remind members that we are tight for time throughout the afternoon. A number of members want to ask supplementary questions, so answers will need to be as brief as possible.
Inheritance Tax (Farmers)
To ask the Scottish Government whether it will provide an update on how it is challenging the United Kingdom Government’s proposed inheritance tax changes for farmers. (S6O-04608)
Disappointingly, the Scottish Government was not consulted on or notified of the UK Government’s changes to agricultural property relief and business property relief. The changes will hit family businesses across Scotland hard. We are now working constructively with the UK Government on ensuring that Scottish tenant farmers remain exempt from inheritance tax.
The Scottish Government must be engaged in any reserved tax changes that will impact Scotland in the future. It remains our position that inheritance tax powers should be devolved to the Scottish Parliament, as that would ensure that the tax could be suitably tailored to Scotland’s needs.
Farmers in Scotland could face devastating consequences as a result of the UK Government’s proposed inheritance tax changes. As Labour has let farmers down, farmers will now be turning to the Scottish Government for its support, but the last budget saw a real-terms cut for rural affairs, and yesterday’s programme for government will have given Scotland’s farmers little confidence or certainty. What new action can the Scottish Government take to support our farming sector?
The member talks about what the Scottish Government has done. It has given absolute certainty to the farming community that we are delivering a programme for government that delivers for Scottish farmers. We will be investing more than £660 million per year in Scottish agriculture; we have ensured that there will be direct payments; and we are working with the sector—and across all sectors—to work out how we can reduce emissions while delivering payments to allow our farmers to continue producing food.
Fishing Licence Authorisation (National Marine Plan Consideration)
To ask the Scottish Government, when authorising fishing licences, what process it follows to comply with any legal duty under section 15 of the Marine (Scotland) Act 2010, and the judgment in the Open Seas Trust v the Scottish Ministers case, to act in accordance with the national marine plan. (S6O-04609)
Following the outcome of the judicial review proceedings, the Scottish Government has put in place new arrangements in relation to fishing licence authorisation decisions to ensure that the national marine plan is taken into account, as is required by section 15 of the Marine (Scotland) Act 2010. Marine directorate officials have developed training and tools for decision makers to support that process.
Scottish ministers have already lost two court cases on this matter, in July 2023 and April 2024. It is nearly two years since that first case, and my understanding is that the Open Seas Trust has alleged that Scottish ministers have continued to issue licences unlawfully and did not consider the national marine plan when they made those authorisations. Indeed, that has happened as recently as January. Will the minister commit to publishing in detail the new arrangements that he refers to—the detail of which, I understand, has not been made public—and to ensuring that the Government starts following the legal duties of the 2010 act and that authorisations do not allow significant harm to happen to priority marine habitats?
Following the judicial review outcome, the Open Seas Trust and the marine directorate have been in regular correspondence on the processes that have been adopted to comply with section 15 of the 2010 act and the specific information relating to individual licence transfers. The directorate continues to consider and respond to those information requests in line with our obligations, including in relation to data protection.
We have introduced processes to ensure that fisheries licensing decisions are carried out in line with the court’s ruling. As part of those processes, we have developed an assessment template to support the consideration of the relevant policies in the national marine plan, and I will ask my officials to write to Mr Harvie to confirm that.
Horticulture
To ask the Scottish Government what action it is taking to promote horticulture. (S6O-04610)
The Scottish Government greatly values the horticultural sector’s important contributions to the Scottish economy, society and the environment, providing plants and trees for gardens and green spaces and producing high-quality fruit and vegetables.
I have engaged extensively across the horticultural sector to address challenges. Examples of action that we have taken to promote horticulture include our small producers pilot fund, support for grow-your-own initiatives and the berry festival, which will be launched at this year’s Royal Highland Show. I am pleased that the fruit and veg aid scheme will continue to support producer organisations in Scotland operating in the edible horticultural sector from 2026.
The horticultural sector has the potential to play an even more significant role in Scotland’s economic life and wellbeing, but to do so, horticulture needs a champion in Government, given its cross-portfolio impacts in areas such as the economy, tourism, health, education, environment and biosecurity. Will the minister commit today to being horticulture’s champion across Government, and will he outline what further action the Government will take to promote the success of the horticultural sector in Scotland?
I would be absolutely delighted to commit to being the champion for horticulture. I recognise the significant role that the sector plays in the Scottish Government’s policy priorities; indeed, I recently wrote to ministerial colleagues to highlight cross-portfolio interests, and I will soon facilitate a meeting to pursue integration of environmental and therapeutic horticulture into cross-Government strategies.
I very much welcome the Horticultural Trades Association’s regular engagement, which has highlighted opportunities for us to work with the sector towards shared goals across a wide range of policy areas, and I look forward to updating ministers and sector representatives on my continuing work to promote the success of horticulture in Scotland.
I also recognise the work of colleagues in advocating for the sector, particularly Annabelle Ewing, Christine Grahame and even my old friend Rachael Hamilton, and the work that they do on the cross-party group.
On that note, I call Rachel Hamilton.
I thank my friend for the compliment.
In the light of the news that we have heard today about the Redhall walled garden in Edinburgh, which is at risk of closure due to Government cuts, I would just note that when Jim Fairlie kindly visited the CPG, he said that he would work with the health minister to ensure that a preventative agenda and working with horticulture to promote wellbeing were high on his agenda. What has the minister done in relation to those conversations?
As I have just said, I have written to all ministers. Given the time constraints, I will write to Rachael Hamilton with all the details on the points that she raises.
I am sorry, but I know nothing of the details of the walled garden issue. If the member wants to give me those details, I will follow up the issue.
Food Security
To ask the Scottish Government when it last engaged with the United Kingdom Government on the subject of food security. (S6O-04611)
The Scottish Government takes every opportunity to engage with the UK Government, and we continue to make representations to the Government on a range of issues, such as food security. The formal mechanism is the interministerial group for environment, food and rural affairs, which last met on 27 January. There are also regular meetings at official level to discuss food security. We were deeply disappointed that the March IMG was cancelled, because the Secretary of State for Environment, Food and Rural Affairs was unable to attend, so we have urged the UK Government to prioritise those important meetings.
Was there any indication at the previous meeting attended by the UK Parliamentary Under-Secretary of State for Scotland that Labour cares about, or even understands, the needs of our agricultural industries in Scotland? Labour is threatening family farms with its agricultural property relief changes, it has Barnettised agricultural support funding and it does not seem to be in any hurry to take steps to undo the harms of Brexit.
The Scottish Government is absolutely committed to working with and supporting our agricultural sector. As part of that, we engage with counterparts in the UK Government, as I did last week, to ensure that we are doing all that we can to support our farmers, crofters and landowners. Although I was encouraged that the Parliamentary Under-Secretary of State for Scotland wanted to hear from Scottish agricultural stakeholders last week, I was very clear about pressing our position on a variety of issues, including the APR changes, and I will continue to do so in the future.
We have a couple of supplementary questions.
When discussing food security with the UK Government, did the Scottish Government share its proposals for the human rights bill, specifically in relation to how it would implement a right to food? If so, were those proposals within the competence of this Parliament, and what response was received?
The round-table meeting was the work of the UK Government, and it was more interested in hearing from the sector itself, which I was glad about. The issues raised will be taken up jointly with the UK Government, and the Under-Secretary of State for Scotland and I will be liaising on them.
Changes in land use have worrying consequences for food security, with projections showing that nearly 20 per cent of farmland in England could be removed from food production in order to meet green targets. In April, the minister, in replying to a question from Tess White, said that no assessment had been made at a national level of the impact of the loss of land from energy infrastructure developments, where responsibilities cross the UK and Scottish Governments. Given the importance of food security, will the minister now commit to conducting a study, as has been done in the UK, of the potential impacts in Scotland of loss of land for alternative uses, and its potential impact on Scottish food security?
The Scottish Government has been clear that protecting our food security and resilience is a key priority for Scotland, and we continue to do that through a range of measures.
Quota Management Groups
To ask the Scottish Government whether it will provide an update on the introduction of quota management groups and whether they would benefit fishers and coastal communities. (S6O-04612)
The “Evaluation of the Quota Management Group (QMG) Trial” report was published on 7 April 2025. The report explores the suitability of quota management groups as a means of managing Scottish sea fish quotas, and recommends that the quota management groups are formalised by the Scottish Government. The Scottish Government will consider the report and the next steps in relation to the trial.
I thank the minister for the update. In 2020, the Scottish Government initiated a quota management groups trial. What does the evaluation of that trial demonstrate, how has any learning from the trial been carried forward and how does the Scottish Government envisage that QMGs might maximise the contribution that fisheries make to Scotland?
The evaluation found that the trial had achieved its aims, and that QMGs are a viable alternative to producer organisations and had improved the information available to the Scottish Government. It recommended that QMGs be formalised.
The Scottish Government is considering its next steps following the report; however, the trial has given us a greater understanding of the operation of the quota management system, and in particular how the fish quota is utilised by sectoral groups.
Together with some local creel fishermen, I have been increasingly concerned about the number of creels that are being used off the Fife coast. One company has claimed to own 18,000 creels, and that is causing great concern about the size of the catch and the healthiness of the stock.
When the minister is considering the quota management groups and inshore fisheries measures, will he consider limiting the number of creels that are used?
I am not aware of the specific case that Willie Rennie brings to the chamber, but I am more than happy to respond to him in writing. If he wants to write to us, we will take that up for him.
Farm Incomes
To ask the Scottish Government what its response is to figures showing that farm incomes are at a five-year low. (S6O-04613)
We know that farmers very much appreciate the Scottish Government’s commitment to maintaining direct payments as we transition from the common agricultural policy, recognising the stability that that gives to the sector. That is in stark contrast to the current and previous United Kingdom Governments. We note the results of the Scottish farm business income report, which demonstrates the volatility of the sector, thereby reinforcing that our approach is the correct one. That is why we continue to provide the most generous package of support in the UK, investing around £660 million in agriculture support, and why, this year, we introduced the future farming investment scheme, providing £14 million to invest in business efficiencies to benefit nature and climate.
I thank the minister for his response—perhaps he can tell us when that financial support plan will actually be published, because we are still waiting for it.
I also want to raise an issue that was raised with me last night at the NFU Scotland parliamentary reception, which I know that the minister attended. Farmers are concerned about the issue of public procurement and the need to have healthy, home-grown, locally produced food on the menu in schools and hospitals. What more is the Scottish Government going to do to make that happen?
Murdo Fraser raises a very good point. As a result of the Good Food Nation (Scotland) Act 2022, good food nation plans are now in the process of being created, and I very much hope that local authorities will take those plans and work with local communities on aspects such as purchasing local food, including venison—as we know, there is a deer management issue in Scotland right now. If we can get all those people together and talking about how we can make that work, that would be very positive, and it is something that we should be doing.
Now that the dust has settled on Murdo Fraser’s party being roundly booted out of Government, how would the minister assess what the Tories did for farmers while they were in Government? How did that impact farm incomes, and how does the truth of the matter stack up against the Tories’ pretence to be the champions of agriculture and rural Scotland?
There is absolutely no doubt that the Westminster Tory Government caused significant difficulties for Scotland’s agricultural sector. The harms from Brexit are deep and long lasting, in particular the creation of issues of cost and trade barriers for those who are involved in exporting and issues in attracting labour.
What the Tories started, Labour is continuing. Energy costs for businesses that are 50 per cent higher than in the European Union make everything more expensive for farmers, especially their supply chain. The uncertainty and failure to stick with any decisions on future payments will not have helped, even though, thankfully, we make those decisions in Scotland. For the avoidance of doubt, the Scottish National Party Government promised to maintain direct payments, and we have. We promised certainty and stability, which we have delivered. We promised to work with the industry to co-develop our new support framework, which is what we are doing.
The minister was asked about the level of farm incomes, but what about the distribution of farm incomes? When will the Scottish Government start to publish information about the end ownership and control of the recipients of farm support? Recipients and beneficiaries of public money should be a matter of public record. The minister must surely know that that was legislated for last year by the Parliament. When will that finally be enacted by the Government?
The distribution of farm support is a complex issue, because there are data protection issues. However, the distribution of £660 million into the rural economy will ensure that it has a bright future.
Anaerobic Digestion Facilities
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding whether anaerobic digestion facilities can support the decarbonisation of the agricultural sector by providing low-carbon fertiliser and the creation of biogas. (S6O-04614)
Although I have not had specific discussions on this issue, our draft bioenergy policy statement recognises anaerobic digestion’s potential to support decarbonisation across hard-to-decarbonise sectors, including agriculture, and to contribute to a more circular economy. The Scottish Government is supportive of farmers and crofters wishing to reduce their energy costs and emissions through small farm-scale renewables and energy efficiency measures. We also recognise the value of processing farming and other organic waste through anaerobic digestion and the important contribution that that makes to Scotland’s renewable and bioenergy ambitions and to reducing our emissions.
With 48 per cent of Scotland’s dairy herd in the south-west of Scotland, there is potential to harness anaerobic digestion and biogas production to not only cut greenhouse gas emissions but to provide a source of off-grid energy for rural areas, which have disproportionately higher numbers of households that are in fuel poverty. Meanwhile, 39 per cent of homes in Dumfries and Galloway are not connected to the main gas grid. What role does the Scottish Government envisage anaerobic digestion and biogas playing, and what sources of information and advice exist for farmers who might be looking to adopt that innovative technology on their farms?
We recognise the benefit and value of small farm-scale renewable production, and that farmers may wish to take advantage of it to decarbonise their operations and reduce costs. Renewable energy production, including from anaerobic digestion, could also help farmers to increase their energy security. Biomethane production is supported by the United Kingdom Government’s green gas support scheme, which provides tariff support for biomethane that is produced via anaerobic digestion and is injected into the gas grid. Producers will receive tariff payments for a 15-year lifetime. It is funded by the green gas levy and licensed on Great Britain’s gas suppliers.
Scotland’s Farm Advisory Service also provides support in areas such as renewable energy, reducing energy bills on farms, energy use and fuel management, energy improvements and future energy solutions. Farmers are small and medium-sized enterprises and should be able to benefit from using Business Energy Scotland’s one-to-one advice services and funding. I encourage farmers to contact Business Energy Scotland to discuss any plans as early as possible.
Given the continued vacuum in any policies that the Government has introduced, can the minister give an indication of when secondary legislation will be lodged to deliver some of the policies for farmers to undertake the just transition?
There is no vacuum. There is a route map, which the member is well aware of, because he sits on the committee that deals with the legislation that will be required in order for us to complete the route map.
“Climate change action: policy package” (Land Use and Agriculture Measures)
To ask the Scottish Government what progress it has made on implementing the land use and agriculture measures set out in its “Climate change action: policy package”, published in April 2024. (S6O-04615)
We published the first update on the policy package in March. Two policies are complete. The First Minister announced the funding split for future agricultural support in February, and the whole farm plan was introduced this year.
We continue to make progress on developing options for a methane-suppressing feed products pilot; work is on-going to transition the regional land use partnerships to a formal initiative and to deliver small pilot schemes on deer management; and research is being commissioned to understand the potential for the partial rewetting of peatland.
The minister will be aware of the impact of agriculture on policies to promote healthy eating. People in Glasgow and Rutherglen face daily food insecurity, yet there is nothing in yesterday’s programme for government to address the issues in the food supply chain that leave parts of Glasgow as fresh food deserts. Will the minister back Labour’s call to enshrine in law the right to food and ensure that everyone, no matter where they live, can access affordable, healthy food?
The Scottish Government absolutely supports the production of food—and good-quality food—across the country. As I said, we have the small producers pilot fund, and there are various other initiatives. We work with Trellis and various other organisations to ensure that good food is available right across the country.
Will the minister set out the extent to which, under Labour, the Barnettisation of agricultural funding has impacted on the progress of those initiatives?
As I have said before, we are absolutely committed to continuing to work closely with the industry to develop new support and to improve the sustainability of farming and food production in Scotland. However, the United Kingdom Government’s decisions can have a significant impact on the devolved responsibilities of the Scottish Government, whether through the clumsy imposition of the inheritance tax changes or the wholly inappropriate Barnettisation of future agricultural budgets. I therefore continue to call on the UK Government to engage in meaningful dialogue with the Scottish Government and the other devolved nations to ensure that funding settlements reflect the real potential for Scotland’s land to deliver for food production, nature and climate.
That concludes portfolio questions on rural affairs, land reform and islands. There will be a brief pause before we move to the next portfolio, to allow members on the front benches to change over.
Health and Social Care
The next portfolio questions are on health and social care. I remind members that questions 2 and 5 have been grouped together, so I will take supplementary questions on those after the substantive questions have been asked. There is a lot of demand for supplementary questions, so I ask for brevity in questions and answers.
Brain Tumours (Outcomes)
To ask the Scottish Government how it is working to improve outcomes for people with brain tumours. (S6O-04616)
Through our 10-year cancer strategy and action plan, there is a key focus on improving outcomes for less survivable cancers, including brain tumours. Actions include the Get Checked Early and NHS Inform websites highlighting possible symptoms of brain tumours and encouraging early detection and referral; the Scottish referral guidelines for suspected cancer providing updated clinical guidance for the urgent referral of suspected brain tumours; a new national headache pathway, which lists the symptoms that require urgent or emergency assessment to exclude a brain tumour; and a clinical management pathway for adult brain tumours, supporting consistency in access to treatment and care.
During the recent wear a hat day event in the Parliament, I met two of my constituents, Don and Rachel McKie, who, sadly, lost their son to a glioblastoma in 2006. Since that time, they have raised more than £50,000 for the Brain Tumour Charity. They are such an inspiring family.
Less survivable cancers such as brain tumours can be difficult to diagnose, as, often, they present as non-specific conditions. What more can be done to raise awareness? Are there any plans to commit further investment to fund the essential research that is required?
First, I thank Marie McNair for her advocacy and her campaigning work in bringing the wear a hat day event to the Parliament. I pass on my deepest condolences and sympathies to her constituents, Mr and Mrs McKie, for their loss. I also thank them for their campaigning and fundraising over the years. Awareness raising and lived experience are absolutely critical in getting to the point of being able to detect less survivable cancers such as brain tumours early, so I thank them for that.
Alongside what I have set out around the less survivable cancers task force, of which the Brain Tumour Charity is a member, and developing practical and impactful actions to raise awareness and support increased detection of those cancers, we have also invested in our Get Checked Early website, which has content on brain cancer to highlight symptoms and advises when to seek professional advice.
Ms McNair will be interested in the work that has been done by the incredible rapid cancer diagnostic services, which have been expanded to NHS Forth Valley this week, providing primary care with access to a new fast-track diagnostic pathway for people with non-specific symptoms of suspected cancer, such as brain tumours.
There are a couple of supplementary questions. They will need to be brief, as will the responses.
The analysis of proton versus photon radiotherapy in oligodendroglioma and assessment of cognitive health—APPROACH—trial is currently exploring whether proton beam therapy can improve cognitive outcomes for people with primary brain tumours in England and Wales. However, Scottish patients are unable to participate due to lack of funding to cover excess treatment costs.
What consideration has the Scottish Government given to support patients during the APPROACH trial to ensure that no one misses out on cutting-edge treatment?
I thank Foysol Choudhury for raising an important issue. He will understand the importance of research and innovation in relation to treatments, to understand and prove their efficacy. Under the leadership of our chief scientific officer, Professor Dame Anna Dominiczak, we are looking to capture as many clinical trials in Scotland as possible so that we get the clinical benefits for our patients here, as well as the continued investment in research and development and the skilled jobs that come alongside that.
We will continue to explore that, and I would be happy to follow up with Foysol Choudhury if he wishes to raise any specific examples.
Patients often report varying and non-specific symptoms that push them to go and see a general practitioner, and then it turns out that they might have a brain tumour. What actions can the Scottish Government take to ensure that GPs are best trained to be able to spot brain tumour symptoms from the very first appointment?
I thank Beatrice Wishart for raising that important point. We need to continue to work with our primary care teams, because she is right that general practice is fundamentally important in that respect, as is the wider interaction with the primary care environment.
I point Beatrice Wishart to the expansion of the rapid cancer diagnostic services, which are providing primary care with the agency to make referrals into secondary care diagnostics and treatment. That will answer her question about ensuring that pathways are available for non-specific symptoms and that people can access those services.
Attention Deficit Hyperactivity Disorder Assessments (Waiting Times)
To ask the Scottish Government what support is currently available for those experiencing long waiting times for an ADHD assessment. (S6O-04617)
This year, we are providing funding of £123.5 million to national health service boards to support improvements across mental health services, including neurodevelopmental services. I expect each board to have arrangements in place to ensure that people who are waiting for an ADHD assessment are signposted to appropriate support.
Since 2020, local authorities have received more than £65 million to deliver community mental health and wellbeing support and services for children, young people and families, and £16 million a year to ensure that every secondary school has access to school counselling services.
Our £1 million autism support fund for adults funds organisations that support people with ADHD, especially where it co-occurs with autism.
I thank the minister for her answer, especially in relation to signposting patients.
In Lanarkshire, in recent years, the number of ADHD referrals has equalled those of all other mental health conditions combined. Given that volume, NHS Lanarkshire is developing a new care model. Will the minister provide an expected timeline for when the new ADHD service pathway will be available?
Clare Adamson will understand that ADHD is not a mental illness; it is a form of neurodivergence. However, I absolutely recognise that mental health conditions often co-occur with ADHD.
Long waits for neurodevelopmental support are unacceptable. Health boards and service partners have to work together to ensure that children and their families, as well as adults, receive support and access to services that meet their needs at the earliest opportunity.
My officials are liaising with NHS boards across Scotland, including in Lanarkshire, to understand what provision they have in place, and they are exploring how to address the current issues. In addition, we fund the national autism implementation team, which is currently supporting NHS boards to develop, enhance and redesign existing local neurodevelopmental services. I would be happy to meet Clare Adamson at a later date to update her on the work that is happening in Lanarkshire.
Child Attention Deficit Hyperactivity Disorder Assessments
To ask the Scottish Government what pathways are available to obtain a child ADHD assessment for those who do not have a co-existing mental health disorder that meets the child and adolescent mental health services mental health criteria and who cannot afford a private assessment. (S6O-04620)
As I have tried hard to help members to understand, CAMHS is not the correct service for children who are seeking a diagnosis for neurodevelopmental conditions such as ADHD, unless they have a co-existing mental health condition. For many young people, a neurodevelopmental pathway will ensure that the right help and support is provided.
The design and management of neurodevelopmental diagnostic services is for individual health boards to determine. Each will have their own arrangements and crucial links to education authorities. Demand has increased markedly, but I expect services to be designed to ensure that children receive the right support for their needs as quickly as possible.
I accept the importance of a route to support neurodivergent young people in school that is not dependent on a diagnosis. However, will the minister accept that there are young people who urgently need a diagnosis? I raise the case of Archie from Kinross, whose parents have been knocked back three times by NHS Tayside for a CAMHS referral. They have spent thousands of pounds on a private assessment, and he now has a diagnosis of autism spectrum disorder. Archie’s medical professionals believe that he would benefit from trial medication that would come with an ADHD diagnosis, but he would have to wait 10 years to receive a diagnosis in Tayside and he would probably be an adult before getting through the waiting list.
Will the minister acknowledge that there is a need for an urgent diagnostic pathway, particularly to support young people such as Archie and the thousands of people across Scotland who do not have a route to getting a diagnosis?
It is not acceptable for there to be no route to diagnosis at all. While people are waiting for a diagnosis, they should be signposted to sources of support. The education system should be able to meet their needs, regardless of whether there is a diagnosis. Some individuals who are referred will not meet the diagnostic threshold, but that does not necessarily mean that they will not have support needs; they might have support needs without meeting the diagnostic threshold. It is important that we consider how to develop a sustainable service of diagnosis and support and where it should sit, which is possibly outside CAMHS. I would be happy to meet Mark Ruskell outside the chamber to discuss that more fully.
The reality is that, outwith CAMHS, diagnosis has become a private-only service. That is what has happened to a seven-year-old constituent in my region of Glasgow. Is the Government content that the only route for people to get ADHD support just now is through private healthcare?
Not at all. As Mr Ruskell indicated, some people are waiting for medication for ADHD support. The challenge with ADHD is that there is a global shortage of medication because of the rise in the number of people who are seeking a diagnosis. That issue is not unique to Scotland. There are challenges with providing a sustainable route to diagnosis and support in Scotland, and there are challenges with triaging and starting people on medication. Due to the global shortage of medication, many services in Scotland are focusing on maintaining medication for those who are already established on medication, rather than on initiating new patients. Again, I would be more than happy to pick up that conversation outside the chamber.
I require briefer contributions, particularly from the ministerial team.
Breast Reconstruction Surgery (Access and Waiting Times)
To ask the Scottish Government whether it will provide an update on progress made to improve access to and reduce waiting times for breast reconstruction surgery following cancer treatment. (S6O-04618)
Last year, we provided funding to several health boards to deliver reductions to plastic-breast backlogs. Through our £100 million investment to address long waits this year, we have extended that level of funding to NHS Greater Glasgow and Clyde and NHS Grampian, and it will be provided on a recurring basis to ensure longer-term service sustainability.
Through engagement with health boards, we have improved our understanding of the existing consultant workforce that is qualified to deliver those complex procedures and are engaging with NHS Education for Scotland to assess training capacity in that area to improve waiting times for that crucial procedure.
I declare an interest as a practising national health service general practitioner.
In the chamber last year, I raised the case of my constituent Shareen. Shareen is waiting for breast reconstruction surgery following cancer treatment and was told that she would be on the waiting list for years. The Cabinet Secretary for Health and Social Care assured me that the Scottish Government was working with health boards to maximise capacity and reduce waiting times. Six months later, patients in Glasgow are being told that waiting times are longer than the 104 weeks that was advised last year. The reality is that patients are facing a wait of a further three to five years.
Those are not just numbers—they represent years of uncertainty, distress and delayed recovery. For women, breast reconstruction is not a luxury. It is not simply cosmetic surgery, as the cabinet secretary said last year. It is, in fact, a vital part of healing from cancer. Where is the real plan to cut the shocking waiting times and give women the timely, life-changing treatment that they deserve?
I also need briefer questions.
I absolutely understand and sympathise with the position that Mrs Gault is in. I thank Sandesh Gulhane for raising the issue again.
I will need to check the Official Report. I do not remember describing this as cosmetic surgery, but as reconstructive surgery, which it is. It is a complex procedure that requires specialist provision.
The £30 million intervention that we brought forward last year allowed for the employment of further consultants in the field. I hope that the additional investment that we are bringing forward this year will not just provide sustainability but deliver against the waiting times that we want to see and give confidence to patients such as Mrs Gault that we will get through those. Dr Gulhane is absolutely right to say that it is imperative that we do so for those women, and that is what we intend to do.
National Health Service Productivity
To ask the Scottish Government what steps are being taken to reverse the decline in NHS productivity since the Covid-19 pandemic, as referenced in research by the Institute for Fiscal Studies. (S6O-04619)
In March, we published the “NHS Scotland operational improvement plan”, which details how we will deliver a more accessible NHS, with reductions to long waits and service pressures.
Productivity will be increased through a number of measures that are set out in the plan, including regional delivery models and maximising our national treatment centres, deploying digital technologies such as the roll-out of the new digital dermatology pathway and a national theatre scheduling tool, and collaborating with health boards to identify and implement best practice, to maximise and optimise efficiencies. That is supported through a record £21.7 billion investment, including £200 million to directly target long waits and improve flow through hospitals.
I welcome progress on increasing the number of surgical procedures by 50 per cent this year, as indicated in the programme for government.
Despite record numbers of NHS doctors, nurses, support staff and investment, many of our constituents are enduring lengthy waits for treatment. Will the cabinet secretary detail which health boards are showing the greatest signs of improvement and how that is being shared across the NHS to help to drive recovery?
Mr Gibson is absolutely right that sharing best practice across the health service is critical to ensuring that we can deliver for the people of Scotland. The centre for sustainable delivery has a central role in working across NHS Scotland to drive that productivity and share best practice. That intensive and on-going cycle of work is carried out in close collaboration with health boards.
As well as the actions in the operational improvement plan that are being taken forward, that is reflected across health boards’ year-on-year delivery plans. We know that there is still some way for us to go, but we are seeing clear improvements. In 2020-24, nationally, in-patient and day-case activity was more than 7.4 per cent more than in 2023, and new out-patient activity was 2.4 per cent higher. We will build on that in the year ahead.
Accident and emergency waits are improving, and the number of people stuck in hospital unnecessarily is reducing. Waiting times are coming down. That is progress, and it is just the start of the progress that I want to deliver for Mr Gibson’s constituents and for the people of Scotland, who cherish our NHS.
When we talk about productivity, we actually mean helping our healthcare professionals to have more time to deliver effective healthcare. Technology is the obvious solution, particularly when the whole of the health service is currently plagued by systems that do not talk to one another and by paper records, with pharmacists unable to reliably check basic medical details about patients. Does the cabinet secretary agree that creating a single shared patient record and a universal digital platform for healthcare is absolutely key to improving productivity?
Yes.
General Practitioner Funding
To ask the Scottish Government what its response is to the reported intimation from the British Medical Association that it is considering a formal dispute with it over GP underfunding. (S6O-04621)
The Government has been listening carefully to the views of Scotland’s GPs, who have described the multiple contributions that general practice can make as we shift to more community-focused care and have argued that GPs must be given the resources that they need to fulfil their role. We have listened and we have been persuaded.
As a result, we are already committed to increasing investment in primary and community care, so that GPs and services in the community will have the resources that they need to carry out their essential role in our health system. That was evident from the budget and from the programme for government announcement yesterday. We will keep talking to the BMA, with which I have a very constructive and positive relationship—yes, there are challenges, but there is also an agreed sense of purpose in terms of the opportunities that there are for general practice to contribute.
It seems that yesterday’s programme for government announcement did not impress the British Medical Association, because it is pretty angry today. It thinks that there is more rhetoric than reality and that what was announced yesterday will “do very little” and is a “drop in the ocean”. The reality is that the share of the overall health budget for general practitioners has fallen every single year in real terms since 2008. That has a direct impact on the staff that GPs employ and the way that they can meet demand. What new actions will the minister take to fend off the formal dispute that is coming down the tracks?
First and foremost, we will continue talking to the BMA. On the announcement on the programme for government, the 100,000 new appointments are to help general practice to deliver what it does best, which is to prevent ill health. Cardiovascular disease is evidently an issue for us in Scotland, and we have worked with the BMA to deliver on that, for which I am grateful to it.
That basis of constructive dialogue and of finding ways in which we can support general practice is the way in which I will deal with the discussions with the BMA. Yes, we need more resource going in and, yes, we need to provide GPs with greater support, because they are the absolute fulcrum of our NHS.
Women’s Health Outcomes
To ask the Scottish Government whether it will provide an update on the work that it is doing to improve women’s health outcomes. (S6O-04622)
The Government’s 2021 women’s health plan marked the start of an important journey to improve health outcomes for women and girls in Scotland. In November last year, we published a report setting out the progress that was made in the first three years. Our ambition is that women and girls enjoy the best possible health throughout their lives. That continues to be our guiding principle as we work on the next phase of the plan, which is set to be published this year.
Recent freedom of information requests from Scottish Labour to health boards have revealed just how bad things are for women on the ground. Thousands are stuck on waiting lists for treatment for gynaecological conditions. Waiting times have dramatically increased, despite Scottish Government manifesto commitments to improve women’s health. A survey found that 90 per cent of women have concerns about accessing comprehensive health screening. Women are feeling very much left behind.
Nothing in the programme for government will improve outcomes for women in the here and now, and progress on women’s health has already been slow. Does the Government intend to deliver on its commitment to improve waiting times for women? When will women start to see a difference on the ground?
Timely access to gynaecology services will be a priority as we develop the next phase of the women’s health plan. In 2024-25, we allocated £450,000 to gynaecology from our £30 million targeted investment in planned care, aiming to deliver 3,500 new out-patient appointments. In actual fact, we realigned that commitment in year and spent £630,000. That included day-case and in-patient care—more than was planned for. That shows the priority and commitment that we are determined to deliver.
The 2025-26 budget will provide £21 billion for health and social care, including a commitment to spend £200 million to reduce waiting times. To improve capacity, we will deliver more than 150,000 extra appointments and procedures in the coming year, which will ensure that people receive the care that they need as quickly as possible. Gynaecology will continue to be a priority area for that funding.
Can the minister outline how the Scottish Government has increased funding for gynaecology services, which has helped to drive down waiting times in women’s health?
As a result of last year’s additional investment of £30 million to address the longest waits, health boards exceeded the commitment to deliver 64,000 appointments and procedures in 2024-25. As of March 2025, health boards are reporting delivery of 105,500 appointments and procedures. For gynaecology, boards have reported a final position of just under 3,500 extra appointments and procedures delivered, which is due to an investment of £630,000.
We will continue to build on that momentum. As I mentioned in my answer to the previous question, the funding that we are putting in—the £200 million to address waiting list backlogs and improve capacity—will be targeted at key priority areas such as gynaecology.
Prostate Cancer Treatment Gap
To ask the Scottish Government what action it is taking to improve performance and close any treatment gap for prostate cancer, in light of reports that a lower proportion of patients in Scotland are treated within the 62-day target, at 49 per cent, compared with higher rates reported in England. (S6O-04623)
Although cancer waiting times reporting across United Kingdom nations are not directly comparable, we note that prostate cancer five-year survival rates in Scotland are similar to those observed in England.
The earlier prostate cancer is diagnosed, the easier it is to treat, which is why we continue to invest in our detect cancer earlier programme. Additionally, the Scottish Government continues to invest in cancer services and in improving waiting times. Over the past five years, we have invested more than £40 million, which has been focused on urological cancers, including prostate cancer, and colorectal and breast cancers. In 2024-25, £11.3 million was provided to boards.
Yesterday, the First Minister said in his statement:
“More cancer patients are now treated faster. Compared with a decade ago, 16 per cent more patients receive care within the 31-day standard and 11 per cent more within the 62-day standard.”—[Official Report, 6 May 2025; c 11.]
However, the reality is that prostate cancer outcomes in Scotland have fallen significantly behind those in England. Cancer staging is the same on both sides of the border. Despite national health service spending being higher per person in Scotland, more than one in three men are diagnosed at stage 4, which compares with only one in eight in London. That gap is staggering and unacceptable.
Can the cabinet secretary tell us when men in Scotland can expect the same chances of early diagnosis, which helps to save lives, as those who live elsewhere in the UK?
The figures that the First Minister provided to the Parliament yesterday, which Sue Webber reflected on, are accurate. Although the 62-day target has been more difficult for us to meet, we have been treating more patients within that timeframe than at any time since pre-Covid. That serves to illustrate the additional demand that there is on services.
We have continued to prioritise prostate cancer. I again pay tribute to Sir Chris Hoy for his campaigning and awareness-raising work. In that regard, I have written to the UK National Screening Committee, which we take a lead from in our screening programmes, in order to ensure that we have the right processes and policies in place to meet the demands that Sue Webber is asking us to address.
It is vital that we detect cancer early to ensure the best chance of survival for the affected patients. What steps is the NHS taking, supported by the Scottish Government, to improve prostate cancer pathways?
In 2024-25, £11.3 million in cancer waiting times funding was made available across Scotland. Most of that funding is being directed to tackling urological cancers, such as prostate cancer, as well as colorectal and breast cancers. We are establishing a network of urology diagnostic hubs across NHS Scotland—seven have already been established—in order to provide efficient, patient-centred care for urology patients. A clinical review of the Scottish referral guidelines for suspected cancer, including prostate cancer, is under way to help to ensure that the right person is on the right pathway at the right time. Those guidelines are due to be published in the spring.
That concludes portfolio questions on health and social care. There will be a brief pause before we move to the next item of business, to allow members on the front benches to change.