Meeting of the Parliament

Meeting date: Thursday, October 7, 2010

Official Report 1082KB pdf

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Scottish Executive Question Time

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General Questions

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National Dementia Strategy

1. To ask the Scottish Executive what steps it is taking to ensure that the national dementia strategy’s aim of strengthening the integration of health and social care services is met. (S3O-11654)

Strengthening the integration of health and social care responses to dementia is a central aim of the national dementia strategy. The strategy said that we would provide national support and funding to a local national health service board and local authority partnership to demonstrate the value of a whole-system approach. Because of the high level of interest and the quality of applications, we have now decided to support three partnerships—in North Lanarkshire, Midlothian, and Perth and Kinross. That complements activity in implementing national standards in dementia care pathways and work to use outcomes data locally to measure and compare the impact of dementia services.

At a recent briefing meeting with NHS Lothian, local MSPs heard of progress on the strategy. The strategy sets targets for NHS boards to deliver agreed improvements in early diagnosis and service response by March 2011. Will the cabinet secretary say whether similar targets have been set for local authorities with regard to social care services and, if so, whether similar progress has been made?

Let me say first that I appreciate the tenor of the member’s question, and I hope that she has no doubt about the importance that the Government attaches to the work. The national dementia strategy is the first ever dementia strategy in Scotland.

The member will be aware of the different performance arrangements that we have with health boards and local authorities. For health boards, I set what are known as HEAT—health improvement, efficiency, access and treatment—targets. For local authorities, we have the concordat outcomes-based approach. However, the work that we have done with local authorities on the strategy and its implementation leaves me in no doubt that there is a commitment across local authorities to ensure that they play their full part.

Is the minister aware of the serious human rights issue in the inappropriate prescribing of antipsychotic drugs to older people with dementia in care homes and hospitals? What steps is she taking to tackle that serious and sadly all-too-common practice?

I am aware of the issue and of Rhona Brankin’s long-standing interest in it. We have had exchanges in the chamber on the issue, and I know that she has also had exchanges, and perhaps correspondence, with the Minister for Public Health and Sport. The issue is complex, as I know the member appreciates. Rather than try to summarise it, I am more than happy to write to her, and meet her if she would find that helpful, to go into some of the issues and explain the steps that the Government is taking.

Does the cabinet secretary recognise the value of the voluntary sector in dealing with dementia cases? For example, East Kilbride dementia carers group has come to an arrangement with South Lanarkshire Council on the use of direct payments so that care is personalised on the choice of the dementia sufferers and their family on what is best for their wellbeing. Is that something that she would encourage other local authorities to investigate?

Yes, I recognise and greatly appreciate the role and contribution of the voluntary sector. East Kilbride dementia carers group is one of many examples of voluntary organisations making a big contribution. I would encourage not just local authorities but health boards and the statutory sector in general to look innovatively at how they can work even more closely with the voluntary sector.

In my experience over the past few years in the job, I have found that the voluntary sector, because it tends to be close to the service users, is often the most innovative, flexible and fleet of foot in finding solutions to difficult problems. I certainly agree with the tenor of Linda Fabiani’s question.

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NHS Highland (Dunbar Hospital)

2. To ask the Scottish Executive what discussions it is having with NHS Highland regarding the future of Dunbar hospital. (S3O-11656)

I have recently written to the member on this important matter and confirmed that I am aware that services at Dunbar hospital are currently being examined as a part of a wider review of services throughout west Caithness by NHS Highland. I have asked the board to keep me informed as the review progresses. The board has been clear that its objective is to ensure that services in the area meet the needs of local people, that they remain of the highest quality and that they continue to offer best value for taxpayers’ investment.

I look forward to receiving the cabinet secretary’s letter.

NHS Highland does not appear to be listening to the people on the ground at all with regard to providing what is best for the area. Local people did not want an office-hours accident and emergency service in Thurso and they did not agree to four beds being removed from the hospital. Will the cabinet secretary look into why the views of local people are not being taken into account and see whether she can bring this to a stop?

I will make two points to Jamie Stone, both of which I hope will be helpful. As members appreciate, we have had debates on this issue frequently and will no doubt have them in the future. Health care is not delivered in a static way. Boards are always seeking to enhance and improve the quality of services that they provide in the community because, generally speaking, people want to be treated as close to home as possible and, as far as is possible, in their own community. That work often has an impact on in-patient services.

The second point is that I expect health boards to engage positively, constructively and meaningfully with local communities when they are contemplating change. I have made that crystal clear to a number of health boards on a number of occasions in relation to a number of issues. I will continue to make that clear to boards, including NHS Highland in this regard.

Does the cabinet secretary recognise the need for respite beds for geriatric patients in this case? Local people are concerned about that issue. Will the projected need for beds at the Dunbar hospital be reduced by modern treatments?

Rob Gibson is making the point that I made in my first answer. I do not want to pre-empt in any way the consultation that is under way with regard to Dunbar hospital and others in the area. As medical technology advances and the modes of delivery of health care progress, more people can be treated in the community, and the pattern of health services that we provide has to adapt over time to reflect that. That does not take away from the fact that I expect local communities to be fully involved in the discussions and decision making around all the decisions, which, on occasion, can be very difficult to make.

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Victims and Witnesses (Support)

3. To ask the Scottish Executive what action it is taking to support victims and witnesses. (S3O-11613)

We are building on our record funding of victim support organisations, introduction of victim statements and extension of the victim notification scheme by reviewing provision for victims in order to further enhance their role within the criminal justice system. Separately, we are also reviewing support for witnesses.

What proportion of the cabinet secretary’s budget is spent on victims?

I do not know the precise proportion, but I can say that we put £4.2 million into Victim Support Scotland in 2010-11. That is a record amount, which was warmly received by the organisation when I hosted and made the opening speech at its international victim support conference earlier this week. I know also that Victim Support Scotland is the envy of many other victim support organisations elsewhere in the world.

Question 4 was withdrawn.

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People Trafficking

5. To ask the Scottish Executive what action it will take to ensure that people traffickers are prosecuted and that their victims are protected and supported. (S3O-11583)

The Crown Office and Procurator Fiscal Service is committed to disrupting human trafficking through the investigation and prosecution of these offences, including confiscation of assets and profits. As I explained to the Equal Opportunities Committee earlier this week, only a small number of offences of human trafficking have been reported to the Crown Office and Procurator Fiscal Service by the police. Of those reported, two cases were unable to proceed due to a lack of sufficient admissible evidence, and the other cases are currently under consideration.

There have been a number of successful prosecutions for criminal offences against a background of people trafficking, such as identity offences, trading in prostitution, managing an immoral house, knowingly permitting premises to be used as a brothel and knowingly living on the earnings of prostitution.

The Crown Office and Procurator Fiscal Service is working with the Scottish Government and other relevant agencies to ensure that the victims of human trafficking are identified as such at an early stage and are provided with the appropriate support and protection at the beginning of the investigative process.

I take this opportunity to thank the Lord Advocate for all the superb work that she has done over the past few years and to say how sorry we are that she is leaving her post.

Will the Lord Advocate confirm that, in the new trafficking guidance, which I believe is to be issued soon, there will be a presumption against prosecuting the victims of trafficking? Can she say why there have been several successful prosecutions of people trafficking in England but none in Scotland? Is there anything that the prosecution service or other public services could do to help to rectify that situation?

I thank Mr Chisholm for his kind remarks. However, I am not going immediately and I hope to be around for some months yet.

On the identification and support of victims, the guidance that we will issue to prosecutors this week will contain a presumption against prosecution where there are credible factors and criteria identifying an individual as a victim of trafficking in the context of these offences. That will be an important part of ensuring that we encourage victims of trafficking to come forward and co-operate with the authorities. As I mentioned on Tuesday, many of the victims have grave suspicion of authorities and might not come from a culture in which co-operation with the police and other authorities is something that they would do. Therefore, we have to overcome barriers that, although they also exist with some victims in other contexts, are considerable in this context. The issue of support is also important.

On the number of prosecutions, only four reports have been made to prosecutors, and we can do no more than consider the cases that come to us. Certainly, there is evidence that an organised crime element is involved in trafficking in Scotland. I think that 3 per cent of those who were identified as being part of a hierarchy of organised crime are involved in human trafficking. There is certainly no complacency, but the reality is that the vast bulk of trafficking activity takes place south of the border, which is why significantly more prosecutions occur down south.

Nonetheless, along with the police and the other relevant agencies, we are alert to the activity that is taking place. The guidance to prosecutors will ensure that they are alert to the need to recognise victims of trafficking not only in the context of trafficking or prostitution but also in the context of crimes such as domestic abuse or crimes that the victims themselves might have committed. Prosecutors should be aware of the criteria and the indicators that people with whom they deal might be victims of trafficking.

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Carers and Young Carers Strategies (Implementation Group)

6. To ask the Scottish Executive what progress has been made on developing the carers and young carers strategies and when the implementation group will be set up. (S3O-11605)

The Scottish Government and the Convention of Scottish Local Authorities jointly published the carers and young carers strategy on 26 July. We have been discussing issues to do with the implementation group with COSLA, which is our partner in the strategy. Invitations to a range of stakeholders to participate in the group will be issued shortly.

I hope that the minister will join me in repudiating the comments about carers that were reputedly made by the Conservative candidate for Clydesdale, Colin McGavigan.

Carers centres across the country fear that they might face substantial cuts in their budgets, many of which have been at a standstill for three, four or five years. However, those centres are critical to the carers support infrastructure and deliver preventive carers support, which prevents crisis situations from arising. What discussions has the minister had with COSLA since the implementation of the strategy, and how will local authorities’ implementation of the strategy be monitored?

In a rare display of Labour-Scottish National Party unity, I join Des McNulty in repudiating the comments that have been attributed to the Conservative candidate. Carers make a tremendous contribution, often above and beyond the call of any duty, and we should all be extremely grateful to them for that.

I recognise the responsibility that the Government has to carers. I also recognise that we have a considerable way to go to fulfil that responsibility. One of the commitments that the Government set, which was reflected in our concordat with local government, was a commitment to increase the amount of respite care that is available to carers. Although there is still work to do, there is considerable and welcome progress towards meeting that commitment.

Discussions with COSLA are on-going. The strategy is a joint publication, which was approved by the COSLA convention prior to formal approval by the relevant committees of COSLA. There are 114 action points in the strategy and there will be considerable challenges in taking all those points forward. That is why it is important that we continue to have close co-operation with our local authority partners.

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School Mergers (Consultation)

7. To ask the Scottish Government what requirements local authorities must meet when consulting on proposed school mergers. (S3O-11618)

When proposing school mergers, local authorities must undertake a consultation, using the updated and robust processes that are set out in the Schools (Consultation) (Scotland) Act 2010.

Is the cabinet secretary aware of plans by South Lanarkshire Council to close and merge a number of rural primary schools in the South of Scotland? Will he confirm that the council is obliged to follow the robust procedures that are set out in the 2010 act, which the Scottish Parliament passed?

Is the cabinet secretary also aware that the council is proposing significant changes to the school day in some secondary schools? What consultations and procedures are councils required to carry out and adhere to on such proposals?

There are statutory requirements in relation to school days and, in particular, the amount of time for which children are taught through the year.

I am aware of South Lanarkshire Council’s proposals and I confirm that the council, like every other council, must follow the robust and updated procedures that the Government laid out. There is also guidance under the 2010 act, which is very clear and suggests that, when such matters are being considered, local communities should be encouraged to come forward with ideas and alternatives.

I stress that there should be a process of consultation and dialogue, not of dictation, as South Lanarkshire Council—and every other council in the same situation—moves forward.

Is the cabinet secretary aware that North Lanarkshire Council is considering closing Abronhill nursery school? Will he confirm that, when local authorities are consulting on closures or mergers of nursery schools, they are required to meet the same improved standards as they must meet when they consult on school closures or mergers?

That consultation would normally have to be undertaken. The general principles also apply.

In the difficult circumstances in which a proposal is made for any closure, it is important that there is a genuine process of consultation, that the process is open and transparent, that the views and representations of parents and the community are taken into account and that alternatives are considered in a constructive and imaginative manner. Those are prerequisites for moving forward.

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Supported Employment

8. To ask the Scottish Executive when a minister last visited a supported employment workshop. (S3O-11585)

I had an opportunity to visit Royal Strathclyde Blindcraft Industries on 6 July, where I met staff and employees. RSBI is a successful example of a supported employment workshop that offers training, development and career progression, to benefit people with disabilities and the local economy.

Will the minister tell the Parliament what state the order books are in for the relatively small number of sheltered workshops in Scotland? Is he aware which workshops have empty order books? What meetings has he convened with ministerial colleagues to address the developing crisis for sheltered workshops throughout Scotland?

I had a chance to listen to some of the debate this morning, when such issues were raised. I acknowledge the genuine commitment and compassion that Helen Eadie has displayed on the matter, in the debate and in discussions with me. I hope that she acknowledges that there is the same commitment on the Government benches. We provide direct funding for some supported employment workshops, in Aberdeen and other areas.

The member asked about orders. Of course, it is not possible for us to provide contracts if we have no requirement for the goods but, in areas in which we have a requirement for goods, we are closely considering whether we can place contracts that will benefit the workshops. That work is continuing.

As was mentioned in the debate, where we can we also use the European Union public procurement directive, in relation to reserving contracts for supported factories. That is helping the order books of the workshops that Helen Eadie mentioned. I am happy to get back to the member with the other information for which she asked, although that is held by individual workshops.

Before we come to the next item of business, I am sure that members will want to join me in welcoming to the gallery the Rwandan high commissioner to the United Kingdom, His Excellency Ernest Rwamucyo, and the deputy high commissioner, Ms Linda Kalimba. [Applause.]