Contents
- Portfolio Question Time
- Patient Safety Commissioner for Scotland Bill: Stage 1
- Patient Safety Commissioner for Scotland Bill: Financial Resolution
- Business Motion
- Decision Time
- St Michael’s Hospital
Portfolio Question Time
Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business is portfolio question time, and the first portfolio is rural affairs, land reform and islands. In order to get in as many questions as possible, I would appreciate succinct questions and answers to match.
Question 1 was not lodged. Question 2 is from Jamie Halcro Johnston, who joins us remotely.
Ferries (Impact of Disruption on Island Communities)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding how the Scottish Government analyses the impact on island communities of disruption to ferry services. (S6O-02197)
I am working with the Cabinet Secretary for Rural Affairs, Land Reform and Islands and other ministerial colleagues to understand the impact of ferry disruptions on island communities. However, that requires not just ministerial engagement but dialogue with our local authority partners. That is why we took the decision to re-establish the islands transport forum, which is chaired by myself, through the islands strategic group. Furthermore, the First Minister’s policy prospectus, which was announced on 18 April, included a commitment to publish a new rural delivery plan within the lifetime of this Parliament. That will cover the issues that are critical to Scotland’s island, rural and coastal communities, including transport.
The minister will be well aware of the serious disruption that Scotland’s island communities have endured for far too long, with cancellations, reduced sailings and emergency timetables, often at very short notice, becoming an everyday occurrence for many. Residents often cannot leave their island or get home; island businesses cannot operate and get the supplies that they need or deliver the services that they have promised; and booking trips or stays on our islands is becoming a gamble that is not worth taking for some potential visitors. All of that is a result of 16 years of chaotic mismanagement of our ferries network by the Scottish National Party.
When will the Scottish Government finally accept responsibility for the increasing carnage that its lack of investment in new ferries is causing, and when will it look seriously at compensating islanders and island businesses for the total mess that Scottish ministers in Edinburgh have caused?
I recognise the impact that delays and disruption have regrettably had on our island communities. The Government and I are committed to investing in our ferry services, and we will deliver six new major vessels to serve Scotland’s ferry network by 2026—that is a priority for the Government. Although I am sympathetic to the calls to support businesses through compensation, our focus rightly has to be on building resilience in the ferry network. That includes the current chartering of the MV Alfred to support CalMac services and proactively working with NorthLink on potential additional capacity on services to Orkney. We will continue to do all that we can to increase the resilience of the fleet and to add to it so that our island communities are better served.
The Minister for Transport will be well aware of the disruption to ferry services across the Pentland Firth following the grounding of the MV Pentalina earlier this month. I thank the minister for his engagement with me on that issue. I know that Serco NorthLink has been working hard to identify how freight and passenger demand might be met while the Pentalina is unavailable, but I remain concerned about pinch points on particular sailings and a loss of connectivity to and from the smaller isles in Orkney. I therefore again ask the minister to look at increasing the number of return daily sailings between Stromness and Scrabster to four while that remains the only ferry route across the Pentland Firth.
I am grateful to Mr McArthur for his engagement with me on the issue. We will continue to look at the pressures on that crossing. As Mr McArthur is aware, because I wrote to him on the subject, thanks to NorthLink we have already increased the number of crossings on a Sunday. NorthLink is gathering intelligence and looking at other points of pressure with a view to adding to the services. I can assure Mr McArthur and Orkney islanders that we will continue to look at all the information that we have and act accordingly. Once again, I say that I am very grateful to Mr McArthur and to Orkney Islands Council, with which I will meet directly after this question time, for the intelligence that they have provided.
Scotch Beef
To ask the Scottish Government what it is doing to help ensure that quality Scotch beef is available in supermarkets in Scotland. (S6O-02198)
Scotch beef is an iconic product, and I am pleased to say that it is available in each of the main grocery retailers in Scotland as well as in the vast majority of our independent high street butchers. Whenever I meet retailers, the sourcing of Scottish produce, including Scotch beef, is always part of the agenda. In addition, Quality Meat Scotland regularly meets retailers and their Scotch beef suppliers to promote and align marketing campaigns on Scotch beef. It is, of course, important to our agriculture sector that our supermarkets stock not just Scotch beef but Scotch lamb and specially selected pork.
It was recently reported that Scotbeef had lost the contract to supply Aldi with beef. Scotch beef is a product of unparalleled quality that everyone should be able to enjoy if they wish, so does the cabinet secretary agree that, although Aldi stocks other Scotch beef products, it is vital that, during the on-going cost of living crisis, discount retailers continue to provide as wide a range of products as possible and give people affordable access to the best of Scotland’s larder?
I absolutely agree that Scotch beef should be available to everyone from all walks of life. I know that, over the years, Aldi has strongly supported Scottish produce and its supply across Scotland, including by offering Scotch beef to its customers. My understanding of the situation is that a change in suppliers has resulted in a temporary reduction in the availability of Scotch beef in Aldi. However, Aldi remains committed to sourcing Scotch beef. It is in the process of acquiring a new contract, and it will have Scotch beef back on its shelves as soon as possible.
With support from QMS, the Scottish beef industry delivers the highest standards of production and of animal welfare and wellbeing. That results in the production of the highest quality of beef, with a carbon footprint that is significantly below the global average.
Last month, the Climate Change Committee spelled out its belief that Scotland will need to slash dairy and beef numbers by 29 per cent and 26 per cent respectively to meet the net zero targets. Will the cabinet secretary rule out any cut to red meat production and assure me and the farming industry that she has a practical and achievable plan to meet the legal climate change targets and protect livestock farming in Scotland?
That is exactly what we are trying to do. I give that assurance to Finlay Carson, as I have done previously when his colleagues have raised with me the issue relating to a reduction in numbers. We know that we produce livestock well in Scotland, and there will continue to be a role for that into the future. That is why our vision for agriculture and our agriculture reform programme route map make clear our commitment to enabling the producers of high-quality food to deliver on our shared outcomes for biodiversity recovery and climate adaptation and mitigation, and it is why we continue to support those sectors.
I remind members of my entry in the register of members’ interests, which shows that I am part of a family farming partnership, and we produce beef.
Farmers have a duty to reduce their emissions in order to achieve net zero. I completely agree with that, but one measure that is needed in order to do that is keeping livestock on the farm after they are ready for slaughter. That happens with beef cattle, many of which are ready at 11 months but cannot be sold as Scotch beef until they are at 12 months. Will the cabinet secretary address that issue with QMS?
I am happy to raise the matter with QMS and to discuss it with Edward Mountain if he would like to do so.
Mental Health (Farmers and Crofters)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding actions to tackle mental health problems amongst farmers and crofters. (S6O-02199)
I regularly engage with farmers and crofters to discuss actions on the range of challenges that they face and, in turn, I raise those points with relevant ministers. In the case of mental health, that is the Cabinet Secretary for NHS Recovery, Health and Social Care and his team.
The Scottish Government takes the mental health of our farmers and crofters seriously. Over the past financial year, we committed £50,000 to supporting the Royal Scottish Agricultural Benevolent Institution and £50,000 to the national rural mental health forum. We recognise that the sector continues to face significant challenges and we are fully committed to working with it to address those challenges where we can.
Depression and suicide rates for farmers are among the highest of any occupation. Tragically, those figures are growing and the situation is getting worse. What steps will the Scottish Government take to not only halt but reverse that trend?
That is, of course, a really worrying trend. I welcome the member raising this important topic in the chamber, which I know we will discuss further during his colleague’s member’s business debate tomorrow.
Every life that is lost to suicide is an enormous tragedy that has a devastating and long-lasting impact on families, friends and communities. That is why the work of organisations such as RSABI and the national rural mental health forum, and why continuing to support them, is so vital. I cannot direct people enough to the resources that those organisations have available 24/7, such as a helpline and web chat. It is really important that not just I but other members across the chamber highlight those avenues of support to people, so that they know that they can reach out and seek that help and that it will be available to them.
I have a supplementary from Jim Fairlie.
I would like to withdraw my supplementary, please.
That is duly noted.
Lamlash Bay No-take Zone
To ask the Scottish Government what it has learnt from the fisheries no-take zone at Lamlash bay. (S6O-02200)
Lamlash bay is an excellent example of the Scottish Government working with a local coastal community—building on the voluntary no-take zone by incorporating it into the south Arran marine protected area—to support the recovery of the maerl beds in the bay.
Since designation, commercially important species such as the king scallop and European lobster have increased in size, age and density. We have continued that approach to MPA designation and management, and we are currently working with coastal communities to develop fisheries management measures for the rest of the MPA network.
The Arran no-take zone has seen tourism grow while scallop and lobster numbers have increased four-fold. Given that economic success, how does the Government plan to continue to work with the Community of Arran Seabed Trust—COAST—to collect further data on the impact of that internationally recognised no-take zone?
Our monitoring strategy sets out how we intend to monitor MPAs and how we will continue to monitor the related surveys that we do. Many partners, including NatureScot, are involved in that work; we work with them to gather the evidence and to assess the overall condition of the sites.
NatureScot has recently launched a community-led biodiversity monitoring project to try to support community groups and individuals who want to participate in the monitoring of our marine protected areas. COAST has provided a lot of valuable evidence to NatureScot and the Scottish Government about the seas around Arran, which we very much appreciate.
In another no-take zone—Broad bay—we know that marine biodiversity is almost non-existent. Leaning on evidence from one example such as Lamlash bay while ignoring another is no way to go about policy making. Furthermore, more work needs to be done to establish the effectiveness of the current MPA network.
Does the cabinet secretary agree that we should not rush into imposing new, un-evidenced marine protections simply to appease the Government’s Green coalition partners and that we should, instead, seek to understand the protections that already exist?—[Interruption.].
Could we hear the member who has the floor?
We will, of course, consider the examples that the member has raised, as well as other examples that we know exist across the world, when we look to develop that work.
It is important to remember that we have carried out a consultation, which I believe received more than 4,000 responses. It is vital that we fully consider each of those responses. I know that a lot of feeling exists around this subject and that other organisations have expressed concern. We want to listen to those points of view in a careful and considered way before setting up further steps from that point.
The Scottish Government adopted a national marine plan in 2015 to develop a planning system for our seas, in which no-take zones play a part, but the recent Open Seas report, “Ease the Squeeze: Ocean Recovery in Busier Seas”, highlights the Government’s failure to comply with that plan. Therefore, will the Scottish Government commit to creating a cohesive spatial plan for our seas, with community consultation, engagement and development at its core?
I thank the member for raising that point. She will be aware that we are in the process of updating and bringing forward a new national marine plan, which I am sure that she will engage with. I am happy to write to her to provide further information and any indicative timelines for that.
Greyhound Racing (Animal Welfare)
To ask the Scottish Government what its assessment is of the welfare of animals used in greyhound racing in Scotland. (S6O-02201)
The Scottish Animal Welfare Commission published its report on the welfare of greyhounds used for racing in Scotland on 9 March. The Government welcomes the publication of that report and we are currently considering the recommendations.
Further to that, we will shortly be launching a consultation on extending the animal licensing framework that was introduced in 2021; that will include greyhound racing and other animal care services. The responses to the consultation, along with the views of the Rural Affairs and Islands Committee, which is currently considering greyhound racing, and the Scottish Animal Welfare Commission’s report will inform our next steps regarding greyhound racing in Scotland.
The cabinet secretary will be aware that Shawfield stadium in my constituency is the only licensed greyhound racing track in Scotland, and no racing has taken place there since the start of the Covid pandemic. Given my concern about the welfare of greyhounds that have been raced at Shawfield previously, I hope that there is no return to racing.
Can the cabinet secretary confirm exactly when the consultation on extending the licensing legislation to animal care services will be launched and whether, as part of the consultation, the Government will consider a phase-out ban on greyhound racing?
I thank the member for asking the question and highlighting that important subject. Màiri McAllan, who was the Minister for Environment, Biodiversity and Land Reform at the time, confirmed in a debate in October last year that the licensing of racing would be considered as part of the animal care services consultation. On the timescale, we hope to bring forward the consultation shortly.
The committee is currently considering greyhound racing in Scotland, and it is important that we consider the evidence that it has taken. I believe that it has had a number of evidence sessions so far on the topic. Of course, the Scottish Government will carefully consider any recommendations that the committee makes before we set out our next steps. On the consultation, we welcome responses from everyone with an interest, and we will consider the next steps once we have completed that exercise and received the committee’s report.
Rural Crime Strategy
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the delivery of the rural crime strategy. (S6O-02202)
The Scottish Government takes all crime, including that committed in rural areas, extremely seriously.
Although delivery of the “Rural Crime Strategy 2022-2025” is a matter for Police Scotland and its partners within the Scottish Partnership Against Rural Crime, or SPARC as it is known, the Scottish Government is fully engaged with the work of SPARC and receives regular updates on its activity.
The member will be aware that the overriding aim of the strategy is to protect rural communities through strong partnerships, and ministers are looking forward to hearing more about that work as it progresses.
SPARC has seen positive results in reductions in rural crime and associated financial costs in the past year alone. Between April 2022 and March 2023, there were 284 fewer rural crimes reported than there were in the previous year, as well as an overall reduction in the financial harm to Scotland’s rural communities of more than £2 million, which equates to a drop of almost 36 per cent. SPARC’s approach is working, so will the cabinet secretary meet me and SPARC to discuss what action can be taken to build further on the reduction in crime for our communities across Scotland?
I thank the member for highlighting those important statistics, which demonstrate how important and necessary SPARC’s work is. The member will be aware that the ministerial responsibility for rural crime sits with the Cabinet Secretary for Justice and Home Affairs. However, the fight against rural crime requires, and benefits from, the support and input of all our ministerial colleagues.
As Emma Harper highlighted, the reduction in rural crime is testament to that partnership approach and the vital work of Police Scotland and the other partners that are involved in SPARC. Ministers would be delighted to join Emma Harper in meeting SPARC to discuss those issues further.
The SPARC report highlighted that the cost of rural theft of machinery was almost £350,000 in March alone. The north-east was identified as one of the most targeted areas and we are now heading into May and June, which are the worst months for theft. Bold steps need to be taken to tackle the issue, particularly when such crime makes it impossible for farmers to work. Does the cabinet secretary agree with the Scottish Conservatives’ plan to introduce immobilisers and regulate the sale of agricultural vehicles to reduce rural crime?
I am happy to discuss the matter further with Alexander Burnett to see what more can be done in that area.
Despite the passing of Emma Harper’s law, there is still an enormous task ahead of us to stop dog attacks on lambs. The minister will have heard about the recent terrible attack near Kelty. There has also been a further attack at West Lomond where more sheep were lost. Both those farmers are incandescent with rage. Why have too many dog owners still not got the message?
It has been absolutely terrible to see some of the incidents that have taken place recently, especially at a time when we have been trying to increase awareness and do what we can to ensure that every dog owner is aware of their responsibilities, which are very clearly set out. We know that the penalties for that crime have increased due to the member’s bill that was taken forward by Emma Harper. Important work was done there, but I am more than happy to consider what more we can do to raise that awareness and ensure that we are doing everything we possibly can to get the message out there that all dogs should be on leads so that we are saved from truly horrendous scenes of the kind that we have seen in recent weeks.
Good Food Nation (Scotland) Act 2022
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the role of the Good Food Nation (Scotland) Act 2022 in promoting a healthier diet. (S6O-02203)
The ministerial working group on food provides a forum for me and my ministerial colleagues to come together and work across portfolios on relevant aspects of food policy as we work towards our ambition of Scotland becoming a good food nation. At our last meeting, on 12 January, the group covered issues relating to the promotion of a healthier diet. I look forward to continuing to discuss the next steps in relation to the Good Food Nation (Scotland) Act 2022 with my colleagues.
Partick farmers market, in my constituency of Glasgow Kelvin, brings into the heart of Glasgow’s west end fresh food produce straight from the producers. Does the minister agree that such good models play an important role in educating people about the food that they eat, promoting healthier lifestyles and supporting farmers and food producers?
I could not agree more. Farmers markets play an important role in supporting our farmers and producers and our local communities and economies. They also do so much more, because if we support such initiatives, we also shorten supply chains, connecting people to our food and where it comes from, as well as helping to promote healthier diets. Through our local food strategy, we recognise the importance of connecting people with their food and where it comes from as well as better connecting Scottish producers with their buyers. All of that plays a vital role in our vision of Scotland being a good food nation.
A brief supplementary, please, Mr Whittle.
The cabinet secretary will be aware that, for all the time that I have been here, I have been pushing the role of public procurement in schools and hospitals. Does the cabinet secretary now agree with the Conservative position that we should be pushing public procurement as much as possible to buy local food to increase the health of the nation?
I do not think that we have ever really disagreed with that point. I know that Brian Whittle has raised the issue with me on a number of occasions. It is important that we look to address that through the good food nation plans that will be developed, as there will be a critical role for them.
I would also point to some of the other work that we are looking at. The Food for Life programme has been working with our local authorities to increase the supply of local produce to our schools, in particular. We can see the benefits for health and for our local communities and economies of taking such an approach. That is why we decided to extend the pilot to look at other areas of the public sector in which we could make that approach work, with a particular focus on Glasgow. Ideally, we would like that approach to be expanded across Scotland.
I look forward to working with the member on that, and I am more than happy to have a conversation about how such work can feature in our future good food nation plans.
NHS Recovery, Health and Social Care
General Practices (National Health Service Boards)
To ask the Scottish Government whether it tracks how many GP practices are currently being run directly by NHS boards. (S6O-02204)
Public Health Scotland regularly publishes data in relation to GP practices, including their contractual status. As of 1 April 2023, 57 out of 905 GP practices in Scotland were classed as 2C practices, with 2C status usually being understood to mean that those practices are run directly by an NHS board.
The decisions by Inverurie and Oldmeldrum practices to end their contracts with NHS Grampian due to a lack of GPs mean that 34,000 patients within a 5-mile radius in Aberdeenshire face challenges in accessing a local doctor. Dr Innes, a partner at the Inverurie practice, said:
“We have explored every avenue to recruit ... but there ... are not enough ... GPs out there.”
It is clear that GPs are beyond the end of their tether at the lack of support from the Scottish Government.
What specific measures were put in place by the cabinet secretary’s predecessor to address the lack of GPs? When will the north-east have sufficient numbers?
A range of actions have already been taken to support GP numbers. For example, we are going through a programme of recruiting another 800 GPs into the system by 2027. We have also put in place additional measures. For example, since 2017, there has been an increase of 291 GPs, and we now have a record 5,209 GPs working in practices in Scotland.
Alongside that, we have put in place initiatives to support GPs in rural areas such as Aberdeenshire, in relation to which Liam Kerr made representations, including the golden hello programme. We are also taking a range of actions to encourage graduate entry medical students to go into rural settings through the Scottish graduate entry medicine—ScotGEM—programme.
A range of work is under way to increase further recruitment to general practice in Scotland, as well as a range of measures to encourage people to work in our rural areas. As I mentioned, a record 5,209 GPs are operating in Scotland at the moment.
However, I recognise the concerns that Liam Kerr has raised on behalf of his constituents. I know that the health and social care partnership and the health board are looking at the specific issues that exist in relation to the Inverurie practice and whether it would be possible for others to come in to operate the practice or whether it will require to be operated directly by the local health board in the future. It is important that people are reassured that they will continue to be able to access general practice services, whether those are delivered through the NHS or through another practice.
What encouragement can the cabinet secretary give to NHS Tayside to consider directly providing GP services in the village of Invergowrie, in my constituency, where there is some uncertainty over the future of GP provision, to ensure that my elderly and vulnerable constituents can have convenient access to GP services, given the transport challenges that they may face in accessing services in other parts of the county or in the city of Dundee?
It is important that any practice that is looking to change access to GP services in a local health board area goes through a process of engaging with the health board to ensure that patients at the practice will continue to have access to a GP as and when that is necessary.
I encourage the practice in question to engage with the health board, and I encourage the health board, in engaging with the practice, to take proactive action to ensure that the concerns that John Swinney has raised regarding his constituents’ access to GP services, particularly in the light of the transport issues that they face, are addressed and that appropriate measures are maintained in place so that his constituents can access a GP.
Jeane Freeman brought in the policy to recruit another 800 doctors within 10 years. Audit Scotland suggested that that number was arbitrary, given that Scotland was about 860 doctors short at that time, and that, at the end of the 10 years, because of wastage, we would still be 660 GPs short. Can the cabinet secretary enlighten us as to why the number 800 was arrived at?
As the member has just acknowledged, the figure predates me, but it was chosen in recognition of the need for an increase in the number of GPs in the country. The good thing—I am sure that the member will be pleased about this—is that we are making progress on the recruitment programme at an appropriate rate, so that we can deliver on the 800 figure by 2027.
At the same time, we are doing all that we can to encourage more people into general practice as we go forward.
A representative of the British Medical Association has said that the closure of Inverurie medical practice in Aberdeenshire means that “no practice is safe” and that the crisis in GP care could lead to the collapse of NHS Scotland. What is the Scottish Government doing to support affected communities until such measures to increase GP numbers take place?
Key to supporting primary care services that are delivered by general practices are not only GPs but the wider support teams that assist them in delivering the services that patients require. The provision of advanced nurse practitioners, the deployment of musculoskeletal physiotherapists and the basing of pharmacists in GP practices can all help to provide a range of primary care services directly to patients.
That workforce has increased markedly over recent years. We have recruited more than 3,000 additional staff to work alongside GP practices to support them in the delivery of the services that they offer to patients. We certainly need to do more to expand and develop that workforce further, because primary care is absolutely critical to delivering a sustainable healthcare system. That wider multidisciplinary primary care team that can support GPs is going to be critical in making sure that we can deliver that.
Alongside that, we also need to ensure that patients get access to the right services directly at the time when they require them. Much of those can be provided by primary care, with the right support team in place, rather than people always having to go to a secondary care setting, which is what happens for most patients at the moment.
The GP position at the Hillswick surgery, in my constituency, is still vacant after six months of advertising. Hillswick offers an established training practice for medical students. How is the Scottish Government supporting GP practices in island areas to recruit and retain GPs?
As I said, we are taking forward a number of initiatives to help to attract GPs to rural areas, including our golden hello programme, which helps to support GPs to take up harder-to-fill posts in rural environments such as the one that the member highlighted.
We have also established the ScotGEM programme to encourage graduates to enter general practice in rural areas. That will encourage more people to go into rural areas such as the one that the member has highlighted.
Musculoskeletal Pathway (Implementation)
To ask the Scottish Government whether it will set out its proposed timetable for implementing the new musculoskeletal pathway, including how it will ensure that the views of third sector organisations are reflected in the process. (S6O-02205)
The Scottish Government is continuing work with NHS 24 and stakeholders to review the musculoskeletal—or MSK—pathway. Any timetable would be contingent on the outcome of that on-going review work. We expect individual health boards to continue to improve their own MSK pathways for patients with third sector partners at a local level.
Having an up-to-date and fit-for-purpose MSK pathway is vital to ensuring that patients can access the care that they need when they need it, and third sector organisations are a key part of that. Will the minister agree to meet relevant charities and MSK groups as a matter of priority?
I thank Pam Duncan-Glancy for inviting me to the cross-party group on arthritis and musculoskeletal conditions, where I learned a lot about the various conditions. I appreciate that very much.
As I said in my speech at that meeting, third sector organisations are incredibly helpful—I referenced a couple in my constituency of Argyll and Bute. I would be very happy to meet with the groups that the member has suggested.
Palliative Care Sector (Support)
To ask the Scottish Government what plans it has put in place to support the palliative care sector, in light of reports that the number of people needing these services is estimated to rise by an additional 10,000 by 2040. (S6O-02206)
We are aware of Scottish research that shows a rise in the number of people with a palliative care need, and the Scottish Government is developing a new palliative and end-of-life care strategy to ensure that everyone who needs it can access seamless, timely and high-quality palliative care. We are considering the issues that Scottish hospices raised at their meeting in March with the then Cabinet Secretary for Health and Social Care and the then Minister for Public Health, Women’s Health and Sport, which included funding and the long-term sustainability of the hospice sector.
Hospices will start closing if help cannot be sourced to match the national health service pay offer. Scottish charitable hospices need to find £15.5 million over the two years to 2024. The time for meetings and discussions is over. What can the Scottish Government do urgently to address the crisis in the palliative care sector?
I recognise the importance of palliative care and the importance more widely of the need for us to speak about the end-of-life stages that we go through. Last week, I was at “The Cost of Dying” photography exhibition in Glasgow, which I found incredibly important and thought provoking.
As Jeremy Balfour will know, the 2023-24 Scottish Government budget underlines our on-going commitment to prioritising investment in health and social care, in providing additional funding of £1 billion. However, I recognise that there are issues in the hospice sector, and I am working with officials to discuss them.
A major provider of palliative care in Scotland is our hospice network. St Margaret of Scotland Hospice, in my constituency, has contacted me regarding funding pressures. Will the minister meet me and representatives of the hospice to discuss those pressures and how we can assist hospices as we move forward?
I would be very happy to meet representatives of St Margaret of Scotland Hospice.
Edington Hospital
To ask the Scottish Government what discussions it has had with NHS Lothian, and local groups, since March 2023 regarding the reopening of the Edington hospital in North Berwick. (S6O-02207)
My officials engage regularly with NHS Lothian and with East Lothian health and social care partnership on a range of issues, and they last discussed Edington hospital in March 2023. The health and social care partnership has recently provided the Scottish Government with an update on its on-going review of community provision, which includes Edington hospital, and we have been informed that a 12-week public consultation on proposed changes is due to take place.
As the cabinet secretary will be aware, the story around Edington hospital’s closure goes back to 2021 but, as the First Minister has confirmed, the responsibility for continued Covid recovery now passes to all elements of Government rather than being centred in one place.
Can the cabinet secretary confirm that he will be able to attend the meeting on 22 May—which has been arranged by Paul McLennan, as the constituency MSP—with local groups, including North Berwick community council and Friends of the Edington Hospital?
I am aware that the health and social care partnership board is taking forward a consultation exercise to look at the existing provision that it has in place. I am not aware at this stage of the particular meeting to which Martin Whitfield referred, but it is clearly important that a consultation exercise is being taken forward in order to consult with the local community, hear what its views are, and take those views into account in determining the final outcome of any process. That is what I would expect to happen in this case.
By the sound of it, there will be no meeting. That is consistent, because ministers have repeatedly failed to meet local stakeholders following the closure of residential care beds at the Edington and the withdrawal of minor injuries services.
With access to community treatment and care services restricted in some surgeries, vulnerable older people and young families face long and impractical bus journeys to East Lothian community hospital in Haddington, or all the way into Edinburgh, in order to access simple national health service services, such as having their wounds dressed. Does that not prove that the Scottish National Party has all but failed and has given up on community-based health services in East Lothian and across the south of Scotland?
That is wrong, especially considering the facility that we have built at East Lothian community hospital, which provides a range of services to the local community.
That aside, Craig Hoy is well aware that the health and social care partnership and the health board are responsible for designing and developing services to reflect the needs of the local community. They have set out their intention to take forward a consultation exercise that will involve the opportunity for people, including elected members such as Craig Hoy, to participate in that process and submit their views to the health and social care partnership and the health board. That will then determine the future approach to delivery of those services locally. The best way to deliver services is through local processes and local consultation, to allow the local community to have its views on what should be provided locally.
National Health Service Dentistry
To ask the Scottish Government what its response is to recent research from the British Dental Association that shows that 83 per cent of dentists in Scotland expect to reduce the amount of NHS work they do in the year ahead. (S6O-02208)
The Scottish Government is aware of the survey and understands the concerns expressed, which is why it wrote to all national health service dental teams on 7 February to confirm the continuation of the bridging payment to 31 October 2023 while we prepare for the implementation of payment reform. Payment reform will comprise a new, modernised system that will provide greater clinical discretion for NHS dental teams and greater transparency for NHS patients. It is our intention that payment reform will maintain the confidence of NHS dental teams by ensuring the future viability of NHS dentistry in Scotland.
That sounds like a temporary filling to what is a long-term cavity in their funding—no pun intended.
I will be frank with the minister: NHS dentistry in Scotland is at crisis point, and everybody knows it. A person would need to be living in a cave not to. If members have not seen their inboxes, they are filled with constituents’ problems in accessing NHS dentists and with emails from dentists who face massive funding issues.
In my region, not only can people not register for an NHS dentist, but the waiting lists have been closed altogether. Put simply, some people have no access to an NHS dentist. My question on behalf of those constituents is a very simple one. If the only way to get immediate dentistry treatment in Scotland right now is to pay for it, what do people do if they cannot pay for it?
I compliment Jamie Greene on his puns, but I disagree with him. I do not believe that NHS dentistry is in crisis. However, there are—[Interruption.]
Members, we need to hear the minister’s answer, please.
I accept that there are a number of difficulties, but we have come far in a reasonably short time and, as I said, payment reform is how we will change the system.
The Scottish Government has clearly linked ambitions to sustained and improved NHS dental services, and we intend to work collaboratively with health boards to find local solutions. We have expanded funding to local dental services to support that. In addition, we are working with the other nations of the United Kingdom to improve the pipeline of dentists coming to Scotland from Europe, which was so negatively impacted by Brexit.
Last week, dental practices in Langholm and Annan announced that they were deregistering 2,000 adult NHS patients. That adds to the more than 10,000 NHS patients who have been deregistered with other practices in recent weeks in Dumfries and Galloway. People cannot register with an NHS dentist, and that is a crisis. Why does the minister think that the Government’s actions, including promises of future funding arrangements, are so badly failing to stem the collapse of NHS dentistry in Dumfries and Galloway?
I appreciate the issues in dentistry in Scotland, and I am working very hard with my colleagues to ensure that we find solutions with dentists. I outlined in my response to Jamie Greene’s question what those are.
A single practice in Orkney provides NHS dentistry. That shows the particular fragility in the islands in the context of the BDA figures that Jamie Greene referred to. With payment reform now pushed back to November, does the minister accept that it is vital that dentists have sight of the detail of what is proposed well ahead of the November deadline? What assurances has she had from the chief dental officer that there will not be any further delay in the reform process?
I agree that it is important to involve the dentistry profession in the discussions that we are having. That has happened to date, and that is continuing apace as I stand here.
In 2022, the Nuffield Trust found that the number of European Union and European Free Trade Association-trained dentists registering to practice in the United Kingdom was halved after the EU referendum and that that is yet to recover. It is undeniable that Brexit, along with the pandemic, has been a factor in the current challenging situation that dentistry faces. Despite that difficult context, can the minister provide an update on the progress that is being made in providing extra support in areas in which there is the greatest patient need?
It is true that some areas are particularly affected by the present situation, which is made worse, as I have highlighted before, by the labour market effects of Brexit. That is why we have expanded Scottish dental access initiative grants. Those grants—[Interruption.]
Please. We need to hear the minister. I will not have all this harping away from a sedentary position. The minister has the floor, and we need to listen to her response.
We have extended Scottish dental access initiative grants to wider parts of Scotland, and we have also made available an enhanced recruitment and retention allowance.
I am also fully aware of the need to increase workforce pipelines from overseas. As I have said previously, I am working with and writing to Department of Health and Social Care ministers to ensure that the changes are made on a four-country basis to improve the registration process for overseas dentists.
General Practitioner Workforce
To ask the Scottish Government what action it is taking to increase the general practitioner workforce. (S6O-02209)
We are making good progress to increase the GP workforce. Since 2017, GP head count has increased by 291 and a record 5,209 GPs are now working in Scotland.
We have increased medical undergraduate intake by 448 places since 2015-16, and we will also be increasing the number of general practice specialty training posts by 35 in 2023, with further uplifts being considered for 2024 and beyond. Fill rates for specialty training are at a record high, with a 99 per cent fill rate for 2022.
Last year, Humza Yousaf launched our GP recruitment marketing campaign, and we are providing significant investment in initiatives that ensure that being a GP remains an attractive career for those in the medical profession.
I spoke with staff at one of my local GP practices, and they told me that their unsuitable premises are making recruitment and retention difficult. They are currently operating in a building that is too small. What capital funding is available for building, developing or improving primary care facilities in Ayrshire and Arran?
I recognise the member’s point, because I have GP practices in my constituency that are experiencing similar challenges.
Part of the difficulty that we have at present is that the cut to our capital budget has resulted in the Scottish Government having less capital available to it. That is restricting the level of investment that we can make across the whole of the public sector. Alongside that, projects that are presently in delivery or due to be delivered are experiencing very significant inflation as a result of construction inflation being markedly higher during the past year and a half.
All that is having a negative impact on the expansion of capital investment projects, including in primary care, but I assure the member that, once we have more flexibility in our capital budgets, we will always look at the opportunity to make more funding available to invest in areas such as primary care to support GP practices across the country.
Being a GP is a team effort. There is a disparity between agenda for change uplifts for national health service admin staff in hospitals and Review Body on Doctors’ and Dentists’ Remuneration uplifts for GPs, which is leaving primary care staff feeling devalued. We hear that staff are leaving general practice for comparable hospital posts. A concerned practice manager wrote to Douglas Ross and me to express concern, as the disparity means that they are losing staff. That is putting pressure on practices to close and is leaving patients frustrated because they cannot contact their practice.
I am concerned that the cabinet secretary cares more about hospitals than primary care, which is where 90 per cent of all patient contact occurs. Will the cabinet secretary ensure parity between hospital and GP admin staff uplifts in pay so that primary care providers can recruit and retain the staff they desperately need?
I recognise the issue that the member raises, because it is one that I have discussed with GPs in my own constituency. We have passed on the uplift for general practice that was recommended by the DDRB. I recognise the challenges that some of our GP practices face because of the agenda for change agreement for the rest of the NHS, but the reality is that the finances are not available to enable us to pass that on to primary care in the same way. The member will be well aware why that is the case; it is because of the financial circumstances that we face as a result of the appalling management of the United Kingdom economy—[Interruption.]—by his colleagues at Westminster.
Members, I keep having to say this. The point of having questions and answers is that we ask the questions and then we listen to the answers. Cabinet secretary, please continue.
I suspect that the Conservative members are interrupting because they do not like the answer. The reality is that the Conservatives’ mismanagement of the UK economy has resulted in significant cuts to public expenditure, which is having a direct impact on our expenditure here in Scotland.
I hear what the member is saying—I recognise the challenges that that creates for general practice. However, I think that the member should also recognise the consequences of his own party’s actions at Westminster, which are having a direct impact on public expenditure here in Scotland.
Child and Adolescent Mental Health Services (Waiting Times)
To ask the Scottish Government what it is doing to reduce waiting times for NHS Scotland’s child and adolescent mental health services. (S6O-02210)
We have set the conditions needed for long-term, sustainable improvement to CAMHS. That includes significant additional funding for CAMHS services and new community-based mental health and wellbeing support for children and young people. As a result, we are seeing sustained, positive changes in waiting lists, with a significant drop in the number of waits over 18 weeks. I absolutely recognise that we must see further sustainable improvement and reduced variation. We are continuing to provide tailored support to the boards that are facing the greatest challenges and ensuring that robust improvement plans are in place. Progress is being monitored closely.
I have a teenage constituent who has been waiting the best part of three years for a diagnosis from CAMHS. She could well be an adult by the time it comes through. We learned this week that a Scottish Government pledge to recruit an additional 1,000 mental health specialists has not been delivered. Families such as the family of my constituent are now facing a crisis situation, so when is the minister going to make things better?
At the moment, we are seeing the most sustained positive changes in CAMHS waiting lists that we have seen for over half a decade. I know that that is not much comfort to the member’s constituent who has been waiting for over three years. If the member wants to write to me about that particular case, I am more than happy to look into it.
However, the last four quarters have seen the highest figures on record for the number of children starting CAMHS treatment. The number of children starting treatment in the latest published quarter is comfortably the highest figure on record—5,548. That is up by 11.1 per cent.
The overall CAMHS waiting list has decreased by 9.3 per cent since the last quarter—a reduction of 777. The number of children waiting over 18 weeks has decreased by 31.9 per cent since the last quarter, which is a reduction of over 1,000 children. The number of children waiting over 52 weeks has decreased by 41.9 per cent since the last quarter, which is a reduction of 523 children.
That has been made possible by the hard work of the CAMHS workforce, which has more than doubled under this Government.
Addressing the CAMHS backlog is only one part of improving the mental health of our young people. Research by the Mental Health Foundation last year found that 54 per cent of college students presenting to student mental health teams had moderate to severe symptoms of depression. Therefore, will the minister provide an update on when the Government expects to conclude the development of the student mental health action plan and when it expects the plan to be published?
I had a meeting recently with my ministerial colleague Graeme Dey, and that was the topic of our discussion. We are working closely on ensuring that the commitments meet the needs of the student population and that there is sufficient financial backing for the commitments that will be made. We will be more than happy to update the member as soon as we can.
General Practice (Long-term Sustainability)
To ask the Scottish Government what action it is taking to ensure the long-term sustainability of general practice. (S6O-02211)
We are absolutely committed to the long-term sustainability of general practice. We continue to make good progress on increasing the general practitioner workforce. Since 2017, GP head count has increased by 291 and a record 5,209 GPs are now working in Scotland. We remain committed to the GP contract and the delivery of extended multidisciplinary teams, making it easier for patients to see the right person, at the right time, in GP practices and the community. We have recruited more than 3,220 healthcare professionals since 2018 to support GP practices through our £170 million primary care improvement fund.
In Fife, the Rosyth practice has become the latest to fall under the direct management of NHS Fife. The medical director of NHS Fife has said:
“The GP Partners at Park Road medical practice are independent contractors of the Health Board. They have confirmed, following the retirement of one of their GP Partners, that they are now no longer able to continue to manage the practice.”
That follows the news that the total number of full-time, whole-time equivalent GPs in Scotland fell by 119 between 2019 and 2022, despite a rise in patient numbers.
I have tried to ask NHS Fife to establish how many GPs are due to retire in the next few years, but it is very difficult to get that information. Does the Government hold that information? What plans are you putting in place to address that? As it stands, the information that I am getting is that more and more GPs are ready to retire; the crisis will get worse. What will you do to deal with that?
I remind members to speak through the chair, please.
I hear the point that the member is making about the information that he has not been able to get from NHS Fife. I will undertake to see whether we can get that information for him.
As I have already outlined, we are taking forward a range of different measures, including recruiting more GPs, increasing the number of training places that are available for GPs and expanding the workforce that supports GPs through primary care services. All those measures are collective actions that we are taking to address the issues that the member has highlighted. It is important that general practice is seen as being an attractive place for individuals to work.
I assure the member of my determination to make sure that we do everything that we can to support general practice, expand the primary care services, make general practices attractive locations for GPs and wider multidisciplinary teams to work in and make sure that patients get the appropriate care in the right place within their local communities. I hope that I can assure the member that the actions that we are taking will address the issues that he has highlighted.
The cabinet secretary has commented on ScotGEM a couple of times. Does he recognise the positive feedback that I have had from NHS Dumfries and Galloway regarding the programme, which is unique to Scotland?
The member is right that ScotGEM is proving to be an effective programme that provides graduate entry medical degrees with a focus on rural practice. It is an important part of a wider range of programmes that we have in place to encourage individuals into general practice in rural areas. I want to make sure that we build on that programme. We are also committed to developing our remote and rural workforce recruitment strategy, which will be published by the end of next year. We are committed to supporting employers to ensure that health and social care staff in our remote and rural areas are able to meet the needs of their local communities in the years ahead.
That concludes portfolio questions on NHS recovery, health and social care. There will be a short pause before we move on to the next item of business.