Health, Wellbeing and Sport
Good afternoon. The first item of business this afternoon is portfolio questions on health, wellbeing and sport.
National Health Service Infrastructure (Highlands)
To ask the Scottish Government what it is doing in the Highlands to ensure that NHS infrastructure is fit for the 21st century. (S4O-04428)
We have been in discussions with NHS Highland over the future of facilities in the Moray Firth area and it was agreed that a master plan was required in order to ensure that the totality of the investment that is needed in NHS Highland facilities was fully understood. NHS Highland recently presented a master plan to its board that outlines a number of available options taking into account clinical, public and financial considerations. We will work closely with NHS Highland to ensure that the plan delivers the best possible outcome for the people of NHS Highland.
I very much welcome that answer. Can the cabinet secretary confirm that the significant investment that is planned for the next decade—particularly at Raigmore—including a potential new build will not be at the expense of the planned state-of-the-art facilities at Fort William with the replacement of the Belford hospital, in Badenoch and Strathspey and on Skye?
I am happy to confirm to Dave Thompson that the state-of-the-art new hospitals in Badenoch and on Skye will not be adversely impacted by the plans for Raigmore hospital. Those existing capital projects will continue as planned and they will absolutely contribute to an improved infrastructure that will allow NHS Highland to successfully implement the Highland care strategy, which outlines its vision for the future delivery of health and social care services for people in the Highlands for the next 10 years.
NHS Highland will continue to develop its plans for a future replacement for the Belford hospital in Fort William as well.
In respect of Raigmore, the member will be aware that NHS Highland has identified five main options and that it plans to undertake a full public consultation on them. We will, of course, consider the plans when they are submitted, but I am confident that they will tie in with the overall strategy as NHS Highland takes it forward.
I echo the comments about the Belford hospital. There has been a campaign for a new Belford for my whole political career in this Parliament, but little progress has been made on that to date. We should not stall that at all. Progress is being made in Badenoch and Skye, but we also need progress in north-west Sutherland, where the facilities are not fit for purpose and there needs to be a change. I understand that NHS Highland is consulting on that, but it will lead to capital expenditure. Can the cabinet secretary assure us that that capital expenditure will not come out of NHS Highland’s normal revenue, which has been tight for a number of years? If it did, that would impact on patient care. Will she make funds available for those capital projects?
I am pleased that Rhoda Grant is pleased that the plans for the Belford are moving forward. There are some exciting developments on that front.
On north-west Sutherland, as I said in my initial answer, NHS Highland has to look at its whole plan in relation to the clinical priorities and its financial considerations. We will wait for NHS Highland’s more detailed plans, which will come forward once it has decided what its priorities are and which options it will pursue. As Rhoda Grant said, it is consulting on the proposals for north-west Sutherland, and we will wait to see the plans that it wants to take forward. Capital considerations will be made in the same way as with any capital developments within the NHS in Scotland.
Question 2 has not been lodged by Murdo Fraser. Although an explanation was provided, it was unsatisfactory.
NHS 24 Performance (Grampian)
To ask the Scottish Government whether it is satisfied with the performance of NHS 24 in Grampian. (S4O-04430)
NHS 24 is Scotland’s provider of a national telehealth service. There are four national contact centres—based at Glasgow, Aberdeen, South Queensferry and Clydebank—where trained call handlers take calls from people throughout Scotland. All calls are triaged and directed to the most appropriate healthcare professional within an appropriate timescale, based on clinical need.
The performance of national organisations, including NHS 24, is managed nationally and not regionally. NHS 24’s unscheduled care service, which is the first point of contact for most people when general practitioner surgeries are closed, dealt with around 1.3 million calls in 2013-14. Of those calls, 95 per cent were answered within 30 seconds against the target of 90 per cent.
Given that answer, I am sure that the minister will be as horrified as I was to hear of the case of a constituent of mine who, having been assured at 5 o’clock on a Friday afternoon that, if he had any problems, he should phone NHS 24, did so with severe abdominal pain at 7.45 on Saturday morning and again at 11 o’clock. He eventually called an ambulance at 2 o’clock and was seen by a doctor from the associated GMED out-of-hours service at 4 o’clock in Turriff. Will the minister assure me that the resources and staffing are available to ensure that that kind of thing is not likely to happen to any more of my constituents?
If Alex Johnstone has not already done so, he should write to me about the details of that case. It is not acceptable. We need to ensure that NHS 24 provides a rapid response in every case, and I want to understand more fully the circumstances of why that did not happen in that case. I assure him that I will investigate the case and get back to him.
Child and Adolescent Mental Health Services (North East Scotland)
To ask the Scottish Government what it is doing to improve access to child and adolescent mental health services in North East Scotland. (S4O-04431)
I have spoken to the chief executive of NHS Grampian to obtain assurances that the health board is doing all that it can to achieve the CAMHS target. As a result of that discussion, I have written to the board asking for a detailed recovery plan by 3 July. NHS Grampian has done significant work in service redesign to increase its capacity to meet the target sustainably. As a result of that redesign, it has already identified where it needs to increase capacity.
My question actually relates to NHS Tayside, as figures show that the longest waiting times there have got even worse. In the first three months of this year, only 35 per cent of young people started to receive the treatment that they desperately needed within the 18-week target. That is down from 52 per cent at the end of last year.
Everyone knows that early action is more likely to result in full recovery. It also minimises the impact on other aspects of the development of children and young people, such as their education. I thought that that was why the minister’s department had changed the health improvement, efficiency and governance, access and treatment targets from 26 weeks to 18 weeks at the start of the year. However, parents in my region tell me that they are questioning the Government’s commitment to the targets. ISD Scotland statistics show that around 250 young people in Tayside will now have to wait more than a year to start treatment.
Could we have a question, please?
Will the minister reassure parents in Tayside? Has he asked for a detailed recovery plan from NHS Tayside?
I will deal with the latter point first: yes, I have. I have spoken to a representative of NHS Tayside.
I assure Alison McInnes, all other members in the chamber and all their constituents that the Government is still committed to the targets that it has set. Our commitment can be demonstrated through the £15 million that we announced for the mental health innovation fund last year, which is now supplemented by an additional £85 million over five years for mental health, which was announced in May this year.
I am aware of the particular issues in NHS Tayside. It is not the case that the longest waits are getting longer. Part of the challenge in NHS Tayside is that there have been some particularly long waits, which the health board is dealing with first, hence the particular challenge with achieving the 18-week target. However, I assure Alison McInnes of the Government’s determination that the target will be achieved.
Seven-day Services (Delivery)
To ask the Scottish Government what progress the national health service has made with the delivery of seven-day services. (S4O-04432)
NHS Scotland already provides high-quality, round-the-clock care and operates a range of services across seven days. However, the Scottish Government is taking forward work to build on that.
The sustainability and seven-day services task force is considering how best to improve the care that our patients receive in the evenings and at weekends and how best to support a sustainable NHS for the future. The task force published an interim report in March this year, which outlined a number of specific actions to be taken. They include: considering the effectiveness of ward rounds at weekends; considering further opportunities for nurses, allied health professionals and healthcare scientists to contribute to developing sustainable services; and co-ordinating further work to support the sustainability of Scotland’s six rural general hospitals.
Last week, I visited the Marie Curie hospice in Edinburgh, where I was advised that no back-up is available at weekends for out-patients and that, therefore, some terminally ill patients have to go for emergency treatment at an accident and emergency department. The hospice is seeking to reconfigure its service so that it can provide more of a 24/7 approach and take the pressure off A and E.
I listened carefully to what the cabinet secretary said about the interim report. When can we expect a further report? One of the issues that I believe was raised at the meeting of the Health and Sport Committee on 17 March concerned data collection, so anything further on that would be helpful, too.
The Scottish Government has committed to developing a palliative and end-of-life framework for action, supporting high-quality palliative care and end-of-life care, by the end of this year. We will ensure that we fully reflect that in our work on seven-day services.
The seven-day services programme is linked into a range of national activity that is being taken forward and is concerned with developing new approaches to and optimising out-of-hours care. The member will be aware of the out-of-hours primary care review, which is being led by Sir Lewis Ritchie, and the unscheduled care programme. We have to ensure that all of that is supporting organisations such as Marie Curie in the development of seven-day services.
We absolutely have to get palliative and end-of-life care right, and I am determined to do so.
Although the delivery of a seven-day service is, of course, a laudable aim, can the cabinet secretary tell Parliament how NHS Ayrshire and Arran will cope this winter, when increased admissions are likely, or even later this month, given that elective surgery is being cancelled in NHS Ayrshire and Arran just now, during the summer months, due to the number of medical patients who are being admitted to surgical wards?
We will ensure that the necessary capacity and resilience is there in all of our boards to cope with winter pressures.
The member has hit upon the need for us to consider new models of care. Obviously, the priority at the moment is focusing on winter and ensuring that the capacity is there. However, as we look beyond that timeframe—the debate later today will touch on some of this—we absolutely need to ensure that we get the models of care right so that we can ensure that there is no knock-on effect on elective capacity from, for example, people coming in through emergency procedures, which happens far too often at the moment.
I am happy to keep John Scott updated about winter resilience and about the wider debate as we take that forward.
Clearly, the Government is taking the issue of seven-day working seriously. However, does the cabinet secretary agree that, as Roderick Campbell alluded to, we need to have confidence in the detail that is being provided by health boards, which would underpin seven-day working? Would she like to comment on the reports today of the whistleblower in NHS Tayside, who seems to have blown a hole in the A and E target figures in Tayside by reporting more gaming in what had looked to be the best practice in Scotland?
I will answer that in two parts. First, the detail that is being provided to underpin work on seven-day services is absolutely part of the work that the task force is taking forward.
The second issue is a serious one and needs to be dealt with as such. Let me respond to that in detail. Richard Simpson has made a serious allegation in this chamber, and I want to put the few facts on the record.
It is not my allegation.
Order.
The system that NHS Tayside has for the A and E department—
Presiding Officer, it is not my allegation; it is a report in the press.
Order.
The member has reported an allegation that has been made. I will deal with it.
Cabinet secretary, Dr Simpson’s question is somewhat wide of the initial question anyway, so perhaps it could be dealt with in some other way.
I call Nanette Milne.
Has the Government made an assessment of how many more staff would need to be recruited, and at what cost, if the NHS were to move generally to a seven-day service?
That is part of the on-going work on seven-day services. It is important that the workforce requirements to sustain seven-day working are considered. Obviously, some staff already work across seven days; it is a little bit more challenging when it comes to medical staff, given their contracts. I want to ensure that any change is made in consultation and partnership with the workforce, whichever part of the workforce we are talking about. That is the way in which we do things in the NHS, and nothing will be imposed on anyone.
What is important, though, is that there is a requirement for us to look at new ways of working as we look towards future models of care. Seven-day working is important but, as I have said before in this chamber, it is not about doing complex operations at 4 o’clock in the morning just because we can; it is about making sure that the core services are sustainable and sustained. For example, it is about being able to discharge more patients at the weekend so that we do not have that blockage on a Monday and a Tuesday within our acute hospitals. I am happy to keep Nanette Milne posted on that.
Individual Patient Treatment Requests
To ask the Scottish Government what consideration can be given to individual patient treatment requests for further or repeat courses when the initial treatment has had some success. (S4O-04433)
We expect national health service boards to have procedures in place to deal with a wide variety of individual patient treatment requests for both medicines and other therapeutic interventions. Decisions on individual treatment are a matter for discussion between the individual and their consultant.
I thank the cabinet secretary for her reply. I am asking the question on behalf of my constituent Brian Houliston. Brian and his wife Shona are in the public gallery this afternoon. Brian is suffering from oesophageal cancer and had to fight to receive a treatment that is available on the NHS in England, which has successfully shrunk the tumour and restored his health. He has now been refused funding for the second part of his treatment and will have to raise something in the region of £26,000 for follow-up private treatment.
Can the cabinet secretary please advise what can be done to ensure that Mr Houliston receives his treatment on the NHS, which would prolong his life and provide evidence of possible treatment for other patients suffering from that cancer?
I am conscious that Elaine Murray’s constituent is in the public gallery. I would be very happy to follow up with her some of the detail around the case because obviously there is a limit to how much we can discuss individual cases in the chamber.
I assume that Elaine Murray might be talking about selective internal radiation therapy. It is important to know that selective internal radiation therapy treatment is not routinely provided in the United Kingdom. However, a UK-wide clinical evaluation is currently under way to assess the effectiveness of that type of therapy for a small number of patients.
We would normally say that, if a person wishes to access a certain therapy, they should discuss it with the team that is responsible for their care in the first instance to identify whether their specialist doctor considers that they would benefit from that new treatment. We would expect boards to have processes in place to allow patients who are recommended by their specialist as potentially benefiting from that treatment to be considered for that therapy.
I think that the best way to follow up would be if Elaine Murray emails or writes to me with the particular circumstances of the case. I can then get back to her in more detail.
Neurological Alliance of Scotland (Funding)
To ask the Scottish Government whether it will reconsider its decision to discontinue core funding for the Neurological Alliance of Scotland. (S4O-04434)
The Scottish Government remains fully committed to working with all stakeholders to improve outcomes for people with neurological conditions. We will continue to work with third sector colleagues and, indeed, we will be refocusing effort in that area. To that end, we expect to increase funding for specific projects to improve services and experiences for people with neurological conditions. This year we expect to invest almost three times as much funding as last year—up to £210,000—to support robust improvement projects.
Through the chief scientist office, we have currently committed more than £2 million on projects relating to neurological conditions. In addition, £700,000 has been committed to funding motor neurone disease specialist nurses.
I thank the minister for that response, which I will take as a no to my question. I have looked carefully at Monday’s written answer from him to the parliamentary question S4W-25750 lodged by my colleague Nanette Milne on this very subject. The Scottish Government has turned down the alliance’s request for just £35,000 of core funding—funding that enables neurological charities to work together to move neurology up both the political and the national health service agenda, which I think most people believe it has done very successfully.
How does the Scottish Government’s rejection of that request accord with the cabinet secretary’s amendment to this afternoon’s debate on health, which talks of fostering a “mature debate” and developing a “consensual approach” to future challenges?
In the interests of mature debate, I will answer that question. First, it is not the case that funding has been discontinued as such: there was an agreed funding period that came to an end. I am meeting the chair of the alliance soon, and I will be happy to discuss the matter with him.
The Scottish Government already funds the Health and Social Care Alliance Scotland with in excess of £3 million per year. The group has a variety of strategic outcomes and strong experience and expertise in topics such as health and social care integration, which is a key concern for the neurological community.
A number—in fact, a majority—of the member organisations of the Neurological Alliance of Scotland are also members of the Health and Social Care Alliance, and I believe that it is therefore well placed to provide a strong voice for the neurological community.
We also fund the national neurological advisory group, and given the threefold increase in project funding—which I notice was not welcomed by Alex Fergusson—neurological clients will be able to apply for and benefit from that resource.
Question 8, from Mark Griffin, has not been lodged. Again, the explanation was not satisfactory.
NHS Lothian (Meetings)
To ask the Scottish Government when it last met NHS Lothian. (S4O-04436)
Ministers and Government officials regularly meet representatives of NHS Lothian to discuss matters of importance to local people.
Was sickness absence discussed at the most recent meeting? If so, what is the Government’s explanation for the increase in sickness absence in NHS Lothian in each of the past three years?
Sickness absence is a regular item for discussion between NHS Lothian and officials. It forms part of the annual review process, which looks at the progress that is being made in that regard.
I say to Gavin Brown that we absolutely want to tackle sickness absence. That is against a background of the Government ensuring that there are more staff than ever in our national health service, which I am sure he will welcome. I can certainly tell him that the number of whole-time equivalent staff who are employed in the board increased substantially—by 10.7 per cent—from September 2006 to March 2015.
Oh dear.
That includes a 34 per cent increase in medical and dental consultant numbers and a 12.6 per cent increase in the number of qualified nurses and midwives. Richard Simpson might not want to hear about that, because he likes to talk about doom and gloom—
No, I am tired of hearing about it.
I am sure that, for the people of NHS Lothian’s area, the figures will be welcome news indeed.
Is the cabinet secretary aware of the concerns of the National Osteoporosis Society and the clinicians who are involved in the management of osteoporosis and the prevention of fragility fractures that the waiting time guarantee for a DEXA—dual energy X-ray absorptiometry—scan in NHS Lothian is not being met? Some patients are having to wait 15 months from fracture to treatment and are at risk of fracturing again during the time that they have to wait. Will the cabinet secretary commit to raising the matter directly with NHS Lothian to ensure that any specific issues can be addressed and that patients receive the care to which they are entitled?
I share the society’s concern at the suggestion that any patient should have an excessive wait for a DEXA scan, which would not be acceptable. Although a DEXA scan is not one of the eight key diagnostic tests that are covered by the six-week waiting time standard, the Scottish Government expects all boards to ensure that waits for other diagnostic tests are kept as short as possible and that, if possible, the tests are carried out within six weeks.
We are aware that NHS Lothian’s current waiting time for a DEXA scan is well in excess of six weeks and we have made it clear to the board that it must take immediate action to significantly reduce that wait as quickly as possible. My officials will monitor the board’s progress closely over the next few months.
Has the cabinet secretary spoken to NHS Lothian about the problem of general practices? I understand that 26 practices have now closed their doors. Is she prepared to say when the £50 million general practitioner fund will be made available for Lothian to make a bid to?
The detail of the fund to which Sarah Boyack refers will be made available very soon. The fund is being used strategically in negotiation with the Royal College of General Practitioners in Scotland, the British Medical Association and others to help with some of the immediate recruitment and retention issues and the workforce pressures that have been highlighted by those organisations and others.
I am aware of the issues in Lothian that Sarah Boyack raises. In the short term, part of the reason why a number of GPs are taking earlier retirement than they had planned is that pension changes that have been made have accelerated some plans for retirement. That is unfortunate, but it is a fact. NHS boards are discussing with those GP practices how they can ensure continuity of patient care while further medium to longer-term plans are put in place. I would be happy to speak to Sarah Boyack about those issues in more detail.
General Practice (Resource Allocation)
To ask the Scottish Government whether it considers that resources for GP practices should be moved from richer areas to poorer areas. (S4O-04437)
The Government is committed to investing in all of general practice. The Scottish allocation formula for allocating the global sum for practice funding accounts for about half the current funding and fees of practices. The formula is on the basis of the relative need of patients and the workload and it takes into consideration the relative costs of service delivery.
The formula is weighted to account for the socioeconomic status of the GP practice population. By including that weighting, the formula acknowledges that people from deprived backgrounds typically have poorer health outcomes, higher morbidity and greater health needs.
As the member will be aware, we are reviewing the general medical services contract in Scotland. At the same time, we are reviewing the financial framework that funds general practice, in order to put in place a sustainable and stable method of funding for the future.
I am grateful that the system is being reviewed. It seems to me—I wonder whether the cabinet secretary agrees—that, if life expectancy falls so dramatically from the west end of Glasgow to the east end, current funding resources might not be ideal.
I understand that the member represents constituents from among the most deprived areas of Glasgow, and we know that, across Government, we need to tackle the many factors that cause those health inequalities. This is not just for the NHS to tackle, and the problems cannot be resolved in general practice alone. As we take forward the discussion about new models of primary care, I am keen for us to consider the opportunities to get this right and to put tackling health inequalities at the centre of the discussions. We can do more in primary care to tackle health inequalities.
National Health Service (Skye)
To ask the Scottish Government whether it will provide an update on the review of provision of NHS services on Skye. (S4O-04438)
NHS Highland undertook formal public consultation between May and August last year on its proposals to modernise community and hospital services in Skye, Lochalsh and south-west Ross. The proposals to build a new hospital in Broadford, alongside the development of Portree community hospital, were endorsed by the board of NHS Highland last December. As the proposals were considered a major service change, they were subsequently submitted to the Government. I carefully considered all the available evidence and representations and I approved the proposals in February. I have been clear that NHS Highland must continue to involve fully all local stakeholders as plans are developed and this important work is taken forward.
In the Highlands, we want a centre of excellence in Raigmore hospital in Inverness, but we also want appropriate NHS services throughout the region. Given the £6 million overspend at Raigmore hospital this year, can the cabinet secretary assure people across the Highlands, and particularly on the Isle of Skye, that local, accessible NHS services will not be cut and that local voices and concerns will continue to be heard and heard with respect?
I absolutely agree that local voices should be heard with respect. The board had a difficult decision to make and, had it made a different decision, I am sure that other voices would have been raised by people who were not happy with that. It made a decision based on what it thought was the best available evidence. It has taken that forward, and it continues to engage with local people about that process. It is important to say that the independent Scottish Health Council confirmed that the board’s public engagement process was consistent with national guidance.
The decision is made and the board is getting on with the work in hand. It will continue to discuss with local people further enhancements that can be made across the Isle of Skye and beyond.
Telecare (Highlands and Islands)
To ask the Scottish Government what assessment it has made of how telehealth could assist in the delivery of healthcare across the Highlands and Islands. (S4O-04439)
The Scottish Government has set out the policy direction and strategic priorities to support the expansion of telehealth and telecare in Scotland in the national telehealth and telecare delivery plan, which was launched in early 2013. That work is supported by the £30 million technology-enabled care—TEC—programme from April 2015, for three years, to support local developments.
It is the role of health boards, local authorities and new joint integration boards to assess and commission appropriate services to address local needs, and that is being facilitated by the national improvement programme for TEC, called delivering our ambitions, which was launched in September 2014. The councils in the Highlands and Islands are active partners in that work and have received specific TEC funding of £407,000 for 2015-16 in order to expand expertise and provision across their local areas.
Does the minister agree that those opportunities are severely limited by very poor mobile telephone connectivity, and will she join me in calling on the United Kingdom Government to address urgently the very poor 2G, 3G and 4G availability across the Highlands and Islands?
Mobile connectivity is an integral part of the Scottish Government’s world-class digital ambitions and is of particular importance to rural communities. Many of the coverage problems that we experience in Scotland, particularly in relation to 3G, stem from the UK Government’s flawed approach to auctioning spectrum, which allowed operators to focus solely on urban areas at the expense of rural communities.
Ensuring that the same mistakes are not repeated with the 4G roll-out is a key priority for the Scottish Government, so we continue to press the UK Government on digital connectivity issues. Earlier this week the Deputy First Minister met John Whittingdale, the Westminster Secretary of State for Culture, Media and Sport, to discuss the issue.
The Scottish Government is keen to test new models that could extend coverage to areas that mobile operators see as being non-commercial. We recently funded a community-owned mobile telephone mast on the island of Coll, which I am sure Mike MacKenzie knows about. A partnership between Development Coll and Vodafone has brought 3G and 4G services to the island, making it the first island in Scotland to receive 4G.
Thank you. If we have slightly shorter questions and more succinct answers I might be able to make a bit more progress.
NHS Lanarkshire (Meetings)
To ask the Scottish Government when officials last met the board of NHS Lanarkshire. (S4O-04440)
Ministers and Government officials regularly meet representatives of all health boards, including NHS Lanarkshire.
In recent years, much progress has been made in the North Lanarkshire part of NHS Lanarkshire, with new multidisciplinary health facilities in Coatbridge, Airdrie and Kilsyth. Has there been any discussion with NHS Lanarkshire regarding a proposal to build a new multidisciplinary health facility in Chryston, in the northern corridor area of North Lanarkshire? Many of the residents in that area are receiving health services from two health boards—NHS Greater Glasgow and Clyde and NHS Lanarkshire. Having one health facility in that area may resolve some of the issues that are being caused by delivery of services.
Planning of local services is obviously down to NHS Lanarkshire in consultation with its neighbouring boards. It has not brought to us any proposals on a new facility for Chryston. I am happy to find out from NHS Lanarkshire whether that is in its plans for the future and I will write to John Wilson with that information.
NHS Fife (Meetings)
To ask the Scottish Government when it last met NHS Fife and what issues were discussed. (S4O-04441)
Ministers and Government officials regularly meet representatives of NHS Fife to discuss matters of importance to local people.
I have been contacted by constituents who recently lost their young grandson in tragic circumstances. They have raised with me concerns about the process of identifying the body and about the mortuary facilities in Fife. I am currently in communication with NHS Fife about those issues, but can the cabinet secretary confirm whether there is consistency across all health boards in respect of mortuary facilities? Is there guidance on minimum standards that health boards are expected to meet?
It would be helpful if Claire Baker would write either to me or to the Minister for Public Health, Maureen Watt, with more details about the concerns that have been raised in respect of mortuary facilities. Meanwhile, we will provide her with the information about standards for which she asks. It would, given the circumstances of the case that she has highlighted, be helpful to have more detail on the case and the nature of the concerns. We will make sure that she gets a reply.
Deaf People (Support)
To ask the Scottish Government what it is doing to support the estimated 850,000 people in Scotland who are deaf or have a hearing loss. (S4O-04442)
The Scottish Government believes that adults and children who have sensory impairment should expect seamless provision of assessment, care and support and the same access to employment, education, leisure, healthcare and social care as everyone else. Sensory impairment includes varying degrees of hearing loss, sight loss and dual sensory impairment.
For that reason we have invested £2 million to drive improvement via our sensory impairment strategy, called see hear. It was launched in April 2014 and is the first strategy of its kind in the United Kingdom, and sets a course towards the step change that is needed to make Scotland a more inclusive place for people with sensory loss.
It is important that individuals who require a hearing aid receive one as soon as possible in order to support them to live independently and to reduce their risk of experiencing isolation. The picture across Scotland is very mixed when it comes to accessing specialist hearing services; that could be addressed by establishing local audiology teams. What assurance can the minister give that a postcode lottery is not developing in Scotland? What engagement has the Scottish Government had with the third sector, which already delivers significant community-based basic maintenance and support?
This Government engages regularly with the third sector on a range of topics. I assure Nanette Milne that hearing services is an area on which we have dialogue. I have recently met Action Hearing Loss, for example, to discuss issues, and we will maintain that dialogue continually.
Where we have any targets in any part of the national health service, we expect them to be met.
Scotland Bill (NHS Funding)
To ask the Scottish Government what discussions it has had with the United Kingdom Government regarding the impact of the proposed Scotland Bill on national health service funding. (S4O-04443)
Negotiation of a new fiscal framework for Scotland is one of the highest priorities of the Scottish Government in the months ahead, and the Deputy First Minister met the Chancellor of the Exchequer on Monday to take forward those discussions. We will seek to agree a new fiscal framework that reflects the needs and interests of the people of Scotland. Our commitment to protecting the NHS remains unchanged.
Does the cabinet secretary share my concerns about the chancellor’s latest announcement of further cuts, including cuts to public health funding, at a time when we need to do everything we can to protect the health service in Scotland?
I certainly join Gil Paterson in expressing my concern that the chancellor seems to be intent on additional cuts, including cuts from this year’s health funding for England of £200 million that goes towards public health.
This Government will work to mitigate the impact on our budget and to provide further reassurance on our commitment to the NHS. Since 2010-11 Westminster has cut Scotland’s fiscal resource budget by 9 per cent in real terms, but we have increased the health resource budget by 5 per cent in real terms over the same period. This year we have taken total health spending to over £12 billion for the first time.
I will keep Gil Paterson informed of how we will mitigate the cuts to public health funding.
NHS Fife (Consultant Posts)
To ask the Scottish Government how many unfilled consultant posts there are in NHS Fife. (S4O-04444)
Under this Government, the number of consultants in post in NHS Fife is at a record high, having increased by 64.2 whole-time equivalents, from 168.2 in September 2006 to 232.3 in March 2015. Out of an establishment of 281.9 WTE consultant posts in NHS Fife, 52.6 WTE are currently vacant.
The position in Fife reflects the fact that we have some of the highest staffing levels ever across our NHS, including record numbers of consultants. The increase in vacancies is linked to the efforts to increase capacity by recruiting even more staff. We acknowledge the efforts that are being made by all NHS boards, including NHS Fife, to fill any vacancies in whatever way they can.
Let us have a brief supplementary and a brief answer, please.
I thank the cabinet secretary for that answer. I recognise that progress is being made and that hard work is going on. Nevertheless, the situation is still unacceptable. Given how difficult it is to recruit consultants in more rural areas, what proposals and plans is she considering for a long-term solution to the problem?
I am glad that Alex Rowley welcomes the progress that has been made. I also welcome the tone of his question. He has hit upon an issue that we must consider in order to see how we can help our district general and rural general hospitals, which can find it difficult to recruit to certain specialties. Teaching hospitals have less of a problem with that. We have to consider imaginative solutions—for example, recruiting people to work across networks by spending some of their time in a teaching hospital and some of their time in district general or rural general hospitals. That has already happened, but on quite a small scale. We have to look at more innovative ways of addressing the problem. I am happy to keep Alex Rowley posted on progress.
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