Plenary, 14 Jan 2010

Meeting date: Thursday, January 14, 2010

Official Report 737KB pdf

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Question Time

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SCOTTISH EXECUTIVE

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Health and Wellbeing

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NHS Highland (Rheumatology Service)

To ask the Scottish Government what progress has been made in discussions with NHS Highland to ensure the provision of a seven-day rheumatology service in Dingwall providing specialist facilities to the whole national health service board area. (S3O-9079)

I apologise to members for my rapidly disappearing voice. You will be pleased to note, Presiding Officer, that that will lead to shorter answers than normal today.

A review of the rheumatology service across Highland, which includes the Highland rheumatology unit at Dingwall, is currently under way. The review is at an early stage and no decisions have been made. The issue was raised with me at the board's annual review on 7 December, and I have asked the board to keep me informed of progress.

Does the cabinet secretary agree that NHS Highland is indulging in sharp practice in using an efficiency savings drive in the mid-Highland community health partnership to remove four of the 14 beds at the Dingwall rheumatology unit while conducting a whole health board review of the service that may take longer than this financial year? Does she also agree that NHS Highland should clarify what efforts it is making to offer relief to as many patients as possible who want to use that well-loved unit, which has welcomed patients from all over the Highlands and the Western Isles?

I can inform Rob Gibson that I have received information on the matter from NHS Highland and reassure him that the decision on beds—to which I will return in a second—in no way pre-empts the wider review of the rheumatology service to which I referred.

NHS Highland has made a temporary move, until the end of the financial year, to reduce the number of beds from 14 to 10. It has advised me that the beds in Dingwall were underoccupied, with the average occupancy rate being 70 per cent. Because the service operates mostly on the basis of planned admissions, it is possible—indeed, it is the best use of resources—for it to operate at near full capacity. I am also advised that the change allows the operation of a new day-case service for patients who need infusion therapy. Currently, those patients have to travel to Inverness.

Members will appreciate that, in the current economic climate, the Government has taken steps to protect the NHS budget into the next financial year. Nevertheless, all NHS boards are required to ensure that they use funds efficiently, which means using funds to deliver the best quality of service to patients. I note the points that Rob Gibson has made and ask him to accept my reassurance that the decisions that have been made in the short term in no way pre-empt the longer-term review.

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NHS Emergency Services

To ask the Scottish Executive how many people have attended national health service emergency services due to falls during the recent cold weather conditions. (S3O-9094)

The Scottish Ambulance Service responded to 1,037 cases of falls between 28 December 2009 and 3 January 2010—an increase of 38 per cent on the same period last year. According to provisional management information, between 28 December 2009 and 3 January 2010 there were approximately 50 per cent more attendances at accident and emergency departments throughout Scotland due to falls and fractures than during the same period last year. I thank all the staff who work in the NHS for the fantastic way in which they responded to the recent cold snap.

I hope that the cabinet secretary finds her voice soon. Like her, I pay tribute to all NHS workers for their significant efforts when the number of attendances at emergency services has been at a record high. What additional capacity, over and above the existing planning for winter pressures, has been provided to support the considerable effort that has been made by NHS emergency staff and ambulance staff?

As Jackie Baillie will be aware, NHS boards draw up robust winter plans every year. This year, the importance of those winter plans was underlined by the swine flu outbreak, although, as it turned out, the pressure on the NHS over the festive period came from the weather, not the flu pandemic.

The winter plan for each board area sets out how capacity is utilised as demand on the service increases. There is a range of things that an NHS board will do, should the circumstances require steps to be taken, such as rearranging staff rotas or cancelling elective admissions. I am pleased to say that, outwith NHS Borders, the impact of the weather on elective admissions has been minimal.

In my initial answer, I congratulated NHS staff, and I am glad that Jackie Baillie joined me in doing so. I make particular mention of staff working in accident and emergency departments. Obviously, given the weather conditions over the past couple of weeks, the demand on accident and emergency has been higher than it was in the corresponding week last year, but the performance of accident and emergency departments against the four-hour target is broadly comparable to that in the same week last year. That is a fantastic achievement, and every member of staff who has contributed to it thoroughly deserves the congratulations that they have received today.

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Fuel Poverty (Fife)

To ask the Scottish Executive what steps it is taking to tackle fuel poverty in Fife. (S3O-9096)

The energy assistance package is a national programme to tackle fuel poverty. By the end of November, the fuel poverty programme had helped 2,408 households in Fife. All were provided with energy savings advice; 711 were referred for a benefits check; 783 were referred for a social tariff check; 221 were provided with insulation measures; and 296 were provided with heating system measures.

This year, we have also allocated £120,806 to Fife Council in respect of 377 homes, under the social sector stage 3 stream. That money is funding energy efficiency measures that complement work that is delivered by the energy companies under the carbon emissions reduction target obligation. The home insulation scheme includes 8,955 properties in Fife and, in the first month of operation, the programme of doorstep visits generated requests under the energy assistance package, including 31 benefit checks, 64 social tariff referrals, 109 referrals to CERT or stage 3 of the energy assistance package, and 57 stage 4 referrals.

I urge the minister to take immediate action to introduce a boiler scrappage scheme, funded through Barnett consequentials, that would give households some £400 towards an energy-efficient boiler. I know that the minister has said that it is possible to do so, and I ask him to make it happen as soon as possible. Why should people who have high fuel bills and old and inefficient boilers have to wait while the minister, uncharacteristically, dithers?

Without further dithering, I inform the member that, in the energy assistance package, we provide free and discounted boilers, and we will decide whether to extend that generally to a boiler scrappage scheme. However, unlike in the previous Administration, the fundamental guiding principle of our policy on tackling fuel poverty in Scotland is to focus resources on those who are in most need. Based on the recommendations of the fuel poverty action forum last year, we reoriented programmes so that people who are in fuel poverty receive priority in terms of resources and the programme.

I thank the minister for ensuring that, in Fife, we have had more central heating installations than we had under the previous Administration. With regard to the new boiler and heating systems, I welcome the focus on families with children under the age of 16—a measure that I urged the previous Administration to take when it introduced its central heating system policies.

Question, Ms Marwick.

Following yesterday's welcome news, are there any other groups to whom the minister would like to extend the energy efficiency package in order to ensure that those who are most in need of help are the ones who receive it?

It is factually correct that, under this Administration, more central heating systems have been installed than were installed at any time under the previous Administration. Last year was a record year in that regard.

I was glad to announce yesterday the extension of eligibility to large families in receipt of the additional element of child tax credit. I have also asked the fuel poverty forum to examine other areas of eligibility. Before Christmas I asked it to consider specifically whether it would be possible to identify households with a disabled adult that are living in fuel poverty, and yesterday I asked it to find out whether it is possible to identify people who are chronically sick—including cancer patients—and living in fuel poverty, to see whether we can extend eligibility for the programme to those groups. I emphasise that only people in fuel poverty in those groups would be assisted.

I remind members that Presiding Officers prefer short and succinct questions and answers, to enable us to get as many back benchers in as we can.

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Convention of Scottish Local Authorities (Meetings)

To ask the Scottish Executive when the Cabinet Secretary for Health and Wellbeing last met representatives of COSLA and what issues were discussed. (S3O-9114)

I attended the meeting yesterday between the Convention of Scottish Local Authorities and the Scottish Cabinet at which various issues were discussed. In line with COSLA's role as a key partner in the planning and delivery of health and social care services in Scotland, I and the Minister for Public Health and Sport enjoy regular and close contact with COSLA representatives on a number of health and social care issues.

Has the minister discussed in her meetings with COSLA the implications of the statement that emerged from yesterday's meeting on the concordat? We were told that there would be

"a step change in the range of services available to elderly people".

Will the minister clarify whether that will end the postcode lottery in the cost and quality of care for older people throughout Scotland? How will that change be evident in the process of single outcome agreements, a troublingly small number of which refer to issues that relate to older and disabled people? Will it end the waiting list for direct payments?

As Johann Lamont is well aware, the Scottish Government and COSLA have been working together closely—and, I believe, constructively and successfully—since the start of the current Administration to identify and address many issues related to care for older people. For example, we have worked closely together to ensure proper funding of and consistent eligibility criteria for free personal care. We are working together on a range of issues to ensure that that standard of care exists for people.

Johann Lamont referred to the statement that was issued after yesterday's meeting, but we are not addressing issues only in the here and now—the Government and COSLA are also seeking to address the challenges that are presented by the demographics of our country. We have an ageing population, so the work to reshape services for older people is critically important.

I assure Johann Lamont that I—and the Minister for Public Health and Sport, I am sure—would be happy to meet her to discuss all those issues in more detail. There is between the Government and COSLA a real spirit of working together to ensure that we are providing services for older people that they deserve and have a right to expect.

Will the cabinet secretary find time to discuss urgently with COSLA—and national health service boards, for that matter—what approach is to be taken to fund the estimated additional £36.3 million that will be payable by Scotland's NHS from 1 April because of Labour's 1 per cent increase in national insurance?

Jackson Carlaw raises an important point. I said in response to an earlier question that the Government is working as hard as we can to protect the NHS from the consequences of Labour's recession. That recession hits—and will continue to hit—the NHS and other parts of the public sector hard.

As Jackson Carlaw rightly points out, the implications of the national insurance increase for the NHS amount to almost £40 million, which will be shared among boards throughout the country. My job as health secretary is to work with the NHS over the coming months and years to ensure that it can cope with the tighter financial constraints that it faces—and will continue to face; I gently remind Jackson Carlaw that it is not only Labour but his own party that promises cuts—while continuing to deliver services of the quality that people expect. I thank Jackson Carlaw for raising an issue that has a serious impact on the NHS.

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Antipsychotic Drugs (Older People)

To ask the Scottish Executive what action it has taken to reduce the overprescribing of antipsychotic drugs to older people. (S3O-9098)

Special care is required when antipsychotic medication is used in frail elderly people. Doctors should use medication of any type only after careful consideration of the risks and benefits for the patient.

Dementia is a top priority for the Scottish Government, as it is for all parties in the Parliament. We are due to publish Scotland's first ever national dementia strategy in April. As part of that, we are looking into how medicines, including antipsychotic medicines, can and should be prescribed in all care settings.

In answer to my written question S3W-29604, the Minister for Public Health and Sport said that the Government does not collect centrally the number of older people in care homes who are prescribed antipsychotic drugs. Alzheimer Scotland says that up to 14,750 residents in care homes are prescribed such drugs and that an estimated 70 per cent are prescribed them inappropriately. Indeed, a recent report to the United Kingdom Government estimates that an additional 1,800 deaths are directly attributable to the use of such drugs in the UK.

What is the cabinet secretary doing to ensure that general practitioners comply with part 5 of the Adults with Incapacity (Scotland) Act 2000? Does she agree that there should be mandatory education for GPs and care home staff on the risks and benefits of antipsychotic drugs? Will she agree to make the booklet, "Information for carers—Caring and consent", widely available to the families of those with dementia, whether they are being cared for in a care home, in their own home or in hospital?

I am very happy to consider all the points that Rhona Brankin has raised in her question, but I will perhaps reply to her in writing on some of the details. I hope that we can all agree that such issues should not be subject to party-political considerations, as we are all concerned about the needs of older people in care homes. All of us are, or certainly should be, concerned about the implications of the ageing population for the number of patients with dementia in future years. We need to have in place the right level of services for such patients.

On the issue of antipsychotic medication, Rhona Brankin raises an extremely important point. She may be aware that the Scottish intercollegiate guidelines network guideline 86 provides guidance on the use of antipsychotic drugs for people with dementia. The standards for integrated care pathways for dementia also contain specific standards about the use and evaluation of the benefits of medication. On what is an important and sensitive subject, I can give Rhona Brankin an assurance that the points that she has raised today will be fully considered by the Government.

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Energy Assistance Package

To ask the Scottish Executive, given the recent cold weather, what further steps it plans to take in addition to those outlined on 29 October 2009, to reduce the average waiting time for central heating installation for applicants who have qualified for stage 4 of the energy assistance package. (S3O-9059)

Following discussions with my officials, Scottish Gas has committed to install the enhanced energy efficiency measures for the vast majority of all energy assistance package customers in under 12 weeks and, where reasonably practical, any applicant waiting for three months or more as at 31 December 2009 will have their system installed by 31 March 2010.

Usually, we require that insulation is installed ahead of the heating system, but to limit delays in the cold weather we have instructed Scottish Gas to install the measures in whichever order is appropriate to the householder's needs.

The snow has made it just as difficult for the surveying and installation engineers to travel to jobs as for anyone else. I want to note my appreciation of the teams that are working so hard to progress installations.

I add my appreciation of the work of those teams, which have been working in the most difficult of conditions.

As the minister will know from our previous discussion, I have recently been contacted by a pensioner constituent who, having applied for a central heating installation and been accepted on to the scheme, was left facing the entire winter without any heating in his home. Previously, funding was brought forward to speed up central heating installations for pensioner households whose systems had broken down beyond repair—

A question please, Mr Scott.

Will the minister consider what additional steps can be taken to reduce waiting times further and to ensure that priority is given to making certain that no pensioner household in Scotland that is eligible for stage 4 assistance is without central heating over the winter?

John Scott makes a fair point that no pensioner should have to wait unduly, especially after being accepted on to the scheme. We are taking every possible measure to ensure that that does not happen. I am aware of the case to which he referred, which is very much the exception and not the rule. However, I can tell him that, compared with a 99-day waiting period under the old scheme, we are now down to a 60-day period under the new energy assistance package.

One of the frustrations of people having to wait for central heating under stage 4 of the energy assistance package is that the same company is involved in delivering stages 3 and 4 of the scheme. I hear what the minister says about turning the normal order of installation on its head, but the people concerned get more than one visit even though the same company is doing the work. The Scottish fuel poverty forum has recommended that those visits be co-ordinated to reduce disruption to constituents, speed up delivery and avoid long waiting times. What measures is the Scottish Government taking to ensure that those visits are co-ordinated while retaining the maximum input to the carbon emissions reduction target?

I have a meeting scheduled with Scottish Gas, at which I will discuss progress on implementing the measures that I announced in October, one of which is about ensuring that there is far better co-ordination on the ground to minimise delay. I get a monthly management report on all aspects of the energy assistance package, and the figures clearly indicate that there has been a substantial reduction in waiting times at each stage from approval through to completion. However, I am aware that that is not always achieved, and I and my officials are working with Scottish Gas to further improve the situation.

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Alcohol etc (Scotland) Bill

To ask the Scottish Government, further to the letter of 17 December 2009 signed by all 17 of Scotland's public health chiefs in support of minimum pricing for alcohol, what other support exists for its Alcohol etc (Scotland) Bill. (S3O-9086)

Our bill is receiving growing support, and minimum pricing is now backed by a broad coalition. As well as all 17 of Scotland's public health directors, other supporters of our policy on minimum pricing include the four United Kingdom chief medical officers, the British Medical Association, the Royal College of Nursing, the royal colleges, the Association of Chief Police Officers in Scotland, the Scottish Licensed Trade Association and the Church of Scotland.

Last week, the House of Commons Health Select Committee published a detailed report on alcohol, which included a clear recommendation for minimum pricing that was backed by Labour and Liberal Democrat members. Today, it appears that the Labour Secretary of State for Health in England may also support the policy of minimum pricing. It is disappointing that some colleagues in this Parliament continue to put party politics before public health, but I remain hopeful that good sense will prevail.

I will add one more organisation to the cabinet secretary's list—Breakthrough Breast Cancer. Breast cancer continues to be the most common cancer among women in Scotland. Each year, 4,000 Scottish women are diagnosed with the disease and 1,000 die from it. Does the cabinet secretary share Breakthrough Breast Cancer's concern that unless action is taken now to reduce levels of alcohol consumption, efforts to reduce the number of women who are affected by breast cancer will be at significant risk?

The policy of minimum pricing is part of a package of measures to tackle the problem of alcohol misuse in Scotland. The package has the potential to benefit the country in a range of ways, one of which Stuart McMillan has put his finger on. Enormous health benefits could flow from such a policy. The number of people who get and die from cancer would be reduced, as would the economic impact of alcohol misuse and the impact on the NHS and other public services.

I believe that there is a broad coalition in favour of a policy of minimum pricing and that the argument for it is progressively being won. When I spoke to Andy Burnham on the telephone this morning, I congratulated him on his position—or, at least, on his position as stated in this morning's Daily Telegraph. His comments—which he repeated to me—that the public mood on the issue is changing are completely accurate. The vast majority of people in Scotland believe that it is time to take action on alcohol misuse, and they will not forgive parties that put party politics ahead of public health. On such an important issue, I appeal to all parties to do the right thing when our bill comes before the Parliament.

I hope that the cabinet secretary's voice improves, even if the things that she says do not. As Gordon Brewer said on "Newsnight Scotland" the other night, she continues to make assertions.

Does the cabinet secretary agree that it is not helpful to make statements on the basis of assertions rather than evidence and that, therefore, the Scottish Government's recent press releases on the topic of alcohol and minimum pricing are unhelpful because they overegg the pudding to make the case? Number 10 has indicated that Labour's United Kingdom policy on the minimum pricing of alcohol has not changed, but that a debate is entirely appropriate. I hope that the debate will continue, without suggestions that it is about party politics, which it is not.

My comments are genuinely made more in sorrow than in anger, because I have always thought that Richard Simpson took a principled stance on public health issues, including the issue of alcohol. Indeed, he is on record in the chamber as supporting the unit pricing of alcohol—that is his stated position. I agree with Richard Simpson that we should have a debate on the issue; I believe that it is one of the most important debates that we can have in Scotland at this time. That is why I find it so sad and completely incomprehensible that Labour decided to state its position before the Alcohol etc (Scotland) Bill had even started going through the parliamentary process and before the debate had properly begun in the Parliament.

With reference to Richard Simpson's comments on assertions, I repeat that the Scottish Government's views on minimum pricing are not simply the views of the Scottish Government: they are backed by doctors, nurses, the police, public health experts and significant and growing numbers in Labour's ranks. It is time that Labour took a step back from its fixed position on the issue and decided to join the mainstream in Scotland that is determined to take action on alcohol misuse.

Question 8 was not lodged.

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Mental Health Services

To ask the Scottish Executive what actions are being taken to improve services available to people affected by mental health issues. (S3O-9123)

We are continuing to deliver on our challenging national performance targets, complemented by a range of other activity designed to improve and modernise the provision of mental health services and ensure that quality, integrated mental health services are available for all who need them. This service improvement agenda is a key part of our partnership approach to improving the mental health and wellbeing of the people of Scotland, which is focused on promotion, prevention and recovery.

Is the Cabinet Secretary for Health and Wellbeing concerned about the increasing number of children suffering from mental health issues who are sent to adult or non-specialist wards? In Glasgow, the number of such children has doubled from 21 to 41. Given that the Mental Welfare Commission for Scotland acknowledged the previous Administration's progress towards halving the number of inappropriate admissions by 2011, is the she working towards that target? When does she expect progress to be made on the target?

I share Pauline McNeill's views on, and concerns about, the issue. The area of child and adolescent mental health services is a key priority for the Government, as is evidenced by a range of action that has been taken.

To address Pauline McNeill's specific point, obviously our aim is to ensure that the right care and treatment are available at the right place and time for young people. We acknowledge that there are still instances when young people are admitted to adult beds, but we are working very closely with national health service boards to address that. As evidence of that, I cite the recent opening of Skye house for young people from the west of Scotland. We are seeing progress in the provision of in-patient beds for young people. The recent opening of Skye house provided 24 beds, which is an increase from 16 and brings the total to 42.

We are working closely with NHS boards in the north and south-east of Scotland around their consideration of bed requirements to meet local and regional needs. The issue is extremely important, and the Government remains committed to making further progress, building on the progress that has already been made.

Scotland has one of the highest suicide rates in western Europe; it is almost twice as high as the rate in England and Wales. What actions is the Scottish Government taking to tackle that worrying statistic?

Nanette Milne, like Pauline McNeill, raises a very important issue. She is aware that there is a specific health improvement, efficiency, access and treatment target for suicide, which is to reduce the suicide rate between 2002 and 2013 by 20 per cent. That target is supported by key front-line staff in mental health and substance misuse services. We will continue to make progress towards that target, because this area, as is the case with the many other areas of mental health, is extremely important. Mental health, as others have said in the chamber down the years, has for some time been seen as the Cinderella of the health service. I hope that, with the range of actions that the Government is taking, that is changing quickly for the better.

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NHS Lanarkshire (Meetings)

To ask the Scottish Executive when it last met representatives of NHS Lanarkshire. (S3O-9113)

I meet all national health service chairs regularly. The most recent meeting was on 23 November. The Minister for Public Health and Sport met NHS Lanarkshire on 20 October when she chaired the board's annual review.

The minister may recall that I have written to her about a constituent's concern about weight management and gastric banding services in Lanarkshire. I seek simply to appeal to the cabinet secretary in relation to the provision of such services in the west of Scotland. It is clear from her correspondence that Glasgow has a fairly well-developed service. Patients can work their way through the system and, if a gastric banding intervention is required, necessary and appropriate, they can achieve it. However, it appears that, in the west of Scotland, only Glasgow is capable of providing that service. That concerns a number of my constituents. One in particular is concerned about the impact on his emotional wellbeing as well as his physical wellbeing. That clearly worries and concerns him, his family and me.

I appeal to the cabinet secretary to get together with west of Scotland NHS boards to develop a west of Scotland centre and allow people from throughout the west of Scotland to access a well-managed service that has at the end, perhaps, the intervention that my constituent seeks.

That is a constructive contribution from Andy Kerr. I am certainly happy to consider that in discussion with west of Scotland boards. As Andy Kerr said, he has corresponded with me on the issue on behalf of constituents for a period of time. It is an important issue. Many people throughout Scotland feel that gastric band surgery would be of assistance to them. It is not of assistance to everybody who has weight management issues, and it is clear that clinical decisions have to be at the forefront of all considerations, but it is important that people in such circumstances have access to the right treatment when they need it.

I give Andy Kerr an undertaking that I will continue to consider the issue, as NHS boards are doing. I am more than happy to continue the correspondence that we have started.

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Fuel Poverty

To ask the Scottish Government what measures it is taking to tackle fuel poverty in areas of multiple deprivation in Glasgow and across Scotland given the impact that the recent severe cold weather will have on those already in or in danger of suffering the effects of fuel poverty. (S3O-9081)

The Scottish Government is helping people throughout Scotland to reduce their heating bills and keep their homes warm through the energy assistance package. Anyone can call 0800 512012 to obtain guidance on energy savings or check their entitlement to benefits and cheap tariffs.

Between April and the end of November, some 5,138 fuel poor households had heating and insulation measures installed under stage 4 of the package. That should save them an average of £858 a year on their fuel bills. Yesterday, I announced that we intend to make such help available to even more households. In addition to the families and pensioners who are already eligible, we will extend stage 4 to larger families with children under 16 who get more than the family element of child tax credit.

We are helping people to switch to cheaper energy tariffs and payment methods, which together can save people an average of £300 a year. Many people are eligible for cheaper rates and if they call today they could be on a new tariff within a couple of weeks.

What impact would the abolition of attendance allowance have on those who experience the effects of fuel poverty?

The Labour Government's proposals from London to abolish attendance allowance would be damaging to older people because that would reduce their incomes substantially—in some cases, by more than £70 a week. As attendance allowance was originally intended to be an anti-poverty measure, such a policy would be extremely regressive. It would put more and more pensioners in Scotland into fuel poverty.

Among the poorest people in our society are some whom we often forget—asylum seekers and refugees. Will the minister clarify their entitlement to the various measures that are available? What efforts has the Government made to ensure that they are protected from the impact of cold weather?

I suppose that it all depends on where those people live and the state of their housing. However, if asylum seekers resident in Glasgow, for example, meet the eligibility criteria, there is no reason why they should be turned down for the programme.

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British Sign Language

To ask the Scottish Executive what steps it is taking to promote the use of British Sign Language. (S3O-9101)

Like the previous Administration, the Scottish Government has since its inception recognised the importance of British Sign Language for deaf people and taken positive steps to promote it. The British Sign Language and linguistic access working group, which was established in 2000, has been working within a strategic plan to deliver improved access for deaf people. At the moment there is undercapacity to deliver many of the required improvements and in that respect the group has identified various necessary long-term targets, including systematically increasing the pool of available BSL teachers, particularly at advanced levels, and developing a coherent progression route for BSL learners and for the training of BSL to English interpreters. To that end, the Scottish Government is providing from 2008 to 2011 almost £1.5 million to a consortium led by the Scottish Association for Sign Language Interpreters.

I appreciate the need for long-term planning and welcome the Government's continuing commitment to promoting BSL. Has it considered or is it actively considering giving BSL the same legal recognition that Gaelic has?

The proposal has been discussed with representatives of the BSL community and other groups, but the Government has not taken a definitive decision on the issue. We continue to discuss with all the key stakeholders points arising from the suggestion; indeed, I am quite happy to discuss the matter in more detail with Cathie Craigie in recognition of her particular commitment to the cause.

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Hospital In-patients (Nutrition)

To ask the Scottish Executive what guidance it issues to national health service boards in respect of the cost of providing a nutritional diet to hospital in-patients. (S3O-9104)

Although the Scottish Government issues guidance to support NHS boards in providing a nutritious diet to hospital in-patients, it is for boards to manage expenditure on food provision at the local level within the overall funding available to them.

I thank the minister for her answer, but surely the great disparity in costs, which range from around £6 a day in some health boards to up to £36 a day, cannot be accounted for purely by geography or overheads. Given the importance of good nutrition in the recovery process, will the minister undertake to review at an early opportunity the quality and cost of hospital food?

I thank Patricia Ferguson for raising an issue that we will all agree is extremely important. Good nutrition in hospitals is fundamental to patient recovery, and I assure her that we keep all these matters under review.

Some of the variation in the costs of food provision between NHS boards can be accounted for by geography, transport costs and other overheads as well as by the different patient mix in different hospitals. After all, the quality and balance of hospital food must be right; dietary requirements vary greatly according to patient circumstances and hospitals must provide the right nutritional balance according to patient need.

As Patricia Ferguson knows, we have committed to considering the adoption of national nutritional standards for the NHS and local authorities. We are continuing to consider the matter; however, we are awaiting the NHS Quality Improvement Scotland review of its food in hospitals guidance, which is due to be published in April, and will take further decisions when we have considered that report.

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NHS Greater Glasgow and Clyde (Renal Clinics)

To ask the Scottish Executive whether NHS Greater Glasgow and Clyde patients have complained that renal consultants are seeing fewer patients and that waiting times have been adversely affected as a result of management decisions to relocate clinics from the in-patient unit at the Western infirmary to out-patient clinics at the Victoria and Stobhill hospitals. (S3O-9124)

I am advised by NHS Greater Glasgow and Clyde that neither the senior management team in charge of renal services, nor the patient liaison team, has received any complaints from patients since the opening of the new Victoria and Stobhill hospitals relating to renal consultants reviewing fewer patients. If Des McNulty has any particular concerns from constituents, I would of course be glad to consider them.

The particular concern is that consultants are waiting in Victoria and Stobhill hospitals for patients who have difficult transport arrangements to get to those locations. When the patients arrive, in-patient treatment must then take place on a different site. The whole situation seems to me and to them to be extremely wasteful. Will the minister ask NHS Greater Glasgow and Clyde to review the management arrangements in consultation with the consultants and patients to see whether better arrangements can be arrived at?

As I said to Des McNulty, those issues have not been raised with me before today. If consultants have issues about patient flow and management within hospitals, they should seek to consider them with NHS Greater Glasgow and Clyde.

With the introduction of the new services at the new Victoria and Stobhill hospitals, the majority of patients are experiencing less travel time to receive their regular dialysis. They are also receiving that dialysis in modern, state-of-the-art, up-to-date facilities. There is an improvement there, but if there are issues such as those that Des McNulty has identified, I am sure that NHS Greater Glasgow and Clyde will be happy to discuss them further with the consultants concerned.

We have a little time in hand for the next debate, so I will allow another question. Question 15 has been withdrawn.

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Swimming

To ask the Scottish Executive what value it places on swimming as a way of improving both physical and mental health. (S3O-9060)

Thank you, Presiding Officer. [Laughter.]

The Scottish Government recognises that swimming is an excellent way to be physically active that not only promotes general wellbeing, but reduces the risk of major chronic disease such as coronary heart disease, stroke, diabetes and some cancers.

Is the minister aware of the threat of closure to the community-owned mid-Argyll swimming pool in Lochgilphead? Does she agree that such a closure would be a disaster for local people? Will she, like me, encourage all stakeholders to do everything possible to secure the swimming pool's future?

As I understand it, all stakeholders are working hard to ensure the future of the swimming pool in mid-Argyll. Mid Argyll Community Enterprises is looking at a range of options to secure the pool's future. I understand that Jim Mather, the constituency MSP, is organising a meeting between the council, the enterprise company and other stakeholders, and that sportscotland has been invited to attend that meeting. Swimming is important and the Scottish Government remains committed to supporting, where we are able, the ability of people to take advantage of the sport that has all the benefits to which I referred earlier.

If Jamie McGrigor could not hear my answer, my colleague Hugh O'Donnell suggested that he could read it in the Official Report tomorrow.