Meeting of the Parliament

Meeting date: Thursday, December 15, 2011

Official Report 1073KB pdf

---

Scottish Executive Question Time

---

General Questions

---

Ovarian Cancer (Awareness)

1. To ask the Scottish Government what initiatives there are to raise awareness of the symptoms of ovarian cancer to allow early diagnosis and treatment. (S4O-00479)

Earlier this year, I launched the detect cancer early initiative. During the summer months, we undertook engagement with stakeholders, and the implementation plan is being finalised. While the focus of the initiative will be on lung, breast and bowel cancer in the first instance, I am confident that the programme will also help to tackle fears about and negative attitudes to cancer and its treatment more generally and so encourage people to present earlier with any suspicious signs or symptoms.

I welcome that action plan. As with other cancers, the key to dealing with ovarian cancer is awareness and early detection. The awareness level is low among women and sometimes even among health professionals. Could consideration be given to a specific campaign to raise awareness of ovarian cancer?

I am always happy to consider such proposals. I agree strongly with the thrust of Linda Fabiani’s question that key to our battle against cancer is the raising of awareness among the public—women in this case—and health professionals so that people can be diagnosed earlier and given treatment earlier.

In the region of 600 cases of ovarian cancer are diagnosed each year, so an individual general practitioner might see a case of ovarian cancer only once every five years. We therefore need to ensure that we raise awareness and understanding among GPs and other health professionals. Of course, referral guidance was published in 2007 that encouraged GPs to look for signs of suspected cancer. I absolutely agree with Linda Fabiani and will continue to look at what more we can do.

---

A9 Upgrading Works

2. To ask the Scottish Executive when it will publish a detailed timetable for the A9 upgrading works between Perth and Inverness. (S4O-00480)

We intend to announce more details on our timetable in 2012.

I am sure that we all welcome the announcement that the A9 dual carriageway between Perth and Inverness will be completed in fulfilment of a Scottish National Party manifesto commitment from 2007. However, local people want to know when exactly the works will be done, how they will be funded and where the money will come from. Can the cabinet secretary be precise? When will we have that clarity?

Early in 2012, I will announce the details of each stage to complete the dualling between Perth and Inverness. Some of that is already built into a programme, but most of it will be in the period beyond 2015. We will be specific about the sequence in which we undertake the works and when we hope to start and complete each stage.

The cabinet secretary will be aware that orders are about to be laid for another two-plus-one overtaking lane at the northern A9 at Black Mount near Carrbridge, just south of the Slochd. What does the cabinet secretary think about not proceeding with that proposal but going straight to dualling, given that the Government has committed to dualling, rather than spending a lot of time and money putting in the overtaking lane and then having to tear some of it up to dual not very much later?

Mr Thompson makes a worthwhile point and we are considering it during the compilation of the schedule that I referred to in my previous answer.

---

Long-term Medical Conditions

3. To ask the Scottish Government how it helps people with long-term medical conditions. (S4O-00481)

Our healthcare quality strategy aims to ensure that people with long-term conditions receive high-quality, safe, effective and person-centred care. We want to put people with long-term conditions at the heart of the national health service, enable them to be treated closer to home and offer support so that they are better able to self-manage their condition where that is appropriate.

We are seeing on-going improvements in services so that they are better designed for people with long-term conditions. For example, in 2009-10, older people required 125,000 fewer days in hospital and 29,000 got telecare at home instead of care in a hospital setting. We have also had very positive feedback from the 76,000 people who are now managing their medicines better through local pharmacies’ chronic medication service.

As the cabinet secretary knows, Scotland has the highest incidence of multiple sclerosis per head of population in the world. Does she agree that, in tackling MS, it is important to deal with many national and local partners to determine the causes and possible treatments of the condition?

I very much agree with George Adam that, in tackling multiple sclerosis and supporting people who have it, we need to consider a range of joined-up and integrated approaches. That includes research into the condition, ensuring that we have services in place for people with the condition, providing services as close to home as possible and, as is the case with other long-term conditions, ensuring that we are supporting people to self-manage their condition. I assure George Adam that that will remain central to our work as we move forward.

I welcome the work of the Long Term Conditions Alliance Scotland and its approach to self-management, which is supported by the Government. In relation to another long-term condition, what action and resources are in place from the Government to deal with chronic pain?

As the member will be aware, I took the step some years back of recognising chronic pain as a long-term condition. That was acknowledged by all those involved in work in that area as a key step forward in improving services for those with chronic pain and ensuring that there are pain management clinics and other services for people with chronic pain. We will continue to push forward with that work.

I spoke relatively recently at the conference of those involved in chronic pain, where it was recognised that while there is more to do, there is real progress in that area of work. More generally, I put on record my continued support for the Long Term Conditions Alliance Scotland and its work on self-management.

---

Childhood Sexual Abuse Survivors (Identification)

4. To ask the Scottish Executive what it is doing to improve the early identification of adults who are survivors of childhood sexual abuse. (S4O-00482)

In 2005, the Scottish Government launched the national strategy for survivors of childhood sexual abuse. As part of the strategy, we have funded awareness raising and training for staff in statutory and voluntary organisations to help them to support adults who access those services to disclose their abuse.

Since 2008, a national programme of work on improving the healthcare identification and management of gender-based violence has taken place throughout NHS Scotland. To date, approximately 2,800 staff from mental health, substance misuse and maternity services have been trained in routine inquiry.

I thank the minister for that full answer. He will be aware from the physical health groupwork project undertaken by Open Secret as part of the national strategy for survivors of childhood sexual abuse that such survivors have an increased risk of experiencing a wide range of medical conditions, including chronic pelvic pain, non-epileptic seizures, gastrointestinal problems, gynaecological problems and immune disorders. In view of that, what is the Scottish Government doing to help to increase awareness among medical professionals of the causal relationship between physical ill health and childhood sexual abuse in order to improve the early identification of survivors and encourage trauma-informed practice in treatment and the promotion of and access to appropriate services for survivors?

The member referred to the Open Secret physical health service, which has been funded for the past two years by the Scottish Government because we recognise the importance of that area of work.

The member will be aware that the Government recognises the need to increase awareness among professionals of the physical effects of childhood sexual abuse. That is why physical health and complex trauma continue to be a priority for the national strategy and in our funding of that strategy.

We will continue to work with Open Secret to consider further measures that we could take to ensure that there is greater awareness among other healthcare professionals and that they are sensitive to the needs of survivors of childhood sexual abuse.

---

Reserved Matters (Scottish Government Position)

5. To ask the Scottish Executive, in order to inform voters ahead of the proposed independence referendum, when it will publish its position on the issues that are currently reserved. (S4O-0048)

The Scottish Government sets out its position on reserved matters regularly. Details on a range of key issues related to constitutional reform have been included in Scottish Government publications including “Choosing Scotland’s Future: A National Conversation: Independence and Responsibility in the Modern World”, which was published in 2007, and “Your Scotland, Your Voice: A National Conversation”, which was published in 2009.

I apologise for having missed those two publications. I ask for something a bit more high profile, as it would take at least a year to embed any new concepts that would be inevitable if, for example, pensions were to be run from Edinburgh and not London. We see the confusion that has arisen over defence—at least, I hope that it is confusion and not the policy. People need to know not only about defence but about the euro. They need to know who will pay their pensions and how they will be paid. People need that sort of information and it does no members of the Parliament any good if misinformation is peddled.

Margo MacDonald’s question is understandable. The Scottish Government will ensure that voters have all the information that they need about the referendum and independence to be able to take an authoritative, well-informed decision about Scotland’s constitutional future. Well in advance of the referendum, the Scottish Government will publish a white paper detailing the positive platform for Scotland’s future on which Scottish voters will be asked to decide.

---

Hidden Waiting Lists (NHS Lothian)

6. To ask the Scottish Executive when it will publish its response to the investigation by NHS Lothian of so-called hidden waiting lists. (S4O-00484)

I received NHS Lothian’s report earlier this week and I am giving it my full consideration. A copy will be placed in the Scottish Parliament information centre early next week and I am happy to ensure that Sarah Boyack gets a copy as soon as it is available.

Following the acceptance that patients had been offered unreasonable appointments, I welcomed the First Minister’s assurance that the patients concerned were now receiving treatment locally. However, subsequent reports have suggested that some of those patients could be among the 700 in NHS Lothian’s area who are to be treated by private providers at public expense.

Does the cabinet secretary agree that the use of private providers by the national health service should be a last resort, not the default position? Is the sustained use of private providers by NHS Lothian an inevitable consequence of Scottish Government cuts, now that 270 nursing and midwifery posts have been lost in the past year and 300 more are projected to be lost in the months ahead?

The cost of using private providers is reducing. I am on record as having said and I put it on record again now that the use of private providers should be at the margins and a last resort for any NHS board. That is in marked contrast to the position of the previous Administration, which set up Stracathro hospital under private stewardship. Under this Administration, that hospital has been fully restored to the national health service.

I am proud of our position and our record on that matter and I will continue to ensure that the national health service provides quality care to patients in every part of Scotland. I assure Sarah Boyack that, if there are any lessons to be learned and actions to be taken as a result of the NHS Lothian report, they will be learned and taken.

---

Single Police Force (Headquarters)

7. To ask the Scottish Government when a decision will be made regarding the location of the headquarters of the proposed single police force. (S4O-00485)

The Government intends to introduce a bill to Parliament early in the new year to establish single police and fire services. We have begun preparations for transition to the new police service, working with the Association of Chief Police Officers in Scotland and other partners. I expect a decision on the location of the headquarters to be an early outcome of that work.

Does the minister accept that, whatever the national position is, there will be a need for a major office in Glasgow and the west of Scotland and that an early move from Pitt Street to, perhaps, Dalmarnock would be a cost saving and a boost for the local area?

I have no doubt that that would be a boost to the local area and I accept the challenges that exist in Pitt Street. Some progress has been made in moving forensics out, and we must also take cognisance of the new Gartcosh campus.

There will have to be specific arrangements for the city of Glasgow and the west of Scotland. However, those matters are best dealt with by the new authority once it is established, in conjunction with the new chief constable, whoever he or she may be.

---

Grampian Police and Judicial Services (Discussions)

8. To ask the Scottish Government what recent discussions it has had with the police and judicial services in the Grampian force area. (S4O-00486)

We regularly meet the police and judicial services throughout the country, including the Grampian area, to discuss a range of issues. I last met Grampian Police on 31 August. My officials last met the chief constable of Grampian Police on 7 December.

The cabinet secretary will be aware, in the light of the construction of HMP Grampian and the closure of HMP Craiginches, of the need for remand facilities in Aberdeen. Given the inadequacy of the holding cells in the Queen Street police headquarters and in the court buildings, will he facilitate a meeting with all relevant parties in the north-east to see how the provision of the necessary facilities can be brought about?

Obviously, police cells are fundamentally a matter for the chief constable and the police board. I recognise that there are particular difficulties in the city of Aberdeen, especially as we move towards the opening of HMP Grampian. I am more than happy to meet the member or other parties—as I do regularly—to discuss what solutions may be available.

The cabinet secretary will be aware of widespread concern about the proposals to abolish volunteer groups that monitor conditions in prisons and replace them with a Government-run advocacy service. Will he therefore take the advice of his Aberdeen City Council Scottish National Party colleague, Councillor Jim Kiddie, who is convener of the council’s social care and wellbeing committee and the Aberdeen prison visiting committee, who is said to be dismayed at the Government’s plans? Will he do what Councillor Kiddie has urged and think again?

I met representatives from the prison visiting committees an hour ago. I did them the courtesy of meeting them and indicating that I will consider and reflect on the issue.

We are in a time of limited resources. There is a problem with those who go into and out of prison on a revolving-door basis. We require to monitor prisoners and safeguard their rights. That is done in a variety of ways, which range from the work of the chief inspector of prisons through to the Parliament’s requirement to comply with the European convention on human rights. We also require to meet the needs of prisoners, and there is a specific need to ensure that an advocacy service is available for that purpose.

I can say to Nanette Milne exactly what I said to the representatives from the prison visiting committees: I will reflect on the issue, but I believe that an advocacy service is essential.

---

Winter Resilience

9. To ask the Scottish Executive whether it considers that there is adequate winter resilience preparation across the country. (S4O-00487)

Winter preparedness is an on-going process rather than a one-off event. As Scotland experienced its first severe winter weather of the year last week, I commend all those involved in the preparation and response. I am satisfied that the measures put in place were effective, although we will continue to learn lessons and improve.

Over the past year, public, voluntary and private sector organisations have worked with the Scottish Government to identify and learn from the lessons of last winter and have conducted exercises together to deal with a range of severe conditions. On 26 October, the Scottish Government led a debate on winter resilience, during which a wide range of members voiced their support for the findings of the winter weather review group and for the Scottish Government’s major ready for winter initiative. Although disruption can never be ruled out, particularly when the weather reaches damaging levels, I am content that arrangements have been put in place all across the country to ensure that Scotland is as prepared for winter as it can be.

I ask members to settle down a bit, because there is a bit too much noise.

One of the complaints that I heard most frequently last winter was that, once gritting got under way, the roads were treated but the pavements were not. Many of the most vulnerable people do not have private access to a car and rely on their feet to get them about, even if it is only to the bus stop. Will the Government work with local authorities to impress on them the importance of ensuring that pavements, not just roads, are gritted?

Absolutely. I know that my colleague the Minister for Housing and Transport has raised that issue. Clearly, there were reasons why there were particular difficulties last year as a result of the severe snow, which closed roads and impacted on pavements. Equally, as the member correctly points out, local authorities have an obligation to deal with the issue and many authorities have been investing in equipment that was previously lacking.

I know, anecdotally, that steps have been taken in the city of Edinburgh to ensure that matters are dealt with by the local authority, by other organisations charged with responsibility and by citizens who are prepared to look after both themselves and their neighbours. I take the point on board and will raise it with my colleague the Minister for Housing and Transport.