SCOTTISH EXECUTIVE
Hairmyres Hospital (Private Sector Contracts)
To ask the Scottish Executive whether it will review the terms and conditions of private sector cleaning and catering contracts at Hairmyres hospital, Lanarkshire. (S1O-5204)
Cleaning and catering arrangements at Hairmyres hospital are matters for Lanarkshire Acute Hospitals NHS Trust in the first instance. I am told that meetings have been held with the private sector consortium to discuss various problems.
I visited the hospital two weeks ago. In ward 1—the cancer ward—the toilet had been cleaned only once that week and, even then, it had not been done satisfactorily. In addition, the food that was being served up was not fit for human consumption. As a matter of urgency, will the minister intervene to get Hairmyres hospital sorted out? [Interruption.] The local member, the Minister for Finance and Public Services, should read his local newspaper and see the real concern instead of shouting abuse at me.
Ensuring that we have the clean hospitals to which patients have the right is a top priority for the Executive. I am interested in hearing any views that are expressed on the issue. However, this year, for the first time, national standards for cleaning have been established by the Clinical Standards Board for Scotland. The board is working with Audit Scotland to visit every hospital in Scotland to check performance against those cleaning standards. I will receive reports from those two bodies in the near future. I hear what Alex Neil is saying, but I hope that everybody will welcome that development.
Although I welcome the move from private sector to public sector catering at the Victoria hospital in Kirkcaldy, will the minister investigate the claims of the GMB that the terms and conditions of that move are the private sector terms and conditions and will remain for a year outwith the Whitley Council's terms and conditions?
In the health plan, we said that the contracting out of cleaning services should no longer be regarded as the norm. There was a problem in the late 1980s and the early 1990s because services were contracted out for ideological reasons and quality went out of the window. We are saying that the criteria must be quality and value for money.
Public Bodies (Funding)
To ask the Scottish Executive what plans it has to review the formulae used to distribute funding to public bodies. (S1O-5211)
Distribution formulae are reviewed regularly. The Arbuthnott formula is reviewed by a standing committee that is chaired by Sir John Arbuthnott. In conjunction with the Convention of Scottish Local Authorities, the Executive keeps the local government distribution formulae under constant review.
Is the minister aware that central Government funding for transport, drugs, health and enterprise funding in Grampian always tends to come bottom or near the bottom of the league? Is he aware that it is becoming increasingly difficult to deliver an adequate level of public services in Grampian because of the formulae? Will he undertake to review the formulae to assess their impact on Grampian and make any necessary changes?
I do not agree with the premise of the question. For 2002-03, national health service funding in Grampian is £27.7 million; that figure will rise to £30.8 million in 2003-04. There have been significant increases for local councils. Funding for Aberdeen Council is up 9.6 per cent and funding for Aberdeenshire Council is up 10.2 per cent. I have held meetings with those councils recently to discuss finance-related matters.
Will the formulae ensure that local authorities and local enterprise companies have sufficient funding for economic development in areas of high unemployment? In particular, will the Executive ensure that pump-priming investment of £15 million to £20 million is made available to Scottish Enterprise Forth Valley and Falkirk Council to enable them to kick-start the Falkirk action plan? Such investment could help to provide up to 4,000 jobs in the Falkirk area, which has suffered recent redundancies at companies such as BP, Exabyte Scotland Ltd and Dyson Refractories Ltd.
Let me reiterate my point. The Executive allocates resources where need is most apparent. Therefore, in my work with other ministers as we sit around the table and discuss the spending review, we will focus on outcomes and on the real difference that our expenditure makes in communities such as the one to which Mr Canavan referred.
Let me take the minister back to his answer to Mr Lochhead. In his review of the Arbuthnott formula, what independent evidence is gathered and who gathers it? It is obvious that Sir John Arbuthnott does not do that work himself.
It is clear that the Arbuthnott formula did not come from nowhere. We undertook a huge consultation exercise with interested parties: communities, health authorities, local government and other organisations. We set down a system that has been in place for only a year or so. For the first time in 20 years, resources are allocated in the health service on the basis of need. The Executive wants to analyse those needs in order to meet demand and deliver services.
Lothian NHS Board (Strategic Change Deduction)
To ask the Scottish Executive what guidance it has given to Lothian NHS Board regarding the 1 per cent per annum strategic change deduction agreed by the board's chief executive. (S1O-5213)
The Scottish Executive has not issued any specific guidance to NHS Lothian on its strategic change fund. Local financial planning is a matter for local health care systems.
I thank the minister for her answer. Is she aware that, under anyone's criteria, the strategic change deduction is a cut for the NHS in West Lothian of £1.38 million? Is she also aware that, according to the pan-Lothian review group, that money is needed to cover the £24 million shortfall, some of which comes from the overspend and overrun on the Edinburgh royal infirmary? I am aware of the situation at St John's hospital, where the accident and emergency new build is now a refurbishment—
Order.
Will the minister tell us why West Lothian patients are paying for the profits of the ERI public-private finance initiative?
Fiona Hyslop mentioned that St John's hospital in West Lothian is to have a refurbished accident and emergency department. That is an improvement to the existing service. Why does the SNP's discussion paper on health and community care say that the party will increase the proportion of Scotland's health budget that is controlled locally when members such as Fiona Hyslop continue to ask the Executive to take local decisions?
Does the minister agree that it is dishonest of members to claim that health cuts are taking place when record expenditure is going into the national health service in Scotland, in Lothian and in West Lothian? Does she recognise that the true picture in West Lothian is one of an increasing number of doctors and nurses and of increased investment in private—[Members: "Oh."] I meant to say primary care facilities. The SNP does not wish to welcome that investment.
What is the question?
Does the minister also recognise the increased investment in accident and emergency services?
I recognise that Lothian NHS Board's expenditure is increasing from £726 million this year to a projected £783 million in 2003-04. That increase must be good for all patients in the Lothian NHS Board area.
Does the minister accept that Edinburgh is a centre of medical excellence, that Edinburgh provides teaching and services in certain specialist subjects and that those services are made available to patients from throughout Scotland? Will she ensure that the needs of Edinburgh and the Lothians are properly taken into account in the future allocation of additional resources to health services in Scotland?
The allocation of resources throughout the national health service will take into consideration the amounts of money that are available for each individual health board. We acknowledge that there are different concerns within different areas. That is why we have the health boards—to react specifically to local concerns.
Question 4 has been withdrawn.
ScotRail Timetable
To ask the Scottish Executive what statutory or other influence it has over ScotRail's train timetabling. (S1O-5207)
Detailed timetabling is a matter for ScotRail and Railtrack to determine, but we will specify the levels of service that will be required under the next franchise when we issue directions and guidance later this year.
Does the minister agree that the travelling public and commuters have endured disruption to their services for five months and that they would expect the Scottish Executive to put the maximum amount of pressure on ScotRail to return services to normal as soon as possible? Does he agree that further modernisation and improvement to our railway services can be achieved only if the baseline of ScotRail timetabling is put back to its original state and that ScotRail should not be demonstrating complacency?
The body with the powers to monitor and seek compliance with ScotRail's franchise obligations is the Strategic Rail Authority, which operates on our behalf. The joint process of drawing up timetables that ScotRail and Railtrack undertake involves consultation with other train operating companies that use the same lines, with the Rail Passengers Committee Scotland, which represents customers, and with the Strathclyde Passenger Transport Executive, which has a statutory role in that process.
The minister will be aware that train operators are affected by the track upon which the trains run. Given that organisations as diverse as Strathclyde Passenger Transport and Scottish Financial Enterprise support the concept of a Scottish Railtrack, will the minister tell us why, as a minister responsible for transport, he is capable of running the roads but not capable of running rail?
The ownership and the operation of the railway infrastructure are not the same issue as the timetabling of trains. That is how the structure of the industry stands. It is our duty to work with the appropriate bodies to ensure that services are put back in place. The onus for restoring services lies with ScotRail as the operating company, not with Railtrack as the infrastructure operator or with the Executive. Passengers should look to ScotRail for the services that they are entitled to expect.
Scottish Water (Contracting Out)
To ask the Scottish Executive what steps it is taking to ensure that Scottish Water maximises the amount of work that is contracted out locally, particularly in rural areas. (S1O-5242)
Our overarching instruction to Scottish Water is that it should ensure that it provides the best possible service at the best value for its customers. It is for Scottish Water to determine how best to achieve that aim.
Does the minister acknowledge that considerable disquiet exists in rural areas about the fact that Scottish Water's tendency to use large centralised contracts will lead to very little work being done by local labour, which will create unemployment? That runs contrary the Executive's rural development policy. Will the minister undertake to audit regularly Scottish Water to identify how many jobs are being lost in rural areas as a result of Scottish Water's centralised contracting?
I can assure the member that Scottish Water will spend about £1.8 billion in contracting arrangements over the next four years. I am interested that the Civil Engineering Contractors Association (Scotland) estimates that the water contracts will approach 50 per cent of all the contracts that are placed with its members. Given that much of the £1.8 billion is not to be spent in the central belt, there will be ample opportunity for employment in rural areas.
What progress is the Scottish Executive making with setting up water customer consultation panels? When will those panels be in place?
I am able to assure the member that the convener of the water customer consultation panels, who will be involved in authorising and approving the members of those panels, will be announced shortly.
I am not sure that that was in order, but never mind.
New Deal: Next Phase
To ask the Scottish Executive what progress is being made on implementing the new deal: next phase programme. (S1O-5239)
New deal: next phase will offer greater flexibility, with more focus on employer needs and people who are hard to help. Pilot projects are under way in a number of areas across Scotland.
Does the minister consider that there is sufficient flexibility in the tailored pathways and other schemes to meet the needs of those unemployed people who are furthest from the labour market in terms of the length and depth of the intervention that is required to make them employment ready?
There should be. Two aspects of new deal plus provide flexibility. The first is local account managers in each jobcentre plus—as they have been newly named. Part of their job is to gather local labour information and liaise with employers to make sure that barriers to recruitment are dealt with. Further flexibility is provided by the advisers discretionary fund, which makes available up to £300 to tackle the barriers that clients face.
Is the minister aware that in the year to January 2002, barely one in three young new starts in the new deal found their way into sustained employment? That figure is the second worst of any region or nation in the United Kingdom. Does the minister recognise that there is a problem with the operation of the new deal in Scotland? What does he plan to do about that?
I am aware of recent independent evaluation work performed by the National Institute of Economic and Social Research, which shows that half the drop in youth unemployment since 1997 is due to the new deal and the other half is due to the strength of the Scottish economy. The very fact that the new deal is developing and the next phase, which includes a range of new measures and flexibilities aimed at those who have particular difficulties in accessing employment opportunities, is coming in shows that we have a track record. New deal can deliver, but we are not complacent, and it can be improved. That is important, and we will continue to make improvements. That is the task of the Scottish welfare to work task force.
Does the minister acknowledge that the new deal has failed miserably to reach all its original targets? Does he accept that the only success that it has had has been in massaging the unemployment figures? I put it to him that he better get the next phase of the new deal right.
My CV has been trailed through the press extensively recently. Mr Gallie will know that in the early 1980s I was a teacher, and I can remember the hopelessness felt by young students in schools and their certainty that the labour market had no place for them when they left school. We have almost eradicated long-term youth unemployment, and the new deal has been a significant contributor to that. I am proud of it. It is one of the greatest achievements since 1997.
Hospital Acquired Infections
To ask the Scottish Executive what action will be taken following the publication of the report on hospital acquired infection by the Clinical Standards Board for Scotland. (S1O-5229)
The Clinical Standards Board for Scotland team has already started a programme of visits to every national health service trust to check performance against the standard. That will be completed by the autumn. We shall be holding an HAI convention on 28 June to help drive forward action and spread best practice on this key issue.
Does the minister accept the CSBS's findings that infection control is poorly co-ordinated and insufficiently resourced, and that that is a damning indictment of the Government's failure to address a problem that now affects more than 9 per cent of hospital patients? What kind of health service is it that guarantees that around one in 10 patients will be infected in and made ill by the hospital in which they are treated? Action is now required, not words.
I hope that we will be judged not by the difficulties that we face, but by the way in which we respond to them. HAI has been a key issue for me. In January, I asked the Clinical Standards Board to accelerate its visits. We should be pleased that we have national standards for the first time, but every trust needs to be checked. The Clinical Standards Board is doing so as quickly as possible. We have done more. The convention will be an important event at which we will collect expertise and best practice, not just from Scotland but from further afield. We will ensure that we drive forward action and spread best practice to every hospital in Scotland.
I welcome the 50 nurses from the Royal College of Nursing to the gallery. I know that they are keen to train and play their part in infection control.
Escalating intervention is a part of the whole performance management process. If standards are not met, more and more will be done. If action by the Clinical Standards Board is not adequate, at a certain point the Health and Safety Executive can intervene. At the moment, that may be happening in a hospital. We might hear about that in due course. There is a system to ensure that standards are in force.
Does the minister agree that, as we have a national health service and national standards, it is about time that we had a nationalised cleaning service that could provide care for patients in a clean environment, instead of providing profits to private contractors?
I dealt with the issue of clean hospitals in answering question 1. I repeat the general message that quality is the key issue, along with value for money. Quality is up there as a key criterion—it was not in the late 1980s and early 1990s when contracts went to the private sector, not because that was good for quality but for ideological reasons. The criteria for us are quality and best value. That means that it is no longer the norm for services to be contracted out.
Will the minister expand on his answer? Will he give an assurance that if the quality commission reports that quality standards cannot be met under the present arrangement of contracting out cleaning services, he will renationalise those services and return them to the standard that they once had?
The reality is that standards must be met. If there are issues, whether an in-house or a privatised contract is involved, it is up to the trust to ensure that standards are applied. If standards are not applied, action will be taken, whether or not the service is contracted out.
Freight Costs (Island Communities)
To ask the Scottish Executive what proposals it has to address the levels of freight costs faced by island communities. (S1O-5205)
The level of freight charges imposed on services to the northern isles is a matter for the companies concerned. Tariff rebate subsidy is available only on bulk freight of low-value commodities and on livestock from the northern isles.
I thank the minister for his answer and for his announcement about livestock the other day. Does he accept that there might be increased competition on freight to the northern isles as a result of freight issues relating to NorthLink Orkney and Shetland Ferries Ltd? In that context, will he undertake to examine the financial effects on NorthLink as a result of that undoubted increase in competition?
I am aware of the possibility of competition on those routes. The withdrawal of competition on livestock was part of the underlying issue that we had to resolve this summer. Competition can bring benefits to the customers of freight operators. The extent of our commitment to the northern isles contract is that NorthLink is contracted to us for the carriage of cars and passengers, but not freight or livestock. Ensuring that the contract that NorthLink has entered into with us allows it to run and sustain those services in line with the terms of the contract is a matter for NorthLink.
Is the minister aware that hauliers in Argyll who used the Caledonian MacBrayne ferries were not directly consulted on the draft specification for the CalMac tender and that that is a source of anxiety for them? Will the minister assure me that, when the draft is published, hauliers will be allowed meaningful input before the document is finalised?
I am aware of some of the concerns that have been raised by Maureen Macmillan and others. When we produce the draft service specification within the next few weeks, we will put it out for consultation and invite responses from all those who have an interest in the future of the services.
Does not the minister recognise that the threats are more immediate than that? I know that he is aware of the problems of freight transfer to the island of Colonsay. He wrote to me saying that he would investigate the problem with CalMac and come back with a clear solution. Does he know that the current contract expires this month, which gives him two weeks to resolve the problem? Can he give the people of Colonsay a commitment that the current freight service will not be discontinued until alternative arrangements are in place?
I reassure the people of Colonsay, Coll and Tiree that CalMac has entered into discussions with the haulier in question with a view to finding a solution. I have every confidence in CalMac's assurance that an amicable solution can be found within the time frame indicated.
NHS Drugs Bill 2002-03
To ask the Scottish Executive what the estimated increase is in the NHS drugs bill for 2002-03. (S1O-5230)
The increase from last year to next year will be 8.1 per cent.
Does the minister agree that, even with the welcome announcements of extra NHS funding, the large increase in the drugs bill—approaching £15 million in the three health boards in my region alone—is likely to be repeated in future and that it will put severe pressure on NHS boards? In view of the fact that the Minister for Health and Community Care appeared to rule out central funding of the drugs bill when I raised the issue last week, how does the Executive intend to respond to the increasingly serious situation so as to prevent further health service rationing and postcode prescribing?
As we made clear, we are not minded to change direction, so the member might be disappointed. Unified budgets contain sufficient funding to cover NHS prescribing costs.
I understand that in some health board areas there is an intention to apply the Arbuthnott prescribing formula to the general uplift before it is passed to general practice. The outcome of that could be that some areas will get more and others less, irrespective of local experience. Will the minister consider whether the general practitioner prescribing budget could remain ring fenced within trusts while we try to understand whether the allocation method creates increased pressures for drug rationing in the areas that lose?
I would be happy to meet the member to discuss those issues and to consider what we should do in future.
When will a decision be made about the ending of postcode prescribing for infliximab, particularly as two months ago the National Institute for Clinical Excellence south of the border made the decision to make the drug generally available?
I will look into the specific drug medicine that Alex Neil mentioned. There are sufficient resources to consider drug prescribing. If there are any problems throughout the country, we are happy to discuss those with members.
Local Authorities (Consultation)
To ask the Scottish Executive what procedures it has in place to consult with those local authorities that are not members of the Convention of Scottish Local Authorities. (S1O-5202)
Procedures for consultation depend on the issue at hand. Consultation on matters of collective local authority interest is carried out through COSLA and with individual councils on matters of local significance, as has been done in the past. All local authorities can make representations at any time.
I thank the minister, but those councils can make representations only if they are aware that they can. The minister will be aware that Falkirk Council and Clackmannanshire Council were not informed of the £5 million for concessionary travel that councils could bid for. Glasgow City Council knew about it only through the Strathclyde Passenger Transport Authority. Will the minister do something to ensure that there is a level playing field for all councils?
As I said in my previous answer, matters of collective interest to local authorities are discussed with COSLA and distributed through the means that is agreed with COSLA. Those local authorities have not approached me individually on those matters.
Dunbar Hospital, Thurso<br /> (Accident and Emergency Services)
To ask the Scottish Executive what action it plans to take to reinstate accident and emergency services at the Dunbar hospital, Thurso. (S1O-5212)
It is very important that accident and emergency services—including the minor injuries service that is provided in Thurso—are accessible and safe. I understand that the minor injuries service has recently been withdrawn temporarily because of some concerns about patient safety. Highland NHS Board is working with the GPs and others involved to identify a basis on which the service can be resumed.
That answer will be welcome in my constituency, because the service is vital. Does the minister agree that we should be not reducing services, but building on a sure foundation and increasing services in such remote rural areas?
The Executive is always keen to improve the services that are provided to the people of Scotland. We acknowledge the particular difficulties in remote and rural areas, which is why we have established the remote and rural areas resource initiative—RARARI—to consider such difficulties and find ways to address them.
Given that pressures on remote and rural general practitioners led to the break in the accident and emergency service at Dunbar hospital, what steps is the Executive taking to address those problems, not only in Thurso, but throughout the Highlands and Islands?
As I said, RARARI is charged with identifying problems and developing solutions. Its recruitment and retention sub-group will report soon and I am sure that it will address some of the GP issues. The Executive has also supported several other interventions, such as inducement payment schemes and the associate allowance, which we hope will have an impact on the number of GPs who work in those areas.
ME/Chronic Fatigue Syndrome (Schoolchildren)
To ask the Scottish Executive how many schoolchildren currently suffer from ME and chronic fatigue syndrome. (S1O-5196)
That information is unavailable. Although estimates of the prevalence of any given condition can usually be obtained through the returns that are made by a sample of Scottish general practices, it is unfortunate that the opportunity to provide that information is unavailable, because the number of cases that the sample practices have recorded is too low to allow a statistically reliable estimate to be made.
Will the minister investigate the research by Dr Betty Dowsett and Jane Colby, which suggests that more than 50 per cent of long-term schoolchildren's sickness absence is caused by ME, and that many pupils miss years of education?
I thank Helen Eadie for that. The Scottish Executive education department issued guidance on the education of children who are absent from school through ill health and it identified issues that relate to children who suffer from ME and CFS. We wish to develop work on primary care issues and I am happy to engage in local discussion to address those issues. We await the recommendations of the short-life action group, which will report in the summer, on ways to improve dialogue. This week, several members of the cross-party group in the Scottish Parliament on ME met people who suffer from ME, and I have given a commitment to meet them in June to discuss issues of mutual interest.
When we debated ME a few months back, I suggested that the Executive should research attitudes to ME in schools and the guidance on ME that schools' guidance departments share. Has the Executive progressed that idea?
As I said in response to Helen Eadie, the Executive's education department gave schools guidance last year on how to deal with some of the issues. That must be refined further. It would be sensible to await the outcome of the short-life action group's report and to address those issues in the further discussion that will take place with members of that group. I hope that that will be useful.
As a member of the cross-party group on ME, I am concerned about young people who miss much of their schooling because they suffer from ME. What provision is the Executive making for young people who have long absences from school?
As I said, I am happy to open a discussion on that matter. If members have concerns about how youngsters who suffer from CFS or ME access school education—an important part of their life—we are happy to engage in dialogue on that in order to improve guidance and local ways of working to address such needs.
Scottish Crime Survey
To ask the Scottish Executive how it will build on the fall in the fear of crime as reported in the 2000 Scottish Crime Survey. (S1O-5240)
It is encouraging to see that, between the 1996 and 2000 Scottish crime surveys, the percentage of participants who described crime as an "extremely serious" issue in Scotland fell significantly from 44 per cent to 28 per cent. Although the fear of crime is falling, there remains a need to target areas of criminal activity that impact most on the everyday life of our communities.
I am sure that the minister will join me in congratulating central Scotland police on the success of its safer central campaign. The force has exceptionally high detection rates—the figure for the Stirling Council area has reached 70 per cent, which is the highest in Scotland.
We have set new targets for detection of serious crime. The targets aim to increase by 4.1 per cent what are already record levels for detection of serious violent crime. Levels of detection are at their highest since 1939. The police are to be highly commended on that record.
It is obvious that crime statistics are down, but is crime down? There is a lot of evidence to show that many people do not report certain thefts unless they are insured. How does the Executive measure its claims for the fall in the rate of fear? Are pensioners no longer double-locking their doors? I do not think so.
The surveys, which began as small regional surveys, have been amalgamated into a Scottish crime survey, which has a proper scientific basis. There are individual instances in which old age pensioners are afraid, but the general level of fear has reduced. If I could quote one or two figures—
One or two only, please.
One or two? I will choose one. There has been a 32 per cent reduction in housebreaking. The target is set for a further 10 per cent reduction in housebreaking. The need for people to feel that they must sit behind closed doors is decreasing and I hope that that will continue.
Is the minister aware that the most recent crime figures—not the two-year-old survey to which the question referred—show that the increase in the number of violent crimes in 1991 rose to an appalling 23,751. Apart from the anodyne response that the minister gave in response to the question, what does he intend to do about that?
I am sorry that Bill Aitken regards the reduction in crime that has occurred and the reduction in fear of crime as anodyne. The rise in the number of people carrying offensive weapons is the largest element in the increase in the figures. We will encourage the police to continue programmes such as Strathclyde police's spotlight initiative, in which offensive weapons are picked up. Those programmes lead to an increase in the number of charges that are brought and in the number of people who are convicted. We will continue with those programmes.
Does the minister agree that there is an issue about persistent crime? The issue is certainly one that is reported to me by my constituents. I refer to persistent crime that is not even recorded. Will the minister comment on the fact that the police tell me that they do not regard it as worth while in terms of officer hours to refer offenders to the children's panel when no consequences ensue. What monitoring is being undertaken of the police's non-pursuit of offences? How do we record properly the level of persistent crime when we know that the police are not pursuing those crimes through the system? [Applause.]
Anecdotal evidence exists of the sort of crime to which Johann Lamont referred. We will discuss with the Association of Chief Police Officers in Scotland whether there is evidence of police throughout the country not picking up youth offenders. I must say that the number of individuals who are being picked up for youth crimes has increased. Over the past 10 years, the number of persistent offenders who have been picked up and referred to children's hearings has increased by 40 per cent. Until last year, although the general level of crime has gone down, the number of persistent offenders who were brought in front of children's hearings went up. I accept that there is a problem in some areas. Those problems will be addressed.
Previous
Point of Order