First Minister’s Question Time
Engagements
1. To ask the First Minister what engagements he has planned for the rest of the day. (S4F-01380)
Later today, I will be speaking with Scottish Enterprise, which is announcing that we have a record number of Scottish companies that were supported into new overseas markets last year by its international trade arm, Scottish Development International. Last year, SDI worked with 2,096 companies—a 50 per cent increase from the previous year. That is expected to lead to an increase in export sales of £880 million over the next three years.
Along with the excellent rise in job numbers yesterday, I am sure that those improving economic statistics will be welcomed by the whole Parliament. No doubt we will still have many disappointments in the future—it could not be otherwise in a recession—but those are excellent figures for the Scottish economy that we all should welcome.
A packet of paracetamol costs 19 pence in Tesco. To dispense it on a free prescription costs the national health service £3.10 per prescription. The NHS spends £7.2 million a year dispensing paracetamol. For that amount of money, 200 Scottish cancer patients could get cetuximab to treat their condition for free for a year. Although that treatment is free in England, Scots cancer patients have to pay about £3,000 a month for it. Does the First Minister think that that is fair?
I remind Johann Lamont that the Labour Party supported the move to free prescriptions in this chamber, in this Parliament. If it wants to reverse that policy—as many people suspect it does, in terms of the cuts commission’s deliberations—it should say clearly to the people of Scotland. In particular, it should say that to the up to 600,000 families who earn £16,000 a year or less who had to pay for prescriptions under the previous system.
The cancer drugs issue is hugely difficult and challenging. We can talk about cetuximab if Johann Lamont wishes to do so. The position, incidentally, is not as she stated.
Not everything in this world is an argument between the First Minister and me about manifestos—some things are more important than that. Government is precisely about the hugely challenging issues.
Scots cancer patients are three times less likely to get on the Scottish NHS the drugs that they need than are patients in England, according to cancer charities. Scottish cancer patients have to pay thousands of pounds for vital life-enhancing drugs that are available free south of the border. That means that some Scottish cancer victims are planning to uproot their families from their homes and communities to move to England for treatment that they cannot afford here. We are in danger of exporting health refugees. [Interruption.]
Members: Shame!
Order. [Interruption.] Order.
I absolutely agree that it is shameful, so I am asking—[Interruption.]
Order.
I agree that it is shameful that we are in danger of exporting health refugees, so what is the First Minister’s advice to those families?
I will deal with the question in two ways. First, on the specific question of cetuximab, the drug was authorised by the Scottish Medicines Consortium in January 2010. The decision to restrict its use was the application from the pharmaceutical company Merck Serono Ltd. I quote from the SMC decision:
“The submitting company has requested that SMC review a niche within the licensed indication specifically for patients who had not previously received chemotherapy for their ... disease. The efficacy and safety data presented reflects this niche.”
Therefore, for that, it was approved by the SMC. It is similar to the decision that was made by the National Institute for Health and Care Excellence in England.
Of course it is the case that in England there is a cancer drugs fund to which people can apply, but cetuximab is listed in the cancer drugs fund only for specific conditions and there are restrictions on its use. We also know that the cancer drugs fund is coming to an end next year and has been heavily restricted in recent weeks.
We also know that the cancer drugs fund has been heavily criticised, including by the cancer charities that challenge the idea of the fund. We also know that the Labour Party in this Parliament voted not only to remove prescription charges from Scotland—which was a good vote—but voted against the idea of the cancer drugs fund because of the challenges to that fund. I know that Johann Lamont will not like to be reminded of this, but in tackling the extraordinarily difficult issues of access to medicine and deciding the right thing to do, if we look at the track record of the Parliament on facing up to the inequality that prescription charges imposed on the Scottish people, and on finding the right way to make available medicines that help people with life-limiting conditions, we see that the fact is that the Labour Party agreed with the Government, both on prescription charges and on our attitude to the cancer drugs fund. That puts Johann Lamont in an extraordinarily difficult position in pursuing the line of questioning that she is now pursuing.
The extraordinarily difficult position that I am in is that I am not able to address the problems: I can only ask the questions. I am not in government and I have a responsibility to raise the difficult issues, so I am asking the First Minister not to retreat to the comfortable refuge of party politics, but to focus on what is happening in the real world.
With respect, I say to the First Minister that what he said is not good enough for people like Maureen Fleming—a mother of three and a grandmother of 10 who has bowel cancer. Maureen has been denied the drugs that her consultant has said would improve her condition and extend her life. The Flemings are a proud family who are struggling to get together the £10,000 that is needed for the first three months’ treatment. However, they cannot afford to pay for any more treatment after that, so they are planning to leave their home of 27 years and to rent a flat in Newcastle because they can get the drug free in England. Time is short; Maureen Fleming has come to the chamber today to hear at first hand the First Minister’s advice to her and cancer victims like her.
As Johann Lamont will have noted, the review of the SMC process put forward a wide range of ways in which the SMC is effectively carrying out its job for the Scottish people. I can give Johann Lamont a list of drugs that are, because of the efficiency of the SMC process, available in Scotland but not in England.
Parliament and the cancer charities in Scotland decided that the cancer drugs fund was not the right way to go and, as we know, the cancer drugs fund in England will come to an end next year. In Scotland, we have in the Scottish Medicines Consortium an efficient process that we would be very unwise to challenge. Its effectiveness is widely admired because of the rapidity with which it judges and evaluates drugs. It is, however, capable of improvement, which is why the Routledge review was set up. We also have the individual patient treatment request system to which people can apply, according to the nature of their individual conditions. Improvements can be made to that system as well.
Johann Lamont accuses me of playing party politics, but she introduced the subject in a party political way. It is perfectly reasonable to point out that the Labour Party agreed, both on prescription charges and on our attitude to the cancer drugs fund, with our judgments on the best way in which to deliver health to the Scottish people. In the current extraordinarily difficult circumstances, we are trying to reach a position that gives the best treatment to the people of Scotland—that is the basis on which we have the SMC and the individual patient treatment request system. It is not the case that there is a simple or easy solution; we make the best judgments that we can make. That is done—as it is done, I hope, by every member—with a genuine wish to protect the welfare and health of patients in Scotland.
I regret that, in all that, the First Minister did not address the question that I posed to him. Mrs Fleming represents a failure in the system. While we are deliberating about how we might address the problem in the future, it is the business of Government to address what is happening now to families who do not have time to wait. We are talking about the real lives of real Scots. I will engage in the policy debate, but I urge the First Minister to act now for the people who are being failed by the system.
The First Minister and I agree that the NHS should be free at the point of need, but the reality in the First Minister’s Scotland is that if a person has a headache, their prescription is free, but if they have cancer, their prescription can cost £3,000 a month. Is not it the case that, in this Scotland, Scots with hay fever can get their prescriptions free, but Scots with cancer may have to leave their homeland for treatment to save their lives?
When this Administration abolished prescription charges, we were a minority in Parliament. If the Labour Party—and Johann Lamont—had wanted to stop that policy because they did not think that it was the right move, they could have stopped it by voting against it. In fact, they supported the policy because—I hope and believe—they felt that, for the 600,000 Scots on £16,000 a year and less, it was the right thing to do. If the Labour Party had felt that a cancer drugs fund was the right policy to have, it could have supported a cancer drugs fund in this Parliament, but it agreed with us and the cancer charities that that was not the right or proportionate thing to do.
There are always improvements that can be made to the system, but the SMC process is a robust and effective system. It is doing the absolute best that it can, and we are making improvements. The individual patient treatment request system is also a good system, which is why we are trying to standardise it across the nation by looking at particular aspects that affect individual patients.
However, to pretend to people that there is a solution to the hugely difficult questions—they are being faced by every health service around the world—about the efficacy of drugs that might be approved for use is to mislead people entirely. To pretend to people that the situation in England will continue—which it will not—or that it is satisfactory at present, is also wrong.
The last thing that I will say to Johann Lamont is that although I have every consideration and respect for the individual cases—we have all had constituents in that position, because of how things are done—we have to have regard to information from the drugs companies. Last week, a statement from Roche argued that there is the drugs tourism to which Johann Lamont referred. We should reflect on the fact that, when Avastin—the drug about which Roche was particularly concerned—came to the Scottish Medicines Consortium, Roche did not offer the discount that was asked for under the patient access scheme. That was Roche pharmaceuticals division, which has an operating profit of £10.9 billion this year. Just occasionally, in trying to overcome such difficult issues, we should perhaps ask drugs companies such as Roche why they are not prepared to offer to the Scottish people effective drugs at reasonable prices that would allow more of them to be approved.
Secretary of State for Scotland (Meetings)
2. To ask the First Minister when he will next meet the Secretary of State for Scotland. (S4F-01375)
No plans in the near future.
Last year, we had the embarrassing pantomime of the First Minister pretending to have legal advice on an independent Scotland’s relationship with the European Union and fighting his way through the courts to guard its contents, only for us all to find that no such advice existed—it was made up to cover for the fact that everything that the Government said about the EU was based on little more than wishful thinking.
Then, in October, the Deputy First Minister promised the Parliament that she would tell us how much that aborted action finally cost taxpayers but, as of this morning, that information has still not been lodged. I will therefore ask again: how much public money was spent on a pointless action to prevent the publication of legal advice that never existed?
I accused Willie Rennie of kamikaze tactics last week, but to talk about Europe with the phrase “embarrassing pantomime”, in the wake of a performance in the House of Commons that the leader of the Liberal Democrats—whom I should give another mention to, because he does not get a question today—said showed that the Prime Minister had taken leave of his senses, although the Liberal Democrats and the Conservatives are allies in the coalition Government, takes the most extraordinary degree of bravado, on which I congratulate Ruth Davidson.
The cost of the action is a mere fraction of the inflated cost that Ruth Davidson suggested last year. She would do well not to make such grandiose claims in the future.
In terms of bare-faced bravado, the First Minister is going some himself, when the Scottish National Party’s own voters are more interested in holding a referendum on Europe than they are in voting for independence. [Interruption.]
Order.
Although we were promised the information seven months ago, it is still being kept secret. We do not have it. Last night, we heard from another minister, who said that at last Scottish Government legal advice on the EU actually exists. On the basis that his minister was not pretending, the First Minister needs to tell the people of Scotland what that advice contains.
Last year, the Scottish Information Commissioner ruled that we have a right to know on such a critical issue. Vague promises of edited highlights in a far-off white paper just will not cut it. Will the First Minister again go through the costly farce of fighting in the courts to stop the people of Scotland knowing the truth, or will he finally reveal what the Information Commissioner says that he should reveal?
That is not what the Information Commissioner ruled at all. I suggest that Ruth Davidson goes back to have a look at her ruling.
When we request specific legal advice from the law officers, it is quite normal then to receive it. That is no great surprise. In terms of going forward—[Interruption.]
Order.
What we will do is exactly what the Deputy First Minister said on 23 October:
“the Government’s position in the independence white paper will be based on and consistent with the advice that we receive.”—[Official Report, 23 October 2012; c 12408.]
I remind Ruth Davidson that the United Kingdom Government has not published advice from the law officers—that has not been done. The UK Government has published legal advice from an eminent expert—Professor James Crawford.
We now have a large selection of eminent experts who can opine on the Scottish Government’s position of negotiating from within the context of the European Union, with our timescale of 18 months being a reasonable timescale for the successful completion of the negotiations. We can cite Sir David Edward, the British judge of the European Court of Justice; Graham Avery, the honorary director-general of the European Commission; Lord Malloch-Brown, a minister in the previous Labour Government; and—from only yesterday—John Bruton, the former Taoiseach and EU ambassador to the United States. We can also cite Professor David Scheffer, who has said exactly the same thing.
Perhaps the absolutely clinching view that we can negotiate our position from within and that 18 months is a reasonable timescale comes from the UK Government’s chosen legal adviser, Professor James Crawford. When he was asked about that precise question on the “Today” programme, he replied:
“Well, the Scottish estimate is about 18 months, and that seems realistic.”
Now that we have that huge consensus of legal experts—up to and including even the UK Government’s expert—can Ruth Davidson bring herself to join the consensus and not engage in the fractious dispute that the Tory party is pursuing at Westminster?
Offshore Wind Energy
3. To ask the First Minister what discussions the Scottish Government has had with Vattenfall regarding its investment in offshore wind energy projects. (S4F-01387)
Scottish Enterprise and Scottish Development International have held discussions with Vattenfall and a number of other interested parties regarding offshore wind energy projects. In relation to the European offshore wind deployment centre in Aberdeen bay, Vattenfall is continuing to develop the scheme alongside its project partners, the Aberdeen Renewable Energy Group and Technip Offshore Wind, and it has said that it is confident of securing new investment in the project.
What estimate have the Scottish Government and its agencies made of the benefits of the European offshore wind deployment centre as a driver for jobs and investment in the supply chain in Scotland?
The centre will of course create employment—I think that the estimate is 265 jobs in the construction phase and 25 jobs in the operation phase—but its purpose is to be not a wind farm, as is often said, but a deployment centre that tests new offshore wind technologies. That is why there are only 11 turbines in the proposed development. The development’s significance is in exactly that—it is to put Scotland, and Aberdeen as an energy capital, in a central position in the development of that exciting new technology.
It is estimated that that technology—deepwater offshore wind in Scotland—will be able to provide tens of thousands of jobs in Scotland, because it will be necessary for the energy needs of not just Scotland and England but the European continent.
As the First Minister rightly says, the offshore wind deployment centre is important for the future of Scotland’s offshore industry. If Vattenfall cannot sell its shares, will he step in to secure the centre’s future?
I saw the Labour Party spokesperson, Ken Macintosh’s colleague in Aberdeen, suggest that we should match the funding of €40 million that the Scottish European Green Energy Centre—established by the Scottish Government—secured from the European Union. I would like to know whether that is another Labour Party spending commitment. Is the Labour Party saying that the Scottish Government should spend €40 million?
The deployment centre is a commercial project, supported by the €40 million of European investment that the Scottish Government secured through the green energy centre. The project partners are confident that they will be able to secure interest in the project. Why should they not be? Many companies are interested in the development of deepwater offshore wind in Scotland.
If Ken Macintosh is proposing a spending commitment, he should come to the chamber—
I am asking the question.
He says that he was only asking the question. His colleague in Aberdeen wisnae asking the question; he was making a recommendation. If that is the Labour Party’s policy, perhaps Ken Macintosh could square that with the other priorities, such as the one that Johann Lamont brought to me earlier.
Electronic Tagging
4. To ask the First Minister what the Scottish Government’s position is on the use of electronic tagging of offenders as an alternative to short-term sentences. (S4F-01377)
There is strong evidence that community sentences are an effective alternative to short prison sentences. That is clear, because 58 per cent of offenders who are imprisoned for three months or less are reconvicted within a year, compared with only 24 per cent of those who receive a community sentence.
Electronic monitoring has been used in Scotland since 2002. It continues to play a significant part in offender management. We are consulting this summer on the possible development of the electronic monitoring service to include the satellite tracking of offenders.
Is the First Minister aware that, in Sweden, anyone who is given a sentence of six months or less can apply to be tagged at home under house arrest while being monitored? If there is any breach, they are returned to jail. Is he also aware that reoffending has fallen to 12 per cent and that the cost to the taxpayer is some £40 per day, not the £165 per day of a prison place? Given that the success of tagging there over 20 years, with the First Minister consider following the Swedish model?
The Government is always happy to learn about practice in other jurisdictions. In fact, last week, the Government supported and chaired an event at the University of Strathclyde that heard from the head of the Swedish probation service, who outlined how its system operates.
Many of the characteristics of the Swedish system are already in place in Scotland, but the consultation on electronic monitoring this summer will be an opportunity to capture formally any options for improvements. Although we have the lowest crime rate in 37 years, we are always keen to continue to improve whenever we can.
I call Margo MacDonald.
Thank you, Presiding Officer. I hope that you are feeling well.
I wonder whether the First Minister has had a chance to look at the Official Report of the debate that we had on Tuesday. In that debate, people whom he has classified as offenders were split into two camps: those who had electronic tags and could vote in an election; and those who had received a custodial sentence for the same crime, more or less, and could not vote. Does he agree that that raises a matter of equity that we should consider?
I read the proceedings and thought that it was an excellent debate on all sides as various arguments were put forward. However, I agree with the majority position that was taken in the debate: when people engage in crime and receive a prison sentence, they sacrifice some of their entitlements, such as the entitlement to freedom and, rightly, the entitlement to vote.
It was a good debate on the subject and the way in which it was conducted did the Parliament proud.
Bullying (National Health Service)
5. To ask the First Minister what steps the Scottish Government is taking to tackle bullying in the national health service. (S4F-01388)
In 2011, we worked with health boards and trade unions to develop the new policy on preventing and dealing with bullying and harassment, which sets out a new minimum standard for ensuring that all members of national health service staff are treated fairly and consistently.
In addition, the national confidential alert line went live on 2 April this year. It provides a further source of advice and support for staff who fear that they may be bullied or who wish to raise concerns about the health service to report those concerns in confidence and be reassured that health boards will listen.
The First Minister frequently praises and thanks hard-working staff for their dedication, and he is right to do so, but according to the Royal College of Nursing less than a third of nurses believe that, if they reported their concerns, they would be believed.
Any suggestion of a culture of management bullying—whether in specific workplaces or more widely—is completely unacceptable, particularly when it would threaten robust whistleblowing procedures, which we know to be absolutely necessary. Therefore, in the light of reports that one in four NHS staff have been subjected to bullying and that, in the Scottish Ambulance Service, more than a third of staff say that they have been a victim of bullying, will the First Minister undertake to ensure that the new national whistleblowing helpline that he mentioned is publicised more widely? For example, will he agree that the helpline’s telephone number should be printed on all NHS payslips?
The member should be a bit careful about the statistics that he uses. For example, the 2010 staff survey showed that 22 per cent of staff believed that they had been bullied or harassed in the previous 12 months, but 31 per cent of that treatment was by service users or relatives of service users. It is quite important to understand the terms of the statistics.
I agree with Drew Smith, which is why we have introduced, for the first time, a confidential alert line. I do not agree with Jackie Baillie who, on the radio last week, seemed to suggest that such a thing was not necessary under the great days of the—
Oh, come on.
Jackie Baillie did suggest that on the radio last week—I have with me the extraordinary quote in which she did so.
A far more productive consideration, given that the alert line has just been introduced, is how it is being publicised. It was introduced on 25 March, when 158,000 credit card flyers and 5,000 posters were issued to the health boards to promote it. It is certainly true that we are planning further promotion of that national confidential resource throughout the year to ensure that staff are aware of it. I am sure that Drew Smith will be delighted to hear that that includes messages on NHS payslips.
Gaelic-medium Education
6. To ask the First Minister what discussions the Scottish Government is having with local authorities regarding access to Gaelic-medium schools. (S4F-01381)
The Scottish Government hosted the first ministerial summit on Gaelic-medium education on 20 February this year. It was attended by all local authorities that provide Gaelic-medium education and leading educationists. At the summit, the Minister for Learning, Science and Scotland’s Languages, Alasdair Allan, announced £90,000 to fund further summer schools in Gaelic communities for trainee teachers, new research on how best to support pupils with additional needs and the development of prelim exam papers in Gaelic.
Does the First Minister agree with the many members of the Gaelic community who feel strongly that the urgent priority should be to address the concerns to do with teacher training that relate to the employment and retention of teachers in Gaelic-medium education in areas where there is the highest demand, rather than to insist that local authorities spend a lot of their resources in areas where there is no demand?
Yes, I agree with that, which is why I answered Liz Smith in the way that I did. She should know about the new posts at the University of the Highlands and Islands in Gaelic teacher training, which I think are highly effective.
I hope that all members have taken advantage of the promotion of Gaelic-medium education that has been taking place in the Parliament this week. I know that many have, because I asked.
We should be delighted by the indications from public opinion surveys that—contrary to the view that is sometimes put forward by some of our less reputable organs of the press that there is a great reservoir of discontent about the promotion of Gaelic as one of our national languages—there is widespread public support for Gaelic-medium education and for BBC Alba, which has achieved outstanding audience figures of more than 500,000 people on many occasions. That is a spectacular achievement, which should be celebrated by everyone in the chamber.
That ends First Minister’s question time. I will allow a short pause to enable members who are not participating in the members’ business debate to leave and the public gallery to clear.