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Chamber and committees

Meeting of the Parliament

Meeting date: Thursday, January 17, 2013


Contents


General Question Time


Royal Alexandra Hospital Death Rates



1. To ask the Scottish Government for what reason reported death rates at the Royal Alexandra hospital are higher at the weekend than on weekdays. (S4O-01699)

The Cabinet Secretary for Health and Wellbeing (Alex Neil)

I understand that that is not the case. The member is referencing raw data that was released under freedom of information by NHS Greater Glasgow and Clyde. In the release, the mortality rate was expressed as a percentage of the number of discharges. As there are fewer discharges at the weekend, the denominator is small, thus artificially inflating the proportion of deaths. NHS Greater Glasgow and Clyde has undertaken a more robust analysis of the data between 2002 and 2012 and, as a result, has been able to assure me that there is no significant difference in the mortality rates at the Royal Alexandra hospital between weekdays and weekends. I am sure that the NHS board would be happy to write to the member with the details of its analysis.

Hugh Henry

I look forward to that information. However, the fact remains that the health board provided information about the mortality rate at the weekend that showed that it was double that during the week. There can be lies, damned lies and statistics, but if what Mr Neil said is the case, why did the health board put out information that showed that the death rate at the weekend was twice that during the week? As well as writing to me, the cabinet secretary should ask the health board to go back and interrogate its statistics. Further, he is the Cabinet Secretary for Health and Wellbeing, so he should undertake his own investigation into those worrying and shocking statistics and give everyone an assurance that, in fact, the health board is not fiddling figures and let us get the real facts.

Alex Neil

It is always advisable for members to leave a degree of flexibility for their supplementary question in case the answer to their original question does not fit with what they wanted to hear. I will provide Mr Henry with the accurate figures, through the health board, and he will then be able to see that there has been no fiddling and no problem of the kind that he described.


Radioactive Material (Dalgety Bay)



2. To ask the Scottish Government what its assessment is of the health risks of the radioactive material at the foreshore at Dalgety Bay. I register an interest in that regard. (S4O-01700)

The Minister for Public Health (Michael Matheson)

The Scottish ministers take advice on that issue from a number of sources. The Scottish Environment Protection Agency has restricted access to certain parts of the beach and has posted advice notices to the public. In October last year, the Health Protection Agency reported that there was no public health reason for individuals to stop using the area, subject to those restrictions already in place.

As Helen Eadie will be aware, we met last week and I was able to tell her that I had received advice from the committee on medical aspects of radiation in the environment—COMARE—that concluded that increased rates of certain types of cancer that were reported in the media in November are very unlikely to be linked to radioactive contamination.

Helen Eadie

I thank the minister for that answer and for the very cordial meeting that we had last week. I am grateful to him for releasing the COMARE report to members of the public in Dalgety Bay. To enhance the message to the public about the outcome of that report, will the minister agree to come to a meeting in Dalgety Bay with members of the public to offer assurance to them about the report’s findings?

Michael Matheson

At the meeting last week, I gave Helen Eadie an undertaking to try to ensure that there was better co-ordination between the various agencies involved in the matter to ensure that they impart information to the residents of Dalgety Bay in a more planned way. Unfortunately, not all those agencies are within my control—for example, the Ministry of Defence. I have given an undertaking to ensure that the COMARE report is made available to the Dalgety Bay residents forum, which will provide the residents with the assurance that the experts have considered the matter and that, on the basis of the information provided by NHS Fife, they do not believe that there is a link between the radioactive contamination and elevated levels of types of cancer that were identified.

Following the provision of that report and the work that my officials will take forward, I will be more than happy to continue a dialogue with Helen Eadie to see what further measures can be taken to help to ensure that the residents are properly informed of various matters on this issue.

I will allow a brief supplementary question from Annabelle Ewing.

Annabelle Ewing (Mid Scotland and Fife) (SNP)

Thank you, Presiding Officer. Of course, the health and safety of the people of Fife must always come first. As it is the MOD that has failed to deal with the contamination over two decades, including during the Tony Blair and Gordon Brown years, does the minister agree that it should pay for the remediation—and that it should do so as soon as possible—as it has done at Almondbank?

Michael Matheson

I agree that the safety of the people of Fife must come first. That is why SEPA is working closely with the Ministry of Defence on investigations into the radioactive contamination at Dalgety Bay. Should SEPA identify the MOD as being wholly or partly responsible for the contamination, we will expect it to fund its portion of the remediation costs as determined by SEPA at that time.


Accountable Policing (Dumfries and Galloway)



3. To ask the Scottish Government how policing in Dumfries and Galloway will be accountable to local people once the single police force becomes operational. (S4O-01701)

The Cabinet Secretary for Justice (Kenny MacAskill)

Each local authority area will have a designated local police commander who will work more closely than ever before with locally elected councillors and community planning partnerships to shape local services and prioritise local needs. That includes a statutory requirement to prepare a local police plan for each local authority area.

All 32 local authorities and the eight regional police services are involved in developing and trialling the new local engagement and scrutiny arrangements that will be introduced on day 1 of the new service. In collaboration with the Convention of Scottish Local Authorities and the Improvement Service, we have today published national guidance on good practice in the area.

Elaine Murray

In Dumfries and Galloway, we were assured that local accountability would be preserved when the single police force took over from Dumfries and Galloway Constabulary. The recent announcement that there is to be one deputy chief constable for the west of Scotland, essentially incorporating Dumfries and Galloway into Strathclyde, has caused concern in the region. Can the cabinet secretary tell me when the detail of the local structure will be released? The local police do not seem to know when that will happen. Can he assure me that, in Dumfries and Galloway in particular, there will be no loss of accountability and no loss of financial accountability with regard to the role of the council?

Kenny MacAskill

The fundamental structure has been passed by the Parliament. As to how the local authority will interact with the police, that is a matter for the local commander. There will be an announcement shortly by the police service of Scotland about the local commander. That is an operational matter for the chief constable. The local commander will be the person who interacts with Dumfries and Galloway Council. I recall from previous discussions with the chief executive of the council that he saw great advantages in bringing matters together to ensure that the co-operation that exists in community planning partnerships continues.

These matters are being worked through. The local commander will be appointed—that is a matter for the chief constable—and he or she will work closely with the local authority in whatever form the local area wishes in setting up its committee.


Social Unavailability Codes



4. To ask the Scottish Government what its position is on the inappropriate use of social unavailability codes by national health service boards to meet waiting time targets. (S4O-01702)

The Cabinet Secretary for Health and Wellbeing (Alex Neil)

Social unavailability has been replaced by a patient-led system in which the patient’s explicit agreement is needed if they want their treatment to be delayed for any reason. That came into effect on 1 October 2012. Guidance on the new system was issued to the service in August 2012 and I expect all boards to ensure that they are fully compliant.

The new system of patient-advised unavailability ensures that the service is more tailored to patients’ needs and gives them greater control, as well as providing more detail on the reasons for unavailability. The new arrangement also means that, if an in-patient or day-case patient has advised that they will be unavailable, for example because of holiday or work commitments, the health board must send a letter to the patient to confirm their request and explain the impact on their waiting time.

Jackie Baillie

This week it was NHS Grampian in the waiting times scandal; last week it was NHS Forth Valley. In a report compiled by a former NHS manager, NHS Forth Valley was revealed as making the most extensive use of social unavailability codes in Scotland to avoid breaching the waiting time guarantee. Was the cabinet secretary aware of that when he stood up in this chamber and gave NHS Forth Valley a clean bill of health regarding waiting times? If not, does he believe that the practice in NHS Forth Valley was acceptable?

Alex Neil

There is no scandal in relation to NHS Grampian other than in the head of Jackie Baillie. The scans referred to have an annual throughput of about 3,500 patients. Because of a breakdown in a scanner there has been a backlog of 550 patients, but of the 3,500 patients who get these scans in Grampian every year, only about 100 come within the patient waiting time guarantee. The BBC and Jackie Baillie should check their facts before they make allegations about scandals that do not exist.

On a point of order, Presiding Officer. My question was entirely about NHS Forth Valley, aside from one reference to NHS Grampian. The cabinet secretary did not at any point address the question about NHS Forth Valley.

That is not a point of order, but you have made your point.

Jim Hume (South Scotland) (LD)

Does the cabinet secretary recognise that bed blocking, due to a lack of beds and an increase in acute illnesses, has led to pressure on NHS staff to use social unavailability to hide the missing of waiting time targets and that there is emerging evidence that that lack of infrastructure has had the knock-on effect of increasing the number of trolley waits, in which patients who are admitted to accident and emergency have to wait for a free bed?

Alex Neil

Jim Hume also needs to get up to date on the rules that govern social unavailability and the new rules that have been operating since 1 October.

In the past 3 or 4 weeks, because of an increase in instances of norovirus and seasonal flu, there have undoubtedly been pressures throughout the NHS in Scotland. Those pressures come from the fact that there are many more patients. The number presenting at A and E across the board has increased by about only 2 or 3 per cent, but admission rates have risen by 15 per cent on average over that period. Inevitably that creates pressures on the system, but to say that there is some great crisis is absolutely absurd.


Smoking (Enclosed Premises)



5. To ask the Scottish Government how many people have been prosecuted in the last year for smoking in enclosed premises or permitting smoking to take place in enclosed premises. (S4O-01703)

The Cabinet Secretary for Justice (Kenny MacAskill)

In the year to 31 December 2012, 32 charges of smoking in non-smoking premises have been reported to the procurator fiscal. Of the 29 cases in which action was taken, court proceedings were raised in six and a further 23 were dealt with by direct measures. One case of permitting smoking to take place in non-smoking premises was reported and no action was taken in that case.

Such offences can also be dealt with by fixed penalties issued by the local authority enforcement officers.

Stewart Maxwell

Is the cabinet secretary aware that, in the six years since the legislation came into force in 2006, Highland Council has never issued a fine in connection with the smoking ban and that Dundee City Council has issued 718 fines? Can the cabinet secretary explain the large variation in the number of fines that are issued for breaching the ban on smoking in enclosed premises?

Kenny MacAskill

We must get matters in context. The ban on smoking in public places has been a success and the evidence indicates a high level of compliance with the legislation.

However, enforcement is fundamentally a matter for local authorities. We expect all local authorities to ensure that people comply with the legislation and to have suitable enforcement protocols in place to ensure that the effectiveness of the smoking ban is maintained. Why there is that discrepancy I am unable to advise, but I am happy to discuss the matter directly with Stewart Maxwell and, indeed, the Lord Advocate.

Is the cabinet secretary satisfied that all premises that sell tobacco are now registered? Have any prosecutions taken place for the sale of tobacco from unregistered premises?

I do not have particular knowledge of that matter but I am happy to engage with Dr Simpson on it or, indeed, to write to him with the specific answer.


Walking and Cycling Infrastructure (Mid Scotland and Fife)



6. To ask the Scottish Government what recent support it has given to developing walking and cycling infrastructure in Mid Scotland and Fife. (S4O-01704)

The Minister for Transport and Veterans (Keith Brown)

Since 2011, we have invested over £4 million in Mid Scotland and Fife for cycling and walking infrastructure projects, including the cycling, walking and safer streets grant and Sustrans capital funding. I am happy to write to Ms Baxter with further detail on the issue, including our investment in other measures such as those delivered by Cycling Scotland.

Jayne Baxter

I should declare an interest as a Fife councillor. The minister might be interested to know that there is an excellent proposal in Fife to develop a pathway into Dunfermline town centre from Duloch in the eastern expansion, which will not just create a cycle route but improve the surrounding green space and facilities in order to increase use of the area. However, the funding for the scheme is complex. Will the minister join me in supporting the project and will he consider ways of simplifying funding for such active travel projects?

Keith Brown

I am happy to look into the matter, but I have to say that we are content with the process. We make direct grants to Cycling Scotland and local authorities can bid for that money. In addition to the moneys that I have already mentioned, we have made available £759,000 that local authorities can bid for as match funding to work in partnership with Sustrans, whose capital budget for the next two years is in the region of £10 million. As I have said, a process has been put in place. I am not aware of any issues in the rest of Scotland with accessing that money, but I am happy to listen to the member’s comments.

Roderick Campbell (North East Fife) (SNP)

The minister will be aware that north-east Fife is a very scenic area that includes a large part of the Fife coastal path. However, it also contains a number of busy commuter routes. How can the existing infrastructure in north-east Fife be improved to increase the uptake and improve the safety of cycling?

Keith Brown

Many movements can be and indeed are being made on the cycling infrastructure in the kingdom of Fife. Fife’s cycle path network provides more than 300 miles of signposted cycle routes, with eight different signed routes in the Howe of Fife and north-east Fife that are primarily for leisure but which can also be used for commuting.

More specifically, through working in partnership with Sustrans with Scottish Government funding, Fife Council has already delivered the new community link from Tayport to Newport-on-Tay cycleway and a further project is planned to improve the St Andrews cycle network in the town centre. I have a number of other examples of things that can be and have been done and am happy to provide the member with that detail.


Subsea Power Cables (Western Isles and Orkney)



7. To ask the Scottish Government what progress has been made on expediting the proposed new subsea power cables to the Western Isles and Orkney. (S4O-01705)

The Cabinet Secretary for Finance, Employment and Sustainable Growth (John Swinney)

The transmission network owner and operator, Scottish Hydro Electric Transmission plc, estimates for the Western Isles high-voltage direct current link a delay of at least 12 months in the planned completion date of October 2015, with a real potential that it could be later, and estimates that the alternating current link to Orkney will be completed in 2018. As the Minister for Energy, Enterprise and Tourism pointed out when he met the company on Monday, the delays and uncertainty for developers on Orkney and the Western Isles are clearly disappointing, and the Scottish Government will continue to work with industry and the Office of the Gas and Electricity Markets to seek interim solutions to connect more generation, drive forward the necessary grid connection upgrades and ensure a fair transmission charging regime.

Mike MacKenzie

Does the cabinet secretary consider that by delaying the provision of these cables, which will lead to significant cost increases and significant delays for generation projects both large and small, Ofgem and the United Kingdom Government have acted in consumers’ best interests?

John Swinney

As I said in my first answer, the delays in UK electricity market reform and, more important, the uncertainty caused by the process and the surrounding debate within the UK Government have been a significant factor in the delays that are being experienced. The Scottish Government has tried positively and actively to support a positive resolution to the electricity market reform process in the interests of Scotland, consumers and investment and to work with Ofgem to ensure that any solutions that are advanced to realise renewable energy potential as timeously as possible can be achieved. That will remain the Government’s approach.

I see that the Western Isles may expect its link by 2015. Does the minister agree that it is unacceptable that the Orkney upgrade will not be ready until 2018 at the earliest?

John Swinney

I made it clear in my answer to Mr MacKenzie that the Government would prefer those issues to be resolved more speedily. The decision-making processes in this respect lie with Ofgem, the United Kingdom Government and the industry itself. The Government in Scotland will work with all parties to try to advance that agenda.

Mr McGrigor makes a fair point about the significance of renewable energy activity in the Orkney islands, where clear leadership has been taken in this respect by the local authority and the Government. We will use every endeavour that we can to advance that timescale.