SCOTTISH EXECUTIVE
Health and Community Care
Free Prescriptions (Chronic Conditions)
To ask the Scottish Executive when the list of chronic conditions qualifying for free prescriptions will next be revised. (S2O-6752)
The partnership agreement review of prescription charges for people with chronic health conditions and young people in full-time education or training will provide an opportunity to review the current list.
I thank the minister for her reply and, indeed, for her helpful letter of 15 May, which I received after lodging the question.
I am delighted that the member was pleased to receive his response from me.
Is the minister aware that, last week, the Royal College of Nursing annual congress voted by 93 per cent to campaign for the outright abolition of prescription charges? I am sure that that gives the minister an idea of the strength of feeling on the issue. Is it not time that the Executive accepted the case for the outright abolition of prescription charges instead of extending the exemption categories and thereby leaving tens of thousands of people still unable to get their prescription medicine because of the £6.50 charge?
I do not agree that there is widespread support for the abolition of prescription charges that Colin Fox's bill—the Abolition of NHS Prescription Charges (Scotland) Bill—proposes. The consultation that Colin Fox issued was sent to 85 organisations, of which 30 responded. In addition, responses were received from only one member of the public and one community pharmacy.
How on earth can the minister possibly justify a situation in which a chronically sick person can be charged more than £6 for a prescription, when a comparatively healthy person such as me gets free prescriptions just because I happen to be over the age of 60?
As I said, we recognise that the current rules for medical exemption are perceived to be inequitable. That is why we are committed, under the partnership agreement, to reviewing prescription charges for people with chronic health conditions and young people in full-time education or training. As I said, the first phase of the review is already complete. We are now moving towards a full and wide-ranging consultation. I hope that the member will respond to it.
Health Care (Remote and Rural Areas)
To ask the Scottish Executive how it is ensuring the improved delivery of health care in remote and rural areas. (S2O-6737)
When I speak to the hard-working professional staff in our health boards that serve rural areas, I am always impressed by their commitment, flexibility and innovation. I lived in a rural area myself for 25 years. It is right that boards and their staff take the lead in planning and delivering improved services to the people who live in their areas. The Executive is able to support those efforts by providing record levels of investment, which are allocated to boards using a formula that takes account of the effect of population sparsity on the cost of providing services.
Minister, I remind you that you are to give an answer to the question and not a statement.
Yes. So, overall, our aim is to provide services in remote and rural areas that are as local as possible and as specialised as necessary.
I thank the minister for that rundown on the Executive's health policy.
Obviously, the detail must be given by the local health board. That said, the provision of hospices is hugely important to people wherever they live in Scotland, and the Executive supports that. The member will have to get the information from the local health board. If it is at all helpful, I would be happy to give him some aid in getting it.
Given that Highland NHS Board benefited greatly from the Arbuthnott formula whereas Argyll and Clyde NHS Board did not, will the Executive reassess the per capita spend on patients in remote and island communities in Argyll as part of the consultation process to ensure that NHS Highland is not faced in future with the severe financial pressures that NHS Argyll and Clyde faces at the moment?
As the minister announced this morning, the consultation over the next few months will consider boundaries. The member may be aware that a new committee, the NHS Scotland resource allocation committee, has been formed under the chairmanship of Professor Karen Facey to improve and refine the formula. There is no intention to revisit the formula during the consultation on NHS Argyll and Clyde.
The minister will be aware of an innovative project in Pitlochry, in my constituency, to establish a combined facility incorporating a new community hospital, a nursing care home and a general practitioner surgery. Regrettably, the care home provider, the Church of Scotland, has withdrawn from the project at a very late stage. Will the minister assure the community that Tayside NHS Board intends to press ahead with the new community hospital, regardless of the care home provision issues that need to be addressed?
I am aware of the Church of Scotland's recent decision not to proceed with the care home places in the new premises. However, I am encouraged by the fact that NHS Tayside has made it clear that the health care elements of the project will go ahead and that the people of Pitlochry and the surrounding area will have the new community hospital and GP premises that they have been promised in the past. I understand that, following the Church of Scotland's withdrawal, NHS Tayside is exploring with alternative providers the possibility of including care home places in the project.
Is the minister aware that GP practices that serve the most rural and remote areas in Scotland receive four times as much additional payment per patient as do practices in the most deprived areas? That information was recently highlighted in a letter from Professor Graham Watt, professor of general practice at the University of Glasgow.
As the member knows, the Arbuthnott formula takes account of the influence of deprivation and remoteness on health care needs and supports the broader aims of achieving social justice and tackling inequalities. Indeed, that was one of the reasons for setting up the Arbuthnott review. I have pointed out that the NHS Scotland resource allocation committee has been formed, under the chairmanship of Professor Karen Facey, to improve and refine the formula, although I repeat that the formula already takes account of the influence of both deprivation and remoteness on health care needs.
I note that, in her response to Rob Gibson, the minister mentioned the use of telemedicine, particularly with regard to the link between the islands and the dermatology department at Raigmore hospital in Inverness. I wonder whether the minister is aware of my meetings with the centre for rural health, which has expressed concern that telemedicine should play a greater part in delivering medical services to remote and rural areas. Are there any plans to roll out such services?
As I said, we feel that telemedicine is hugely important. We expect that, when Professor Kerr reports later this week, he will make significant points about health care delivery in rural areas and might well touch on telemedicine.
Autism
To ask the Scottish Executive what progress it is making in dealing with autism. (S2O-6790)
The Scottish Executive is working to improve services across health, education and social care agencies for children and adults with autistic spectrum disorders. We are undertaking a programme of work that will improve awareness and understanding of autistic spectrum disorders among professionals and families and give people quicker access to diagnosis and interventions that are appropriate to individual needs.
Is the minister satisfied that sufficient specialised support is currently available for autistic youngsters? Provision of support among the various health boards appears to vary.
Of course, the early and accurate diagnosis of autistic spectrum disorder is absolutely essential if children and their families are to get access to the supports that they need. Currently, we are providing funding to NHS Education for Scotland to develop information and training for general practitioners and primary care staff. We are also providing funding to the Scottish Social Services Council for the development of autistic spectrum disorder skills qualifications for social care staff. It is hugely important that social care, education and medical staff work as part of an inter-agency team to support pupils with autistic spectrum disorder in schools. We believe that the Education (Additional Support for Learning) (Scotland) Act 2004 will provide that inter-agency working for youngsters who suffer from autistic spectrum disorder.
Is the minister aware of the excellent work that is being done in our schools to improve services for young people with autism, which is being delivered by her ministerial colleagues with responsibility for education? Leaving aside the Education (Additional Support for Learning) (Scotland) Act 2004 and the code of practice on additional support for learning, which is currently before the Parliament, is she aware of the involvement of Her Majesty's Inspectorate of Education in inspecting services for young people with autistic spectrum disorder in education throughout Scotland? I think that an announcement was made last year, but work was due to start in April this year. Will she bring the Parliament up to date with progress on HMIE's inspection programme? In particular, will she comment on whether educational services such as speech and language therapy—which are delivered by health boards or health authorities and so come within her remit—are subject to inspection by HMIE as part of that welcome programme?
As the member says, HMIE will carry out an inspection of educational provision for children and young people with autistic spectrum disorder throughout Scotland. He was accurate in saying that the programme started in April this year, and it will continue until March 2006.
National Breastfeeding Awareness Week
To ask the Scottish Executive what action was taken at a national level to promote breastfeeding in Scotland during national breastfeeding awareness week. (S2O-6787)
The Executive supported a number of activities during breastfeeding awareness week 2005. Through NHS Health Scotland, we ran the breastfeeding television campaign and circulated associated promotional posters to each national health service board for use in its local activities. Local activities were supported by the national breastfeeding adviser, who visited a range of boards during the week. I was delighted to visit Forth Park hospital in Fife, where I had the honour of presenting Fife NHS Board with its United Nations Children's Fund baby-friendly certificates and met and talked to health professionals and breastfeeding mothers.
I welcome the action that was taken last week. However, the minister knows that, despite significant progress in Scotland in recent years, the national breastfeeding target that was set more than 10 years ago has not been met. Will she say what action will now be taken to revise the target and the current breastfeeding strategies to galvanise future progress? Will raising awareness of the legal protection that mothers now have under the Breastfeeding etc (Scotland) Act 2005 form part of that strategy?
As the member accurately says, the national target that was set in 1995 that 50 per cent of mothers should be breastfeeding at six weeks by 2005 has not been met. However, data that have been collected through the child health surveillance programme show that the rates rose between 1999 and 2004, although they did so much more slowly than they were expected to.
I ask the minister to comment on the importance of breastfeeding in the context of the Scottish Executive's wider policies on food and nutrition.
We are completely committed to supporting and promoting breastfeeding as the most appropriate form of infant feeding in the early years. That links in with our wider policies on nutrition. We are developing a national infant feeding strategy, which will involve a wider range of bodies in supporting that valuable health-promoting behaviour. We must ensure that it is an issue not just for mothers and health professionals, but for all family members, local authorities, schools and many other groups and individuals. We must work closely with the organisations that work with pregnant mothers and parenting groups to ensure that, in addition to breastfeeding, we have advice about healthy weaning and infant feeding.
Environment and Rural Development
We now move to questions on the environment and rural development. Richard Lochhead, who was to have asked question 1, is not here.
Air Quality (European Union Directives)
To ask the Scottish Executive what action is being taken to meet air quality obligations under EU directives. (S2O-6742)
A great deal. The air quality strategy sets national objectives that are either equal to or more stringent than those that have been set by the European Community directives and which will be worked towards by the Executive in partnership with local authorities, the Scottish Environment Protection Agency and other interested parties.
The minister will be aware that the directives will cause traffic management difficulties for local authorities in many urban areas, whether Shandwick Place in Edinburgh or Hope Street in Glasgow. The strategy is a national one that has been signed up to by the national Government. Will the Executive commit to financing and assisting local authorities that face the consequences of those decisions, desirable though they may be?
We work with local authorities on meeting their requirements under the air quality management areas. Mr MacAskill refers to two areas where those requirements might apply. Local authorities are required to develop air quality action plans only where there is an issue over whether they can meet the targets that have been set for them. They will be funded in the usual way for matters for which they have legal obligations and we expect that to continue. We also provide funding for other important aspects of the delivery of the policy, such as vehicle emissions testing and supporting the use of emission-reducing equipment.
Horse Passports
To ask the Scottish Executive what measures it has taken to ensure that all horse owners are aware of the procedures and timescales involved in obtaining a horse passport. (S2O-6730)
The Scottish Executive Environment and Rural Affairs Department has engaged fully with equine organisations and interests since it first consulted in June 2000 on proposals to extend the requirement for horse passports to all equines. Several meetings have been held with stakeholders, two further consultation exercises have been undertaken and publicity campaigns have been carried out. A news release was issued and public notices were placed in the national and local press to highlight the coming into force of the new regulations earlier this week.
The Environment and Rural Development Committee yesterday approved the regulations covering horse passports and related matters. Does the minister accept that the way in which the issue has been managed has placed many horse owners in Scotland under considerable anxiety and constraint regarding what their obligations are and has, frankly, given them a completely inadequate timetable within which to understand and comply with those obligations? Would it not have been better to defer the commencement of that Scottish statutory instrument?
I find that a quite extraordinary proposition. The horse-owning and operating community—those people with an interest in horses—has been aware of the intention to introduce horse passports in this format for some five years. I do not regard that as an inadequate period of time. Yesterday, the Conservatives sought—unsuccessfully, I am happy to say—to persuade the Parliament to take no further action on the implementation of the regulations. I hope that, in asking their question today, they have helped to advertise even more widely to the readers of Scottish newspapers the fact that the regulations are now in place.
As the minister is aware, the horse passport regulations have been widely discussed by the cross-party group on animal welfare and we welcome the efforts of the Scottish Executive and Ross Finnie in particular to examine the issue in depth. I have to say that the member who asked the question on this subject has not been to any of those meetings. Will the minister consider any issues that might arise because of any differences in the implementation of the EU directive on either side of the border and write to me about them?
There are some differences and Ross Finnie or I will write to Sylvia Jackson on that matter. However, the essential point to make is that horse passports are part of a regime that is common across not only the United Kingdom but the European Union. It is designed as a public health measure and will be given full effect in accordance with the regulations that have been approved by the Scottish Parliament following the debate in the Environment and Rural Development Committee yesterday. Of course, there has to be recognition of the fact that horses will travel from Scotland to the UK and other parts of the EU, which is why the application of those measures across the EU as well as the UK is essential.
Recycling Facilities (West Lothian)
To ask the Scottish Executive what investment it is making in the provision of recycling facilities in West Lothian. (S2O-6783)
West Lothian Council has been awarded more than £33 million in the period up to 2020 for recycling and composting infrastructure.
I welcome the minister's answer but want to take him a step further. West Lothian Council has developed a programme for recycling along with other councils in the Lothian and Borders area, as the Executive's policy suggests that it should do. It has identified an appropriate site with planning permission and its waste contracts end in 2007. Given that West Lothian Council is ready to proceed, is the minister prepared to consider West Lothian Council's application for funding from the waste strategy fund, based on best value, rather than making it wait until the other local authorities are ready?
There is a difficulty with that. The member must understand that, when the Executive prepared its national waste strategy, it did so on the basis of having area waste strategies. The intention behind that was to avoid having unnecessary duplication of facilities and also to ensure that individual taxpayers in each local authority would achieve best value. Although I congratulate West Lothian Council on getting ahead, I do not think that the principle of ensuring that area waste groups work together to secure best value would be served by following the course that the member suggests.
Paisley Road West Busway<br />(Environmental Impact)
To ask the Scottish Executive what the environmental impact will be of the Paisley Road West busway. (S2O-6767)
The measures that are being delivered by Glasgow City Council for the Paisley Road West to Balmore Road quality bus corridor are intended to reduce bus journey time, make the bus service more reliable and ease traffic congestion. That should encourage modal shift from private car to public transport and therefore have a positive environmental impact through a reduction in air and noise pollution.
I appreciate the minister's point, but he will realise that there is a great deal of local concern about the provision of the appropriate services and the effect on local businesses. I want an assurance that the minister will co-operate with the Minister for Transport and others to ensure that there is an across-the-board consideration of the issue so that all the factors are taken into account at the same time.
I will be happy to co-ordinate with the Minister for Transport on that matter. I hope that the member is already aware that Glasgow City Council carried out extensive public consultation to address concerns about the introduction of the quality bus corridor.
As a resident of Paisley Road West, I can tell the minister that, following the consultation that the council carried out, the original plan for a bus lane was changed to a bus corridor, such was the worry that had been expressed about the effect on small businesses. Can the minister give us an assurance that there will not be further closures of small businesses in Paisley Road West, as the communities rely on those small businesses rather than the large and hard-to-get-to shopping centres?
I am unable to give Tommy Sheridan an absolute positive assurance on that. However, I am grateful for his acknowledgement that the extensive consultation that was carried out by the council resulted in an alteration to the plan. I am sure that the council is cognisant of the need to achieve a balance between making environmental improvements and sustaining businesses in its communities.
Waste (Importation for Disposal)
To ask the Scottish Executive whether it encourages the import of waste into Scotland for disposal. (S2O-6804)
I certainly give no encouragement to the importation of waste, but the member should be aware that the import and export of waste from outwith the United Kingdom, as with other trade-related matters, are reserved to Westminster. There is no restriction on the movement of properly notified wastes among the countries of the UK.
The minister will be aware that residents at Straid farm in South Ayrshire are saying that companies that are not properly reported—companies that are not on the Scottish Environment Protection Agency's list—have been dumping waste there. He will also be aware of allegations of criminal gangs from the Republic of Ireland smuggling controlled waste across the border into Northern Ireland for subsequent illegal disposal in Ayrshire. What is the minister doing to ensure the effective implementation of the Scottish waste strategy in Ayrshire?
We are aware of the allegations that waste might be being illegally imported, with respect to the landfill site at Straid farm in particular. That matter is being investigated. The member spoke about persons acting illegally. He will be aware that a trial is being held in Enniskillen of persons who are accused of doing that. The trial is adjourned until 6 June and it would be inappropriate for me to comment on those criminal proceedings.
Do the various regulatory bodies or planning authorities have powers to place restrictions on such sites, so that the waste that is dealt with there is brought only a certain distance before arriving and, in particular, so that it does not arrive from another country?
If the waste is transported within the UK, that movement still requires to be properly authorised. We try as far as possible to observe the proximity principle in such matters. That is our approach for intra-UK waste. We give no encouragement to the importation of waste, as I said in response to Chris Ballance. The licensing of such operations comes under the control of SEPA, which imposes regulations. Unfortunately, and particularly in relation to the two cases that Chris Ballance raised, people are clearly seeking to obviate the law. That is a matter for the criminal authorities to address.
The matter of waste disposal is extremely important for communities all over Scotland and for the Scottish environment. It appears also to be important for the Scottish Executive. Will the minister press for all legislation regarding waste, such as the Transfrontier Shipment of Waste Regulations 1994, to be fully devolved to the Scottish Parliament? If not, why not?
I think that we have the controls in place. The cases that members are raising are, sadly, those in which people are clearly trying to obviate the existing legislation. Whether that legislation is in the hands of this Parliament or the Westminster Parliament, it is highly regrettable whenever people seek to obviate the law. However, that is a matter for the criminal authorities, which have the powers to pursue and prosecute such offenders.
Energy Efficiency (Carbon Dioxide Pollution)
To ask the Scottish Executive how many tonnes of carbon dioxide pollution, that would otherwise contribute to climate change, it estimates will be prevented over the next five years as a result of its policies in respect of making the use of energy more efficient. (S2O-6806)
In support of the review of the Scottish climate change programme, the Scottish Executive has commissioned consultants to calculate the level of carbon savings that are expected in Scotland by 2010 from a range of energy efficiency measures. The research is nearing completion and we expect to publish the results during the review period.
I am sure that the minister is already familiar with the report that the Environment and Rural Development Committee published yesterday, which urges the Executive to take radical action on climate change because Scotland lags behind the rest of the United Kingdom in reducing emission levels. How does the minister respond to the report's recommendation that the energy efficiency strategy that is expected from the Executive must include sectoral targets? Will he give an assurance that it will include such targets?
The proper thing for me, as Minister for Environment and Rural Development, to do is to read the comprehensive report that the committee has prepared and give it my full consideration. Although I have managed to scan through it and I am familiar with some of its major recommendations, I have certainly not been able to give it the detailed consideration that it merits. When I have done so, I will respond to the committee according to normal parliamentary procedure.
One report that is available is on the electricity generation figures for the past 10 to 15 years. Is the minister aware that, despite all the energy saving measures that have been taken, consumption of electricity in Scotland has risen year by year? Can he confirm whether it is the case that, since the early 1980s, Scotland's emissions from power stations and whatever have been among the cleanest in Europe?
There are two separate questions. I suspect that it is because of the concerns that the committee has noted, which are shared by many of us in the chamber, that the climate change programme must be revised and that we must give urgent attention to having a more comprehensive energy efficiency measure. One of the key elements is that we must take serious steps to reduce the amount of energy that is consumed.
Queen Margaret University College (Environmental Sustainability)
To ask the Scottish Executive what input its Environment and Rural Affairs Department has had into discussions with Queen Margaret University College regarding environmental sustainability to support the college in its aim of achieving standards of excellence for sustainability in its new campus development. (S2O-6760)
There have been no specific contacts with the Environment and Rural Affairs Department, but we welcome the moves by Queen Margaret University College to make its new development sustainable. The Executive's guidance to the funding councils asks them
I thank the minister for that informative answer. Is he aware that Queen Margaret University College wishes to install biomass heating at its new campus in support of its key objective for the new campus of environmental sustainability? Will he join me in saying that that is exactly the sort of project that we want to see taking place in new-build developments? Will he, in liaison with his colleagues, ensure that the Executive works with the college to ensure that the project proceeds?
I am happy to give that support. It is clear that the aims and ambitions of the project on which Queen Margaret University College has embarked more than meet the guidance that we give. The project is to be encouraged and I am happy to back it. I am sure that members of my department are also keen to give support, where possible, to the college.
That ends questions to ministers.
On a point of order, Presiding Officer. As I was inadvertently delayed earlier, I was two minutes late in reaching the chamber and missed the time to ask my question, for which I apologise to you, to other members and to the Minister for Environment and Rural Development.
Thank you.
On a point of order, Presiding Officer. During health and community care questions, we reached only question 4 before the time was up. That was due in no small part to the fact that the first two questions took 14 and a half minutes and in large part to the Deputy Minister for Health and Community Care's lengthy answers. Will you remind the minister that this is question time, not answer time? Question time is members' one opportunity to hold ministers to account. We are clearly being prevented from doing so if we reach only question 4.
Further to that point of order, Presiding Officer. I congratulate you on taking the minister to task. In my memory, that is the first time in the Parliament's history that a Presiding Officer has done that. I would like to believe that all Presiding Officers will follow your example in the future.
I am not absolutely sure how to take that.