Plenary, 19 Jun 2008

Meeting date: Thursday, June 19, 2008

Official Report 709KB pdf

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First Minister's Question Time

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Engagements

To ask the First Minister what engagements he has planned for the rest of the day. (S3F-897)

Later today I will have meetings to take forward the Government's programme for Scotland.

Today, I want to raise issues on behalf of Scotland's pensioners. Last autumn, the First Minister repeatedly reassured us that the free central heating programme was safe in his hands and that means testing was not on the agenda. I would be grateful if the First Minister would listen to these words. As of 22 May, the Scottish Government has instructed Scottish Gas that it can progress applications only from "specified categories." What does the First Minister have to say to pensioners whom he has now excluded from the free central heating scheme?

I am not sure how much in command of the subject Wendy Alexander is, but she is quoting from the announcement that the Deputy First Minister made in Parliament a few weeks ago. In that statement, not only did Nicola Sturgeon provide reasons for the move, she pointed out that, thanks to the record of this Government, a record number of installations have taken place in the past year.

On a factual point, there has not been a record number of installations, so I look forward to a correction being made. The number was only for the private sector, not the total scheme, and was fewer than we achieved in a number of years.

There was no answer given to the key question. On central heating, the First Minister said that there was a review and that the scheme was safe in his hands. However, we have ended up both with means testing and with pensioners being excluded.

And there's more. This week, without so much as a press release on the terms of reference from this rather publicity-hungry Government, the Scottish National Party has now started reviewing pensioner travel. How can pensioners in Scotland have confidence in the outcomes of a review when the membership, the remit, the terms of reference and the timetable are apparently all secret?

Before we get on the buses, let us have a look at the central heating scheme.

Oh! So he has got the answer now.

I think that Andy Kerr should be worried about the answer, because not only has there been a record number of installations, the public sector scheme had dried up altogether under the Labour Party. Furthermore, a range of stakeholders back what the SNP is doing to help Scotland's pensioners.

On buses, Wendy Alexander asks about our review, but it is not our review; we are carrying on what the previous Government said it was going to do two years ago. I am looking around the chamber for Tavish Scott, who is my secret weapon. I might have to quote him in absentia. On 15 March 2006, Tavish Scott said:

"The first two years of operation of the scheme will be critical in building up the evidence base for future reflections on the scheme."—[Official Report, 15 March 2006; c 24046.]

We are carrying forward the previous Administration's commitment to conduct a review. The one difference between the approach of this Administration and that of the previous Administration is that the Minister for Transport, Infrastructure and Climate Change has already said that we are not changing the eligibility for old people and disabled people in the scheme.

Will Wendy Alexander stop scaremongering? The old people of Scotland have trust in the Scottish National Party.

The First Minister should be very careful. He has not given us an answer to the question why he promised Parliament that there would be no means testing for pensioners but has now introduced it.

The pattern is that the First Minister reviews, then reassures and then lets pensioners down. If there is no cause for concern about this secret review—[Laughter.]

Order.

I ask the First Minister to guarantee Scotland's pensioners that he will make no changes to the time of day that pensioners can travel—

No change.

—the distance that can be travelled—

No change.

—or the number of journeys that can be undertaken.

No change.

Let us get back to the central heating scheme. The pensioners of Scotland know two things. First, there have been a record number of installations under this Government. Secondly, people look at the newspapers and see the possibility of a further 40 per cent hike in their energy costs, thanks to a Chancellor of the Exchequer who is accumulating an additional £500 million in offshore windfall, but who will not lift a finger to help the industries, the pensioners or the families of Scotland. We are the only oil-rich country in the world that is suffering from fuel poverty.

I move on to the buses. The review is so secret that Tavish Scott announced it in 2006. The Minister for Transport, Infrastructure and Climate Change has made it clear that there will be no change to eligibility for pensioners or disabled people under the scheme. They will have a great deal more confidence in Stewart Stevenson than in Tavish Scott.

I regret that the First Minister has not given an answer to this question: are the times of day, the distance that can be travelled or the number of journeys under consideration?

No.

Order. The First Minister, and nobody else, will answer the question.

If the First Minister is offering a guarantee, he has to forgive Scotland's pensioners for reserving judgment, given that six months ago he gave a similar guarantee on central heating. There is also growing pensioner concern about the local income tax. In the run-up to the election, SNP ministers said that, under SNP proposals,

"There will be no ifs or buts, no means test"

and that pensioners

"will simply have nothing to pay."

Not content with conning parents and students, the SNP is now attempting to con Scotland's pensioners. Will the First Minister confirm that, under his plans, more than 400,000 Scottish pensioners will receive a local income tax bill? Yes or no?

Let us get back to the variety of subjects that Wendy Alexander has raised. Memorably, she said that change is what she does. As far as eligibility for the pensioner and disabled scheme is concerned, there will be no change from the SNP.

I move on to local income tax. The majority of Scotland's pensioners welcome local income tax with open arms, just as they welcomed the council tax freeze that the Scottish National Party introduced. [Applause.]

Order.

It is not just Scotland's pensioners who support local income tax. Just a few weeks ago, a poll showed overwhelming support for local income tax among the population of Scotland: among Tory supporters in Scotland; among Liberal Democrats, who of course support a local income tax; among the Scottish National Party, which supports fair means of taxation; and—by a significant majority—among Labour Party supporters. If Wendy Alexander cannot even scaremonger among her diminishing band of supporters, what chance has she got of scaremongering among the pensioners and students of Scotland?

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Prime Minister (Meetings)

To ask the First Minister when he will next meet the Prime Minister. (S3F-898)

I have no plans to meet the Prime Minister in the near future.

There has been deep concern throughout Scotland about the tragic outbreak of Clostridium difficile at the Vale of Leven hospital. Our thoughts are with all the families who have been affected by that lethal infection. In 2003, when MRSA levels increased by 4 per cent, the then shadow minister for health and community care, Nicola Sturgeon, said:

"It is up to the Health Minister to ensure that superbugs are kept to a minimum and that patients enter Scotland's hospitals to be treated not infected".

She went on to add:

"These figures highlight that so far the Minister has failed".

We are now dealing with a much worse situation, caused by Clostridium difficile and the consequent death toll.

In November the Scottish Government announced a range of measures, including surveillance monitoring for C difficile. Will the First Minister undertake to publish this afternoon details of the incidences of C difficile in every hospital in Scotland this year?

I will publish all information on C difficile and other hospital-acquired infections as soon as the statistics are available.

The most recent comparative statistics for England and Wales and Scotland suggest that there is a serious situation in Scotland, which is why we have increased the budget so massively—to £50 million over the next three years, compared with annual expenditure of £5 million in the past. We acknowledge the extent and seriousness of the problem and the heartbreak of affected families and individuals. We also acknowledge that the problem can undermine the very heart of confidence in the health service. For all those reasons and because of the suffering and anxiety that has been caused, I undertake to publish all information as quickly as it becomes available.

The disquieting aspect of the First Minister's response is that there is so much that we do not know. How can we tackle a problem when we do not know where it is or how serious it is?

One thing is clear: the tragic outbreak at the Vale of Leven hospital arose because of a basic lack of hygiene practice on the wards. Five years ago, Ms Sturgeon was right to say that

"patients enter Scottish hospitals to be treated not infected".

Does the First Minister agree that we need to restore in every ward and hospital in Scotland a clinical presence such as a supersister, who is a visible point of authority and is empowered to enforce the application of robust hygiene standards? That could make the difference.

The equivalent post in Scotland is, of course, the charge nurse. Annabel Goldie will know that only a few weeks ago the Cabinet Secretary for Health and Wellbeing announced a review of the functions of charge nurses in Scotland, precisely to address the range of points that Annabel Goldie made.

In 2006 the monitoring system was set up to enable more accurate and immediate assessment of hospital-acquired infections. I do not think that any member will dispute that that was a good system to set up. A real question that must be asked in the light of the tragic circumstances at the Vale of Leven hospital is whether the fact that the monitoring system clearly did not work in that hospital reflects a defect in the system or a defect in Greater Glasgow and Clyde NHS Board's particular surveillance system. I am sure that the commission of inquiry will answer that key question, because the answer will tell us whether structural change in the monitoring system is required or whether change in the individual health board is the key.

I undertake to ensure that all the information is in the public domain as quickly as possible, including the information that we have, and are getting, from the retrospective exercise that Greater Glasgow and Clyde NHS Board is undertaking.

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Cabinet (Meetings)

To ask the First Minister what issues will be discussed at the next meeting of the Cabinet. (S3F-899)

The next meeting of Cabinet will discuss issues of importance to the people of Scotland.

Will the First Minister say what advice is currently being given to patients and relatives on the life-threatening nature of the C difficile bacteria? What guidance is given on the hygiene steps that people must take?

As Nicol Stephen will know, action was taken by the action teams on 21 May to enforce better hygiene standards, and inspections of the hospital have been made. A great deal of effort has gone into getting across not just to affected patients and their relatives but to the general population, the message about the importance of hygiene in hospitals. As we know, in many cases hospital-acquired infections originate outside the hospital, and are transmitted in the inevitable and welcome visits of people to the hospital. As Nicol Stephen also knows, substantial efforts have been made in the past and even more substantial efforts will be made in the future. We have increased the budget so massively not just to help control infections but to fund the information campaigns that are necessary.

I wonder whether the First Minister heard a radio interview this morning with the daughter-in-law of a patient who died at the Vale of Leven hospital. She said that no one explained that C diff could result in a patient's death and that she had been given soiled clothing to take home with no instructions on how to deal with it. Why is that acceptable? Is the life-threatening nature of C diff still being concealed from some patients and relatives? Is expert advice on hygiene being given to all of them?

Patients and relatives throughout Scotland are anxious and confused, and rightly so; after all, we go into hospital to get better, not worse. The Cabinet Secretary for Health and Wellbeing has launched an inquiry into the causes of the current outbreak, but patients and their relatives need help and examples of really poor practice need to be stopped now. Will the First Minister tell us what advice is being given today to patients, and what expert advice on hygiene is being sent to our hospitals right now?

I heard the interview. I do not believe that the situation is acceptable, and that aspect is being looked at and will have to be improved substantially.

Having watched and read the statement yesterday by the Cabinet Secretary for Health and Wellbeing, I do not think that anyone who has listened to the debate can be under any illusion whatever about the seriousness with which she is taking not just this issue but the range of issues that have arisen from it. We, as a Government, were aware of the situation when we so massively increased the budget for controlling hospital-acquired infections. Such infections have not just arisen in the past year or even in the past few years, but have been a steadily growing challenge, and our country and health service have to meet it. Certainly, information on, and disclosure of, the full extent of the seriousness of C difficile must be given to patients and relatives.

On 14 February, a Scottish Government official attended a meeting with the Department of Health to discuss the United Kingdom Government's new infection guidelines covering C difficile, which were published in January. On returning, the official urged the Scottish Government to issue new guidelines. In the light of the scale of the mortality at the Vale of Leven hospital—a staggering 30 per cent—why, some five months after that meeting, do we still not have any guidance on C difficile in Scotland? Why, when the Scottish Government was advised by Health Protection Scotland on 14 May of deaths from C difficile in Aberdeen royal infirmary, Stobhill hospital and the Vale of Leven hospital, did it only press-release the incidents at Aberdeen and Stobhill and remain silent on the Vale? I am sure that the First Minister agrees that clarity on this serious matter is of the utmost importance.

As the constituency member well knows, the information about the cluster at the Vale of Leven hospital came to light on 21 May. Moreover, what came to light at that time was not what was cited yesterday about six cases and four deaths; the information then was about six cases, three of which were linked to the Vale of Leven. That is why action was taken then. Of course, the retrospective exercise has revealed the full horrific extent of the problem in the Vale of Leven hospital.

Officials in the health directorate are aware of developments in England. Since then, work has been carried out on advice that is specific to Scotland, which will—because of the seriousness with which this Government takes hospital-acquired infections and, in particular, C difficile—be published as quickly as possible.

Will the First Minister say why the Government did not call in the plans for Caltongate, given that the area is central to Edinburgh's status as a world heritage city? The United Nations Educational, Scientific and Cultural Organization is to meet to discuss the danger that the development might pose to that status.

The proposal was returned for decision and determination to the City of Edinburgh Council because we believe that it is well placed to judge the city's development and direction.

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Shell (Strike Action)

In welcoming the settlement of the Shell oil tanker drivers' dispute since my question was framed, I ask the First Minister what contingency plans are in place to deal with the consequences of any possible future disruption.

Your question is not exactly as written, Mr Neil, but I will hand it over to the First Minister.

We welcome the announcement that the threat of a second strike has been lifted and that restocking arrangements are at normal or above normal levels. I thank Scottish motorists for their patience and restraint over the past few days and I acknowledge the excellent work of the emergency services and others in ensuring that the supply situation in Scotland was managed with the minimum of inconvenience to the people of Scotland.

I assure members that contingency arrangements are in place to manage the local consequences of any future disruption to fuel supplies and to ensure the prioritisation of essential services. A national emergency plan for fuel is also available for use in exceptional circumstances—but those circumstances would need to be exceptional for it to be used substantially. The Scottish Government liaised closely with local responders and the United Kingdom Government during the recent events. Our on-going resilience activity will build on those arrangements to ensure that any lessons that are identified are addressed and implemented.

I thank the First Minister for that detailed reply. For the longer term, given that we have had two disruptions to oil supplies recently, are there any lessons to be learned on how the companies and employees might settle their disputes before they reach the point that they reached on both those occasions?

I think that every member of Parliament would agree that jaw-jaw and settlement of negotiations before striking would be infinitely preferable to the difficulties and—more than inconvenience—the potential disruption to the wider economy and to essential services that are threatened during such disputes. The fact that we have managed substantially to avoid that inconvenience and disruption is a tribute to the extraordinary amount of effort that was put in in the local area committees around Scotland.

In the past few days, the resilience room committee has met 11 times to supervise arrangements around Scotland. Such planning takes up a dramatic amount of the time of local authorities, police and other services. Therefore, I certainly agree with Alex Neil that it would be infinitely preferable if such arrangements—however well rehearsed and however well utilised they may have been in Scotland—were not necessary because workers and management were able to settle their differences before strike action as opposed to after it.

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National Concessionary Travel Scheme

To ask the First Minister whether sufficient funding will be found to maintain existing entitlements for pensioners and disabled people under the national concessionary travel scheme between now and 2011. (S3F-922)

The previous Administration, as we discussed earlier, agreed that there should be a review of the free bus travel scheme for older and disabled people. That review began on 17 June and ministers will consider the outcome towards the end of this year. As the Minister for Transport, Infrastructure and Climate Change has made clear, the Scottish Government has no plans whatsoever to increase the qualifying age for concessionary fares on buses and will not consider such an increase as part of its review of the scheme. Around 1.1 million older and disabled people currently benefit from the scheme.

The answer that pensioners and disabled people want to my question is yes.

Will the First Minister ensure that the criteria for the review of the national concessionary travel scheme are made public, so that people can see in black and white what the Government's intentions are? Bearing it in mind that funding for concessionary travel has been scaled back in real terms, will he ensure that any shortfall in funding for concessionary travel will not be made up by fare increases for adult and child passengers who pay for their journeys? Such a form of indirect taxation would be unnecessary and unacceptable.

Yes—we will be delighted to make the review criteria public because that will be the most effective answer to the disgraceful scaremongering on the issue by Des McNulty and others.

Des McNulty should have some command of the subject—the review was announced two years ago by the then Minister for Transport, Tavish Scott—and should be aware that, due to low take-up in the young persons scheme because that scheme was not particularly good, funding for concessionary fares for disabled and older people is rising not only in nominal terms within the overall budget for the scheme but in real terms. Year on year, we expect that, on average, perhaps £10 million a year more will be spent than in the current calendar year.

Given that Des McNulty now has that information, and although it is awkward to the campaign that is taking him out of obscurity, away from parliamentary questions and into the light of day, will he join me in welcoming the fact that we are publishing the criteria for the review and that we can give an absolute commitment to older people and disabled people in Scotland that we will maintain the scheme and that there will be no change to the eligibility criteria?

To avoid confusion, will the First Minister say whether the outgoing Government made adequate provision for continuation of the national concessionary travel scheme?

The outgoing Government's sole contribution to the scheme was to say that there would be a review. That was what Tavish Scott said. When I was criticising earlier—which I regret was in Tavish Scott's absence—I noticed that I even got nods of assent from the Labour benches. I am afraid that the outgoing Government did not indicate its on-going commitment to the scheme. It said what Tavish Scott said in 2006. Therefore, given the budgetary commitments that the present Government has made and the assurance on publishing the eligibility criteria, can we perhaps come to the conclusion that the disabled and pensioners of Scotland will be a lot safer on the bus with the Scottish National Party than they would have been with the Labour and Liberal parties?

If the Labour Party is anxious, as I am, about the present pressures on public transport, perhaps its members will have a word in the ear of the Chancellor of the Exchequer—the £5 billion man, who is raking in excess oil revenues, but without a scintilla of concern for the pressure on the pensioners, families, industries and—yes—on the public transport and bus operators in Scotland.

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“Lessons for Mental Health Care in Scotland”

To ask the First Minister what action is being taken following the publication of the report, "Lessons for Mental Health Care in Scotland". (S3F-914)

The Scottish Government welcomes the report, as the Minister for Public Health has already indicated. We have written to all health boards and local authorities to ask them to consider and take forward the report's key recommendations on the management of risk in relation to suicide and homicide by people with mental illness.

One of the headline issues in Professor Appleby's report is the link between alcohol and drug misuse and homicide. Members will be aware that, last month, we announced the new national drugs strategy, "The Road to Recovery: A New Approach to Tackling Scotland's Drug Problem", with a great deal of support from Mary Scanlon's party, and that this week we launched a consultation on an approach to alcohol misuse in Scotland, with substantially less support from Mary Scanlon's party. In December 2007, we published "Mental Health in Scotland: Closing the Gaps—Making a Difference", which specifically addressed the issues around service provision for people with mental illness and substance misuse problems, which were the primary focus of Professor Appleby's excellent report.

If the First Minister is looking for our support, he will perhaps answer my question positively. During the six years of the study, about 5,000 suicides were recorded in Scotland and 500 murders. In the Highlands, many young men who were at risk of suicide never got beyond their local general practitioner or the repeat prescriptions for antidepressants. Will the First Minister take action to improve early intervention and to shorten waiting times for people with mental health problems to ensure that they can remain in work and at home with their families, and that they receive the appropriate treatment when they need it?

I acknowledge Mary Scanlon's work on the issue over a long period. As I said, we have written to the health boards and local authorities on Professor Appleby's review and we are asking them to consider his recommendations, including the ones that Mary Scanlon supports so strongly, and to report back to us. We are taking the issue seriously.

We are also considering the extent to which, on consideration, mental illness and aspects connected with it could for the first time be brought into the waiting times guarantee. The Minister for Public Health gave an interview on that point earlier this week.

The First Minister will be aware that there are no local outcomes or national priority outcomes for child and adolescent mental health services, that there are no structures in place to collate centrally waiting times for accessing those services, and that there is no accurate picture of transition services between youth and adult services. There is often an arbitrary cut-off at the age of 16 for young people who receive such services.

Ask a question, please.

Will the First Minister take specific measures in response to Professor Appleby's report to correct some of those aspects, so that young people who have complex needs receive child and adolescent mental health services before they need to access adult mental health services?

As I said, we are taking the report extremely seriously. I will write to Jeremy Purvis to provide him with as much information as possible on the issues that he raises. Members should have no doubt that we take the recommendations in Professor Appleby's report extremely seriously and intend to implement them.

On a point of order, Presiding Officer. I hope that you will take this point of order in the constructive way in which it is offered and recognise that my occasional experience of ministerial and First Minister's question time over recent years allows me to say that protection of the integrity of question time is paramount.

There have been a number of occasions in recent years when the subject matter for questions that have been lodged in writing for ministerial or First Minister's question time has been overtaken by events in the course of the week. On those occasions, members have withdrawn their questions and, if the matter was appropriate and topical, the Presiding Officer has asked them to ask a supplementary question at another point during question time, so that they can put across the point that they wished to make. With all due respect, Presiding Officer, that would have been appropriate today. It is wrong under the rules—not just in practice—that members should be allowed, when asking it in the chamber, to change the content of a question that has been lodged in advance in writing.

I hope that you will reflect this afternoon on what has happened and ensure that new advice is issued to all members from the chair, so that the practice that I have described is not allowed. In the future, members should withdraw questions that must be changed and ask to be allowed to raise the issues concerned at another point during question time.

I take the point of order in a constructive manner and thank Jack McConnell for it. Today the member concerned was given the option of withdrawing question 4, but was within his rights to choose not to do so. I will reflect on what Jack McConnell has said for future occasions.

Meeting suspended until 14:15.

On resuming—