Engagements
To ask the First Minister what engagements she has planned for the rest of the day. (S4F-03068)
Engagements to take forward the Government’s programme for Scotland.
Today marks one year since the First Minister took office. She has also been a senior Government minister for more than eight years, including five in charge of the national health service. The First Minister wants us to judge the Scottish National Party Government on its record, and today of all days we should do exactly that.
Everybody in this chamber knows somebody who has been affected by cancer. It is a horrible disease, and perhaps the most common perception is that money is no defence against it. New statistics published this week show that that is not the case. Can the First Minister tell me whether someone living in Scotland is more likely to get cancer if they are richer or poorer?
It has been a long-standing situation that people in our most deprived communities are more likely to die younger from illnesses such as cancer, from stroke and from heart disease. That did not start when the SNP came to Government; it has been true for generations.
What is equally true is that this Government has been working hard—as, I think that it is fair to say, previous Governments did—to close that gap, to see rates of cancer decrease and to see survival rates from cancer increase.
That is why we have policies not just about getting people access to the best cancer treatment. One of the things that we have done in the past year, since I have been First Minister, is to double the fund for new cancer medicines—a step in the right direction—but we have also put a great priority on innovative and ambitious public health measures: to improve people’s diets, to cut the incidence of alcohol misuse and to reduce smoking.
Those are the kinds of policy that, frankly, should not involve party politics. Every single member of this chamber should get behind those things so that far, far fewer people in all parts of our country die from cancer.
Nicola Sturgeon has been responsible for our NHS in one way or another for six out of the last eight years. The reality is that, in Scotland today, the likelihood of someone getting cancer too often depends on how much money they have. The new statistics show that people living in the poorest areas are 32 per cent more likely to have cancer than those from the wealthier areas, and they are 68 per cent more likely to die from it. That is just not right; this is 21st century Scotland, not the Victorian times.
I have never doubted the First Minister’s sincerity, but the job needs a bit more than that. The Government’s cancer strategy was due to be published at the start of this year, but it has been repeatedly delayed. Can the First Minister confirm when her Government’s cancer strategy will be published?
The cancer strategy will be published in the spring of next year. We are working with stakeholders across the NHS, including some of the best cancer clinicians in the world, who we are lucky to have here in Scotland, to make sure that we get that strategy right, such is the importance of the issue.
Kezia Dugdale said that the fact that people in our poorest communities are more likely to die from cancer is not right—I absolutely agree. It was not right when Labour was in office; it is not right now. That is why we are working so hard to reduce deaths from cancer. We saw figures published this week that show that, overall, cancer death rates have dropped by 11 per cent in the past 10 years. Overall, cancer mortality in 2014 was the lowest, and rates for breast, lung, stomach and colorectal cancer are dropping as well. Those are things that all of us should take great optimism from, but the job is not done.
That is why we are working to lower cancer waiting times. Interestingly, it was Labour that set some of the current cancer waiting times—they were never once met when Labour was in Government. We are working to reduce cancer waiting times, and we are working to make sure that we get more people into screening programmes. That is why we are investing £30 million in detect cancer early programmes, so that people come forward earlier when they have symptoms and they are diagnosed earlier. The earlier people are diagnosed, of course, the more chance they have of surviving.
I say to Kezia Dugdale in all seriousness that this is far too important for party political arguments. Let all of us unite to say that we want to see an end to the situation in which the people in our most deprived communities are more likely to die of cancer. I think that that is something worth uniting around.
There is no doubt that we welcome that progress, but the reality is that it is largely in the richer parts of Scotland.
That is why we need a cancer strategy. The English NHS has a widely recognised and welcome plan to fight the disease; we need the same here. In Scotland the system is failing those who are most in need. Some 66 per cent of eligible people in the wealthiest areas are taking up bowel cancer screening, but the rate is just 45 per cent in the poorest areas. The most recent figures show a decline in the number of women in poorer communities who get screened for breast cancer. Those lower rates of screening are a key reason why people from the poorest backgrounds are more likely to die from cancer.
Does the First Minister agree that without dramatic Government action we could be in danger of seeing cancer as a deprivation disease in Scotland?
I agree that serious Government action is needed to improve early diagnosis of cancer. That is important for anyone who has cancer, and given the statistics that Kezia Dugdale quoted it is even more important that we get people from our most deprived communities into a diagnosis as quickly as possible.
That is why this Government is investing £39 million in our detect cancer early programme, which has already resulted in a 4.7 per cent increase in early-stage diagnosis of cancer, alongside a 50 per cent increase in women consulting their general practitioner with breast symptoms and increased uptake of the national bowel screening programme. That is the kind of serious, concerted action that we need from Government.
Over the year that I have been First Minister, I have said on many occasions that, if any member has suggestions to make about things that they think this Government should be doing to further improve, I am happy to listen. However, in all of what I have just heard from Kezia Dugdale, I have heard not one specific suggestion about what she thinks this Government should do—
Nonsense!
Mr Simpson!
We will continue to do the work to get people diagnosed early, to encourage people to come forward, to ensure that we are giving people access to the best technologies and the best drugs, to ensure that we are lowering cancer waiting times and to ensure that we are doing all the things we need to do to improve the public health of people in Scotland in every single part of our country.
With respect, Presiding Officer, Dr Richard Simpson has been coming into this chamber for years to push this Government to be more ambitious when it comes to the cancer strategy.
We need an NHS that is fit for the future. That means an NHS that is ready to tackle the challenges of the 2040s, not the 1940s. We need bold action, but that is just not happening.
Let us look at the First Minister’s record. She has spent 16 years as a member of the Scottish Parliament, eight years as a minister, seven years as Deputy First Minister and five years in charge of our NHS, and this morning she had the cheek to say that she is only just getting started. [Interruption.]
Order.
Week after week, whatever the issue and whatever the failings of her Government, the First Minister always tells me about her opinion poll ratings. Clearly she thinks that that answers the question, but I think that it leads us to pose a question: given her opinion poll ratings, her majority and all her power, what exactly is she waiting for?
I am not sure that opinion polls are the strongest suit for a party that is now in a scrap with the Conservative Party for second place in Scotland. However, given that Kezia Dugdale raised the issue, I will say that opinion polls show that people trust the Scottish National Party more with the national health service than they trust the Labour Party or any other party in Scotland with the national health service.
We will continue to get on with the job—[Interruption.]
Order.
We have seen cancer death rates fall by 11 per cent. We have seen an increase in early-stage diagnosis of cancer, as I said. We are seeing an increase in the number of people who come forward for diagnosis by their GP and for screening. We are working hard to ensure that we have the best cancer centres—we have five state-of-the-art cancer centres in Scotland, and we are investing in state-of-the-art radiotherapy equipment in every single one of them.
We will continue, with the consent of the Scottish people, to get on with the job, and we will leave Labour to do what it has been doing for so many years now—carping on the sidelines and slowly but surely getting beaten in Scotland, not by the SNP but by the Tories.
Secretary of State for Scotland (Meetings)
I thank the First Minister for her electoral endorsement.
To ask the First Minister when she will next meet the Secretary of State for Scotland. (S4F-03060)
I have no plans in the near future.
I have a thank you to make to Ruth Davidson. I thank her for making sure that I got a copy of the internal Tory lines to take for the day. They have nothing to say about David Cameron’s new taxpayer-funded private jet, but nevertheless they were very helpful. I will take it as a wee anniversary present.
On Tuesday, a parents group called fair funding for our kids met the Cabinet Secretary for Education and Lifelong Learning to ask for basic details about how the Scottish National Party Government plans to meet its pledge to double nursery entitlement. The parents left that meeting so frustrated that they decided to speak out because Angela Constance was unable to provide even ballpark figures on how that pledge could possibly be met.
The parents wanted to know, if the Government is to double childcare by 2020, how many extra places that will take, how many extra staff will need to be hired, how many apprenticeships will be needed to train new staff, how many more nurseries will need to be built, how much money it will all cost, and where that money will come from? They say that Angela Constance could not answer a single one of those questions. Can the First Minister?
It will cost £880 million and where that will come from will be set out in our budget. It will take 20,000 additional staff, which will be a mixture of college places and apprenticeships. We are working with local authorities to determine the expansion of capacity that will be required. That will be a mixture of new build and extension of current local authority capacity.
I noted with interest yesterday’s press release from fair funding for our kids. That group of parents is to be commended for its determination over the issue. The group says that there are not enough places now to deliver our policy of doubling childcare and that is the case. That is why we have committed to doubling childcare during the next five years and investing more than £800 million in delivering that. That is a commitment that parents in Scotland will want to get behind.
We know where the SNP stands. We are going to double free childcare during the next parliamentary session. The question is: what is the Tory policy?
More flexibility, and we would love the First Minister to take it up now.
I thank the First Minister for giving everyone the answers that her education secretary seemed to be unable to find yesterday. The mums asked the questions because they have gone to what might be the biggest childcare provider, Glasgow City Council, and they have been told that the Scottish Government’s plans are “impossible”. The First Minister knows that because the mums wrote to her on 23 September to tell her that. I have the letter here.
We spoke to the parents group yesterday. It believed the Government a year ago when it said that it wanted to help, but the parents now feel utterly disillusioned and have lost all trust. For the past year, the First Minister has enjoyed the headlines but eventually she will have to start delivering. Those parents no longer believe that she will. What is the First Minister going to physically do to restore that trust?
I am physically going to invest £800 million to build the capacity in our system to double the provision of free childcare.
Ruth Davidson would give more flexibility. She might have heard me say a few weeks ago that flexibility will be built into our policy so that parents can take their eligible hours not just during term time but during school holidays. They can have more flexibility to fit in with their working patterns. Those are the ambitious plans that this Government has.
Ruth Davidson might want to listen to what the chief executive of Early Years Scotland said today:
“Early Years Scotland welcomes the Scottish Government’s commitment”.
She said that there are challenges, but that she is
“sure that, with our exceptionally dedicated workforce and downright determination to give every child the best start in life ... we will all work together to ensure that this laudable ambition becomes an everyday reality.”
Double childcare provision is the everyday reality that this Government will deliver.
Cabinet (Meetings)
To ask the First Minister what issues will be discussed at the next meeting of the Cabinet. (S4F-03061)
Matters of importance to the people of Scotland.
The timetable for the Government’s national testing for schools has slipped. The Government now expects MSPs to scrap the existing system before details for the new tests are even published. We have seen a cost estimate of £12.5 million. That money could be used for 400 teachers instead. The First Minister told us that she was against crude league tables, but the Educational Institute of Scotland warned this week that, if she carries on, league tables will be back. For a flagship policy, that is a shambles, is it not?
No, it is not. There is disagreement between Willie Rennie and me—there are disagreements between us on many things—but I want to ensure that we are raising standards in our schools, that we continue to close the attainment gap in our schools between children in our least and most deprived areas, that parents have the information that they want about their children’s progress and that I have the information that I need as First Minister to assure the country that we are making progress on those aims.
I am not interested in the return of league tables; I am not interested in high-stakes testing that has teachers teaching to the test. However, it is not acceptable that we cannot have that information in primary schools and in early secondary to know whether the actions that we are taking, such as the £100 million attainment fund, are working to deliver the objectives that we have set.
Willie Rennie and I will continue, no doubt, to debate the issue. I am on the side of making sure not only that we are driving up standards in our schools and closing the attainment gap, but that we are able to evidence that we are doing so. I make no apology for that.
The First Minister says repeatedly that she is not interested in crude league tables, but she will not do a single thing to stop them happening. Information requests gathered by common space have shown that the Scottish Government had only four emails with advice on national testing from only two people and they both had reservations. Therefore, it is quite right to say that the policy is a shambles. It is poorly informed, badly led, set to divert money from teaching and will bring back crude league tables. Opposition is growing from parents, teachers and unions. The First Minister said that she is consulting, but are there any circumstances in which she would abandon the plans?
No. I am not going to abandon the plans, because they are right. I want to see us raise standards, close the attainment gap and have the ability to evidence that we are doing that. We are talking to teachers and parents as we develop the national improvement framework. If Willie Rennie has taken the time to read it, he will know that the proposal for assessments, which are carried out in 30 out of 32 local authorities, is part of the national improvement framework.
We are talking to teachers and others about the timing of the assessments to avoid the high-stakes teach-to-the-test approach that many people, including me, are against. We are talking carefully about how we use the information, so that we can avoid a return to league tables that no one wants to see. I will not apologise for wanting to make sure that I can stand up in this chamber and tell other members and the country at large what is happening in our schools, and give parents access to the information about the progress of their children in schools.
The assessments are not to replace teacher judgment, which is at the core of curriculum for excellence, but to inform teacher judgment. It is the right thing to do. We will continue to talk to others about it, but we will get on with the job of making sure that we are raising standards in our schools. That is what people across the country expect us to do.
HIV Testing
To ask the First Minister what steps the Scottish Government is taking to promote early HIV testing. (S4F-03070)
It is vital that those who are at risk of having contracted HIV are tested promptly. We have reiterated our commitment to promote early HIV testing in the revised framework that was published in September. The Government is providing more than £28 million this year to support national health service boards and third sector organisations to deliver the framework across Scotland. Importantly, that includes funding to tackle the stigma associated with HIV infection, because that stigma is still one of the greatest barriers to people getting tested early.
The First Minister will be aware that Waverley Care, HIV Scotland and the Terrence Higgins Trust have stated that the barriers to HIV testing do, indeed, include stigma, fear and lack of awareness. Looking ahead to European HIV-hepatitis testing week, does the First Minister agree that having postal testing initiatives such as the fast test service from the Terrence Higgins Trust can help to overcome those barriers, raise awareness of early HIV testing, ensure that those who have tested positive receive the treatment that they need as soon as possible and, ultimately, help to prevent needless deaths?
I agree with that, and I hope that members across the chamber agree with it. HIV postal tests are available to any adult living in Scotland, through the Terrence Higgins Trust website. Confidential testing is also provided by Waverley Care in some parts of the country, and we have changed the law so that the sale of instant-result self-testing kits is now legal. Those arrangements complement national health service provision, but they can be particularly helpful for individuals who are nervous about approaching their general practitioner or sexual health clinic for a test.
Jim Eadie is right to raise the issue, and it is absolutely vital that we do everything that we can to deal with and allay the stigma that is associated with HIV so that people are encouraged to come forward for prompt testing.
Welfare Powers (Devolution)
To ask the First Minister what discussions the Scottish Government has had with the United Kingdom Government regarding using the new welfare top-up powers that are being devolved. (S4F-03078)
The Scottish Government has continued to have regular discussions with the UK Government about the devolution of social security. Those discussions have been pursued through the joint ministerial working group on welfare, and the issue has been a key element of discussions at the joint exchequer committee. There are also regular discussions between officials.
The Deputy First Minister has written to the UK Government, asking for confirmation that any additional or increased benefits that are provided by the Scottish Government will not result in the UK Government simply reducing reserved benefits and, in effect, clawing back the funds that are provided.
I hope that the First Minister will eventually agree with Labour about the need to restore what has been lost through cuts to tax credits and that she will raise that issue in face-to-face meetings. In the meantime, other new powers are coming to the Scottish Parliament in respect of the cold weather payment, which is worth £25 a week, winter fuel payments for pensioner households, which are worth £100 to £300, and implementation of the energy company obligation.
I hope that the First Minister agrees that it is a national scandal that fuel poverty affects a staggering 940,000 households—some 2 million people—in Scotland. With all due respect, when will she get on with her job? Fuel poverty has increased on her watch. Will the First Minister admit that she will not meet the pledge of ending fuel poverty by November 2016, and will she tell us what she will do with the new powers to help families and pensioners who have to choose between heating and eating this winter?
We will produce plans to use all our new powers in the interests of people in Scotland. Some of the powers that Jackie Baillie has listed—for example, over the winter fuel payments—give us the opportunity to look at what we do overall to tackle fuel poverty.
Jackie Baillie stands there as the representative of a party that, two weeks ago, had the opportunity to vote not just for sticking-plaster powers but for the devolution of tax credits and the budget for tax credits. Did Labour vote with the SNP for that? No. Labour members trooped through the lobbies of the House of Commons with the Tories to keep those powers in the hands of the Conservatives. That is the action of Labour politicians that people in Scotland are judging day in and day out.
Let us not forget that while others on the Labour benches—to their credit—were voting for £167 billion to be spent on things that matter, not on nuclear weapons, Jackie Baillie was voting with the Tories to renew the Trident nuclear weapons programme.
Jackie Baillie’s credibility on such issues before today was pretty ropey, but she probably ended any credibility that she had when she attended the Finance Committee yesterday and said, “My maths is shaky.” That sums it up.
I draw the First Minister’s attention to comments that were made by the general secretary of the Scottish Trades Union Congress, which recognise the importance of the financial framework to any additional powers. He said:
“it would be completely wrong for the Deputy First Minister to sign up to a mechanism for block grant adjustment which would structurally disadvantage Scotland.”
Does the First Minister agree that Jackie Baillie and her group should heed the advice of the STUC, stop mouthing some of the UK Tory party’s words and stand up for Scotland?
Jackie Baillie and Labour stopped listening to the STUC on the day that they decided to go into an alliance with the Tory party in Scotland on the referendum.
I saw the comments of the STUC yesterday. Indeed, I saw the comments today of Professor Anton Muscatelli, the principal of the University of Glasgow, who is also warning about the dangers of an unfair fiscal framework.
Those are credible, independent voices that should be listened to, not just by Labour, but right across the chamber. Indeed, Professor Muscatelli was a member of the Calman commission.
We have made it clear that we will support a legislative consent motion on the Scotland Bill only if a satisfactory and fair fiscal framework is agreed between the Scottish and United Kingdom Governments. Nobody, absolutely nobody—not even Labour—could reasonably expect any Government to say anything else.
If the new welfare powers are to be used successfully to tackle fuel poverty, as Jackie Baillie was asking for, they are going to have to work in concert with the money that the Government is spending on energy efficiency in the home, yet committee witnesses working in that sector do not appear to have had any opportunity to discuss with Government how that will work ahead of the budget or ahead of the national infrastructure project. Why have they not, and when will we hear the details?
We will discuss those things as the powers are implemented.
I know that Patrick Harvie is a supporter on this and we agree on many of the issues, but even he must concede that the new powers on winter fuel payments, for example, are not going to be in place in the next financial year. We will work with stakeholders as we take over the powers to look at how we use them effectively.
Patrick Harvie is absolutely right to say that as all of the powers come to Scotland, it is vital that we integrate them effectively with the powers and resources that we already have.
I look forward to Patrick Harvie being a key member of the discussion as we take forward those plans in the months and years to come.
NHS 24 (Winter Resilience)
To ask the First Minister what discussions the Scottish Government has had with NHS 24 regarding the provision of winter resilience measures. (S4F-03064)
NHS 24 published its winter plans last month. Those build on the excellent service provided to patients last winter, when over 75,000 calls were received during the festive period. More than nine in 10 of those were answered within 30 seconds.
To ensure the integrity of the winter plan, NHS 24 took the decision last week to pause the introduction of its new patient contact system. A full review is under way into the issues with the new system. I expect an initial report in December and a full and detailed report in January.
Last month, in its update on the management of the information technology contract for NHS 24, Audit Scotland said that the total cost of the future programme had risen by 55 per cent on the original cost predicted more than two years ago. That increase was mainly due to the costs of delayed implementation.
As the First Minister has just said, a further delay to the new IT system was announced last Friday. Can the First Minister tell the Parliament what the cost to the taxpayer of this mismanaged project will now be, and can she give a categorical assurance that patient care will not be put in jeopardy over the winter?
Liz Smith raises very important issues, and it is right that they are raised in the Parliament.
It was disappointing—very disappointing—that the decision to pause introduction had to be taken last week. It was taken in the interests of patient safety, which is the issue that Liz Smith raises. Clearly, it was the right decision to take.
The new system has not been abandoned—it is important to stress that. The implementation has been paused to enable issues to be resolved.
The full review that I referred to in my earlier answer is under way. In itself, that will answer many of the questions that Liz Smith has raised today. We will get the initial report of that review in December, and the full report in January. In addition to that, the Cabinet Secretary for Health, Wellbeing and Sport has asked the chief nursing officer to provide reassurance about the plans for reintroduction.
The issue of the costs being higher than was originally projected has already been discussed in detail in the public domain. NHS 24 still considers that, over time, the new system will allow it to save costs every year, and it is important to bear that in mind.
I will be happy to ensure that—as is incumbent on us—the findings of the review are shared in full with Parliament.
I am slightly surprised that the problems with a large project of this sort were not solved at the beta testing level, and I welcome the fact that, in the interests of patient safety, the project has been suspended. However, there have now been two Audit Scotland reports—in 2012 and 2015—that have been highly critical of the Government’s management of large information and communication technology projects. I ask the First Minister to look very carefully at the new structure that the Government has set up, because it is the most shambolic system that I have ever seen. No business would run its information technology system on the structure that the Government has set up in response to Audit Scotland, and I ask the First Minister now to undertake to relook at it.
As Richard Simpson will have heard me say, a full review is under way. These issues are serious. Detailed plans were in place to manage the transition to the new system, including the contingency of reverting to the legacy system if that was required. Initially, some of the issues impacting on performance, including issues with the wider telecommunications network, were outwith NHS 24’s control, but NHS 24 has apologised to patients who were affected by delays.
It is a priority to ensure that the new system is in place and working as quickly as possible, but that must be done in a way that is consistent with patient safety, particularly given that we are now going into the winter and festive period. NHS 24 has taken the right decision in the circumstances, but all of the issues that have been raised by Liz Smith and Richard Simpson will be looked at in the review and of course, the findings will, as I have said, be shared with Parliament.
That ends First Minister’s questions.
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