Plenary, 20 Mar 2008

Meeting date: Thursday, March 20, 2008

Official Report 789KB pdf

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Question Time

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SCOTTISH EXECUTIVE

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Health and Wellbeing

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NHS Greater Glasgow and Clyde (Meetings)

To ask the Scottish Executive when ministers last met the chair of NHS Greater Glasgow and Clyde and what matters were discussed. (S3O-2706)

I have regular meetings with all national health service board chairs to discuss matters of importance to health and the NHS in Scotland. The most recent meeting was on 25 February. Health officials are in regular contact with Greater Glasgow and Clyde NHS Board about a range of matters.

At the next meeting with board officials, I hope that the cabinet secretary will raise the subject of the future provision of occupational health services in Greater Glasgow and Clyde NHS Board. I have corresponded with Ms Sturgeon about concerns that constituents have raised regarding the proposal to outsource such services. I have grave reservations regarding the possibility of the board adopting such a wholly unacceptable course of action.

Such services should be delivered—indeed, must be delivered—by the public sector. Will the cabinet secretary assure members in the chamber and, more important, the staff who would be affected, that if the board requires additional financial support and resources to continue to provide those occupational health services in-house, her Scottish National Party Government will make such resources readily available?

I affirm that the Government believes passionately in the public provision of health services. Unfortunately, that view was not shared by the previous Labour-Liberal Administration. As Bill Butler said, I have corresponded with him and a range of other members on the issue. As he is aware from my reply to him, there are no firm proposals on the table from NHS Greater Glasgow and Clyde, which is considering a range of possible options for the delivery of occupational health services.

If any firm proposals are put forward in the future, full consultation with the staff concerned will be required. As Bill Butler would expect, I will retain a close interest in the matter.

Has the cabinet secretary been in recent dialogue with Greater Glasgow and Clyde NHS Board with regard to the retention of services at the Vale of Leven hospital? A number of individuals have been in touch with me in the past week with concerns about the issue.

I certainly understand the strength of feeling and opinion in the communities that are served by the Vale of Leven hospital. I offer my thanks to all the staff who work in that hospital for the excellent job that they do.

I have made it clear to NHS Greater Glasgow and Clyde that, in respect of services at the Vale of Leven hospital, I expect the board to pay heed to the report of the independent scrutiny panel. The panel's original report, and the follow-up report that I commissioned, made it clear that no reasons of safety would justify the NHS board not consulting on a full range of options. The board accepted, at its meeting in January, that it would need to go through due process. As I indicated with regard to the previous issue, although the matters are for NHS Greater Glasgow and Clyde I will retain a close interest in developments.

When the cabinet secretary next meets the board, will she raise my on-going concern about the implementation of car parking charges? Radio Clyde reported last week on a supermarket attendant who said that the health board parking attendants were asking him to report staff who used the supermarket car park.

This week, I was contacted by a senior staff nurse at Stobhill, who said that some staff are transferring to other greater Glasgow hospitals where there are no car parking charges. A constituent of mine who tried to park at the Beatson last week, having finally found a space and followed the instructions on the ticket machine that was adjacent to her parking bay, came back to find that she, along with two other ladies who were visiting at the same time, had been slapped with a £40 ticket. They had parked in what turned out to be poorly signposted reserved bays. They got very little change from the parking attendant: "Sorry hen, that's too bad" was the response. Can something be done about that?

The issues to which Jackson Carlaw refers, which were featured on Radio Clyde last Friday, relate to the Southern general hospital, which is in my constituency, so I am well aware of them. I asked the board about the suggestion that staff have been asked not to park in the car park and was assured that that is not the case. I will continue to respond quickly and positively to any suggestions that I hear in that regard.

As I have said before in the chamber, the presumption is that car parking should be provided free at Scottish hospitals. Car parking charges should be a last resort—for example, where there are issues of congestion. Jackson Carlaw said that the person who spoke to him had struggled to find a space at the Beatson. That indicates that there are serious congestion issues at some of our hospitals, especially in our cities, and boards have to respond to those problems.

Members are aware that the Government has asked all NHS boards to review their car parking policies and report to us by June, at which time we will take final decisions on car parking policy. In the meantime, I have acted to cap charges at £3 a day. Although nobody wants to pay such a charge, that compares favourably with the £7 a day that would have been the car parking charge had the previous Labour-Liberal Administration stayed in office.

In responding to an earlier question, the minister referred to strength of feeling. She is well aware of the strength of feeling in Clydebank and the surrounding areas about Greater Glasgow and Clyde NHS Board's proposals to remove continuing care provision from the St Margaret of Scotland hospice. Why will she intervene in other areas of Scotland where there is strength of feeling, given that she appears to be reluctant—as does the chief executive of the health board—to listen to the views of people in my constituency on that important matter?

As Des McNulty is aware, I visited the St Margaret of Scotland hospice a few weeks ago. He was present at that visit. I pay tribute to those who work at the hospice and provide that service. As is demonstrated by the support that the hospice receives, it provides a very valuable service. Des McNulty has also made that clear in the chamber.

In essence, it is a matter for negotiation between NHS Greater Glasgow and Clyde and those who run St Margaret's hospice. As Des McNulty and other members of the Labour Party know—it is a view that they expressed passionately in government—there is a need to shift the balance of care more into the community. Needs around continuing care are changing, and NHS Greater Glasgow and Clyde—like every other NHS board—is duty bound to respond to that. Nevertheless, I have made it clear to the board that I expect it to continue to engage positively with St Margaret's hospice, and I hope that the hospice will engage constructively with the board. I am confident that, if both sides do that, we can reach a satisfactory conclusion.

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Housing (City of Edinburgh Council)

To ask the Scottish Executive what housing resources will be allocated to the City of Edinburgh Council for 2008-09. (S3O-2707)

I will make an announcement in due course about the detailed allocation of resources for the next financial year under the affordable housing investment programme. In the meantime, I will meet elected members and officials from the City of Edinburgh Council later today to discuss a range of housing-related issues.

Does the minister realise that the Edinburgh housing market area has 75 per cent of Scotland's overall shortage of affordable homes and only 15 per cent of Scotland's overall housing spend, in spite of a doubling of Edinburgh's housing resources over a three-year period by the previous Administration? Does he also realise that the previous Scottish Executive planned to proceed to a new distribution formula that would give greater weighting to affordable housing shortages? When will the minister make that shift and give proper recognition to Edinburgh's unique housing problems?

It is always fascinating to hear what ex-ministers would have done had they won the election. The experience is interesting, if not very illuminating.

The allocation to which Malcolm Chisholm refers—75 per cent of the need versus 15 per cent of the spend—was his party's allocation. The previous Government is responsible for that statistic. I will make an announcement as soon as possible on the affordable housing investment programme. I will be interested to hear what colleagues from the City of Edinburgh Council say this afternoon and I will listen to any practical proposals that they make for tackling the clear difficulties that Edinburgh faces.

What has been the result of Scottish Government correspondence with Her Majesty's Treasury on securing housing debt write-off, even in cases in which tenants vote no to stock transfer?

The Cabinet Secretary for Finance and Sustainable Growth wrote to the Treasury on that matter at the tail-end of last year. Unfortunately, I must report to the chamber that, according to the Treasury, there are no circumstances other than through stock transfer in which housing debt will be written off. That result is very disappointing. Perhaps if all parties in the chamber had been more unified in their support of the cabinet secretary taking the matter to the Treasury, we might have got further. If the public, in a democratic ballot, vote no to stock transfer, I believe that it is extremely unfair for them to be penalised by a Labour Government in London.

Does the minister agree that the fact that, last year, more than 1,000 people applied for council houses in Edinburgh demonstrates the city's chronic housing shortage, which was exacerbated by the inaction of the Labour and Liberal Democrat Executive and the Labour council administration that ran Edinburgh for some time? In light of his response to Robin Harper's question on debt relief, which would, in fact, free up £280 million for direct investment, will the minister assure members that he will make further representations to the Treasury and the Chancellor of the Exchequer—who is an Edinburgh MP—to ensure that that decision is reversed as soon as possible?

I agree with the member's view of the situation in which Edinburgh finds itself and her comment that the previous Administration allowed it to happen. There is no doubt that Edinburgh, with its extremely high levels of debt, is in serious difficulty. However, as the member quite rightly pointed out, the Edinburgh MP who is in charge of the Treasury has turned his back on the people of the city.

As I said, the Treasury has confirmed that there are no circumstances other than housing stock transfer in which debt funding could be made available. I—and, I am sure, most members in the chamber—disagree with that position. We believe that there are other possibilities that would allow debt to be written off, and we will continue to pursue those matters with the Treasury or whatever other body we need to pursue them with.

I look forward to this afternoon's meeting with council officers and elected members to find out how we can jointly address the situation and resolve some of Edinburgh's problems, particularly the high level of housing debt—which, I must say, the current administration in Edinburgh was left with by the previous Labour administration.

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NHS Dumfries and Galloway (Budget)

To ask the Scottish Executive how the Cabinet Secretary for Health and Wellbeing's decision to accept the recommendations of the NHS Scotland resource allocation committee will affect the budget of NHS Dumfries and Galloway. (S3O-2733)

NHS Dumfries and Galloway has received in 2008-09 an initial revenue allocation of £228.1 million, which is an increase of £7 million over the equivalent 2007-08 allocation.

As with previous allocation formulae, changes flowing from the NRAC recommendations will be phased in over a number of years. I have made it very clear that, to avoid turbulence, no board will receive less funding than it does at present.

Obviously it is a matter of concern that, in the long run, NHS Dumfries and Galloway might lose up to £12 million from its budget as a result of the decision. Is it the case that the cabinet secretary's decision to reverse the closure of various accident and emergency departments and to invest in other health service provision in the central belt will be funded through cuts to the health service that is offered to my constituents and others in rural regions?

I do not know which part of the English language Elaine Murray struggled with in my response. It is absolutely outrageous for a local member to come to the Parliament and deliberately scaremonger about the loss of funding to NHS boards, particularly when I made it crystal clear in my first response that no board would lose any funding as a result of the NRAC recommendations.

Let me make it clear again for the hard of understanding: as with the previous Arbuthnott and Scottish health authorities revenue equalisation formulae, the NRAC recommendations will be phased in over a number of years to avoid any loss of funding to NHS boards. Elaine Murray would do more of a service to the public whom she supposedly represents if she went back and gave them some accurate facts.

Does the cabinet secretary share my disappointment—although perhaps not my surprise—that, on the very day when a record doubled allocation of about £900,000 has been announced for NHS Dumfries and Galloway to tackle alcohol misuse, all that the Labour Party can do is carp about what was actually a real-terms increase in the budget?

I again confirm that NHS Dumfries and Galloway received, as did all health boards in Scotland, a real-terms increase in its revenue allocation for the next financial year. I also reconfirm that no board will lose any funding as a result of the NRAC recommendations.

I agree with Alasdair Morgan that, today of all days, we should congratulate the Government—and the Minister for Public Health, Shona Robison, in particular—on the announcement of substantial additional funding across Scotland for the fight against alcohol misuse. As the member rightly points out, in Dumfries and Galloway alone, for the next year alone, there will be almost £900,000 of additional funding. Across Scotland, there will be £85 million of additional funding over the next three years. If Labour members could stop scaremongering for long enough, they might be able to find it within themselves to welcome that very good news.

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Social Care

To ask the Scottish Government what discussions ministers have had regarding alternative approaches to social care. (S3O-2681) [Interruption.]

I ask members to ensure that their mobile phones are turned off.

I have regular meetings with representatives of local authorities, the NHS and other partners to discuss how together we can further develop innovative, personalised support for individuals. Most recently, my officials met in control Scotland to discuss how that organisation can contribute to this important agenda.

As the minister knows, Aberdeen City Council aims to adopt the in control approach and hopes to have a team in place by June. What support can the Scottish Government provide the council for that programme? Please will the minister meet me to discuss the social care situation in Aberdeen?

I am aware of developments in Aberdeen. I can inform the member that, between 2006 and the present, in control Scotland has received funding from the Scottish Government to support the personalisation of services. Together with other self-directed support stakeholders, in control will participate in a round-table event in May, which will develop the strategy with the aim of increasing radically the uptake of self-directed support.

I am happy to keep the member informed of those developments. It would perhaps be best to have a meeting after the event in May.

How many local authorities, and which ones, will address the provision of social care to patients with mental health needs? Will the work of local authorities be reflected in the single outcome agreement?

As Margaret Curran well knows, mental health remains a key priority for the Government and for health boards in partnership with local authorities. That is why we now have four health, efficiency, access and treatment—HEAT—targets on mental health, which will give a sense of priority to local partners who are delivering a very good service in mental health.

We are developing the plan for the next three years, which will be very much about localised services for mental health. I would have thought that the member would want to welcome that.

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Healthy Living and Sports (Aberdeen)

To ask the Scottish Executive how it is encouraging healthy living and participation in sports in Aberdeen. (S3O-2702)

It is for each local authority to determine levels of investment and sporting programmes to meet the needs of the communities that it serves.

The Scottish Government continues to work in partnership on the delivery of the national sports strategy, reaching higher, which defines increasing participation as a key outcome. Over the next three years, we will invest £56.5 million, of which £40 million is new money, in initiatives that are dedicated to promoting healthy living, including the promotion of healthy eating, physical activity and achieving a healthy weight.

We are working with the Convention of Scottish Local Authorities and individual local authorities on the implementation of a new concordat. The process is on-going, but I believe that it will secure improved outcomes for the people of Scotland.

The Scottish Government has said that it wants to increase participation in sport, but some swimming pools and sports facilities in Aberdeen are being closed, while the opening hours of others are being severely restricted. How are such decisions consistent with national policy? Has the minister had any discussions with Aberdeen City Council on that issue ahead of any single outcome agreement? What will the Scottish Government do to ensure that people in Aberdeen have more opportunities, not fewer, to take part in sport and lead healthy lives?

It is the responsibility of local authorities to ensure that there is adequate provision of sporting facilities for their residents, and to determine that provision in light of their local needs and priorities. I understand that Aberdeen City Council faces difficulties relating to the age of the plant in the ice arena and to Bon Accord baths, which are about 70 years old. The baths have closed a number of times in recent years because of the problems there. The council has inherited some difficulties with its facilities, but we will work with the council, sportscotland and officials to ensure that the people of Aberdeen get the kind of facilities that they deserve.

The minister recognises the difficulties that are faced by Aberdeen City Council. What encouragement has he given to the local authority in connection with the replacement of the Bon Accord pool with a 50m pool? Does the Government acknowledge that a number of the city's facilities serve not only the people of Aberdeen but the people of the north-east? Will the minister encourage Aberdeenshire Council to accept its responsibility to its residents by supporting some of the facilities in the city?

A meeting was held on 13 February between Aberdeen City Council and sportscotland to discuss a series of initiatives to take forward the proposal for a 50m pool. That is a matter for the local authority to take forward. I hope that Aberdeen City Council and Aberdeenshire Council will work together for the benefit of all the residents in the north-east of Scotland, because a 50m pool would benefit not only those in the city but those in the whole of the north-east.

On the general point about working with the council, I am more than happy for the city council—and Aberdeenshire Council—to contact my office in order that we can discuss such projects and consider what help and assistance the Government can give.

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National Health Service (Rural Dentists)

To ask the Scottish Executive what consideration it has given to the future of rural national health service dentists and their patients, should the recommendations in the Glennie report be implemented. (S3O-2748)

The particular needs of those dentists and their patients will be taken into account when the chief dental officer for Scotland convenes a group to set realistic and achievable timescales for compliance with the recommendations in the Glennie report.

I am sure that the minister will acknowledge that implementing the recommendations of the Glennie report will have a great impact on dentists and patients, whether NHS or private, rural or urban. Will she assure me that the Government will do all that it can to prepare dentists for the implementation of the Glennie report and that, in the process, we will not lose any more rural NHS dental practices?

I gently remind John Farquhar Munro that it was the previous Administration that established the review group that led to the recommendations in the Glennie report. The Government will take a pragmatic approach to achieve best practice in infection control, while recognising the challenges for rural dental practices that the member referred to.

In October last year, I announced £5 million of funding to help dental practitioners to address decontamination issues. I have also asked the chief dental officer to lead on the delivery of a dental premises strategy for Scotland. Further funding will be considered in light of the outcome of that strategy.

In a letter dated 29 February, the chief dental officer explained that the December 2009 target date for all practices to comply with the requirements of upgrading on decontamination is under review. She also advised that she is to reconvene the dental sub-group of the Glennie group to develop an updated action plan to provide realistic and achievable timescales, which will take account of a premises strategy.

I would have thought that members on the Labour benches would take the issue more seriously than appears to be the case. It is important to reassure patients about infection control and to acknowledge the challenges faced by rural dentists. It is a pity that Labour members do not seem to appreciate that.

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Renal Dialysis (Children)

To ask the Scottish Government what plans it has to further assist families with children on renal dialysis. (S3O-2690)

The Scottish paediatric renal urology network is developing guidelines and protocols that would allow as many children as possible with renal disease to be treated nearer home and, in many cases, at home. We warmly welcome that work and encourage adoption of the guidelines across NHS Scotland as a matter of priority.

I am sure that the cabinet secretary will want to join me in welcoming members of the Kidney Kids Scotland organisation that is based in my constituency, which provides valuable support to children who are on renal dialysis.

The minister mentioned the paediatric renal urology network, but is she aware of the difficulties that it is having in ensuring that health boards throughout the country engage effectively with it at local level? Will she consider contacting the chair of each health board to ensure that boards engage effectively with the network and that it is integrated into their regional planning processes?

I welcome to Parliament the Kidney Kids charity, which I understand had a reception earlier today. I thank the organisation very much for the excellent work that it does in supplying equipment, funding clinical posts and providing much-needed financial help to parents. Its work is an excellent example of the contribution that the voluntary sector in Scotland makes to the provision of health care. I know that the whole Parliament will want to put on record its thanks. [Applause.]

As Michael Matheson will be aware, Kidney Kids is an extremely important contributor to the Scottish paediatric renal urology network. The network has developed guidelines and protocols, part of the purpose of which is to enable more children with renal disease to be treated in the chronic category. That means that more of them will be able to be treated at home because, in many cases, children who have chronic as opposed to acute renal disease can have their dialysis in their own homes, rather than in Yorkhill hospital.

I appreciate that there has been some frustration at the slow progress in implementing the guidelines and protocols. I am determined that the implementation process will gather pace and I give Michael Matheson an assurance that I will raise the issue at my next meeting with all NHS board chairs.

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Excellence in Sport (Higher Education)

To ask the Scottish Government what steps the Minister for Communities and Sport is taking to enhance excellence in sport by working collaboratively with the higher education sector. (S3O-2678)

Officials recently met representatives of Scottish Universities Sport and the universities' sports-related academic group. They also attended a sports and physical exercise forum that was convened by the Scottish Further and Higher Education Funding Council and hosted at the University of Stirling. A number of initiatives in this area are being considered and progressed by officials in the education and lifelong learning and sports divisions.

When the minister takes future decisions on such collaborative working, will he take into account the excellent record and facilities of the University of Stirling and, in particular, its co-location with the body that was formerly named the Scottish Institute of Sport, its hugely successful involvement in preparing the swimming training for the most recent Commonwealth games, its contribution to the success of people such as Andrew Murray, Gordon Sherry and Richie Ramsay, and its pathfinder record in offering sports-related degree courses and scholarships over the past two decades?

I am well aware of the history of the University of Stirling's interest in sport. I have visited the campus on two occasions. The co-location that the member mentioned is extremely interesting. The hub of activity around the university and the Institute of Sport is one reason why we chose to put one of sportscotland's hubs in Stirling. It is clear that we recognise the importance of that area.

I have had initial discussions with the Cabinet Secretary for Education and Lifelong Learning on how we can more closely co-ordinate the efforts of the higher education sector and those of the sports sector to ensure that not only students, but the wider community benefit.

What is the current status of the Government's exercise on prescription scheme, which was mentioned in the SNP's manifesto as something that would be available to children across Scotland?

I am happy to tell the member that that scheme is under review. We hope to bring forward the results of that review as soon as possible.

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Sport (Communities)

To ask the Scottish Executive what it is doing to provide support to sport in communities. (S3O-2722)

The provision of sport to local communities is the responsibility of individual local authorities. We continue to support their work, for example through our annual investment of £12 million in active schools and £500,000 in clubgolf. Additionally, through sportscotland, £4.8 million will have been invested in local facility development in the current year and in January we announced investment of more than £2 million through the cashback for communities programme, to support the development of football opportunities in local communities. Work is going on with local authorities on how sport will be delivered through single outcome agreements.

The minister knows of the important work that is done by football clubs in their communities and he will be aware of the role of fans in ensuring that clubs take such work seriously. Given the parlous state of some of our football clubs, will he commend the important work of Supporters Direct in Scotland in helping to create and sustain supporters trusts? Will he match the funding that the previous Executive gave to Supporters Direct—and if not, why not?

I am on record as saying in the Parliament that I acknowledge the important work of Supporters Direct and the important role that fans play in the development of their clubs. As I think that I said during the recent debate on Supporters Direct, discussions are going on between officials and Supporters Direct to ascertain how we can develop and financially support the organisation's important work.

Does the minister accept that if we are to promote sport and physical activity in communities it is often desirable to provide child care for families who want to get involved in sport? Is he concerned that the administration in the City of Edinburgh Council, of which his party is a member, has withdrawn crèches from many leisure centres in the city, including the Leith Victoria swim centre in my constituency? Will he give his support to the demonstration that will take place at 3.30 pm this afternoon, at which people will call for that decision to be reversed?

If that is not your responsibility—

Order.

It is clear that it is for the local authority to take the matter forward and to decide how best to use its resources. We are investing record-breaking resources in local government over the next three years. It is for the City of Edinburgh Council to manage a difficult situation, given the mess that the previous Labour administration left.

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NHS 24 (Doctors)

To ask the Scottish Executive how many doctors are employed by NHS 24. (S3O-2749)

NHS 24 directly employs four doctors, who provide management support to the organisation. Doctors and other clinicians who support local out-of-hours services are employed by NHS boards.

According to its website, NHS 24 was designed primarily to help patients to get

"the right care from the right people at the right time."

Therefore, does the cabinet secretary agree that NHS 24 is no substitute for access to clinical services?

I confirm that NHS 24 is not—and is not intended to be—a substitute for access to clinical services. During the out-of-hours period it is meant to be a gateway for patients that ensures that they access the correct services, so that they receive

"the right care from the right people at the right time."

It is no secret that NHS 24 has had difficulties since its introduction, but when I carried out the organisation's annual review last year I saw clear signs of progress and improvement in performance. NHS 24's progress is a tribute to its staff and I have no doubt that the organisation will continue to improve in the months and years to come.

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National Health Service (Waiting Times)

To ask the Scottish Executive what intermediate targets it has set for waiting times in the NHS on the way to the 2011 target of 18 weeks from referral to treatment. (S3O-2738)

I announced that national maximum waiting times will reduce to 15 weeks for a first out-patient consultation, six weeks for diagnostic tests and 15 weeks for hospital in-patient and day-case treatment by the end of March 2009. Those are key milestones towards delivery of the 18-week whole-journey waiting time target. Following the abolition of hidden waiting lists on 1 January, waiting time targets apply to the thousands of patients who were excluded under the previous Administration.

I welcome the cabinet secretary's commitment to continue Labour's work to reduce waiting times for patients. In doing so, the Scottish National Party's stated aim is not to extend the use of the private sector in the NHS. However, in December the Government gave a contract to PricewaterhouseCoopers to co-ordinate the survey of patient experience in the NHS. That work was previously done in the public sector.

Is the cabinet secretary comfortable that 13 eminent academics from Scottish universities have challenged the contract on the grounds that there might be a conflict of interest, that no guarantee of impartiality can be built in and that the results can be open to commercial manipulation? Is that the same PricewaterhouseCoopers that NHS Lanarkshire employed in 2005 to assess its public consultation process and which concluded that the process was satisfactory, only for Nicola Sturgeon, as Cabinet Secretary for Health and Wellbeing, to condemn it as seriously flawed? Will she undertake to ensure complete transparency in the work that PWC is doing at all stages of the contract?

Before I respond to the question on PricewaterhouseCoopers and the contract that is at issue, I say to Richard Simpson that the real credit for reducing waiting times in the NHS belongs neither to the SNP Government nor—certainly—to the previous Labour Government, but to the NHS staff who do such fantastic work day in, day out delivering for our patients.

As I have said in and outwith the chamber on many occasions, the Government rejects the obsession with the privatisation of our health services that was the hallmark of the previous Labour-Liberal Democrat Government. The previous Government had an obsession with private finance initiative hospitals and private sector delivery of front-line health care services. This Government will not follow that approach.

The contract with PricewaterhouseCoopers for the patient experience programme is not a contract to deliver health care services but a research contract. The service that PricewaterhouseCoopers will provide is one of giving guidance to NHS boards on the design of patient surveys and the collection and analysis of data from the surveys. The process will be completely transparent. We were obliged to put the contract out to tender under European Union procurement rules. I have ensured that a fuller version of the contract is made available on the Scottish Government website than would ever have been the case under the previous Government which, in addition to being obsessed with privatisation, was obsessed with secrecy.

My last point is an important one. PricewaterhouseCoopers will be accountable to the steering group that will govern the patient experience programme. The steering group is not only chaired by the Government chief nursing officer but its membership includes representation from the academic community. The process is both transparent and accountable. Instead of nit-picking about contracts and processes, perhaps it would have been better if Richard Simpson had reflected on the fantastic opportunity that the patient experience programme gives the Government to improve services for patients in Scotland.

What progress has been made on waiting time targets for mental health, drug and alcohol and infertility treatment, and for the 28,000 people who are waiting for physiotherapy?

Mary Scanlon knows, as a result of my previous responses to her questions on the subject, that the Government is committed to looking at what further services can be brought into the ambit of waiting time guarantees. We have announced—and this represents very good progress—that audiology services will be included in the new 18-week referral to treatment target.

We will continue to look at how many other services can be brought within the target. We want to ensure that waiting times are reduced for as many patients as possible.

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British Medical Association

To ask the Scottish Executive what recent discussions it has had with the British Medical Association. (S3O-2662)

Recent discussions with the British Medical Association have included: general practitioner contracts; community nursing; education and training of the medical workforce; non-consultant career grade doctors; and junior doctors.

During those discussions, has the cabinet secretary touched on the matter of agenda for change? She knows that many NHS staff continue to express concern about the way in which agenda for change is being implemented. In particular, staff are expressing concern about the widespread anomalies that are being thrown up as a result of inconsistent band outcomes in different board areas and the divergent pay levels that have resulted from differing incremental dates being set for the same job grades. Notwithstanding the formal review mechanism, what further steps does the Government propose to take to ensure that such inconsistencies are addressed in the interest of fairness and morale in the NHS?

Clearly, agenda for change is an issue of great importance. I have not discussed it in particular with the BMA because, of course, agenda for change covers the NHS's non-medical workforce. That said, I know of the great frustration among NHS staff at the time that it is taking to implement agenda for change. There is not much point in raking over those coals, except to say that those who are implementing agenda for change may have underestimated the scale of the task and raised false expectations about the speed of implementation that would be possible. I and the health department are focused on ensuring that we get to the end of the process as quickly as possible and we are working closely with NHS boards to achieve that. The vast majority of staff are now assimilated to agenda for change pay rates and the vast majority have had their arrears paid. A robust system is built into the process to ensure that there is consistency checking, but we continue to have discussions to ensure that it is as robust as it needs to be.

I am confident that we will soon reach the end of the process. We will then be able to focus on other aspects of agenda for change, such as the knowledge and skills framework that is important in relation to staff training, staff development, skills in the NHS and the multidisciplinary workforce that we need to build for the future.

Because I gave him the nod, there will be a brief supplementary question from Dr Ian McKee.

Thank you, Presiding Officer. When the cabinet secretary next meets the BMA, will she discuss measures to relate the distribution of general practitioners in Scotland to clinical need and deprivation?

I share the BMA's determination to do as much as possible—and certainly more than we have done before—to tackle deprivation and health inequalities in Scotland. It is clear that we need to do a number of things. I am reliably informed by the Minister for Public Health that the report of the health inequalities task force is due within the next few weeks, and that will be an important part of the process.

However, the Government is already investing considerable resources to tackle health inequalities through the enhanced services programme, which is directly related to GPs, and the keep well programme, which I am more than happy to concede is a continuation of a programme that started under the previous Administration. Much work is under way, but I think that all members in the chamber would agree that there is a great deal more to be done to tackle health inequalities.