Plenary, 20 Sep 2001

Meeting date: Thursday, September 20, 2001

Official Report 731KB pdf

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First Minister's Question Time

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SCOTTISH EXECUTIVE

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Prime Minister (Meetings)

To ask the First Minister—[Applause.] I hope that the welcome will be as warm when I finish as it is now.

To ask the First Minister when he will next meet the Prime Minister and what issues he plans to discuss. (S1F-1243)

I am sure that the whole Parliament warmly welcomes Mike Russell to his new post, however temporary it may be. I know why he—always a man of sound judgment—would rather be here than at the Scottish National Party conference.

I last met the Prime Minister on 1 September and we have no immediate plans to meet.

It is always important to ask the First Minister questions, but I hope that we will get some answers today.

After yesterday's announcement about underspends, will the First Minister consider selling tickets for his next meeting with the Prime Minister? It will truly be worth witnessing: he will have to explain why he is constantly telling the press that he needs more money for programmes when he cannot spend the money that he has.

One of the miracles that the First Minister has achieved is in the modernising government programme. That programme started out with a budget of £13 million and ended up with an underspend of £22 million. It almost doubled its budget. Will the First Minister tell us how that was achieved? Did the staff hold a flag day, for example?

I am sure that the Prime Minister of the United Kingdom will be delighted to know that the SNP would like to attend future meetings that we have with him.

Although we hear a new voice, we hear the same old tune. As Mike Russell knows, end-year flexibility is a well-understood process that allows departments to carry over underspends. Of course, he has been rather selective in the points that he made. He might have been better to read what I regard as an unbiased and reliable newspaper—The Courier and Advertiser in Dundee. When the Minister for Health and Community Care made her announcement on debt to Tayside University Hospitals NHS Trust—I believe that Mr Swinney is interested in that—the newspaper reported:

"Health service managers and senior medical staff burst into impromptu applause".

That seems to me to be a wise response to the wise decisions that are being made in the Parliament and by the Executive.

Perhaps I could quote another reliable newspaper—at least, the Labour party used to think it was reliable—the Daily Record, which ends its leader today with the words that the First Minister should "GET A GRIP!"

I remind the First Minister that this is question time. For him, it is answer time. If he is incapable of answering questions on the generality, I will deal with the specifics. What explanation has the First Minister sought from the Minister for Education, Europe and External Affairs for the fact that he managed to avoid spending £86 million, which is one third of his budget? What explanation has the First Minister sought for the fact that the Minister for Education, Europe and External Affairs said to Parliament in February:

"The Executive has made additional resources available for teachers' pay and we stand by that commitment"?—[Official Report, 14 February 2001; Vol 10, c 1203.]

It is obvious from the figures and from the explanation given by the Minister for Finance and Local Government that the money was found by holding back money from existing programmes—holding back from spending money on schools, material and books. What action is the First Minister taking to get an explanation from the Minister for Education, Europe and External Affairs?

The propensity of the SNP to get its sums and arguments wrong grows daily.

No wonder the Minister for Education, Europe and External Affairs is smiling wryly to himself. The SNP has recently developed the skill of posing a question and, in a further part of the question, answering it.

The prudence that the Minister for Education, Europe and External Affairs has shown in his education budget means that we have the best teachers' settlement we have seen in a generation. We have policies that go to the heart of education. We will take no lectures from a party that continually gets its sums wrong, as I said.

The First Minister still does not answer the question. I understand, the chamber understands and the whole of Scotland understands why the First Minister cannot hold his education minister to account.

Talking of education, does the First Minister recall that on 22 August 2001, standing shoulder to shoulder with his Minister for Education, Europe and External Affairs in Livingston, he announced a programme of £12 million for refurbishing Scottish schools? That is just over 1 per cent of what Scottish schools say they need. At that time, did the First Minister know that there was an underspend in the education budget of an amount that was double the annual budget for refurbishing schools? If the First Minister knew that, why was he not honest about it at the time?

I am sorry to be repetitive when I am helping Mike Russell in his new and arduous role. He has a difficult act to follow. However, when he cannot distinguish between end-year flexibility and the investment provided by the chancellor for what we are doing in schools, it beggars belief.

I say again that we are starting to invest in our schools and school buildings after 20 years of neglect by the Conservatives. We are happy to provide a blow-by-blow account of how the education budget works.

Despite Mike Russell's performance today, I would still rather speak to him because there has been some innovation. With John Swinney, there is usually not a great deal.

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Cabinet Reshuffle

To ask the First Minister whether he has any plans to reshuffle his Cabinet. (S1F-1245)

No.

There will be disappointment and delight in equal measure on the Labour benches at that answer. If the First Minister will not change the personnel, perhaps he might change the policies, particularly in relation to the health service.

Only this morning, we read that 40 national health service patients from Liverpool—who have waited six months for heart bypass surgery—are to be operated on at the HCI International Medical Centre in Clydebank. If what matters is what works, as the First Minister is constantly telling us, why is it that patients in Scotland have to wait 12 months before they receive similar consideration for an operation? Six months in Liverpool and 12 months in Glasgow. Is that what the First Minister means by a two-tier health service? Does he find that acceptable?

First, we do not have a two-tier health service in Scotland. That was another illustration of the attempt to talk down a programme that is serving the interests of the wider public.

Although it was as if some of David McLetchie's comments this morning were a revelation, we already use private facilities, where appropriate, and will continue to do so. In that sense, David McLetchie has not thrown a bit of magic into the debate. However, we must recognise that private facilities have only limited capacity in Scotland.

Let us turn to the challenging issue of waiting times. In terms of average waiting times, Scotland compares favourably with any other part of the United Kingdom. We have an important commitment to bringing down the average waiting time to nine months and an important commitment to planning ahead. If a situation arises in which it is appropriate to use private facilities, the Minister for Health and Community Care would want to do so.

That is an interesting answer.

Perhaps the First Minister could tell me why it is appropriate for patients from Liverpool to get heart bypass surgery in Clydebank, but it is apparently not appropriate for patients in Glasgow—waiting for the same operation—to get the operation on their doorstep. Why is the First Minister not prepared to take the further step that has been taken down south? Why will he not enter into a proper working agreement with the independent sector in Scotland to ensure that NHS patients here get the same benefits—the results of which we now see—as those in England?

I asked the First Minister about that two weeks ago and he failed to answer. I ask him again for a clear answer. Will he kindly take off the ideological blinkers and be prepared, for the sake of patients, to consider the measure for Scotland?

There is no end of ideology among the Conservatives, who argue for privatisation. The Scottish National Party argues for no private sector involvement whatever. David McLetchie quoted me last week, saying that what matters is what works. We are doing exactly that in the health service.

I am a bit vexed to have missed this morning's debate—any health debate with mention of "The Kama Sutra" or talk of clothes being stolen from a party

"after it had been stripped naked of all credibility"

must have had a bit of spice. Thank goodness, because David McLetchie's contribution to the health care debate is again singularly inappropriate. We are doing the very things that are pragmatic in Scotland. Health care matters to us. We will therefore use private facilities where appropriate. That is important, and I am sure that it is a view that the Scottish people support.

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Care of the Elderly

To ask the First Minister what discussions have been undertaken with Her Majesty's Government regarding the recommendations of the care development group. (S1F-1249)

The Scottish Executive is in regular contact with the United Kingdom Government on a wide range of issues, including the report of the care development group.

The initial cost of the care development recommendations is £125 million per year, which assumes that the Westminster Government will amend existing social security regulations. If Westminster refuses to amend those regulations, can the First Minister tell us—if he can get his sums right today—which part of the care development plan would have to be cut to fund the £20 million hole that would open up in the free care proposals?

I have said this many times, but I repeat it today: we will deliver full personal care to the people of Scotland. Because of the publication of the report, we will be able to move soon to announcing the Executive's response to what I regard as an excellent paper. Discussions are on-going on a number of issues relating to the care development group report. Those discussions with Westminster are constructive and helpful.

I will not introduce a jarring note by talking about the SNP's inability to get its arithmetic right. There is no gap in our funding proposals. There is the biggest commitment to the biggest aspiration that we have had for older people in Scotland for a generation.

Both the Sutherland commission and the Health and Community Care Committee recommended a single budget for care in the community. Why has that recommendation not been accepted?

Mary Scanlon's point is a practical one. Suffice it to say that the response to the care development group report will be forthcoming, literally within days. We want not only to respond to that report but to the wider issues affecting care in the community in Scotland.

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National Health Service (Pay and Morale)

To ask the First Minister whether the industrial action being taken by medical secretaries in Glasgow and the current ballots for industrial action taking place in the Lothians are related to pay and morale levels across the NHS in Scotland. (S1F-1255)

No. That is an increasingly exceptional issue.

The First Minister recently said that health care matters. I hope that he would agree that health workers matter too, and that he welcomes the striking medical secretaries to the Parliament today. Most of them would rather be here in better circumstances. Three hundred of them have taken strike action for the first time in their lives. The majority of them have worked as medical secretaries for more than 20 years. Their wage level is between £700 and £780 per month—I call that low pay. Does the First Minister think that the medical secretaries have a justified case, and does he agree that the North Glasgow University Hospitals NHS Trust should stop bullying and start negotiating?

The first part of that question was about how we value health service workers—we do. At a recent opening of a new hospital, the Minister for Health and Community Care and I said that we can have buildings, technology and institutions, but what really makes hospitals work is the quality of the staff. The national health service in Scotland has negotiated a national framework agreement with Unison that is worth 22 per cent above inflation over the next three years for the medical secretaries concerned. The vast majority of medical secretaries have already voted to accept the national framework and NHS in Scotland chief executives agreed on 18 September to implement the agreement throughout Scotland as quickly as possible.

As a good trade union supporter, I think that what has happened is positive. I hope that the agreement wins the hearts and minds of the medical secretaries and that they can continue to contribute to the quality of our health service.

Does the First Minister agree that under Labour the morale of NHS staff is better? For example, Labour has removed the two-stage pay offer for nurses that was imposed under the Tories. At the Royal hospital for sick children in my constituency, management and unions have agreed a phased programme for ancillary staff to return to the NHS conditions and pay that they were denied under the old compulsory competitive tendering regime that was imposed on low-paid workers.

I endorse Pauline McNeill's comments. Conservative members may laugh, but over the past three years an extra £1.8 billion has been invested in the NHS. That should be compared with the paltry sums that the previous Government invested in the health service.

We want to talk up morale in the health service, because there is a good story to be told. We have not solved all the problems and there are enormous challenges ahead, but when one considers that we are seeing the biggest hospital building programme in a generation and investment in new staff and better pay, it is clear that the NHS is moving forward. The Parliament would serve well by supporting the people who are taking the health service forward.

Will the First Minister eschew complacent self-congratulation and recognise that, even following the welcome announcement by the Minister for Health and Community Care that the Executive intends to write off deficits, 200 jobs will be lost in Lothian among medical workers? Does he believe that that does anything to enhance morale in the health service?

We are providing record sums to health authorities in Scotland. It is for health authorities to ensure equality of service, investment in staff and continuing refurbishment of infrastructure and buildings. That is what is happening. I repeat: the Executive is providing the health service with formidable sums of money. A massive commitment has been made by a coalition that believes in the NHS. Listening to the Conservatives and the SNP, I often wonder whether they are committed to the kind of things that we are doing. We do not mind whether they are, because we are.

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Homeless People (Mental Health)

To ask the First Minister how the Scottish Executive will assist homeless people who also have mental health problems. (S1F-1252)

The Scottish Executive highlighted the overall health needs of homeless people in "Our National Health: A plan for action, a plan for change", our blueprint for NHS Scotland. To meet those needs we have appointed the health and homelessness co-ordinator. This week we issued guidance to NHS Scotland outlining the action that NHS boards must take to address the health needs of homeless people, including those who have mental health problems.

Is the First Minister aware that the centre for housing policy estimates that people who sleep rough are up to 11 times more likely to suffer mental health problems than people who are housed? Will he commit the Executive to monitoring the work of NHS boards in ensuring that homeless people are provided with every opportunity to access appropriate health services?

I am pleased to respond to the very good question that Janis Hughes has posed. Our overall strategy is for boards to meet the needs of the most vulnerable, including homeless people, from the substantial increases in funding that have been provided. This year boards have received an average increase in funding of 5.5 per cent. Greater Glasgow Health Board has received an increase of 7.72 per cent. Greater priority is being given to mental health in Scotland, and the assumption is being made that people who are homeless have more problems than most. Over the next three years we intend to tackle both issues.

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Air Pollution

To ask the First Minister what health benefits will be derived from setting tougher standards for air pollution. (S1F-1247)

Tougher standards for air pollutants will result in reduced hospital admissions of susceptible individuals, such as those who suffer from heart and lung diseases, and will reduce the risk of premature death of those who are seriously ill.

Is the First Minister aware of research by the University of St Andrews that involved using an aggregate pollution index to allow for the first time a rigorous estimate of the number of premature deaths attributable to total air pollution? Does he agree that the method that has been developed should be used to measure the impact of air pollution on health throughout Scotland? Does he also agree that such data, by quantifying the cost of air pollution to both the public and the public purse, would underpin, promote and encourage action to reduce air pollution?

I agree with both the sentiment and the substance of Nora Radcliffe's comments.

In a sense, air pollution is a difficult area to which to give a high priority. This week, we have moved forward. We want to base our actions on hard evidence of the benefits that may accrue and of the return on our investment. There will be costs associated with meeting our new objectives, but for the people of Scotland that will be a worthwhile investment in this environmental issue.

Before we come to the next debate, I invite members to welcome a delegation of colleagues from the Catalan Parliament, headed by its President, Señor Joan Rigol. [Applause.]