Meeting of the Parliament [Draft]

Meeting date: Wednesday, December 20, 2023

Official Report 1026KB pdf

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Portfolio Question Time

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Rural Affairs, Land Reform and Islands

Good afternoon. The first item of business is portfolio questions, and the first portfolio is rural affairs, land reform and islands. Any member who wishes to ask a supplementary question should press their request-to-speak button during the relevant question. There is a lot of interest in both portfolios, so I would appreciate brief questions and responses.

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Sand Eel Fishing (Closure)

To ask the Scottish Government when it will report on its consultation on proposals to close fishing for sand eel in all Scottish waters. (S6O-02894)

The consultation on proposals to close fishing for sand eel in all Scottish waters closed on 13 October, and my officials are carefully considering all the responses that we received. Following that analysis, we will publish the consultation outcome report, which is scheduled to be published by spring 2024.

Scotland is important globally for its large seabird colonies, which support more than 65 per cent of the British and Irish seabird population. Our seabirds, including the Manx shearwater, are under multiple man-made pressures, from predation and adverse weather conditions that may be a result of climate change to a lack of food as a result of climate change and fisheries. The RSPB described proposals to ban industrial sand eel fishing as

“the single greatest thing we can do right now to help our most threatened seabird species”.

Does the minister agree that Scotland’s wonderful seabirds, including the Manx shearwater, are a hugely important part of Scotland’s coastal ecology and that actions to protect populations in the face of current and future threats are vital?

Yes—I absolutely do. The RSPB quote that Ruth Maguire read out about closure being the biggest thing that we can do to protect our seabirds is warmly welcomed and I agree with it.

The results of the recent seabird census show that Scotland’s internationally important seabird population is suffering as a result of on-going pressures—Ruth Maguire mentioned man-made pressures that have resulted from climate change. Given the importance of the sand eel to the wider ecosystem and the subsequent benefit in aiding long-term sustainability and resilience, sustaining the sand eel population is a priority.

It is not just the Manx shearwater that benefits from that population. Iconic species such as puffins feed on sand eels, so we are prioritising the matter to help to boost the seabird population.

I thank the minister for being clear on that. I remind the minister and members of my entry in the register of members’ interests, which states that I am a partner in a wild salmon fishery. Salmon eat sand eels, but I will talk about the damage that our seabirds have faced as a result of avian flu, which has been catastrophic. There will undoubtedly be some losses when ScotWind is up and running, so surely we must make sure that our seabirds are in the best possible condition and that there are as many as possible to offset those losses. Does the minister agree that sand eel fisheries should therefore be suspended immediately?

I thank Edward Mountain for that positive and constructive question and for his support in what we are doing about sand eel fisheries. He rightly points out that quite a lot of other factors are involved in the decline of seabirds. This summer, we had a very unseasonable bout of pernicious avian flu, which particularly affected our gannet and gull populations. We must do everything that we can, within our powers, to mitigate the effects of things such as avian flu. We cannot really control the source of that, but we can control how we respond to it.

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North Sea Fish Stocks (Catch Limits and Measures)

To ask the Scottish Government what impact the recently announced trilateral agreement on total allowable catch limits and management measures for jointly managed fish stocks in the North Sea will have on fishers in Aberdeen and the north-east of Scotland. (S6O-02895)

Fishing agreements with our coastal state partners include a number of positive outcomes for Scotland, which provide key opportunities to vessels and coastal communities. The trilateral agreement includes quota increases for all six of the jointly managed North Sea stocks, and those opportunities are worth an estimated £199 million to Scotland, which is an increase of £68 million on the previous year. That is welcome news for Scotland’s fishing industry as a whole, and the benefit to fishers in the north-east from the trilateral agreement is estimated to be about £47 million, on the basis of 2022 prices.

I understand that there has been an agreement to set quotas for North Sea cod at levels that reflect the latest science. What scientific data and analysis are used in such determinations? What was Scotland’s overall approach to the negotiations?

The Scottish Government fully supports the headline scientific advice and, whenever it is most appropriate, setting fishing opportunities that are consistent with the maximum sustainable yield approach. Although we used the MSY approach from the International Council for the Exploration of the Sea in a benchmark report from February, there was a significant change in the 2024 scientific advice for North Sea and west of Scotland cod. That new advice structure shows that the stocks in Scottish waters are doing well, particularly the north-western sub-stock, which spawns in the north-west North Sea and the west of Scotland.

That ultimately reflects what we know our fishers have been seeing on the ground, and it is a step change away from the previous zero total allowable catch advice for the west of Scotland. However, the scientific advice for the whole northern shelf was based on the poor state of the southern stock component, which we think is an illogical approach.

My priority ask for the annual negotiations was to secure catch limits that reflect the positive outlook for the north-western stock, including an appropriate and evidence-based allocation for the west of Scotland. I am pleased that the negotiated outcome was a 15 per cent increase, which was supported by that robust evidence.

If I am to get both supplementaries in, I will need briefer responses.

The cabinet secretary will recognise that the deal was made possible because, as the United Kingdom is out of the hated common fisheries policy, that allows us to set our own total allowable catches, license foreign fishing vessels in UK waters and regulate fisheries in Scotland. Will she accept that Scotland’s future is outside the CFP, with decisions being made, in consultation with our fishermen and our fishing communities, here in Scotland and in the UK, and not in Brussels, as the Scottish National Party would have it?

The member has failed to read the trade and co-operation agreement that his colleagues in the UK Government signed up to, which resulted in a poorer deal for our fishermen than when we were in the CFP. I strongly urge him to read that and perhaps come back and offer comments at that point.

The North Sea and the trilateral agreement are important to Shetland’s fishing fleet, and the cabinet secretary recently committed to exploring solutions for several important fish stocks that scientists class as data deficient. How will the Scottish Government work with international partners to ensure adequate resource to ascertain the scientific advice that is so critical to sustainable fisheries management? What timeline can we expect for that?

I am happy to engage further with the member on that issue. The work that we undertake and our relationships with our international partners are critical. Our chief negotiator and our negotiating teams have done a fantastic job in the negotiations this year, and they work incredibly hard to foster the key relationships so that we can work together on the areas where problems are presented. I am more than happy to follow up with the member via correspondence and provide further information.

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Wildlife Management and Muirburn (Scotland) Bill (Licensing Schemes)

To ask the Scottish Government what proportion of the costs of the licensing schemes contained within the Wildlife Management and Muirburn (Scotland) Bill will be covered by the licence fees. (S6O-02896)

NatureScot does not currently operate any licences on a cost-recoverable basis, and the bill does not mandate charges for the three new licence schemes that are set out in the provisions. However, the Scottish Government has committed to reviewing the wider species licensing system and assessing the potential to apply the principle of full cost recovery to species licensing. The bill therefore allows for the introduction of charges for issuing licences by providing that the licensing authority may charge a reasonable fee.

Why does the minister think that the full cost should not be recovered through fees? Without that, there would be a subsidy from the public sector.

I agree with the sentiment of John Mason’s challenge. We want any changes to the policy to be fair and proportionate. That is why our commitment to reviewing species licences includes consideration of the potential to apply the principle of full cost recovery.

Every licence will have individual complexities associated with it, so we want to ensure that the approach is proportionate. Mr Mason can be assured that I am actively looking at the idea of full-cost recovery for all licences.

Grouse shooting sustains 2,640 full-time-equivalent jobs in fragile and rural communities in Scotland, and it contributes £30 million to the Scottish economy. Does the Scottish Government have no idea of the socioeconomic impact of the proposed licence scheme for grouse shooting and muirburn on land managers, as it may cause job losses and disinvestment in the sector? When will the minister publish an impact assessment of the effect of the Government’s legislation on each region in Scotland?

It is clear from all the exchanges with Rachael Hamilton on the topic that she is fundamentally against licensing shooting estates. Such licensing will bring them in line with a lot of other practices that require licences to operate. That will be a good thing for the sector as, if people are licensed to operate within the law, that will give the public confidence in the sector. It is also in keeping with many other shooting estates across Europe.

What about an impact assessment?

I am not prepared to be shouted at—

Ms Hamilton, you have asked a question—allow the answer to be given.

I will leave it there. I think that that is best.

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Agriculture Funding (Bew Review)

To ask the Scottish Government whether it will provide an update on when the previously ring fenced £33 million of funding allocated to the agriculture sector as a result of the Bew review will be returned to its budget for the portfolio covering agriculture. (S6O-02897)

The Deputy First Minister made it clear in her budget statement that we are committed to returning all of the funding to my portfolio to be invested in agricultural priorities at the appropriate time. During the coming financial year, £15 million will be returned and it will be spent entirely on agricultural priorities. We will also provide the same level of support through direct payments to farmers and crofters that was available before Brexit. We are currently providing farmers and crofters with the most generous package of direct support anywhere in the UK. I am sure that the member will welcome and support that.

It is right that uncommitted spend is deferred to mitigate the on-going cost of living crisis, and all portfolios have been asked to make similar and very difficult choices. However, I assure the member that agriculture spending is ring fenced for the portfolio and that it will be returned to ensure that it delivers for the needs of the rural economy.

The National Farmers Union Scotland is rightly furious that the Scottish National Party-Green devolved Government has failed to return £61 million of withdrawn agriculture funds in the draft budget. Today, we heard that only 25 per cent of that funding will be returned, while, at the same time, the Government is cutting other agriculture funds. Can the cabinet secretary explain to Scotland’s farmers and crofters why the SNP is not standing up for rural Scotland? When will our farmers get all of their money back?

The SNP-Green Government is standing up for our rural communities and for our farmers and crofters—[Interruption.] I would be grateful if I could answer the question that Douglas Lumsden posed.

I absolutely understand the NFUS’s concerns. That is why I reiterate that the £61 million of deferred spending is ring fenced and therefore must be returned to the portfolio. As the Deputy First Minister confirmed to the NFUS—as well as to the Parliament—every penny of it will be returned to the portfolio, to be spent on agricultural priorities. I point out exactly what was in the budget yesterday and the levels of protection that we have offered in relation to other schemes that are not available elsewhere in the UK, and I ask the member whether he welcomes that. Our basic payment scheme, greening and the less favoured area support scheme—LFASS—are all are absolutely critical for our farmers and crofters, and they are still being maintained as part of the budget.

Every single portfolio has had to make difficult choices and difficult decisions—as the Deputy First Minister outlined yesterday—but I reiterate the commitment that the money is due back to the portfolio and will be returned to the portfolio.

I will take a supplementary question. I remind Conservative members that they can ask a question but they cannot then provide a running commentary throughout the answer.

Agriculture funding is paid to devolved Governments under historical EU settlements rather than through the Barnett formula. That formula sees Scotland receive about 17 per cent of agriculture funding due to the greater proportion of farming and crofting land. Does the cabinet secretary recognise that cutting the agriculture budget could put the payment framework in jeopardy and that it certainly does not help those of us who are making the case for a greater share of that funding?

I reiterate the points that I made in my previous response: it is deferred spending that will be returned to the portfolio, and it has to be returned to the portfolio, as the Deputy First Minister outlined yesterday. Critically, we are still protecting, and ensuring that we are delivering at the earliest possible point, that direct support for our farmers and crofters. We are trying to deliver it early, to ensure that their cash flow continues to be maintained.

I give an assurance in that regard, but one of the biggest threats that we face is having no clarity on what our budget settlement will be from the UK Government beyond this coming financial year. I hope that all members in the chamber will join me in asking that we get that clarity, so that we know what funding will be available going forward.

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Land Reform (Urban Areas)

To ask the Scottish Government whether urban areas will be included in its land reform legislation. (S6O-02898)

Land reform is an on-going process and each piece of work that we do builds on the legislation and policies that have gone before. In our forthcoming bill, we will bring forward a set of robust land reform measures whose key aim is to tackle the scale and concentration of land ownership in Scotland. In 2016, we extended the community right to buy and the funding that went with it to urban communities.

Our proposals for the forthcoming bill are based on recommendations from the Scottish Land Commission. They will take account of the views of all those who responded to our consultation and, in line with the established process, final decisions on the bill’s contents will be made in due course by ministers. The bill will, of course, be published on the Scottish Parliament website following its introduction.

People owning land or a building that they are not using can severely impact urban communities, especially if the use of that land or building is not beneficial to the community. In that situation, urban communities need to be able to buy that land and use it for a purpose that will benefit communities. Will the cabinet secretary advise exactly what action the Scottish Government is taking to ensure that urban communities’ rights are protected under the land reform legislation?

The member raises a really important point. First, I emphasise that, currently, we have four community rights to buy, which exist under various pieces of legislation. There are also community asset transfers, through the Community Empowerment (Scotland) Act 2015, which are currently being reviewed. We have made commitments previously in relation to considering compulsory sales orders. That is a really complex piece of work that still needs to be undertaken. I know that the Minister for Local Government Empowerment and Planning, Joe FitzPatrick, is currently undertaking a piece of work on compulsory purchase orders, which I think will also consider that piece on CSOs.

We have the forthcoming land reform bill and, as I have said, we will set out the proposals in relation to that. It is also important not to forget the existing rights, although we need to make sure that they are operating as they should. There are also those on-going pieces of work. I will be happy to follow up with the member and provide him with more information on each of those.

There is a brief supplementary from Alasdair Allan.

Given that, through the new legislation, the Scottish Government is continuing to support both rural and urban areas through the community buy-out process, will the cabinet secretary outline whether the new land reform bill will go further than before in terms of increased land ownership transparency?

As briefly as possible, cabinet secretary.

Yes. That is certainly what we hope it will do. We really want to ensure that the bill is as ambitious as possible. I reiterate that we are committed to introducing a bill that is ambitious and that will be a significant step forward in ensuring that our land is owned and used in the public interest and, ultimately, for the benefit of the people of Scotland.

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Low-welfare Pets

To ask the Scottish Government what discussions it has had regarding the sale of low-welfare pets ahead of the Christmas period. (S6O-02899)

The Scottish Government works throughout the year to highlight the responsibilities of pet owners and those who sell domestic animals. Although we have not had specific discussions on the sale of low-welfare pets in the run-up to Christmas, we work closely on an on-going basis with key stakeholders including the Scottish Society for the Prevention of Cruelty to Animals, local authorities and other United Kingdom Administrations to raise awareness of low-welfare breeders and to inform prospective buyers on how to buy a pet safely throughout the year.

We have run comprehensive public campaigns to raise awareness among prospective buyers of pups of the realities of the unlicensed puppy trade. The information and messaging for those campaigns is available online.

Organised crime contaminates many legitimate areas of Scotland’s economy, including through its lucrative trade in puppies and dogs. Those poor animals often suffer chronic ill health, with one drug-dealing dog breeder being prime suspect in a terror campaign that forced a Scottish councillor to quit his post and leave his home. The criminals do not care about people, and they certainly do not care about animal welfare. Will the minister discuss with the Cabinet Secretary for Justice and Home Affairs how to tackle those despicable groups?

Russell Findlay has laid out that it does not matter what the commodity is; unscrupulous people will use any commodity, regardless of what it is. In this case, it is live animals, which affects the lives of the people who take on those animals. They will be left heartbroken when their animals are too ill to make it past a certain point. It is an absolutely disgraceful trade.

I point to the message from the Crown Office and Procurator Fiscal Service, which has done its own campaign on the issue this Christmas. It has been very helpful and anyone can find the campaign online. It is about highlighting the dangers of buying a puppy from unscrupulous people, as Russell Findlay has mentioned, and how that activity could be funding organised crime. It is a very effective campaign. I urge everyone in the chamber to look it up and share it on their social media channels over Christmas, because it is very powerful.

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Energy Performance Certificate Reform (Impact on Island Communities)

To ask the Scottish Government, in relation to its cross-Government co-ordination on islands policies, what discussions the rural affairs secretary has had with ministerial colleagues regarding any impact on island communities of its proposed EPC reforms. (S6O-02900)

Ministers and officials across portfolios are aware of the need to recognise the impact of new policies on island communities. The Minister for Zero Carbon Buildings, Active Travel and Tenants’ Rights has taken forward a long-standing Scottish Government commitment to reform energy performance certificates based on the Climate Change Committee’s recommendations, on which we consulted this year. Our current proposals to reform EPCs do not suggest any new duties or obligations on building owners. We are considering the impact on island communities as we go through the analysis of the consultation responses in the new year, as is required by the Islands (Scotland) Act 2018.

Given the rocketing levels of fuel poverty in off-gas areas, in particular, and the upcoming heat in buildings bill, what specific support with advice and funding will the Scottish Government offer home owners to help them to increase the energy efficiency of their properties by installing insulation to lower their carbon emissions, by installing affordable heat options and by upgrading their homes? For example, can home owners access grants to install solar panels to heat or power their homes?

I refer Sarah Boyack to the raft of initiatives run by Home Energy Scotland, such as the home heating fund. She will have seen in the budget announcement yesterday that there was an uplift in the amount of money that was given in Mr Harvie’s portfolio for the things that she has outlined in her question. Rural fuel poverty is an issue that is disproportionately affecting Scotland. If she has not done so already, I encourage Sarah Boyack to support my calls for a social tariff, which I have been calling on the United Kingdom Government to put in place ever since I was appointed.

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Fisheries Negotiations (Stakeholder Engagement)

To ask the Scottish Government how it engaged with fishing industry stakeholders as part of the annual fisheries negotiations. (S6O-02901)

We work closely and collaboratively with our stakeholders throughout the negotiation period. When the scientific advice is published, officials meet stakeholders from the fishing industry and environmental groups to discuss priorities to feed into the negotiating strategy. We have to seek the best outcome for Scotland’s environment, fishing interests and coastal communities, which means that we have to balance environmental, economic and social considerations, as well as looking at the short and long-term impacts on fish stocks and the fishing industry.

Throughout live negotiations, there are regular stakeholder meetings with the chief negotiator at which they provide updates and allow stakeholders to ask questions. If the Presiding Officer will allow, I will take a brief moment to thank all the stakeholders who have invested so much time and expertise in engaging with us and informing our approach to the negotiations. I also thank our negotiators, who always work tirelessly to do their best for the fishing industry in Scotland.

I agree with the cabinet secretary about the stakeholders and how they negotiate their business. I was delighted to read that the Scottish Fishermen’s Federation had praised the work of the Scottish Government in that area and that North Sea haddock and North Sea whiting were among the quota increases that were reported for Scottish fishers.

However, labour shortages are an acute problem in the seafood sector, particularly in seafood processing. I ask the cabinet secretary to continue to represent the views of the north-east fishers to the UK Government, to ensure that the opportunities that are presented by the increased quotas are not undermined by Brexit-related workforce shortages and the Tory visa rules that were announced this month.

The member raises an important point. I emphasise that, in Scotland, we do not share the United Kingdom Government’s approach to migration and we categorically reject its hostile environment rhetoric.

Of course, we continue to support new domestic entrants to the Scottish seafood industry, but we also recognise and value the vital contribution that migrant workers make to the sector, the wider Scottish economy and our coastal and island communities.

By ending freedom of movement from the European Union and imposing new visa requirements for qualifications and salary thresholds, the UK Government has made it significantly more difficult for us to access labour and attract people to Scotland. I have repeatedly called for urgent reform of UK immigration rules. That has included offering to work with the UK Government to identify pragmatic ways to balance border security and enabling that access to labour. I will, of course, continue to do that.

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NHS Recovery, Health and Social Care

The next portfolio is national health service recovery, health and social care. Again, any member who wishes to ask a supplementary question should press their request-to-speak button during the relevant question. As with rural affairs, there is a lot of interest in asking questions. I would appreciate brevity in the questions and the responses from the front-bench team.

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Obesity

To ask the Scottish Government whether it will provide an update on what steps it is taking to address obesity. (S6O-02902)

Addressing obesity is a public health priority and we continue to take forward a wide range of preventative actions to improve diet and promote health across the life course, as outlined in our diet and healthy weight delivery plan. That includes provision of core funding of £8.25 million to health boards in 2023-24 to deliver adult, child and young people’s weight management services, in line with our national standards and the type 2 diabetes prevention framework.

Statistics published by Public Health Scotland reveal that, this year, 22 per cent of primary 1 pupils were at risk of being overweight or obese. In 2018, the then First Minister made a commitment that the Scottish Government would halve child obesity by 2030. Our current primary 1 pupils were born in that year. By 2030, when those pupils will be in secondary 1, will half of the 22 per cent who are at risk of being overweight or obese be within acceptable standards?

The intention of the Government is to ensure that we have halved child obesity by 2030, from the original weights. I am working closely with my officials and third sector organisations to work out the best way that we can do that.

We know that junk food promotions can encourage overconsumption and impulse buying. Can the minister provide an update on work that is under way on plans to restrict in-premise marketing of food and non-alcoholic drinks that are high in fat, sugar or salt in order to reduce consumption and related harms?

As I have said, the Scottish Government remains absolutely committed to legislation to restrict the promotion of less-healthy food and drink. As part of an extensive consultation process, we have just concluded a series of round-table events with public health and business stakeholders, which will further inform the development of our consultation document on the detail of proposed regulations. The consultation document will be published early next year and it will provide an opportunity for stakeholders to comment on the detail of the proposed regulations, with a view to our laying regulations subject to the outcome of that consultation.

Apart from its impact on personal wellbeing, obesity is also a significant drag on our economy. There is a high level of economic inactivity in Scotland, and remedying that will require behavioural change with regard to diet and access to physical activity. The minister will know of my passion for the education environment as the battleground in which we need to fight in that regard. What work is she doing with the Cabinet Secretary for Education and Skills to deliver solutions to that problem?

I recognise the member’s passion for exercise and healthy eating. In its work on such issues, the Scottish Government takes a cross-portfolio approach. I engage with both the Cabinet Secretary for Education and Skills and the Minister for Children, Young People and Keeping the Promise.

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Wishaw Neonatal Intensive Care Unit

To ask the Scottish Government whether it will reconsider its reported plans to downgrade the Wishaw neonatal intensive care unit. (S6O-02903)

The aim of the national health service and this Government is to ensure that everyone gets the best possible care. That is especially true for neonate babies and their families.

The restructuring of neonatal intensive care units was based on expert clinical evidence that showed that the proposed change was necessary to improve outcomes for the very smallest and sickest babies. The most pre-term and sickest babies do best when they are cared for in larger specialist neonatal units. To undo that would be to choose poorer outcomes for those babies, and that is not a choice that we would make. The member will agree that parents would very much expect us to act on such evidence in the best interests of their babies.

Local neonatal units across Scotland, including the unit in Wishaw, will continue to offer care to babies who need it, including a level of neonatal intensive care.

The minister’s answer will infuriate and worry my constituents in Lanarkshire, and it represents a further blow to Wishaw’s award-winning neonatal workforce. Almost 20,000 people have now signed a petition to stop the Scottish Government downgrading the award-winning, vital, life-saving service in Wishaw. We have a flawed proposal and a flawed process that has produced a flawed decision. It is vulnerable babies, their mothers and families who will be failed unless the minister listens, looks again and does her job properly. Will she extend some festive good will to my constituents, the Wishaw Neonatal Warriors, and finally commit to a full independent review in the new year?

I thank the member for her question, but I do not recognise some of the picture that she has painted. I will meet the chief executive of NHS Lanarkshire tomorrow to discuss the situation.

It is certainly welcome that local neonatal units, including the one in Wishaw, will continue to provide care to the vast majority of babies who need it. The decision to move to three national neonatal intensive care units has been made in line with strong evidence and advice. Does the minister agree that, if we are to deliver the best care outcomes for the smallest and sickest babies born in Scotland, it is important that the expert advice is listened to? Does she also agree that it is vital that the voices of local people are listened to and recognised as part of the process? Can she advise the Parliament what steps the Scottish Government is taking?

I agree with Stephanie Callaghan. We must follow the best advice available. We are moving to three national neonatal intensive care units to give babies who are born at the extremes of prematurity—we are talking about babies who are born before 27 weeks of pregnancy—the best chance of survival. Larger specialist neonatal units have specialist staff and services available on site to give those tiny babies the very best care.

I met families from Lanarkshire in November to hear their concerns, and we will continue to consult families in affected areas so that they have the opportunity to input to the design of service delivery.

The minister has said again that the decision to downgrade the Wishaw unit is based on clinical advice. That is why, back in October, I asked whether the minister would meet the award-winning clinicians in Wishaw. The minister agreed to meet them, and I subsequently wrote to clarify the arrangements for that. However, in its letter, the Government now makes no commitment to meet the clinicians who lead the unit. Why has the minister gone back on her promise to meet the clinicians who run that life-saving unit?

As I said earlier, I will meet the chief exec of NHS Lanarkshire tomorrow, and—

That is not what I asked.

I know that that is not what the member asked. I ask him to let me finish my sentence. The issue in question will be discussed at that meeting.

I urge members to ask their questions and then allow ministers to respond.

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NHS Forth Valley Assurance Board

To ask the Scottish Government whether it will provide an update on the work of its NHS Forth Valley assurance board. (S6O-02904)

The latest version of the improvement plan was agreed recently by both the health board and the assurance board, and there is a clear expectation from all who are involved that progress needs to continue to be made across a range of areas including leadership, culture and governance.

The NHS Forth Valley assurance board continues to meet regularly, with the most recent board meeting taking place on 20 December 2023. The assurance board will continue to monitor and scrutinise the board’s agreed improvement plan. Minutes of the NHS Forth Valley assurance board meetings are published and can be viewed at the www.gov.scot website. A copy of the improvement plan is available on NHS Forth Valley’s website.

I thank the cabinet secretary for that welcome update. The waiting times at Forth Valley royal hospital accident and emergency department have been a long-running concern, and they have highlighted the strain that our dedicated national health service staff are under, particularly in winter. What assurance is there that staff across health boards, including in NHS Forth Valley, will be properly supported through the winter, particularly so that we can get safe staffing levels with proper breaks and hot meals being provided to all staff?

In a range of areas, the improvement plans that are being taken forward by NHS Forth Valley are starting to indicate improvements in the way in which the board is performing. We have seen that over the course of recent weeks. The firebreak that the board is presently operating has been extended for a further two weeks in order to support and sustain some of the improvements that have been made.

During the winter period, our NHS is under enormous pressure, particularly at the front door around our A and E departments. We expect boards to ensure that there are appropriate welfare arrangements in place to support staff during their clinical duties.

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Scottish Medicines Consortium

To ask the Scottish Government when it last met with the Scottish Medicines Consortium. (S6O-02905)

There are quarterly meetings between the chief pharmaceutical officer and medicine policy officials and the Scottish Medicines Consortium. The most recent one took place in September 2023 and the next one is scheduled for January 2024. In addition, both the chief pharmaceutical officer and the head of medicines policy meet representatives of the SMC on a regular and routine basis.

A new drug, trastuzumab deruxtecan, has been approved for use in Scotland for a type of breast cancer called HER2-low. The treatment slows the spread of the cancer and improves the patient’s chances of survival when compared with chemotherapy, which will come as very welcome news to people living with the disease. There will be an eagerness for treatment to begin as quickly as possible. What steps will the Scottish Government take, in tandem with the Scottish Medicines Consortium and NHS Scotland, to ensure that hospitals have access to that life-saving drug as soon as possible?

I am delighted to advise that patients in Scotland will be among the first in the United Kingdom to receive that life-extending medicine to treat HER2-low breast cancer. The Scottish Medicines Consortium published advice on 11 December recommending trastuzumab deruxtecan for routine use to treat patients with HER2-low breast cancer in NHS Scotland. As with other new medicines, once the SMC publishes its advice, it is expected that health boards across Scotland will make the medicine available for routine prescribing within 90 days of the publication of that advice.

I declare an interest as a practising NHS general practitioner.

The Scottish Medicines Consortium does not consider that drugs such as paracetamol and ibuprofen require significant advice, given that they are readily available over the counter and through pharmacy first. However, schools in Fife state that they will not give basic medication such as paracetamol or ibuprofen unless a GP has prescribed it. Does the minister think that that is an appropriate use of GP time, given the pressure that we are under? Will she undertake to work with the Cabinet Secretary for Education and Skills to ensure that the issue is resolved?

I would be happy to speak to the Cabinet Secretary for Education and Skills and my chief pharmaceutical officer with regard to that, in order to understand more about the situation that the member has raised.

People across Scotland are waiting to find out whether life-changing drugs such as Orkambi, Symkevi and Kaftrio will be available on the NHS for those suffering from cystic fibrosis, including those under two years of age. I know that the Scottish Medicines Consortium is working with the National Institute for Health and Care Excellence, but will the minister commit to ensuring that, whatever the outcome, those life-saving drugs will be available to everybody in Scotland without a postcode lottery at health board level?

Along with Jackie Baillie, I recently met families representing the cystic fibrosis community, and I was able to reassure them that, in Scotland, although the National Institute for Health and Care Excellence and the Scottish Medicines Consortium multiple technology appraisal is on-going, all existing and new patients who are on, or who are started on, a treatment for cystic fibrosis will continue to have access to that treatment after they issue their final recommendations, irrespective of outcome.

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“Infant Feeding Statistics Scotland”

To ask the Scottish Government what its response is to the recent Public Health Scotland report “Infant Feeding Statistics Scotland”. (S6O-02906)

I am delighted that the current infant feeding statistics show that breastfeeding rates across Scotland continue to increase, with more than two thirds of all babies being breastfed at birth and more than half continuing to receive breast milk at 10 to 14 days. Rates at six to eight weeks have risen to 47 per cent, which is the highest rate on record, showing that many more babies are being breastfed for longer than ever before.

We are committed to protecting, promoting and supporting breastfeeding as the normal nutrition for babies and giving them the best start in life, with more than £9 million in additional investment over the past five years.

I welcome that further investment. Encouragingly, increases in breastfeeding over the past 10 years have been greatest among those groups with low rates historically, such as young women and those living in the most deprived areas. However, only 34 per cent of babies born in Scotland’s most deprived areas were breastfed at their six to eight-week review, which compares with 63 per cent in the least deprived areas. What further steps is the minister planning to take to improve levels of breastfeeding in deprived areas, and will she consider making additions to the baby box?

I am pleased to see that the latest infant feeding statistics show a continued narrowing of the breastfeeding inequalities gap. Our additional investment has been both targeted and based on best evidence of what works. Scaling that up is part of planned next steps. Our infant feeding teams are pivotal in that effort, and we will continue to use all means necessary, including Scotland’s baby box, to normalise breastfeeding in Scotland. The Family Nurse Partnership has had a crucial role in supporting teenage parents, many of whom are in the lowest Scottish index of multiple deprivation areas, to breastfeed.

The disparity between income deciles on breastfeeding rates is a matter of great concern. Will the minister consider enhancing support for general practitioner surgeries, particularly around aspects such as community link workers and connections with charities such as Home-Start UK, to further enhance the promotion of breastfeeding in the most deprived communities?

I highlighted in my previous answer the important work of the Family Nurse Partnership. I agree that there is a lot of work to do, and it is clear that third sector organisations with which the Scottish Government is working are doing that.

Does the minister agree that, although we want breastfeeding rates to increase, it is not always easy or appropriate for all women to breastfeed? We should not stigmatise those who find that they are unable to breastfeed. All mums need to be equally supported.

Bob Doris raises an important point. I do not disagree with him. It is important that all new mums are supported. I hope that the Family Nurse Partnership is able to support mothers and families in all situations.

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Endometriosis Services

To ask the Scottish Government when it plans to establish a specialist endometriosis centre within every national health service board in Scotland. (S6O-02907)

The role of specialist endometriosis centres in Scotland is to provide co-ordinated, multidisciplinary treatment to individuals with complex systems of endometriosis and to those requiring complex surgery. Scotland operates three centres, which are in Aberdeen, Edinburgh and Glasgow. That was recommended as the optimal approach for effective treatment in Scotland by a specialist working group of expert clinicians and representatives from patient groups and Endometriosis UK. There are no plans to establish a specialist centre within every NHS board.

Local charities in the south of Scotland are dedicated to improving endometriosis treatment. One of them, Endometriosis South of Scotland, which is known as Endo SoS, said:

“Having local centres saves money for patients and the NHS, travel times are reduced, missed appointments are lower and referrals to specialist care are faster.”

It added:

“We need more locations to support the rural population and to reduce diagnostic and general waiting times.”

Will the cabinet secretary find some time to meet me and local campaigners to discuss the need for a specialist endometriosis centre in the Borders?

I would be very happy to meet Rachael Hamilton and her constituents.

We know how substantial an impact endometriosis can have on women’s lives. It is clear that we need to continue to press forward with research into the condition to ensure that the most effective treatment options and support can be provided. Can the minister provide any further information regarding work that the Scottish Government is undertaking to support research into endometriosis-associated pain?

We are jointly funding a £250,000 endometriosis research project with the charity Wellbeing of Women. The research project, which will primarily be run by researchers at the University of Edinburgh, will look at the drug dichloroacetate in the management of endometriosis-associated pain. It is a fantastic project, which I was privileged to visit in the summer.

In addition, in January 2023 our chief scientist office announced funding for the ENDOCAN project, led by researchers at the University of Edinburgh, for a large-scale United Kingdom-wide trial. The research will investigate whether a cannabinoid can reduce endometriosis-associated pain. Funding of just under £300,000 has been committed to the 30-month project.

As well as expanding the number of specialist endometriosis centres, it is also critical that the impacts of endometriosis are recognised in the workplace. I was pleased to learn that East Ayrshire Council has become the first local authority in Scotland to officially recognise the impact that endometriosis has on female employees by signing up to the endometriosis friendly employer scheme. What engagement has the minister had with that important scheme, and will she take the necessary steps to encourage all councils to engage with it?

I think that such schemes are so important. I recently launched one for NHS Scotland staff in relation to menopause and various other areas. It is incredibly important that workplaces appreciate the impact that various conditions have on their workforce and get the right policies in place to ensure that workers are able to be there and do the best in their jobs.

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General Practitioner Services Model (Appointments)

To ask the Scottish Government whether it has reviewed the general practitioner services model, including in relation to whether patients are getting appointments when they need them. (S6O-02908)

I am clear that patients should always have access to general medical services and that all local national health service boards should ensure that general practitioner services continue to be provided to all patients. Patients should always be able to see GPs when they need to.

Five years on from the joint agreement between the Scottish Government and the British Medical Association on the 2018 GP contract, our health and social care partnerships have made significant progress in recruiting multidisciplinary teams to support general practices. We have more than 4,500 staff working in those teams, providing services including physiotherapy, pharmacy and phlebotomy.

A rapidly increasing number of patients are seeking GP appointments, but that demand, combined with cuts to the primary care development fund, is placing immense pressure on GP services and leaving many patients to face long delays or simply unable to get an appointment when they need one. GPs are often taking double, if not triple, the recommended limit of 25 consultations a day, and Audit Scotland has said that the Government is “unlikely” to deliver its promise of 800 new GPs by 2027.

I ask the cabinet secretary to address a specific point about the design of the appointment system. Some patients report that they use one system and can get an appointment, and other patients report that their GP uses a completely different system and that they have to wait longer for an appointment. Does the cabinet secretary agree that every patient across Scotland should expect the same service design—

Cabinet secretary.

—so that they get the same efficient service from their GPs?

The issue that the member raises with regard to the appointment system is down to individual GP practices, because the vast majority of those practices are independent contractors. It is their responsibility to design a system that best meets the needs of the contract in order to deliver appointments to patients.

The member might be aware that, in October, we published the outcomes from the general practice access principles work, which was taken forward to look at how to get greater consistency. It came up with a set of principles that GP practices have been asked to apply. However, because of the independent contractor model, it is down to individual practices to decide on the model that they use locally.

Despite the heroic efforts of GPs and their teams, too many of our constituents are struggling to see their doctors. Earlier this year, a constituent in the Scottish Borders received a positive bowel cancer test, with a letter saying that a blood test was urgent. The local GP practice said that an appointment would take at least 10 days. With cases like that happening right across South Scotland, is it not time that the Scottish Government properly invested in GP services and matched the Scottish Conservatives’ commitment to invest 11 per cent of the national health service budget in primary care?

We are, of course, investing in primary care services. I recognise the concern that the member has raised, but there is variation in how GP practices operate, how they approach certain issues and how some patient services are provided. I have witnessed that at first hand from my personal experience and from my experience as health secretary. It is important that we ensure that people receive good-quality services from GPs, which is why we are increasing the recruitment of GPs and why the number of GP specialty training places that we are offering has been increased this year and will increase again next year. We will continue to invest in primary care.

I am afraid to tell the cabinet secretary that the recruitment of additional staff that he has talked about—pharmacists, physiotherapists, mental health staff and phlebotomists—is not progressing well in my constituency of North East Fife. Last week, I met people from GP practices who told me about recruitment difficulties with NHS Fife. Will the cabinet secretary consider transferring responsibility for the recruitment of additional staff over to GP practices, so that they can make progress?

The challenge with what Mr Rennie suggests is that it would introduce further variation, because GP practices could take different approaches, some of which might not involve the provision of the wider multidisciplinary team that we are trying to achieve. However, I have said to the British Medical Association that I am open to looking at alternatives to the existing model that operates, although the outcomes for patients must continue to be improved as a result of expanding the multidisciplinary team. I am more than happy to continue to engage with the BMA on that, but it is essential that there is a consistent approach to how multidisciplinary teams are provided across the country.

With apologies to the members whom I was not able to call, that concludes portfolio questions on NHS recovery, health and social care. There will be a brief pause before we move to the next item of business to allow the front-bench members to change.