Official Report 934KB pdf
Rural Affairs, Land Reform and Islands
That brings us to questions on rural affairs, land reform and islands.
Question 1 was not lodged.
Island Connectivity (West Scotland)
To ask the Scottish Government what cross-Government action it is taking to support island connectivity in the West Scotland region. (S6O-05388)
The published strategies, such as the strategic transport projects review 2, the national islands plan and the island connectivity plan, outline our commitment to maintain and enhance connectivity across Scotland. Those strategies include on-going and proposed investments in ferries, roads, railways and other infrastructure across the west of Scotland.
Recent and on-going investments include works at the Cumbrae slipway and the procurement of new vessels such as the MV Glen Sannox. Wider committed vessels projects will see one third of the Clyde and Hebrides fleet renewed in the coming years.
The minister knows well the frustrations and anger of local communities on Cumbrae and Arran and in the mainland ports because of ferry routes to Largs, Ardrossan and Troon being delayed. There is a fiasco in our ferries—I think that we all know that.
What will the minister do to rebuild the faith of those communities? It will require the physical upgrading of infrastructure, which he has referred to, which has been for too long neglected. That is what will demonstrate a long-term commitment to connecting our islands.
On the Cumbrae slipway, can the Government say what is being done to make sure that it progresses on time and on budget, with minimal disruption?
Regarding Arran, I note the First Minister’s comments that the acquisition of the harbour is at an advanced stage, but will the Government commit to ensure that any acquisition will come with an infrastructure investment plan to upgrade the harbour and reconnect Arran and Ardrossan?
The first point that Paul O’Kane put to me was about how we are going to rebuild trust. I accept the fact that there is a need to do that. However, since being re-elected in 2021, the Scottish Government has delivered the MV Glen Sannox into service; bought and deployed an additional vessel, the MV Loch Frisa; and extended the charter of the MV Alfred to provide additional resilience. In recent months, we have chartered the MV Arrow to provide cover and additional capacity on the northern isles ferry service route and Clyde and Hebrides ferry service route. Further, we have commissioned two new vessels for Islay, two new vessels for the Little Minch routes and seven new electric vessels for routes across the west coast.
We have started the procurement of two new freight vessels for the northern isles routes, serving Orkney and Shetland. We have progressed investment in the key ports and harbours, as has been mentioned. We have progressed considerations around the potential purchase of Ardrossan harbour. We have confirmed additional revenue funding of £270 million between 2018-19 and 2025-26 to support the operation of local authority ferry services. We have published the “Islands Connectivity Plan—Strategic Approach” and the long-term vessels and ports plan. We have introduced free travel to under-22 islanders on the interisland ferries in Orkney and Shetland and the outer Hebrides. We have extended the young persons concessionary travel scheme, which provides islanders with two free return journeys.
Thank you, minister.
The point that I am making is that we are doing an awful lot of work to try to rebuild that resilience, and the points that the member makes about the Cumbrae section can be picked up as a further consideration.
CalMac’s original plan—to have a single vessel, the MV Alfred, service Arran while both the MV Caledonian Isles and the MV Glen Sannox are unavailable—was inadequate. Although the situation has improved since CalMac was forced to deploy the MV Isle of Arran, the return to service of the MV Glen Sannox and the MV Caledonian Isles has been delayed yet again. Will the minister press CalMac to ensure that the MV Isle of Arran stays on the route until Arran’s primary vessels return and have managed several consecutive days of reliably serving the people and communities of Arran?
I absolutely take on board the point made by Kenneth Gibson, who has been a fierce advocate for his communities in regard to ferries. It is very frustrating that the community of Arran is facing a further delay to the return of the MV Caledonian Isles and the MV Glen Sannox. Ministers and officials continue to engage with CalMac to ensure that all options to expedite the repairs are being considered. The MV Isle of Arran is expected to be redeployed to its original timetable on the Oban to Craignure service when repairs to the MV Alfred lifts are completed.
The redeployment of vessels is particularly challenging due to the annual overhaul schedule at this time of year, but CalMac is committed to ensuring that the lifeline services are maintained to our islands. I am glad to advise that Alfred’s current charter has been extended to the end of February and that it will remain on the Troon to Brodick route until the regular vessels resume service. This winter, we have also been able to support the funding to maintain the dedicated service on the secondary route to Arran via Lochranza.
We will need shorter answers, even in the absence of lodged questions.
Agriculture and Rural Communities (Scotland) Act 2024 (Publication of Controlling Interests of Payees)
To ask the Scottish Government what consultation it has entered into with the Scottish Information Commissioner regarding the publication of the controlling interests of recipients of payments made under the Agriculture and Rural Communities (Scotland) Act 2024. (S6O-05389)
The Scottish Government consulted the Information Commissioner’s Office regarding the publication of data of recipients of payments made under the Agriculture and Rural Communities (Scotland) Act 2024, as required by article 36(4) of the United Kingdom general data protection regulation—UK GDPR—at the time that the bill was introduced. The Scottish Government did not consult the Scottish Information Commissioner, as that office’s remit is limited to regulating compliance with freedom of information legislation for Scottish public authorities.
The Scottish Government has not yet consulted the Information Commissioner’s Office regarding controlling interests, as that will be addressed later, when secondary legislation is being prepared for introduction under the Agriculture and Rural Communities (Scotland) Act 2024.
When I pressed the cabinet secretary to publish the ultimate recipients of farm payments, as legislated for by this Parliament under section 19 of the 2024 act, I was told in a letter:
“we must consult with the Information Commissioner before making any changes ... when we deal with controlling interests.”
I know that the Information Commissioner has been rather busy recently, but it feels like the Information Commissioner’s Office is being used as an excuse by the Government for delay after delay. When will that work be completed? The regulations came into force three weeks ago. When the data is published, will it disclose the names of all individuals, including all big landowners, and not simply list them as anonymous private applicants, as well as organisations and businesses? This is about public money, it is about transparency, it is about public interest, and it is about who pays and who gains.
We are going to need shorter questions as well.
There was quite a lot in there. On the fundamental point about transparency, I absolutely agree with Richard Leonard, which is why we agreed to the measures that were introduced as part of the 2024 act, but I think that we are speaking at cross-purposes slightly.
The Scottish statutory instrument that Richard Leonard referred to, which has just come into force, does not relate to the Agriculture and Rural Communities (Scotland) Act 2024, to which his initial question referred. The SSI relates to our ability to continue to publish data under the retained payment schemes that we have at the moment, rather than being the new regulations that would be needed under new schemes under the 2024 act, if that makes sense.
I am happy to follow up directly with Richard Leonard, to set all that out clearly. I would not want him, or any member in the chamber, to think that I am, by any means, using the Information Commissioner’s Office as an excuse. As I said in the last part of my initial response, we have not yet consulted the ICO on those specific regulations, because they will be brought forward when we are using those other powers.
Future Farm Policy (Climate and Biodiversity Targets)
To ask the Scottish Government how it plans to ensure that future farm policy aligns with Scotland’s climate and biodiversity targets, in light of the concerns raised by environmental stakeholders regarding the agricultural reform process. (S6O-05390)
Reforms are already under way to align agriculture with climate and biodiversity targets while sustainably producing food. This year, we have increased the ecological focus areas, which means that more land is farmed in ways that benefit nature and climate.
We will continue to develop our agriculture policy in a way that works for climate, people and the rural economy, and, as reform advances, we will continue to engage with Scotland’s environmental sector. However, we can meet climate, nature and sustainable food production goals only if we have successful farming and crofting businesses, which is why we will continue to offer vital support through direct payments as we go forward.
The First Minister has previously said:
“The Government is absolutely committed to maintaining an approach to agriculture that focuses on supporting the agriculture sector, supporting the measures to tackle the nature crisis that we face and implementing measures on climate change.”—[Official Report, 18 December 2025; c 26.]
How does the minister propose to deliver on that now, given that leading environmental organisations have lost confidence in the process?
The fact that members of the agriculture reform implementation oversight board have left, which is the situation to which Gillian Mackay is referring, is a decision for them. I think that it was the wrong decision, a regrettable decision and one that they will regret themselves.
However, that does not alter the fact that the Government is maintaining direct support in order to maintain rural communities. Without those strong rural communities, we cannot deliver on the biodiversity and nature promises that we are seeking to deliver, so we will continue with that process.
There is a lot of interest in supplementaries. I will try to get everybody in, but the questions will need to be short, as will the responses. If they are not, I will cut across them.
There is near-universal consensus that things must, and will, change in agriculture. However, does the minister agree that, if we want an agricultural sector that can do the heavy lifting for climate and biodiversity, we need to continue to support Scotland’s agricultural producers to do exactly that—to produce?
I completely agree with that. In the interests of time, I will cut my answer down. Any changes that we make will be developed in partnership. We will work with the agriculture sector to ensure that the support that we give meets its needs and also fulfils our desire to ensure that we have biodiversity and climate change in hand.
The update on the future farming investment scheme, which the Government sneaked out on the very last day before recess, still leaves farmers in the dark on why their applications were deemed ineligible or unsuccessful. Although the minister stated that artificial intelligence was not used in the verification and eligibility process, we know that an Excel-based programme was used. Could applications be deemed ineligible and therefore not progress to the formal assessment stage without any human assessment whatsoever?
The member is now talking about the FFIS, which is kind of going off topic, and an awful lot of such questions will be answered in the debate that we will have tomorrow. However, if the question is about whether the assessment process used more machinery and AI than human involvement, the answer is no, it did not.
Vast amounts of money awarded under the future farming investment scheme have been hoovered up by large agricultural landowners and mega farms—the kind of wealthy farms that can afford to use deer fencing, leaving smaller, less wealthy farms that cannot afford it even more vulnerable to deer overgrazing.
Given that two aims of the future farm policy are improving business efficiency and sustainability and protecting and restoring the natural environment, will the minister assure us that priority under the scheme will be given to farmers—
Minister.
—who engage in sustainable deer management solutions?
Again, we are back to the FFIS. I need to point out that £21.5 million of extra funding was invested in rural Scotland by putting that scheme in place. I also point out that, as I have stated in the chamber, including in response to Ariane Burgess, I am absolutely committed to small producers, who are a vital part of the rural economy working in Scotland. We have the small producers pilot fund and we are determined to do more for small producers as we go forward.
Very briefly, Willie Rennie.
Does the minister agree that this is not an either/or situation and that people who seek to divide environmental groups and the farming sector are doing a disservice? We should be working together. We cannot do this without farmers. There is no way that we will deal with our biodiversity and climate change obligations unless we work together. What efforts is he making to get those environmental stakeholders back on board?
I absolutely applaud Willie Rennie’s good sense in taking some of the heat and division out of these debates. It is absolutely correct that there should not be a divide between our climate change and biodiversity targets and producing food in Scotland. I applaud Willie Rennie’s intervention, because that is what we, as a Government, are trying to do.
Very briefly, Finlay Carson.
How can the minister expect farmers to invest in new biodiversity or emission-reducing measures without clear, long-term, fully funded commitments? Does he accept that, without adequate funding, even the most willing farmer will struggle to meet the targets? Will he ensure that no farmer is left worse off as a result of policy changes?
We have delivered direct support. We have delivered the Scottish upland sheep support scheme and the calf scheme. We have made sure that the less favoured areas support scheme is still in place. We have given those commitments. We have said right from the start that there will be no cliff edges or big-bang moments. We are doing that at pace, with the farming community on board, and we are delivering incremental changes that they can get on board with. We have carried out exactly the right kind of policy, in stark contrast with the scheme that the Conservatives started in Westminster and the Labour Party has continued with. We are doing it right in Scotland. Other places are getting it very wrong.
Question 5 was not lodged.
Lynx Reintroduction (Potential Impact on Farmers and Crofters)
I remind members of my entry in the register of members’ interests, which shows that I have a livestock farm in Moray.
To ask the Scottish Government what discussions the rural secretary has had with ministerial colleagues regarding the potential impact on farmers and crofters of any reintroduction of lynx into Scotland. (S6O-05392)
I absolutely understand that there are concerns in light of the recent public engagement and media attention about proposals to reintroduce lynx in Scotland. Any proposed reintroduction would require a significant amount of consultation and evidence to assess the associated risks and benefits before a licence would be considered.
Neither the Scottish Government nor NatureScot have carried out a formal assessment of any potential impact that lynx would have on rural communities and livestock in Scotland at present. For clarity, our position remains the same: we have no plans to reintroduce lynx in Scotland.
As the minister rightly says, the majority of farmers in Scotland would like the Government to abide by its policy not to reintroduce lynx in Scotland. Has the minister had any discussion with farmers about the likely costs in relation to the loss of livestock, including pedigree livestock, should lynx be reintroduced and start killing them?
I admit that I have not had any such conversations, because it is not in our plans. We do not plan to reintroduce lynx, so I have not needed to have those conversations.
Again, we have a number of supplementaries, so they will need to be brief.
Lynx would help to naturally control excessive deer populations—something that Scotland is in dire need of. Austria, France, Germany, Italy, Poland, Slovenia and Switzerland all successfully reintroduced lynx decades ago and reaped the ecological benefits. Why does the minister believe that it cannot work here?
We recognise the role that reintroductions of native species can play in nature restoration. As I have just said, a proposed reintroduction would require serious and significant consultation. NatureScot currently chairs the national species reintroduction forum, which is made up of a range of organisations from conservation, land use, public and non-governmental organisation sectors. If NatureScot were to receive any form of proposal for lynx reintroduction, it would be put through the NSRF for thorough discussion and consideration. We do not intend to reintroduce lynx or any large carnivores in the foreseeable future, because of the potential for negative impacts on farms and rural communities.
Given the focus on the potential impacts on farmers and crofters, and the fact that, under the Agriculture and Rural Communities (Scotland) Act 2024 and the draft climate change plan, the Scottish Government requires a transition towards sustainable and regenerative agriculture—including making space for nature on farms and crofts—has the Government carried out any assessments of the potential benefits of restoring lynx to Scotland. If not, why not?
As I stated in my previous answer, there would have to be a process and a thorough investigation into what would need to be done. As yet, I have not considered any of the points that Ariane Burgess has just put to me.
Although I recognise the concerns around any possible reintroduction of lynx, will the minister please acknowledge the significant and on-going impacts that sea eagles are already having on farmers and crofters on the west coast of Scotland, in relation to which there has been much discussion but no action?
I applaud the minister for not considering the reintroduction of lynx without the clear consent of affected communities, but when will the Government set out what it will do to address the current concerns on the west coast? The lambing season is right around the corner.
That question is not related to lynx, but the minister can make any additional comments.
Tim Eagle is talking rubbish, because he said that we have not done anything.
Tell that to the west coast farmers.
Last year, we added an extra £500,000 to the sea eagle management scheme, and we will continue to monitor that. I established the wildlife and land management forum, and discussions are on-going about how we manage the issue.
They have done nothing.
To go back to Ariane Burgess’s point, we need to make space for nature and for people to farm, so we are trying to find the balance for both. [Interruption.] That is why we put the extra £500,000 into the sea eagle management scheme last year, and it is why we are committed to making sure that we work with the sector.
I would be obliged if members, particularly Mr Eagle and Mr Carson, whom I have allowed to ask supplementaries, would not shout from a sedentary position.
Combinable Crops (Consultation)
To ask the Scottish Government what discussions it is having with the United Kingdom Government to ensure that the consultation on combinable crops will deliver for Scotland’s arable farmers. (S6O-05393)
I thank Paul McLennan for the question, because it is important.
Our arable producers face significant challenges, including volatile markets and extreme weather conditions. From conversations with stakeholders, I understand that the sector has a long-term concern regarding the supply chain. The Department for Environment, Food and Rural Affairs is carrying out a supply chain fairness review into the combinable crops sector, with a consultation open until 4 February.
My officials have been closely involved in the consultation process and will collaborate in the development of any resulting policy measures, ensuring that the views of Scottish stakeholders are explored and understood as part of the wider consideration of whether any interventions need to be developed.
East Lothian produces excellent grain, but, as the minister said, the sector has faced issues in relation to one of the hardest harvests in years. After a dry spring and summer, growers—especially malting barley producers—face huge pressures. Growers are being left to carry the can for decisions that are made beyond their control, whether in relation to vague contract wording, inconsistent testing standards or an unwillingness to share risk.
What can the Scottish Government do to reinforce the need for joined-up thinking and shared responsibility at every level of the supply chain?
Paul McLennan is well aware that supply chain fairness is a reserved matter, but we are working hard to ensure that Scottish industry concerns are taken into account in the current consultation on fairness in the combinable crops sector. If the consultation responses suggest that interventions are necessary, we will collaborate in the development of that policy response, ensuring that it meets the needs of Scottish stakeholders, such as our malting barley producers. Where we have the powers to do so, we are doing all that we can to protect and support that iconic sector.
On that point, there is a long-standing concern that contracts for malting barley, which is an important combinable crop in the UK, are extremely volatile. Rising whisky costs and a fall in demand mean that it has been hard for those arable farmers to secure contracts ahead of this year’s harvest. What discussions precisely has the Scottish Government had with the UK Government to support those arable farmers and to find new markets for whisky?
Liam Kerr makes a very good point. Given the current global disruption, I applaud the First Minister’s efforts to ensure that tariffs are reduced in America, because that is exactly where malting barley products go. As I have said, we are part of the conversations that the UK Government is having on supply chain fairness, and that work is on-going. We will continue to represent the industry as much as we can.
Question 8 was not lodged.
That concludes portfolio question time on rural affairs, land reform and islands.
On a point of order, Presiding Officer. In my efforts to accommodate your request for brevity, I neglected to draw members’ attention to my entry in the register of members’ interests as a partner in a farming business.
Thank you, Mr Halcro Johnston. There will be a brief pause before we move to the next item of business.
Health and Social Care
The next portfolio is health and social care. I remind members that questions 3 and 5 have been grouped together, so I will take any supplementary questions after both substantive questions have been responded to. I advise members that there is considerable interest in asking supplementary questions. I will try to get in as many as possible, but that will require co-operation from members regarding the brevity of questions and responses.
Whole-system Patient Flow
To ask the Scottish Government what urgent action is being taken to improve whole-system patient flow, including seven-day discharge services, social care capacity and shared responsibility across hospital departments, rather than focusing on redirecting patients away from accident and emergency departments. (S6O-05395)
Through the national health service operational improvement plan, we are supporting boards to reduce waiting times, improve hospital flow and minimise delayed discharges. The plan is backed by £220 million of targeted investment. To support resilience over the winter, we are also providing up to £20 million to fund increased social care and reduce pressure at hospital front doors.
All hospital departments have a part to play, as does the wider health and social care system, and they must work collaboratively to improve patient flow through the system, thereby ensuring that patients can receive the right care in the right place with no unnecessary delays to the patient journey.
The most recent data, which is from November, underlines the significant problem that we still have, as 37 per cent of patients who presented at A and E had to wait for more than four hours. That is unacceptable. In addition to social care capacity, there is a big push to improve the delayed discharge numbers, and there is also pressure to have seven-day discharge services. When will there be such services in every hospital and health board across Scotland?
That requires collaboration not just at the hospital level but also in social and community care. We have been working with the collaborative response and assurance group, which is co-chaired by the Convention of Scottish Local Authorities and the Scottish Government, through me and Mr Arthur, to ensure that the standards that we expect to be met on a consistent and national basis are being met.
There is good practice in some areas, which have seven-day discharge, discharge before noon and work with front-door frailty services. The standards are there to ensure that there is a high level of application and consistency across the country so that we can get better flow through the system. That is happening in some areas, but I want it to happen everywhere.
Several members wish to ask supplementary questions. Again, I appeal for brevity.
I remind members that I am a practising NHS nurse.
Mr Rennie referred to improving patient flow. Nowhere is that more evident than in the recent statistics that show that, under this Scottish National Party Scottish Government, waiting times are down for the sixth month in a row. How will the cabinet secretary work to build on that progress to ensure that people receive high-quality care on an appropriate timescale?
Clare Haughey is absolutely right. The latest planned care flow data shows that waits of over 52 weeks have fallen for a sixth month in a row, with a 29.4 per cent reduction in new out-patient waits and a 19.3 per cent reduction in in-patient and day-case waits since July. We are committed to maintaining that progress through the additional £137 million that has been invested in planned care this year and we are working closely with health board chief executives to ensure improvement.
As part of wider NHS reform, we are introducing a subnational planning approach to strengthen cross-boundary collaboration and help patients to access timely care. It is also important to reflect that 97 per cent of hospital discharges happen without delay.
The system can change effectively only if we reduce the queues at the front door, increase the head count or help the NHS to work more efficiently. I argue that we should go for all three options. However, none of the targets will be met without a revolution in the deployment of significant artificial intelligence and technology, starting with a fully interoperable universal tech platform for the whole of the NHS. When will the cabinet secretary deliver on that key element for future healthcare?
To return to the point that Mr Rennie made, the NHS is not just redirecting patients from the front door. Suppressing demand by ensuring that people get the right care in the right place is important. However, the work that has been done on flow navigation is also important, as is the work that has been done by NHS 24 and the Scottish Ambulance Service to ensure that we call before we convey in order to reduce demand at the front door. We also have a record level of staffing in our NHS.
Mr Whittle and I have discussed innovation at length on several occasions. The Scottish Government is investing to bring forward increased innovation and adoption of technology in the health service, and increased investment in digital is part of the budget that has been put before the Parliament for the health and social care system.
I think that we would all acknowledge that social care is critical if we are to reduce waiting times at A and E. COSLA has calculated that there is a £15 million funding gap in meeting the cost of delivering the real living wage to adult social care workers. That appears to be because the Scottish Government has taken the baseline as £12.71 per hour rather than £12.60, which is the current level of pay. The shortfall will have a devastating impact on social care services. Will the minister clarify whether that was intentional? If it was not, will he move to correct the error?
I agree with Jackie Baillie’s first point about the importance of social care in ensuring that people receive the right care in the right place at the right time, and ensuring that there is proper flow through the system. That is why the collaborative response and assurance group, which involves COSLA, the Scottish Government and health and social care partnerships, is so important. We all have a part to play in making sure that the system works effectively.
It is important that employers honour their statutory responsibilities and obligations on pay. I have just left a meeting with Councillor Paul Kelly and COSLA in which we discussed that point. Discussions on the issue are on-going.
Hospital Discharges and Use of Non-clinical Spaces
To ask the Scottish Government whether it will introduce standards and regular public reporting on hospital discharges and the use of non-clinical spaces to deliver care. (S6O-05396)
We do not currently collect national data on the use of non-clinical spaces. Our focus right now is on addressing the underlying causes of the issue, such as high hospital occupancy and poor patient flow. We are driving improvements and we are working closely with local systems to ensure that plans are in place to cope with demand peaks. Through the NHS Scotland operational improvement plan, we are investing £220 million to reduce waiting times, improve hospital flow and minimise delayed discharges.
Regular public reporting on hospital discharges is undertaken and published by Public Health Scotland and can be found on its website.
Given Healthcare Improvement Scotland’s damning report on NHS Lothian; the horrific story in the Edinburgh Evening News this month about the young father who lost his life after waiting for 13 hours to be seen in accident and emergency; the Royal College of Emergency Medicine noting that, last year, there were around 720,000 days of unnecessary hospital stays in Scotland due to delayed discharges, which is nearly 2,000 years of lost bed capacity that could have helped to relieve exit block and corridor care; and the fact that the RCEM has been raising these issues for years, when is the Scottish Government going to fix this?
First, I express my heartfelt condolences to the family of Dylan Jones at this unimaginably difficult time. I also make it clear that it is not acceptable that Mr Jones waited so long in the accident and emergency department. I know that investigations are on-going in that regard.
As Ms Boyack will recognise, I have regular engagement with the Royal College of Nursing. I know that this is an area of focus for it and that it wants to see greater data reporting, and I am engaged in discussions about how that could happen practically. However, as I said, my first priority is to address the reasons why this is happening. That is an area of concern for me that goes across the entire system. As Ms Baillie’s question alluded, it requires all parts of the system pulling in the same direction.
On that point, will the cabinet secretary advise how the Scottish Government will continue to work with integration authorities and partners to support transparent reporting and improvement planning?
Audit Scotland’s report on delayed discharge, which was published in January, recommends that we strengthen national accountability and evidence via the establishment of a single evaluation framework for all delayed discharge initiatives. Furthermore, its report recommends that that be accompanied by an annual publication of outcomes, value for money and impact.
I welcome the report and I share the view that, despite the hard work that this Government has undertaken in partnership with the Convention of Scottish Local Authorities and partnerships, more must be done to ensure that people receive the care that they need in the right place at the right time. That is why I have asked the collaborative response and assurance group to come together to consider the report’s recommendations as a whole and to develop a partnership approach to addressing them.
National Health Service Dentistry (Rural and Island Communities)
I start by apologising to the chamber, as I will be leaving the session early. I thank you, Presiding Officer, for the latitude to do so, as it enables me to attend a briefing on the A9 by the Cabinet Secretary for Transport.
To ask the Scottish Government what action it is taking to increase the number of dental practices that are accepting new NHS patients, including how it will monitor the effectiveness of the November 2023 payment reforms in improving access for patients in rural and island communities. (S6O-05397)
We continue to offer a range of additional financial support for areas where access is particularly challenging, such as rural and island areas. The support includes grants of up to £100,000 for establishing new dental surgeries and allowances of up to £37,500 for new dentists practising in qualifying areas.
In reviewing the impact of reform, we recognised that its benefits have not yet been experienced equally, so we committed to reviewing and refreshing our financial incentives to support improved access for our most rural communities. We anticipate that revised incentives will be introduced in the 2026-27 financial year.
Despite the Scottish dental access initiative grants, areas such as Argyll and Bute, Orkney and Shetland remain, in effect, closed to new NHS patients. That is the case despite Government data suggesting that more than 95 per cent of the population are registered with an NHS dentist. That clearly does not represent the reality of accessing a dentist.
The situation requires investigation, so what steps will the Scottish Government take to address the problem? Will it consider providing a salaried public dental service to ensure that everyone has access to an NHS dentist?
There are public access dental facilities across NHS boards. In fact, I visited one in Coatbridge today, and I was really pleased to meet new dental students who are doing their vocational training with NHS Lanarkshire, in conjunction with the University of Glasgow. That is an important step forward.
Vocational training is also offered in areas such as Dumfries and Galloway, and we are having in-depth discussions with NHS Western Isles about the situation in that health board area.
Dental Practices (Island Communities)
To ask the Scottish Government how it is supporting dental practices in island communities to provide sufficient levels of service to ensure that islanders can access the dental care that they are entitled to. (S6O-05399)
As I intimated in my answer to Ms Grant, the Scottish Government continues to provide a number of financial incentives in qualifying areas to support access. We recognise that the improvements following the 2023 reforms, which have resulted in consistently high levels of dental treatment at a national level, have not been experienced equally across Scotland. That is why we are committed to better supporting rural and island communities through targeted financial incentives to increase local workforces and improve access.
I recently wrote to the Scottish Government about the serious challenges that dental patients face in the Western Isles, particularly in Uist. Recruitment is difficult, and the United Kingdom Government’s removal of certain dental roles from the skilled worker visa list has clearly made the situation worse. What recent engagement has the Scottish Government had with the UK Government and NHS Western Isles about reversing that decision and improving islanders’ access to dental services?
I, too, am deeply concerned about the UK Government’s changes to the skilled worker visa list, which have resulted in key dental professions no longer qualifying for sponsorship. The changes will impact practices’ ability to recruit qualified staff and reduce access to dental care. Last year, I wrote to the UK Government to urge it to reconsider the changes, and I am very disappointed that my request has been refused.
As I said in response to Ms Grant, my officials are working closely with NHS Western Isles to improve patient access. I understand that it is recruiting new dentists to the area and is seeking locum provision in the interim, pending successful recruitment.
I declare an interest as a practising NHS general practitioner.
I have been told that no body currently holds end-to-end responsibility for practice-level governance of mixed NHS and private dental practices and that responsibility for addressing the issue sits with the Scottish Government. The lack of responsibility placed on any body raises clear concerns about patient safety and clinical accountability. That is particularly important in rural areas, where there are dental deserts, with a complete lack of choice. What is the minister doing to ensure that all mixed dental practices are appropriately regulated?
I recognise that specific issue and I have asked my officials to look into it.
We have seen residents of Bute having to travel by ferry to Paisley to access NHS dentists due to a lack of capacity on that island, and we have seen dental practices in Oban being unable to take on new patients due to staff shortages caused by a lack of housing. This is a holistic issue—it is about housing, transport and healthcare—and it is leading to a situation in which many people are unable to see an NHS dentist.
Does the Government agree that the lack of capacity is a systemic issue? Can salaried posts be created in such places? Will the minister engage with the royal colleges to offer a licensed dental surgery course for international practitioners to convert in Scotland?
Paul Sweeney mentioned my constituency in his question, and I recognise the issues. As someone who cares for all of Scotland and who wants to ensure that everyone in Scotland gets good access to dental services, I am really focused on them.
Through a number of areas in the draft Scottish budget, we have increased the dental spend to more than £500 million. It would be helpful if the member’s party would support that budget, to ensure that we can make that investment. We are also increasing the number of dental students in Scotland by 7 per cent this year, to ensure that we have that throughput and pipeline of dentists.
As I indicated in my response to Alasdair Allan, there are certain things that the Scottish Government relies on the UK Government to change. Therefore, you could perhaps use your influence with your colleagues at Westminster to improve visa access for dental therapists coming to Scotland and the exams that international dentists have to sit to allow them to practice in Scotland.
I remind the minister to always speak through the chair. I also ask for slightly more brevity in her responses so that we can get through the supplementary questions.
ADHD and Autism Task Force (Integrated Care)
To ask the Scottish Government how the work of the recently announced ADHD and autism task force will affect integrated care for residents in Strathkelvin and Bearsden, and for people across Scotland. (S6O-05398)
The children and young people’s neurodevelopment task force was set up in partnership with the Convention of Scottish Local Authorities last autumn, following review of the implementation of the national neurodevelopmental specification for children and young people.
The specification sets out the standards that all services in Scotland should follow to ensure that children and young people receive the neurodevelopmental support that they need, when they need it. The task force is supporting work to deliver the improvements identified in the review to progress implementation of the specification throughout Scotland.
I welcome the work of the task force. However, many of my constituents and other young people are caught in a revolving-door situation whereby they are denied attention deficit hyperactivity disorder assessments until they are substance free, even if their substance use amounts to self-medication. Can the minister confirm that the task force will specifically address the dual-diagnosis barrier and ensure that addiction is never used as a reason to deny or delay an ADHD diagnosis?
I thank Rona Mackay for her supplementary question and her on-going interest in the area. To respond directly to her points, although the task force’s focus is primarily on children and young people, and although significant substance-use difficulties are less common in that group, we recognise that there will be a small number for whom that aspect is relevant, including those with ADHD. In such situations, I recognise that clinicians must balance providing timely support with their responsibilities on safe prescribing and the limitations of assessment when active substance use is involved. However, we want every young person to be able to access the support that they need, when they need it, whether it be for neurodivergence issues, substance use issues or both.
I will take a couple of supplementaries, as long as they are brief.
In my south Scotland region, people in the NHS Ayrshire and Arran health board area are stuck waiting too long for ADHD and autistic spectrum disorder assessments. Although my constituents can often access support without the need for formal diagnosis, continued funding cuts for integration joint boards and the long-term decline of council budgets are placing all services under immense pressure. Does the minister recognise that such cuts only limit the amount of support that can be provided through local services? Does the Government have any plans to give people living with autism and ADHD something to be positive about, rather than cuts?
I recognise the issues that Carol Mochan has raised. When I announced the establishment of the cross-sector task force, it was aligned with £500,000 of additional investment in this year. The budget that is currently before the Parliament proposes an additional £7 million of investment specifically for neurodevelopmental support services. I encourage members to engage constructively with the budget process so that we can pass that budget and get that money into the system.
I ask members to be briefer, please.
Thousands of people are still on waiting lists for assessments. A constituent of mine in East Dunbartonshire has been waiting for four years. That is simply not good enough. The Lib Dems have asked for the Government to focus on that issue, and I am pleased to see that £7.5 million has been allocated in the draft budget. However, all that people want to know is when the waiting list numbers will come down.
This is a complex and challenging subject, and I am grateful to the Liberal Democrats for their constructive engagement on it. We are considering ways in which we can support assessment and diagnosis, but at the heart of our approach there must be a recognition of the significant systemic and societal complexity of the issue. Although diagnosis and assessment are important, we are taking a needs-based approach that recognises that assessment and diagnosis can be part of addressing a person’s needs.
I am grateful to the member’s colleague, Alex Cole-Hamilton, for his engagement in the work of the cross-party summit, as members from other parties have also done. I look forward to the summit being reconvened before the Parliament dissolves, so that it can discuss those matters further.
Eye Hospital Replacement (Edinburgh)
To ask the Scottish Government what the new infrastructure delivery pipeline means for a replacement eye hospital for Edinburgh. (S6O-05400)
The refreshed infrastructure delivery pipeline confirms that replacing the Princess Alexandra eye pavilion remains one of the Government’s four priority health projects, alongside replacing University hospital Monklands and the Belford hospital in Fort William, and progressing the Barra and Vatersay community campus project in Barra.
Capital funding for the replacement of the eye pavilion has been fully committed, and we await the business case from NHS Lothian. It is usual for the business case process, construction and commissioning to take some time, and there will be greater clarity on the timeline following receipt of the outline business case.
The cabinet secretary will recognise the sensitivity of this matter. The eye pavilion was declared unfit for purpose in 2014. A replacement was committed to in 2018 but was cancelled in 2020, after which there was a U-turn during the 2021 Scottish Parliament election campaign. The next election is almost upon us. Although the development of the eye pavilion is in the pipeline, we do not have a clear timeline. We also know from the Government’s spending review that capital spending on health, as a proportion of all capital expenditure, is forecast to decrease. When will we have a clear timeline? Until we have that, people in Edinburgh will remain extremely anxious about the future of the eye pavilion.
There are a number of points in Mr Johnson’s question. I recognise the anxiety that he highlights.
I was grateful for an opportunity, alongside Mr Johnson, Ms Boyack, Mr Macpherson and other colleagues, to meet some of the eye pavilion’s patients, and I recognised their anxiety and the need for progress. That is why I am pleased that we have confirmation of the continued prioritisation of the eye pavilion replacement. As I have said, the capital investment that will be required has been fully committed to over the pipeline. We await the outline business case from NHS Lothian to confirm the rest of the timeline and the project’s progress.
Daniel Johnson referred to capital funding. I have to say that the capital funding that is available to us is being squeezed by United Kingdom Government decision making. Perhaps Mr Johnson can refer that concern to his colleagues at Westminster.
When the cabinet secretary and other colleagues visited the old eye pavilion at my invitation, he would have heard that patient records are currently in paper form. Given the closure of the eye pavilion and the fact that those records had to be stored in halls and distributed around temporary services, will the digitisation of patient records and scans be taken into account in the design of and funding for the new hospital?
It was remiss of me not to reference the fact that Mr Briggs was at the meeting in the Parliament and that he helped to organise the visit to the eye pavilion. I was grateful to have the opportunity to see it. I will need to get back to Mr Briggs about where we are on the paper records. The Government’s general policy is to move to digitised systems and to ensure that we can have digital patient records, digital prescribing and digital applications that allow patients to interact with them. That is the general overview, but I will come back to the member on the specific principles involved in the project.
Rape and Sexual Assault in Hospitals (Protection)
To ask the Scottish Government what action it is taking to protect women from rape and sexual assault in hospitals. (S6O-05401)
Rape and sexual assault occurring in our hospitals—or anywhere else in our society—is unacceptable. I expect all health boards to uphold their legal duties as employers to keep staff, patients and visitors safe. Everyone has the right to access healthcare or their workplace without fear of assault. The safety of patients and staff remains our absolute priority. That is why a national network has been created to bring together health boards and partner organisations to explore and share approaches to preventing sexual harassment across the national heath service in Scotland. That includes reviewing approaches to data, reporting and training, sharing resources and best practice, and providing support for staff and employers.
That is welcome. However, last year, the Women’s Rights Network exposed the facts that there have been 276 sexual assaults and 12 rapes in Scottish hospitals over a period of five years. The Patient Safety Commissioner said that those numbers might be underestimates and called for all health boards to consistently record or categorise all incidents of sexual assault and rape. Can the minister confirm that all health boards are doing so? Does he agree that every woman should be entitled to be treated on a single-sex ward?
There are several elements in Ms White’s question. I have met Karen Titchener, the Patient Safety Commissioner, to discuss the issue with her. As I sought to do in my first answer to Ms White, I gave her my reassurance about our response to the Women’s Rights Network’s report on Scotland.
I expect all health boards to report incidents of sexual assault or harassment, and I expect suspected criminality to be reported to the police. Local boards have a local reporting obligation, on which I have clear expectations.
Ms White will be familiar with the Government’s policy on single-sex wards. It remains our policy that we expect boards to provide single-sex spaces where that is possible.
We are over the time limit, but, before we move to question 8, I am minded to take a couple of supplementaries to question 7 as long as they are brief.
Research carried out for the Women’s Rights Network’s report found that assaults in hospitals were not routinely recorded and that 133 hospitals did not hold data. I hear the minister’s answer, but can he give us assurances that, following that report, he had discussions with the Women’s Rights Network? What work he is doing to implement its specific recommendations?
I have not met the Women’s Rights Network. The report has been debated in the Parliament, Ms Minto met cross-party MSPs in May, and the chief people officer has discussed the report’s findings with NHS Scotland’s human resources directors. We are taking those findings incredibly seriously. I have set out several steps that the Government has taken and the obligations that we expect NHS boards to observe as a result. We will continue to monitor progress on that.
The human rights of women and girls in Scotland are not complex. Sex-based risk is real. Women and girls have unique vulnerabilities to sexual violence, including in institutional settings such as hospitals, but also in prisons, toilets and changing rooms.
Protections that are recognised in law should not be optional. The tribunal’s judgment in the case of the Darlington nurses was clear that failure to provide single-sex changing rooms violated their dignity—
A question, please.
That vulnerability also applies to female patients in mixed-sex hospitals—
Let us hear a question.
How many rapes of women and girls in Scottish hospitals are acceptable to the Government?
None is acceptable to the Government. I have set out the steps that it is taking to provide protections for staff and patients who are accessing or delivering services in hospitals across Scotland.
Walk-in General Practitioner Clinics
To ask the Scottish Government what assessment it has made of the potential benefits of walk-in general practice clinics compared with other potential service delivery models. (S6O-05402)
We are committed to making services more accessible for patients. As part of that, we are investing £36 million in walk-in general practitioner services to provide the distinct benefit of allowing patients to see a GP without an appointment.
The funding for those walk-in services is just part of almost £22.5 billion that has been allocated to the health portfolio, including a record £17.6 billion for services in and resources for the national health service.
Our continued investment in the NHS is allowing us to target areas that are experiencing long waits, to reduce backlogs and to get people the appointments and treatments that they need as quickly as possible.
How have locations for the first walk-in clinics been chosen? Can the cabinet secretary provide more detail on how the clinics might operate?
Improving access to primary care is the key priority for the Government. We are building on our on-going commitment through the service renewal framework to shift more care into community settings and make services more accessible for patients.
As part of that approach, we are developing options to improve access to primary care, including the walk-in models, which will be open from Monday to Sunday and so provide more flexibility for patients.
We will develop those proposals first as a pilot model, which will be complementary and will not duplicate current core general practice. We are considering potential locations for those pilot sites, and we will set out further details as those plans develop.
That concludes portfolio question time on health and social care. Before we move to the next item of business there will be a brief pause to allow front-bench teams to change places.
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Budget 2026-27