Meeting of the Parliament [Draft]
Meeting date: Wednesday, February 21, 2024
Official Report 1126KB pdf
Contents
- Portfolio Question Time
- Primary Care (Access)
- National Health Service Dentistry
- Business Motions
- Parliamentary Bureau Motion
- Decision Time
- Nuclear Energy
Portfolio Question Time
Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business is portfolio question time, and the first portfolio is rural affairs, land reform and Islands. I invite members who wish to ask a supplementary question to press their request-to-speak buttons or to type RTS in the chat function during the relevant question.
Bees (Welfare)
To ask the Scottish Government what action it is taking to protect the welfare of bees in Scotland. (S6O-03086)
The Scottish Government takes the welfare of bees very seriously and works in partnership with NatureScot, Scotland’s Rural College, the national bee unit, Science and Advice for Scottish Agriculture—SASA—and expert stakeholders to ensure that.
In 2022, we updated our honey bee health strategy, which aims to address the challenges that are facing honey bees and beekeepers and to achieve a sustainable, environmentally balanced and healthy population of honey bees in Scotland for pollination and honey production. The strategy is supported by our pollinator strategy, which sets out how Scotland can continue to be a place in which pollinators thrive, along with the actions that are needed to help to achieve that objective.
Many pesticides are known to harm bees and other pollinators. Pesticides that are used in seed treatments have been banned in the United Kingdom since 2018 due to their harmful effects on bee populations. For the fourth year in a row, the UK Government granted emergency approval for use of those pesticides on sugar beet crops in England. Last year, environmental groups expressed the concern that those pesticides could return to Scotland if a proposed reintroduction of sugar beet crops went ahead. Can the minister confirm that no pesticides are used in Scotland that would harm bees and other pollinators, and that there are no plans to introduce them?
I can offer the member some assurance on that front: those pesticides are not currently used in Scotland and we intend to continue not to allow their use. I would be happy to follow up on that, as would Jim Fairlie, but I want to give the member that assurance.
Despite the honeyed words of queen bee Pauline McNeill, one of the biggest risks to animal welfare is Brexit. The buzz is that Labour, after waxing and waning, has been pollinated by Tory Brexit policies that do nothing to remove the sting of losing scientific collaboration through a lack of a substantive European Union veterinary agreement. Does the cabinet secretary agree that, if Labour cares for the welfare of worker bees, it should join our calls to rejoin the EU instead of simply droning on?
Before I call the cabinet secretary, I assume that Mr Gibson’s language was intended to be entirely complimentary to our Ms McNeill.
It was.
It will probably not surprise Kenneth Gibson to hear that I absolutely agree with the sentiments that he has set out. We are extremely concerned not only about the impact of Brexit on our businesses and the agri-food sector, but about the way in which the UK Government chose to implement it. Only now are we seeing the beginnings of border checks on a variety of goods from the EU this year.
The exchange of research and intelligence is vital to effective border controls, which play a really important role in our biosecurity for bees and in so many other respects, and the only way in which we could have looked to achieve that was through a well-negotiated veterinary and phytosanitary agreement. That would have gone some way towards ameliorating our current situation, but from the approach that the UK Government is taking, it is not looking likely.
There remains a lack of knowledge among many people on exactly which bees need help. It is wild bees, such as the species that I champion—the bilberry bumblebee—that are in trouble, not honey bees. In fact, there are some situations in which honey bees can be a risk to wild bees as they compete for flowers and pass on diseases. Does the cabinet secretary agree that we need to do more to regulate use of managed bees by, for example, taking precautions to avoid hives being placed in protected areas that are important to rare species?
The member has raised an important point. He is absolutely right: the emerging scientific evidence shows that managed pollinators—even when they are native, as honey bees are in Scotland—could have a detrimental effect on wild pollinators in fragile ecosystems. That is why it is important for us to try to understand the potential risks that are caused by competition, changes in plant communities and disease cross-transmission, which results from the use of managed honey bees and pollinators under Scottish conditions.
However, the relevant scientific evidence that we need in order to address that is not currently widely available. That research, education and open dialogue with everyone involved in the area and our key stakeholders will be key to our fully understanding and then trying to mitigate some of those risks.
Land Ownership
To ask the Scottish Government whether it will provide an update on its plan to diversify land ownership in Scotland. (S6O-03087)
The Scottish Government is committed to an on-going programme of land reform based on the principles set out in the “Scottish Land Rights and Responsibilities Statement 2022”. Those principles include bringing about a more diverse pattern of land ownership and tenure, and giving citizens more opportunities to own, lease and have access to land.
Our forthcoming land reform bill will build on our record of success in diversifying land ownership, particularly in terms of the steady growth that we have seen in community ownership. Among other important reforms, the bill will include new measures to regulate the market in large-scale landholdings through the introduction of a public interest test and requirements for community bodies to receive prior notification of sales or the transfer of such holdings.
I thank the cabinet secretary for that reply, but
“Community ownership of land has flatlined since 2016/17 ... only 16 hectares of land went into community ownership in 2021/22. Less than 3% of Scotland’s land is in community ownership and patterns of private landownership remain highly concentrated.”
Those are not my words, but the hard-hitting conclusions of Dr Josh Doble of Community Land Scotland.
The Government’s record on land ownership is dismal, from scrapping the dedicated land fund to feathering the nests of the wealthiest landowners, the biggest land speculators and some of the worst carbon polluters. Why will the cabinet secretary not think big and act radical, break up the private land monopolies, halt the extraction of wealth and spread the common ownership of our land?
I categorically refute the assertions that Richard Leonard has made in his response to me, some of which are factually inaccurate. The member referred to our scrapping the land fund, which is not the case. We have not scrapped the land fund in Scotland, because we recognise what a vital tool that is in enabling communities to take ownership.
Three per cent.
It is this Government that has driven forward the land reform agenda, and we have the proposals to continue on our land reform journey by introducing a bill that will help with the diversity of land ownership that the member talks about—
Three per cent.
Mr Leonard, we need to hear so please desist.
—and which we recognise as being hugely important.
I have had several requests for supplementary questions.
A range of powers and processes is key to diversifying land ownership and how that land is utilised to provide infrastructure development and regeneration projects that are in the public interest. How does the Scottish Government intend to deliver its commitment to reform and modernise the compulsory purchase system in Scotland, so that it is clearer, fairer and faster for all parties?
The member is absolutely right. We have a number of powers available to us when it comes to community ownership, across various pieces of legislation, but we also have other tools such as compulsory purchase, as the member has outlined.
Indeed, the Government has committed to taking forward reform in relation to compulsory purchase orders. I can advise the Parliament that the Minister for Local Government, Empowerment and Planning has appointed an advisory group to support that process. That group, which comprises experts and practitioners, will be co-chaired by Roseanna Cunningham and the Scottish Government’s chief planner. It will be tasked with identifying opportunities for reform to inform our approach to legislation in the future. The first meeting of that new group is set to take place next month.
Achieving net zero relies on significant action in areas including tree planting, the restoration of peatland and improving biodiversity, all of which are acknowledged as being best achieved through delivery at scale and over a long term. What measures is the cabinet secretary proposing to address the potential challenges created by having a larger number of smaller landowners to co-ordinate, as well as the potential gaps in expertise, funding and succession planning among new individuals and organisations that are taking ownership of more pieces of land?
I would not necessarily agree with what Brian Whittle has set out. As well as the large-scale tree planting and peatland restoration that the member has talked about, what is important is the integrated land uses that we can have and our encouraging more of that planting at a smaller scale. We have made various changes to try to do that, such as the forestry grant scheme, and all of that work, collectively, makes a difference. It is not a case of either/or, but of how we encourage peatland restoration or tree planting in smaller businesses, on farms and crofts, and stitch that work into the fabric of our landscape, as well as the work that can be done co-operatively on a larger scale.
What work has the Scottish Government done to evaluate its powers to implement a land value tax and how much revenue such a tax could raise?
I am happy to set that out. In 2017, the Scottish Government asked the Scottish Land Commission to look at the potential for introducing a form of land value tax in Scotland. One of the key findings of that work was that
“although the theoretical case for the introduction of a land value tax is strong, there is a lack of empirical evidence that land value taxes have actually delivered the theoretical benefits attributed to them.”
The Scottish Land Commission went on to outline that, to date, no country has ever replaced the existing taxes on land and property with a single tax, and that
“most people accept ... the idea”
that
“a single tax is not practical”
at the moment.
However, we remain committed to exploring options. We have had proposals in relation to other methods of tax that we should be considering, and I assure the member that we are looking to consider those options further and to ensure that we deliver on our commitments to taking a fair and progressive approach to taxation.
United Kingdom Immigration Rules (Agriculture Workers)
To ask the Scottish Government how proposed United Kingdom immigration rule changes will potentially affect overseas workers in the agricultural sector in Scotland, in light of the recent letter from Scotland Food and Drink, and industry partners, to the Home Secretary. (S6O-03088)
The UK Government’s arbitrary decision to reduce net migration is ultimately really short-sighted and will dramatically constrain Scottish employers’ ability to recruit the skills that they need from overseas.
Migrant workers play a hugely vital role across the breadth of our economy, including the food and drink industry, and those changes could cause irreparable damage to the food supply chain as well as to the wider sustainability of our rural economy.
Only independence would give Scotland the opportunity to devise a humane, principled approach to migration that is needs based and delivers positive outcomes for our communities, our public services and our economy.
As the newly published “Supporting and enabling sustainable communities: action plan to address depopulation” indicates, tackling the issue of the lack of people, and the lack of powers to attract them to live and work in rural areas, as well as in urban areas such as my constituency, is urgent. What is the Scottish Government’s understanding of the Labour Party’s policy intent around giving Scotland control over migration powers?
The cabinet secretary will comment on matters within her jurisdiction.
It is important to highlight that we published our addressing depopulation action plan last week, which sets out our strategic approach to managing what is a complex challenge. It is about supporting communities to be sustainable into the future, through talent attraction and migration.
This year, we will launch a talent attraction and migration service, which will enable employers to use the immigration system effectively and efficiently to help meet the labour and skills needs that we know we have, as well as enabling people to access good-quality information to help them move to Scotland and settle in our communities.
I wish that we had Labour’s support for our efforts, but, as we all know, just like the current Tory Westminster Government, Labour does not support fully devolving migration powers to Scotland, which prevents us from developing policy that better meets Scotland’s needs and interests. Only independence will give us the powers that we need to do so.
Vacant and Derelict Land and Buildings
To ask the Scottish Government what role the Scottish Land Commission will play in tackling the legacy of vacant and derelict land, including in relation to examining the issue of empty and derelict buildings within an urban setting. (S6O-03089)
The Scottish Land Commission convened the national task force on vacant and derelict land, which reported its findings and recommendations in 2020. Action on those recommendations is being progressed by many organisations. The Scottish Land Commission has published a range of analysis, guidance and advice. As set out in its 2023-25 programme of work, the SLC is currently reviewing progress against the recommendations in order to maintain that momentum and to understand where continued focus is required. Through its good practice programme, the SLC continues to provide advice and signposting to support action on vacant and derelict land.
The cabinet secretary will be acutely aware of the long-standing problem that we have of vacant and derelict land and buildings that blight the appearance of our countryside, cities, towns and villages. Such land and buildings are mostly owned by absentee private owners who, by their inaction, have shown that they could not care less about the impact that that has on our local communities.
Does the cabinet secretary agree that more needs to be done to tackle the problem? Does she also agree that councils need more than their rarely-used amenity powers, which are not effective in dealing with such important issues?
The member raises a really important issue. I am sure that we can all empathise, as we see similar situations in our constituencies.
As the member outlined, planning authorities have the power to serve amenity notices, to require land and property owners to clean up land that, due to its state, is having a detrimental impact on the amenity of the area, and to require landowners to carry out work or repairs to improve their property where its appearance is having a negative impact on the street scene.
Local authorities also have direct action powers to make the necessary improvements themselves and then bill the owner for the work, but I know that there has been difficulty recouping some such costs in the past. Through the most recent planning act, we are introducing new powers to allow authorities to place charging orders on properties, to ensure that they at least get those costs back at some point.
Furthermore, we are about to launch a public consultation to explore the options and opportunities for improving the resources that are available to our planning authorities, to strengthen their capacity to take on that work.
If urban communities are not included in the promised land reform bill, they will have to wait a decade for change and they will continue to be held to ransom by the dead hand of land bankers. Will the minister be bold, deal with those vested interests and empower rural and urban communities in the bill?
I am sure that the member appreciates that I cannot set out today the exact measures that will be introduced in the bill. However, I hark back to some of the really important measures that we consulted on, and highlight that the proposals and the recommendations that we put forward for consultation were based on recommendations from the Scottish Land Commission on some of the key issues that need to be addressed.
As I highlighted in my response to a previous question, this Government has a strong track record when it comes to land reform. We are committed to going further, which is why we are introducing the land reform bill. I look forward to doing that.
Activities Involving Animals (Licensing)
I apologise to members in the chamber: I need to leave early to attend a committee meeting.
To ask the Scottish Government when it plans to publish its response to its consultation on the licensing of activities involving animals. (S6O-03090)
The Scottish Government published its analysis of the response to the consultation on the licensing of activities involving animals on 16 February 2024.
I thank the minister for the response and welcome him to his new position. Data from the Greyhound Board of Great Britain revealed that more than 22,000 dogs were injured and more than 800 were killed within a five-year period across the United Kingdom. That jaw-dropping figure shows that as long as greyhounds race around oval tracks at high speeds, they will continue to get seriously harmed or killed. Does the minister agree with the view of thousands of respondents and key organisations, including the Scottish Society for Prevention of Cruelty to Animals and the Dogs Trust, that the licensing of tracks would fail to address the inherent risks of greyhound racing?
I note that the consultation analysis showed that many respondents believe that greyhound racing should be completely prohibited rather than licensed. We will consider the issue further as Mr Ruskell’s proposed prohibition of greyhound racing (Scotland) bill progresses.
Crofting (New Entrants)
To ask the Scottish Government what its response is to the most recent figures published by the Crofting Commission showing an increase in the number of new entrants between March 2022 and March 2023. (S6O-03091)
I am delighted to see that, once again, the Crofting Commission is reporting a high number of new entrants to crofting.
Each of the 510 new crofters in 2022-23 represents a new or continuing member of the local community, highlighting the invaluable role that crofting plays in supporting population retention in our rural and island areas. It is also encouraging to see that almost half of those new crofters are women, and that just under a third are aged 40 or younger. That is positive news for the sector and critical to its future.
I welcome the minister to his new role and thank him for his response. Can he outline how the Scottish Government intends to build on that progress by further expanding access to those who are looking to begin crofting, such as by ensuring that abandoned crofts become available for others to use?
We are encouraging opportunities for new crofters. That is a key action in our national development plan for crofting. In 2023, the Scottish Land Matching Service’s crofting resource was launched, which links prospective crofters to available crofting opportunities. As of last week, 195 people were looking for a croft in that way.
The Crofting Commission also launched its croft succession project in the Uists and Barra and in Sutherland to encourage succession planning and living succession, which will help to create further opportunities for new entrants. We continue to provide more than £40 million-worth of funding each year to crofters through various schemes, including the crofting agricultural grant scheme and the croft house grant.
Deer Numbers (Support for Sustainable Management)
To ask the Scottish Government how it is supporting communities to sustainably manage and reduce deer numbers. (S6O-03092)
Effective deer management is vital to tackle the twin climate and biodiversity crises. Our consultation paper, “Managing deer for climate and nature”, which was published on 5 January, seeks views on our proposals for new deer legislation.
It is important that local stalkers are able to contribute to deer management and that the benefits of venison as a healthy and nutritious food are available to communities.
We are piloting projects that increase community involvement in deer management by providing £80,000 to create new venison larders, and we are working with NatureScot to support community deer management at Creag Meagaidh.
Community models of deer management are common in many European countries and have recently been piloted in Scotland. Can the minister provide an update on that pilot and any lessons that have been learned? Can she say whether there is scope to roll out community-based models on publicly owned land throughout Scotland and incentivise communities to participate in that vital work?
The Creag Meagaidh pilot provides local residents with opportunities to develop deer management skills. Once they are qualified, it provides them free access to stalk deer on the reserve. We have already seen a successful reduction in deer numbers there, and participants have given enthusiastic feedback on the pilot’s benefits.
I am keen that we learn from the pilot and support more community-led deer management schemes, which is why I am pleased that a proposal is being developed in the Cairngorms to increase deer management in the national park. The proposal includes trialling new incentives and providing support for local venison.
I welcome the minister’s answer to Colin Beattie.
The British Association for Shooting and Conservation Scotland has a flagship policy that calls on the Scottish Government to allow trained local deer stalkers to carry out deer management on publicly owned land. It will enable a sustainable food source to be harvested, processed and consumed locally; protect the environment; drive and improve economic productivity; and enhance community knowledge of deer impacts and benefits.
Will the minister implement BASC’s community deer management proposals as part of addressing the significant challenges of deer legislation in this parliamentary session?
As I said in my previous answer, I am pleased with the result of the pilot scheme on community-led deer management, I am excited about the work that is under way in the Cairngorms national park and I look forward to expanding the programme, so that we can have more community benefits from our deer management plans.
Land and Rivers Management (Support for Farmers)
To ask the Scottish Government what financial and advisory support is available to farmers to better manage land and rivers, including to prevent flooding. (S6O-03093)
The agri-environment climate scheme, which the Scottish Government reopened last week, offers support to manage land and rivers. That support includes the availability of more than £4 million to fund irrigation lagoons in order to improve water quality and drainage in rural areas.
In addition, the Farm Advisory Service offers a range of support on water and land management through events, peer-to-peer groups, videos, podcasts and technical notes. There is also advice line support, and up to £1,000 of bespoke consultancy advice is available to all registered agricultural businesses in Scotland.
After Christmas, I met the families who had been flooded out of their homes in Cupar, and I promised that I would do everything that I could to prevent that happening again.
I am told by experts that part of the solution is to help farmers to cope with extreme weather events due to climate change through additional investment in fields and rivers. However, AECS, which the cabinet secretary talked about, is not primarily about flooding and dealing with those issues, and the flood bank repair fund, which she did not mention, is about repairing rather than adapting.
Will the cabinet secretary establish a new fund that will help farmers and landowners to deal with the effects of flooding, so that I can go back to my residents in Cupar and tell them that I have done everything that I possibly can?
The member raises a hugely important point. I was sorry to hear about the impact on his constituents. Having experienced similar events in my constituency, I know how devastating the impact of flooding events can be.
I appreciate what the member said about AECS and the flood bank repair scheme. I am not in a position today to commit to a new fund, because the issue does not necessarily sit in my portfolio; it involves working with colleagues across Government, and particularly Màiri McAllan. However, we have committed to have a discussion with our regulators and farmers. That started from a commitment relating to water scarcity in the summer last year. However, with the events that we have seen over the winter, we know that we need to consider the issues more in the round, including some of the flooding events that we have seen.
There is a commitment for that work to happen, and I believe that a meeting in relation to that is due to take place next month. By starting that conversation—
Thank you, cabinet secretary.
—we can then look to develop solutions.
Thank you. I would like to squeeze in a brief supplementary from Rachael Hamilton.
As Willie Rennie said, in the past few years, parts of Scotland have been devastated by extreme weather and flooding, which has exposed the Scottish National Party’s inability to deal with flooding in Scotland, leaving rural communities behind. What lessons has the Scottish Government learned from the adverse weather? Does the cabinet secretary support a regional catchment management approach to mitigate flood risk? Does she consider that natural flood management interventions should replace traditional prevention schemes as an objective through the lens of the Agriculture and Rural Communities (Scotland) Bill?
First, I state that I am really disappointed with some of those comments. As I outlined in my response to Willie Rennie, I have experienced and seen at first hand in my constituency events that have caused utter devastation on a scale that nobody could have predicted and that no scheme could have prevented, given the sheer scale of the river and water levels that we saw.
As I outlined, it is vital that we look at the issues in the round. We are getting warmer summers with less water and we are experiencing storm events with increasing frequency. We need to look at the issues as a whole, as well as at what we can do at catchment scale on each of those issues. The discussion that I referred to, which is due to take place, will be critical in starting to address that and determining how we move forward.
That concludes portfolio questions on rural affairs, land reform and islands. There will be a brief pause to allow the front-bench teams to change positions for the next portfolio questions.
NHS Recovery, Health and Social Care
Mesh Survivors (Financial Redress)
I apologise to you, Presiding Officer, and to members because, after this question, I have to leave to attend a committee meeting.
To ask the Scottish Government what its position is regarding financial redress for vaginal mesh survivors in Scotland, in light of the recommendations contained within “The Hughes Report”. (S6O-03094)
We continue to review “The Hughes Report” and any implications for patients in Scotland. It is clear that the redress scheme that is envisaged would involve a very substantial financial commitment, which needs to be considered carefully. I and the Scottish Government recognise the pain and upset that women who are affected by mesh continue to endure. We remain committed to providing healthcare support that is focused on their needs, including a choice of surgeon for mesh removal when that is what the women want.
I have been contacted by vaginal mesh survivors in my constituency who are keen for the Scottish Government to consider potential financial redress for them in light of “The Hughes Report” recommending a £20,000 interim scheme payment in England by 2025. There is also scope for potential further payments. All those payments are significantly above the £1,000 one-off payments that have been made so far in Scotland.
Although I appreciate that the report is specific to England, given the clear pain and suffering that survivors endure, does the minister agree that the Scottish Government should still appropriately consider the report, including the issue of appropriate financial redress? In doing so, will the Scottish Government meaningfully engage with mesh survivors as part of its considerations?
I agree with what Bob Doris said. We will, of course, review the report carefully, and I wish to hear the views of women in Scotland who have been badly affected. We have often engaged with affected women to guide the development of national health service mesh services and direct Government support, and I am happy to commit to continuing to seek ways to do that in the future.
In all fairness, the United Kingdom Government has not yet responded to the report, so we do not know what its view will be. I credit the Scottish Government for making an immediate payment of £1,000 to affected women and for paying for women to go to the United States to have mesh removed.
On the back of the Cumberlege report, the Scottish Government was committed, in principle, to a further redress scheme. Is the minister at least prepared to say that, in relation to a compensation scheme that might finally emerge, it would be unconscionable for women in Scotland to be in any way disadvantaged compared with women anywhere else? We were at the forefront internationally of responding to mesh, and it would be to our great detriment if we were to find ourselves falling behind.
I recognise the work that Jackson Carlaw has done, along with members across the chamber, for women in this situation. As he pointed out, the UK Government is yet to respond to the report. We are reviewing the implications for patients in Scotland. It would not be responsible for me to make a commitment without knowing the UK Government’s position, but I absolutely recognise what Jackson Carlaw suggested.
One of the recommendations of “The Hughes Report” is to improve access to disability benefits for transvaginal mesh survivors. What action is the Scottish Government taking to improve access to social security benefits for those who are adversely affected by transvaginal mesh or by hernia mesh? The minister recently met some of my constituents who are directly affected.
I recognise Katy Clark’s work in supporting people with hernia mesh implants. If she does not mind, I will check and come back to her with a written response to her specific question.
National Health Service Waiting Times (Children, Adolescents and Young Adults)
To ask the Scottish Government how it is tackling NHS waiting times for conditions affecting children, adolescents and young adults. (S6O-03095)
A range of initiatives are in place to support health boards to increase productivity and capacity and to respond to demand through service innovation and redesign. The centre for sustainable delivery is working with boards to accelerate the implementation of high-impact changes, including active clinical referral triage and patient-initiated review, which will free up additional capacity in the NHS system.
We are working with health boards on detailed annual plans to demonstrate how waiting lists will be managed in order to reduce waiting times and improve productivity, with clear evidence on how that will help to free up additional capacity. We are developing a “once for Scotland” pathway, which will harness all opportunities to deliver patient care in the right place and closer to home. That includes maximising the number of day-case procedures to avoid unnecessary stays in hospital.
I have a young constituent who has suffered from tonsillitis more than 14 times in the past 12 to 18 months. The condition is occurring more frequently and has recently been recurring every two weeks. Her education is constantly disrupted with days off school, and she is concerned about how that will impact her end-of-year grade.
My constituent has been told that the waiting time for a tonsillectomy is 22 months. What actions will the cabinet secretary take to ensure that my constituent does not miss out on any more valuable school time? What is the Scottish Government doing to reduce waiting times for that procedure for children and young people?
I thank Pam Gosal for her narration of the situation that is impacting her constituent. My thoughts are with her constituent and her constituent’s family in their efforts to ensure that her constituent receives the treatment that she should.
The Scottish Government commissioned the centre for sustainable delivery to play a central role in working with health boards to ensure that they are continually able to identify new ways of increasing capacity. Its programmes have developed strong clinically led specialty delivery groups, including one for ear, nose and throat services, which promote multidisciplinary team working and support local adoption of service improvement programmes.
We know that there is more to do, but we are making progress. Since the introduction of our long waits target in July 2022, ENT waits of more than two years have reduced by 93 per cent for new out-patient appointments and by 54 per cent for in-patient and day-case appointments.
I will be happy to follow up with Pam Gosal if she provides me with more details of her constituent’s case.
I am pleased that the Conservative member for West Scotland has raised waiting times for children and young people, as long waits for child and adolescent mental health services come up regularly in my casework—indeed, the Government has never met its CAMHS waiting time target. Does the cabinet secretary accept that there might be a link between repeatedly freezing and then reducing the mental health budget in-year, and the Government having never met that waiting time target?
I appreciate Paul Sweeney’s question. I am pleased that progress is being made on long waits, but it is clearly unacceptable for child and adolescent mental health services patients to continue to experience them. However, there has been positive improvement in CAMHS waiting times over the past year. Thirteen out of 14 CAMHS services have in effect eliminated their long waits. Such services continue to respond well to high demand, with one in two children starting treatment within 10 weeks.
Overall, CAMHS waiting lists decreased by 36 per cent in the past year, and the number of children who are waiting for more than 52 weeks decreased by 88 per cent in the same period. I agree that it is unacceptable for children to wait for any longer than is necessary, but the investments that we are making alongside our health board partners and integration joint boards are clearly making a difference in driving down such waiting times.
Framework for Chronic Pain Service Delivery (Update)
To ask the Scottish Government whether it will provide an update on the progress in delivering the actions and aims contained in the framework for chronic pain service delivery. (S6O-03096)
In November 2023, we published a progress report that outlined progress to date on delivery of actions and aims that are outlined in the framework for pain management service delivery. At that time, we also published a revised implementation plan with updated actions, following a period of stakeholder engagement.
Good progress has been made in delivering on the actions in the plan. That progress has been achieved with the support of the newly established stakeholder networks and governance arrangements. Work includes delivery of improved access to information, increasing the knowledge of healthcare professionals via a dedicated chronic pain knowledge hub, and developing new ways to access specialist care.
Chronic pain is a considerable healthcare concern that causes physical and emotional stress to sufferers and their families. Equitable and early access to pain management services is vital. What action is the Scottish Government taking to ensure that healthcare professionals across all levels of care have up-to-date knowledge and understanding of available pain management options?
We recognise the need to further promote awareness and understanding of chronic pain and its impact on the healthcare workforce. We are making it easier for healthcare professionals at all levels to access and navigate high-quality up-to-date information and resources in order to improve the quality of care.
We have established a national pain education group, which, as I mentioned earlier, is developing a national chronic pain knowledge hub for healthcare professionals, service managers and other delivery partners. In addition, the group is developing a pain-informed care toolkit for healthcare professionals to promote pain management options in all settings.
As the former convener of the Parliament’s cross-party group on arthritis and musculoskeletal conditions, I know how important timely access to orthopaedic surgery can be for the mental and physical health of people with arthritis and chronic pain.
Now that the Scottish Government has halted the development of a new treatment centre in Ayr that was set to treat around 3,000 orthopaedic patients per year, patients face an even longer wait. Will the minister commit today to ensuring that patients with chronic pain who are waiting for orthopaedic surgery will have access to whatever physical and mental health support they need, while they are forced to endure even longer waiting times for a lasting solution?
I reiterate that we are setting up a national care service in NHS Golden Jubilee National Hospital, which will work nationwide to support people across Scotland in speeding up operations in orthopaedics.
Maternity Services (Wigtownshire)
To ask the Scottish Government what it is doing to ensure that women in Wigtownshire have the choice to give birth as close to home as possible. (S6O-03097)
We expect all national health service boards to provide maternity services that are delivered as close to home as is practical, balanced with ensuring the safety of mother and baby.
NHS Dumfries and Galloway has been consulting on two options for maternity care in Wigtownshire. The consultation closed on 11 February 2024, with feedback being carried out by an independent third sector organisation. The board will receive a report on the consultation by the end of March. Following internal governance processes, it is expected to be presented at a meeting of the integration joint board in June 2024.
In recent correspondence, the Scottish Government made clear its expectation that all women, at all times, will receive high-quality person-centred maternity care that is tailored to their needs, with quality and safety for mothers and babies being central to decision making. If that is the case, why are mothers-to-be in Wigtownshire, who have no underlying health issues and who do not want to give birth at home, still having to travel 75 miles to give birth in Dumfries, despite a recent review that recommended the return of midwife-led births in the west of my constituency in a perfectly suitable birthing suite that is lying mothballed in Stranraer?
As I explained, NHS Dumfries and Galloway decided on that review, and the integration joint board will decide on the options in June this year. That is when the decision will be made. It is a local decision that will be made by the health board.
With my support to facilitate its happening, members of the Galloway community hospital action group—my constituents Dr Angela Armstrong, Dr Gordon Baird and former charge nurse Janice Mayall—recently gave evidence to the Health, Social Care and Sport Committee as part of our health in remote and rural areas inquiry. Their evidence included the current situation regarding maternity services in Wigtownshire. NHS D and G leadership recently stated that recruitment of midwives is a key challenge to improving the situation.
Will the minister commit to looking closely at the outcome of the health committee’s report when we publish it and, in particular, at how we can improve recruitment?
Emma Harper has raised an incredibly important point about recruitment in rural areas. I am happy to look at the report once the committee delivers it.
Midwives in Wigtownshire and across my South Scotland region are facing increasing pressures in their workload due to rapidly growing work. The pressure is intensified in the region by travel distances between the towns and villages.
As Emma Harper did, I note that if the Scottish Government is truly going to ensure that women in Wigtownshire and other rural areas have a choice of where to give birth, it will have to tackle recruitment and retention. Can the minister give us a timescale for when she might be able to look at the issue for that particular area? Retention is a major issue in the midwife profession.
Given that I represent a rural constituency, I recognise the point that both Carol Mochan and Emma Harper have raised. I cannot give a specific date, but we are working at pace in respect of the review. I will be happy to inform Carol Mochan when I know when that is likely to happen.
National Health Service Dentistry (Greenock and Inverclyde)
To ask the Scottish Government what it is doing to improve access to NHS dentistry in the Greenock and Inverclyde constituency. (S6O-03098)
We introduced on 1 November 2023 major national health service dental payment reform, which includes a new fee structure that is designed to make it more attractive for dentists to provide NHS services. That has generally been well received by the sector.
I acknowledge that access remains challenging in certain areas, including Inverclyde, which is why we have made tailored funding available, including grants of up to £100,000 for opening a new, or extending an existing, practice in the area, as well as golden hello payments of up to £37,500 for new trainee dentists practising in the area.
I welcome the additional investment that the Scottish Government has put in.
The minister will be aware that I have been raising issues regarding NHS dentistry in Inverclyde since 2021. Cases include two constituents who recently contacted me to say that they had been unable to access an NHS dentist despite the fact that they are registered as NHS patients. They have struggled to get appointments for years, but could have them if they were willing to pay.
Will the minister advise members what discussions she has had with local dentists? Will she also advise us what additional incentives are being offered to dentists to increase their NHS patient registers and ensure that NHS patients are not left for years without being able to see a dentist?
As Stuart McMillan knows, I hope to visit a dentist in his constituency to hear directly from them. However, I and my officials often meet dentists to discuss the situation.
As I said, the Scottish Government introduced dental payment reform in November. That remains the most meaningful intervention that we can make to incentivise dentists to increase their NHS activity and provide care to registered patients.
NHS Greater Glasgow and Clyde has assured me that unregistered patients can continue to access urgent and emergency dental care via public dental service clinics. The health board also has a dedicated dental helpline, which provides advice on the local practices that are accepting new NHS patients, as well as general advice and support on oral health.
Pain Management Task Force (Update)
To ask the Scottish Government whether it will provide an update on the pain management task force. (S6O-03099)
The pain management task force was established in June 2022 to oversee the implementation of the framework for pain management service delivery in Scotland. The task force uses programme and risk management methodologies to ensure successful delivery and prioritisation of the framework’s aims. It meets bi-monthly to discuss progress and issues that relate to the delivery of actions in the implementation plan. The group last met on 14 February 2024. We are currently recruiting additional members with lived experience of chronic pain to join the task force. The membership of the task force and minutes from its meetings are available on the Scottish Government website.
Will the minister say when chronic pain patients with lived experience will be notified to become part of the task force? How many patients will be consulted?
I recognise the points that Rona Mackay made. The call for volunteers closed on 16 February. It was shared widely with the stakeholder groups and through social media. We received more than 30 applications and the process is under way to appoint a person with lived experience to the pain management task force by the end of March. The new member will be supported through an on-boarding process to prepare for the next task force meeting in April.
As part of the delivery of the plan, we will continue to engage widely with people with lived experience to understand what questions still need to be answered and the best engagement plan to do that.
Chronic pain management services in NHS Highland are suffering a hiatus after the retirement of a well-respected senior consultant who took a strong interest in the matter. Will the minister meet me and, possibly, other Highland MSPs who share broad concerns on the issue to ensure that NHS Highland takes steps to deal with people who suffer from chronic pain, some of whom have tremendous difficulty—some have even attempted suicide—and find it impossible to conduct any normal sort of life?
I recognise Fergus Ewing’s concerns. Last year, I met people from my constituency who live with chronic pain and I recognise the importance of such people getting the right support at the right time to help them to live with their condition. I would be happy to meet the member and any others who wish to discuss Highland’s situation.
General Practices (Telephone Appointment Queueing System)
To ask the Scottish Government what support it is providing to general practitioner practices to help them transition to a telephone appointment queueing system. (S6O-03100)
GP practices are contracted to provide general medical services by their local health boards rather than the Scottish Government, but practice partners are responsible for designing their own patient appointment and consultation arrangements to meet their service obligations. However, I expect satisfactory systems to be in place for the benefit of all patients. Telephony is a critical component of a general practice’s ability to deliver its contracted service to patients. We are therefore developing advanced telephony guidance, which will be provided to health boards and general practice this year.
I thank the cabinet secretary for that helpful answer. When constituents contact me about general practice, the difficulty in getting through to book an appointment is the most common concern that is raised. Largs Medical Group is keen to move to a much more efficient telecom system, but it has 18 months left on its existing contract. Can the primary care budget—or any other budget—contribute to helping practices to buy out existing contracts, where necessary, to speed up the transition to more efficient, patient-friendly telephone queueing systems?
Currently, there is no primary care budget to help practices to buy out existing telephone contracts, but we will keep that under review. I would be happy to receive more information about the situation that Kenneth Gibson has identified with regard to Largs Medical Group, in order to ensure that that review is informed by the information that he has available to him.
I welcome the cabinet secretary to his new role.
Technology has a key role to play in expanding capacity and reducing costs across the health and social care sector. What work has been done to identify technologies—in particular, those that have been developed by Scottish businesses—that can be rolled out at scale across the service?
I thank Ivan McKee for his question and for his kind words. I agree with him, not least because his view is informed by his and my previous Government experience. We have seen recent success in technology implementation across health and social care, and we must actively prepare for what will come next, including by working with Scottish small and medium-sized enterprises. Our digital health and care strategy commits to ensuring that we have a pipeline of innovation to help to address the challenges that our sector faces.
Scotland’s innovation centres and national health service innovation hubs work alongside Scottish businesses and innovators to support clinical validation and testing environments for new products and services. Our accelerated national innovation adoption approach also supports our NHS, in partnership with industry, to fast track clinically proven innovation on a once-for-Scotland basis. I would be more than happy to discuss that further with Ivan McKee, given his clear interest in the subject.
Health and Social Care Services (Glasgow) (Access)
I welcome the cabinet secretary to his new role.
To ask the Scottish Government what it is doing to support access to health and social care services in Glasgow. (S6O-03101)
The Scottish Government is undertaking a range of work to support access to health and social care services across Scotland, including in Glasgow. We are delivering on our programme for government commitment to increase social care spending by 25 per cent over this session of Parliament, which is two years ahead of our original target. We are also committed to building a national care service to improve the quality and consistency of community health and community care across Scotland.
Despite that investment, many people in Glasgow—disabled people—are being asked to pay more for their social care. In some cases, they are being asked to pay 75 per cent more. I am particularly worried about that because of the impact that it is having on their poverty and their cost of living, but I am more concerned that it is happening without additional financial assessment. My constituents tell me that the increased costs are eating up around three quarters of their benefits during the cost of living crisis.
What action can the cabinet secretary take to ensure that proper financial reassessments take place? Does his Government still believe in the policy of ending care charges? When does he think that those taxes on care will finally be ended?
I recognise the situation that is faced by people across Scotland, especially disabled people, who are disproportionately impacted by the cost of living crisis that is affecting people across the United Kingdom. Across the Government—not just in my portfolio but in the likes of the social security portfolio—we have taken steps to provide as much support as we can, given the limited powers that we have available to us.
On the help that is available through social care services, I would be more than happy to write to Pam Duncan-Glancy to respond directly to the questions that she has raised.
That concludes NHS recovery, health and social care portfolio question time. There will be a short pause before we move on to the next item of business.