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Chamber and committees

Plenary, 21 Sep 2006

Meeting date: Thursday, September 21, 2006


Contents


Question Time


SCOTTISH EXECUTIVE


Environment and Rural Development


Recycling

To ask the Scottish Executive how much recyclable household waste, sorted for recycling by householders and collected by local authorities, goes to landfill. (S2O-10607)

The Minister for Environment and Rural Development (Ross Finnie):

The Scottish Environment Protection Agency's figures show that less than 10 per cent of the material that is regarded for data purposes as collected for recycling or composting is disposed of. That material is not included in the published recycling and composting rates for municipal waste in Scotland.

Mr McNeil:

That is hardly an enlightening response to someone who is not an expert on the matter. Although I am confident that much progress has been made on recycling, it has been reported to me that plastic containers that my constituents in Inverclyde take the time to wash and sort for recycling still go to landfill. After 18 months and £11 million from the Executive, does the minister think that that is acceptable and does he agree that much more needs to be done?

Ross Finnie:

To help Duncan McNeil with my first answer, I say that in 2004-05 a total of 538,900 tonnes of recyclable material was collected, of which about 51,000 tonnes—the 10 per cent that I mentioned—had to go to landfill. Because we knew that the member had asked the question, my officials inquired of Inverclyde Council whether it has a particular problem with materials being sorted and collected and then going to landfill; the council assured my officials that it does not. However, now that the member has alerted me to the situation with plastics, I will investigate the matter further.

Shiona Baird (North East Scotland) (Green):

Is the minister aware that in other parts of the developed world landfilling has been reduced by 70 per cent via intense efforts to increase recycling and composting and without the use of incineration? Will the minister assure us that every effort will be made to develop a genuinely sustainable waste policy that does not rely on unsustainable, wasteful and polluting incinerators?

Ross Finnie:

As the member knows, the waste strategy, which has enabled us to go from a pathetic recycling figure of 6 per cent only a few years ago to nearly 25 per cent now—we will reach 25 per cent this year—makes it clear that the first and prime target is to recover all material that can be recycled. The member mentioned the developed world. She will be acutely aware that almost all the major players in Europe, which have much better levels of recycling than we have, use combined heat and power systems and some form of incineration to deal with the residual element. I am very much against any suggestion that we should give an easy remit to local authorities or industry and not an absolute requirement to recover every fragment of recyclable material before other options are considered. However, I cannot rule out options for dealing with the residual element, particularly given that the technology may improve and that we must reduce landfill to the minimum.


Scottish Rural Development Plan (Modulation)

To ask the Scottish Executive whether Scotland is able to set its own modulation rate to fund the Scottish rural development plan. (S2O-10576)

The draft voluntary modulation regulation currently allows for only one rate of voluntary modulation per member state. The Executive is pursuing that point with the European Commission and member states as the negotiations progress.

Richard Lochhead:

I welcome the fact that the minister is pursuing the issue. Will he acknowledge the widespread feeling in the farming sector that the modulation rate that is set should be the one that is best for Scotland, given that the recent reform of the common agricultural policy was intended to give more flexibility to our ministers to ensure that such deals are the best for Scotland? Is it the aim of the minister's end game to ensure that he has the right to set a modulation rate that is the best for Scotland?

Ross Finnie:

The moment that the European Commissioner for Agriculture and Rural Development, Mariann Fischer Boel, and her officials tabled a revised proposal for modulation we—and, indeed the United Kingdom—made it clear that the present arrangement, which gives us the right at a sub-member-state level to set a modulation rate, is the one that we wish to pursue. This is a complicated matter because the commissioner is also looking at other member states and is apparently concerned that the existence of wide variations and the use of voluntary modulation could constitute a renationalisation of the CAP. We do not share that view and have made it clear to the Commission that we wish to have the status quo, which gives us the absolute power to set an individual rate, as we see fit, here in Scotland.

Alex Johnstone (North East Scotland) (Con):

Can the minister confirm that if he uses the power to raise the level of modulation, should it be granted, it will not be used as an opportunity to remove money from the current budgets and put it into areas that would divert it away from the current recipients? In other words, will he ensure that the same people get the opportunity to earn the same money for doing different things?

Ross Finnie:

We are quite constrained in what we can do in terms of modulation. If we accept the analysis that a substantial proportion of Scottish agriculture is still incapable of surviving without subsidy, it does not make sense to simply and in an unfettered way transfer funds from pillar 1 to pillar 2, because that would simply remove what is, to many people in Scottish agriculture, an essential support. However, people must prepare for the fact that it might not be in existence by 2013.

I do not think that the money can be given to every area on an annual basis. We have a rural development policy that seeks to improve and enhance rural Scotland over a five or 10-year period and I think that that means that individual farmers have to look to the longer term. If all I do is take X per cent from someone and give it straight back to them, I doubt that that will make a substantial material difference to the fabric of rural Scotland.


Nuclear Safety (Marine Environment)

3. Ms Sandra White (Glasgow) (SNP):

To ask the Scottish Executive whether its Environment and Rural Affairs Department was advised at the time about any risk of impact on the marine environment from serious and significant "nuclear safety events" at Faslane and Coulport, which are reported to have significantly increased in number, and, if so, what information it received. (S2O-10550)

The Environment and Rural Affairs Department has received no such information.

Ms White:

I am not just surprised but disgusted by that answer. The minister is telling me that he is not aware of 45 serious incidents in 2004-05, which is double the number of serious incidents in previous years, or of the fact that 13 of those 45 incidents were directly related to Trident nuclear submarines. Will he ensure that he is advised of such events in future? Further, does he support a referendum on Trident nuclear missiles?

You are entitled to answer the first of those questions, minister.

Ross Finnie:

I think that I am obliged to do so.

There are clear arrangements in place between the Ministry of Defence and the Scottish Executive whereby, if there is a serious event that would affect public safety, public health or the environment, it would be reported to us. I am not suggesting for a minute that there have been no incidents; I am saying in a straightforward way that, in accordance with the arrangements in place, which are to do with whether any such events could have a material impact on public health, public safety or the environment, we have been advised of no such incident.


Environmental Footprint (Local Authorities)

To ask the Scottish Executive how it is assisting local authorities to reduce their environmental footprint. (S2O-10571)

The Minister for Environment and Rural Development (Ross Finnie):

The Scottish Executive is helping local authorities to reduce their environmental footprint though a range of initiatives, including the Scotland's global footprint project, the sustainable Scotland network, updated guidance and toolkits on the sustainable development element of the duty of best value, waste audits and support for energy efficiency and renewables.

What action is the Scottish Executive taking to reduce its own footprint, especially by means of reducing its use of flights within the United Kingdom?

Ross Finnie:

In the regular business of my department, it is imperative that ministers and officials regularly meet ministers from the Department for Environment, Food and Rural Affairs, particularly in relation to the European aspects of agriculture, fisheries and the environment. Those meetings, almost without exception, are now conducted by confravision rather than by either party taking a flight north or south. In a variety of ways, including the use of modern technology, the Executive is trying hard to reduce its footprint.

We also have an experiment going on. At Victoria Quay, we have a monitor that shows ministers and, more particularly, members of staff the CO2 emissions that are being produced. That information is monitored and staff can contribute to reductions. If the experiment proves successful, it will be rolled out to other public bodies.

Stewart Stevenson (Banff and Buchan) (SNP):

The minister is probably aware of the many local authority-supported community transport initiatives that exist throughout Scotland and, in particular, the A to B initiative in Aberdeenshire. However, he will note that those are not covered by the pensioners' travel card. Will he speak to his colleagues in the Enterprise, Transport and Lifelong Learning Department to ensure that local authorities have the opportunity to make a bigger contribution to reducing their environmental footprint by bringing such initiatives within the concessionary travel scheme?

I think that that question is just about allowable, minister.

Ross Finnie:

I am grateful to you again, Presiding Officer.

As the member says, there is a wide variety of different projects. I am happy to look into their accessibility. In fact, some of the projects are specifically designed for elderly persons. The one that the member mentions might not be covered, but I am certainly happy to look into the matter.


Organic Agriculture

To ask the Scottish Executive what measures it is taking to support organic agriculture and to meet demand for organic food. (S2O-10617)

The Deputy Minister for Environment and Rural Development (Rhona Brankin):

We are implementing the organic action plan, which includes a range of actions and support measures that are aimed at the sustainable development of the Scottish organic sector. For example, we have significantly increased and extended the grant support that is available to farmers who wish to convert to organic farming. We have also prioritised organics under our processing and marketing grant schemes and increased the provision of advice, including market advice, to organic producers and processors. We work closely with organic stakeholders to ensure that our support is effectively targeted.

Mark Ballard:

The minister will be aware that many farmers are frustrated by the outcome of their applications to the organic aid scheme and wider programmes such as the rural stewardship scheme. Is she seeking to increase the resources that are available for organic farming and other rural stewardship schemes? Is there any prospect of increased funding for those schemes in the short or long term?

Rhona Brankin:

Organic farmers have been prioritised during the past seven years and they have enjoyed a high success rate with applications to the organic aid scheme. Although the success rate is lower this year, the amount of funding that has been allocated—£11.3 million—is considerable. It is twice the amount that was committed last year and it is considerably more than was allocated in any previous year.

I continue to work closely with the organic stakeholders group to ensure that we are targeting the resource effectively and that we have a strong organic sector in the future.

Alasdair Morgan (South of Scotland) (SNP):

In planning ahead, is the minister happy that there is sufficient capacity in the organic dairy industry? I heard a rumour that a major supermarket chain might be about to change all its dairy lines to organic, which would use up the entire Scottish organic milk supply.

Rhona Brankin:

Clearly, we need to keep these things under review. The ranking questions about organic support will be kept under review because we need to be able to consider the implications of moves towards or away from dairy production. I need to be able to ensure, with the organic stakeholders group, that we get the support to the right producers.


Pollution (Mobile Crushing Plants)

To ask the Scottish Executive what controls are available to prevent pollution from the activity of mobile crushing plants used to crush demolition arisings for the purposes of recycling. (S2O-10583)

A mobile plushing cra—I am sorry.

The minister should put her teeth in.

Rhona Brankin:

I assure the member that my teeth are in.

A mobile crushing plant used to crush demolition arisings for the purposes of recycling would require a part B mobile plant licence under the Pollution Prevention and Control (Scotland) Regulations 2000 (SSI 2000/323), which would include conditions on controlling any emissions to the environment.

Fiona Hyslop:

It is rather difficult to say.

I am sure that the minister agrees that no contaminated waste should be recycled as part of the arisings. However, how can she be sure that the materials are separated properly in the first place and that no contamination is spread by the operation of mobile crushing plants that are not licensed in Scotland but are imported from elsewhere?

Rhona Brankin:

I would be concerned to hear that and interested to have information about any specific instances of what the member is referring to. I am not able to comment in full because I am not aware of those instances.

The Scottish Environment Protection Agency should be contacted if there is a problem with the operation of a mobile plant. If planning conditions appear to have been breached or there is statutory nuisance, the local authority should also be informed. The risk to human health, plants and animals from dust, for example, is the reason for the conditions that are placed on operators under the PPC regulations. If the member writes to me with specifics, I will be happy to respond.


Dairy Industry (Dumfries and Galloway)

To ask the Scottish Executive whether it has any concerns about the effect of milk prices on the dairy industry in Dumfries and Galloway. (S2O-10613)

The Minister for Environment and Rural Development (Ross Finnie):

I share the concerns of those who are worried about the level of returns being made by many milk producers, whether they are in Dumfries and Galloway or elsewhere in Scotland. The milk price is determined by a number of factors including the proportion that is sold as fresh milk and the proportion that is sold for processing into added-value products. In both cases, purchasers of raw milk have to acknowledge that long-term continuity of supply will be guaranteed only if producers receive a reasonable return.

Dr Murray:

The minister will be aware that milk production throughout the United Kingdom is at a 13-year low and that prices for milk products have risen substantially, but those price increases have not been reflected in the prices that are being paid to producers. The minister has indicated his concern that processors such as Arla Foods Ltd in my constituency, which has invested significantly in a new processing plant, might risk losing their production base if they do not pay more for the raw materials that they receive from farmers. The minister is clearly concerned about this matter. How might the Scottish Executive input into any discussions with the processors to resolve the issue?

Ross Finnie:

We have debated this hugely complex issue at considerable length in the chamber. The member said that milk production is at an all-time low but the fact is that, during the past 20 to 30 years, milk production in Scotland has reduced by only a small margin. The total amount produced has not decreased by very much; indeed, the fact that there are fewer farmers and dairy cows is more to do with the efficiency of the Scottish milk fields and the use of better genetic and other techniques.

We have also had extensive discussions about the relationships between the farmer and the processor and between the processor and the ultimate purchaser, which is the supermarket in most cases. However, we must bear in mind a point to which I referred in my first answer. In Scotland, a huge percentage of milk is sold simply as raw milk whereas, on the continent, a far greater proportion is sold for processing into higher-added-value products. Many of the discussions that I have had with the industry have been about how to achieve greater vertical integration, which would give our milk producers the opportunity to supply milk for those higher-added-value products.

Alex Fergusson (Galloway and Upper Nithsdale) (Con):

I entirely agree with the final part of the minister's answer. However, to illustrate Elaine Murray's point I am holding up a 250ml carton of milk that I just purchased in the Parliament's canteen for 20p—some might say that is a major investment for me. That 20p for a quarter of a litre is probably 2p more than any dairy farmer is paid for producing a full litre. The enormous disparity between the farm-gate price and the shelf price is the essence of the problem. What representations has the Executive made to the various inquiries that have taken place and are taking place on the issue? What measures has the Executive taken to bring about a more equitable distribution of the funding that is available through the chain at present?

Ross Finnie:

We are all impressed that Alex Fergusson made such a major investment so that he could make his point so tellingly. No doubt his colleagues will have a small whip-round to help him out on that.

Speaking seriously, however, I am concerned about the role of the processors. In my submission to the Competition Commission, I said that the commission's inquiry needs to look not only at the supermarkets but at what is happening back down the chain. There are clear instances of prices in Scotland being set in a way that suggests a rather curious similarity between each round of negotiations involving each of our supermarkets and processors. Although 1p or 2p may keep disappearing from the chain, the negotiations are between the processor and the supermarket and the farmer is never engaged in that process. In highlighting that issue at some length to the commission, I have asked the commission to look right across the chain rather than just at the specifics so that we can, if possible, get some transparency about precisely what is happening in those negotiations. We need to know why such a cosy relationship seems to exist at the top end of the chain and why all price movements ultimately get passed down to the farmer. That is the key point that I made in my submission.


Health and Community Care


Mesothelioma

To ask the Scottish Executive when the number of cases of mesothelioma is expected to peak in Scotland and how many people are expected to be diagnosed in each of the peak years. (S2O-10560)

The Deputy Minister for Health and Community Care (Lewis Macdonald):

The average annual number of new cases diagnosed in Scotland between 1991 and 2003 was 183. Estimates derived from projections of mortality for Great Britain as a whole suggest that the number of new cases of mesothelioma in Scotland may peak at around 195 to 245 per year some time between 2011 and 2015.

Mr Maxwell:

As the minister will be aware, the Scottish medicines consortium has approved the use of Alimta, whereas the National Institute for Health and Clinical Excellence has rejected its use south of the border. Professor Nick Thatcher, who is professor of medical oncology at the University of Manchester and consultant oncologist in medical oncology at the Christie hospital in Manchester, has stated:

"Alimta and cisplatin is the only licensed treatment for mesothelioma patients and has been shown not only to increase quality of life but also to extend life".

Does the minister agree with Professor Thatcher's view that Alimta has been shown to increase quality of life and extend life? Does he accept that, even in the peak years, the cost of prescribing Alimta in Scotland is estimated to be in the high hundreds of thousands or low millions of pounds, out of a health budget of many billions of pounds? Therefore, given that people in Scotland suffer disproportionately from mesothelioma, does he agree that Alimta should continue to be prescribed in Scotland, in line with the SMC decision and irrespective of any decision taken by NICE?

Lewis Macdonald:

Clearly, all such decisions must be informed by the scientific evidence and by the scientific expertise of those involved. Although NICE has made a determination, I understand that it has not yet considered appeals against that determination. I do not expect to receive advice about what should happen in Scotland until that process is completed. We will, of course, take due cognisance of that advice when it comes.

Des McNulty (Clydebank and Milngavie) (Lab):

The minister will be aware that I wrote to the Minister for Health and Community Care on the Alimta issue some months ago, but I want to ask about a related issue. Is the minister aware of the good work that is being done by Clydebank Asbestos Group and Clydeside Action on Asbestos to support people with mesothelioma by helping them to access benefits and support? Is he aware that that work is being considered by Macmillan Cancer Support, which has developed a pilot for cancer sufferers more generally? Will the minister agree to meet Clydebank Asbestos Group, Macmillan Cancer Support and myself to discuss how some of the beneficial work that is being done has broader applicability?

The work that has been done is indeed widely recognised. I am aware of Des McNulty's on-going interest in the issue and I will be happy to meet him to discuss those matters in the way that he suggests.


Chemotherapy Patients (Wigs)

To ask the Scottish Executive whether it will instigate a review of policy in respect of the provision of wigs to patients undergoing chemotherapy. (S2O-10627)

The Deputy Minister for Health and Community Care (Lewis Macdonald):

We are currently reviewing policy on the provision of wigs. From 1 April, we reduced the cost of the basic modacrylic wig to £6.65 to bring it into line with prescription charges for other items. A short-life working group has been established to consider the matter, including questions related to patients who are undergoing chemotherapy.

Margo MacDonald:

I declare an interest as the patron of the Scottish Breast Cancer Campaign.

I congratulate the Executive and the health boards on making the supply of wigs to chemotherapy patients much more satisfactory. Will the minister include in his review an examination of the Edinburgh-based organisation Wig Bank and the service that it operates? The non-profit-making service is run by a chemotherapy patient, who also offers advice and support of a unique nature to people who wish to use the service. Although, as I have conceded, the provision of wigs is now much more satisfactory, they have to be dressed, and they sometimes have to be changed in some way—

The member is arguing her point rather than asking a question.

Could we have something running in tandem with that service to make it better?

Lewis Macdonald:

I would be happy to examine Wig Bank, to which Margo MacDonald refers. Clearly, we want there to be a range of provision. I am pleased with her comments about the improvements in the basic provision, which are important. I am happy to ask my officials in the short-life working group to consider the work in Edinburgh to which she refers.


Dental Services (Western Isles)

Alasdair Morgan will ask question 3.

Members:

Morrison

The Deputy Presiding Officer:

I beg your pardon. It is Alasdair Morrison. I was distracted by Mr Morrison's search for a console to enable the sound engineer to give him sound.

I point out that it is poor practice not to be present in the chamber in time to ask your question. Mr Morrison, are you ready now?

I am indeed. I apologise to the chamber for my delay.

To ask the Scottish Executive whether it can give an update on dental services provision in the Western Isles. (S2O-10610)

The Deputy Minister for Health and Community Care (Lewis Macdonald):

Yes. NHS Western Isles purchased the Bayhead dental practice in Stornoway last year and has since extended the premises by adding a further surgery. New patients are now being registered, opening hours have been extended and a mobile dental unit is now in place.

In addition, the board's salaried service has recruited two additional dentists and seven new dental nurses have been appointed as part of the board's plans to improve oral health in the Western Isles.

Mr Morrison:

I am delighted with that response, so I am almost inclined not to ask a supplementary. Given the success of what has been achieved in the Western Isles, does the minister recognise that the same set of principles, procedures and practices can be translated to other parts of the country?

Lewis Macdonald:

Yes. We are clear that the way in which dental services are provided will vary from community to community. In the Western Isles and Shetland, dental services are provided principally in premises that are owned by national health service boards and are delivered by dentists who are employed by NHS boards. That is clearly part of the right way to deliver dental services in the islands and elsewhere in Scotland. At the same time, we continue to encourage dentists who own their own premises to continue to provide NHS services. For that reason, we have put in place a significant range of extra incentives and rewards for dentists who continue to treat all categories of NHS patient.

Although the minister's news is welcome, can he comment on the overall shortage of dentists and orthodontists throughout the Highlands and Islands and outline the action that he proposes to take to alleviate the critical situation?

Lewis Macdonald:

I am glad to take the opportunity to do that and to report on a number of initiatives. We recently introduced the bursary scheme for dental students, which we announced in the dental action plan in spring 2005. I am delighted to say that the scheme is now in place for students who are starting their studies in the current academic year. It will provide significant additional financial support to dental students in exchange for a commitment to continue to work in the NHS in Scotland for a period of years after their graduation. We believe that the scheme, in addition to the existing support for rural practices through golden hellos and other incentives, will make a significant difference to the supply of dentists in the Highlands in years to come.


Junior Doctors (Training)

To ask the Scottish Executive whether there will be a reduction in training posts for junior doctors under the modernising medical careers initiative. (S2O-10557)

No, there will be no change to, and therefore no reduction in, the number of training posts in August 2007, when the final phase of modernising medical careers is implemented.

Shona Robison:

Does the minister appreciate that there is widespread concern among junior doctors about the new training proposals in the modernising medical careers initiative, correspondence on which is filling all our mailbags? To alleviate some of those concerns, will the minister give a clear commitment to an expansion of consultant numbers, not only to ensure that the current pool of senior house officers has a realistic chance of progressing to consultant grade, but to seize the opportunity to absorb the pool of senior house officers over the next three to five years to help sustain health services throughout Scotland?

Mr Kerr:

The member finished in the right place, because we should design our health care services for the needs of patients, not for the needs of any individual organisation or those who work in the national health service.

I have given reassurance that we will continue to increase—as we have done throughout devolution and this partnership Government—the number of health care professionals in our health service. The job of the national health service is to provide services to communities and patients. The workforce planning that we carry out is precise in its approach. I reassure the member that we will continue to increase the numbers of all health care professionals in the health service. For example, we have increased the number of consultants who work in the service.

MMC will produce better-trained practitioners in our health service. The British Medical Association Scottish junior doctors committee was represented on the MMC delivery group and it is represented on the specialty transitional boards. It is involved in every part of that work and that will continue to be the case. The member can rest assured that, although the final figures are yet to be announced, there will be sufficient training opportunities in the future for those who are coming through the service.

Eleanor Scott (Highlands and Islands) (Green):

The minister is right to say that the health service exists to provide a service for patients, but surely it also has a duty to adhere to good employment practices? There are real concerns among junior doctors about how the modernising medical careers initiative will roll out. There is a singular lack of information. Scotland is one area under MMC, so there is a fear that junior doctors could be sent anywhere in Scotland for their next post, irrespective of where they choose to work. How will the minister reassure those doctors and deal with their real fears, which have resulted in an online petition—it had 600 supporters when I last looked—asking for the roll-out of the modernising medical careers initiative to be postponed?

I think that the minister has got the sense of the question.

Mr Kerr:

First, would "anywhere in Scotland" include places such as the Highlands, where we want our professionals to develop their careers and be exposed to the services that are being provided in remote and rural parts of Scotland? Our desire in that regard fits exactly with our healthy living strategy.

I find it odd that, according to the argument in the member's question, somehow our job is to provide specialty training for anybody who wants it in a particular area, which should be in line not with the needs of patients but with people's career choices. I also find odd the suggestion that we should allow people to work wherever they want. The health service is a national service and our job is to ensure that opportunities are available nationally.

I remind members that the same arrangements will exist under MMC. There has always been competition for consultant posts and there have always been choices for those coming through the training system about where they will work in the future. That will continue under MMC. However, we will have better-rounded and better-trained professionals in the service.

I reiterate that the point is to align the needs of the national health service with the needs of those who are being trained. We want to ensure that that alignment is in the best interests of patients, and I am certain that that will be the case. I repeat that the BMA junior doctors committee has been integrally involved in our planning process.

In a recent letter, the BMA in Scotland said that it appreciated that MMC is a significant change. The BMA has been working with us up until recently, when it began to express concerns about the process. Members can rest assured that the chief medical officer for Scotland will deal with those concerns. I am sure that the outcome will be well-trained, confident individuals working here in Scotland.

We must recognise that, as the BMA has said, we have got our act together in Scotland and MMC is working much more effectively here. Because we are carrying out the process much more effectively, there is a danger that we may see doctors from other parts of the United Kingdom coming to work in Scotland. I do not want that to happen. I want a UK-wide arrangement because we work in a UK market. However, we need to ensure that the service is aligned so that patient needs and training come together in the proper manner. That is what we will do.


General Practitioner Services

To ask the Scottish Executive what its plans are for the development of GP services. (S2O-10575)

The Minister for Health and Community Care (Mr Andy Kerr):

We are committed to the development of GP services to reflect the priorities of the delivering for health programme. We see GPs as significant players in shifting the balance of care by working in partnership with other primary care providers such as community pharmacies, dental practices, optometrists and NHS 24.

Mr Swinney:

Given the spirit of the minister's answer to my colleague Shona Robison that the health service should be configured to meet patients' needs, does he have any concerns that the worthwhile, laudable and supportable objectives that he wants GPs to deliver will be hindered because there might not be enough of them in the future? Is the minister concerned that the number of training places for GPs in Scotland has remained static at 280 and that, with the advancing age of our GPs, 30 per cent of whom are over 50, not enough GPs are being trained to deliver the services that the minister wants to deliver?

Mr Kerr:

We need to get the context straight for the public and the Parliament. Resources devoted to GP services in Scotland have increased by 48 per cent and a further £12.6 million is going into the system. We have more GPs now than we have ever had.

I remind members in the chamber and those people listening outside that the new relationship with our GPs is based on the quality and outcomes framework—the deal negotiated between the Executive and GPs. It is not about head counting the people in their practices; it is about the positive benefit that they bring to their patients. That is how we reward our GPs these days.

We want to plan carefully with GPs and others the shape of the future health service. There is a responsibility on every health board in Scotland to ensure that everyone has access to a GP. I am absolutely confident that that will happen because of the investment that we have made and the increased numbers of GPs and those in training. I disagree with the numbers offered by John Swinney.

Let us put GPs in context. Although they are key providers in local communities, the health service is not just about GPs; it is also about community pharmacists, optometrists, dental services and all the other allied health professionals who play key roles in our community health services.

Question 6 is withdrawn; the member is unwell.


Care Home Provision (Highlands)

To ask the Scottish Executive whether there has been any progress in improving care home provision in the Highlands. (S2O-10565)

The Deputy Minister for Health and Community Care (Lewis Macdonald):

I understand that Highland Council has recently approved the commencement of a care home procurement exercise to secure 168 comprehensive and flexible care home places for frail older people. The council is currently refurbishing a number of its care homes in rural locations to ensure compliance with statutory requirements.

John Farquhar Munro:

The minister will be aware that because of recent decisions by Highland Council, many people in rural communities are concerned that it will not be possible for them to be cared for near their homes and families. Does the minister agree that, wherever possible, care for the elderly must be delivered and provided as locally as possible?

Lewis Macdonald:

The principle of access to care is important, but the way it is delivered is a matter for local authorities rather than the Executive. However, because we are responsible for the health service, we are cognisant of the problems for those people who are leaving hospital in the Highlands and looking for a place in a care home. We will work with Highland Council to address the issues when it brings them to our attention in detail, which I understand it intends to do in the near future.


“Review of the Scottish Diet Action Plan”

To ask the Scottish Executive when it will publish a response to NHS Health Scotland's "Review of the Scottish Diet Action Plan". (S2O-10623)

The review considers complex and important issues concerning food and health in Scotland. I am considering it carefully and will respond in due course.

Robin Harper:

Does the minister acknowledge that the review of the Executive's diet action plan shows that, overwhelmingly, targets are not being achieved? For example, Scots are getting only half the fruit and vegetables that they need for good health. The review concludes that Executive resources and initiatives are spread too thinly. What does the Executive intend to do about that?

Mr Kerr:

Dietary targets were set in 1996. Since then, our partnership Government has done a great deal to improve the diet of our communities. Cultural change takes time. However, we are working in schools with the hungry for success campaign, in nurseries on diet and curriculum, and in workplaces with Scotland's health at work. There is also the legislation that Peter Peacock is introducing.

The member is right to say that the targets that were set in 1996 have not been met. However, since devolution, the partnership Government has begun to tackle some of the biggest challenges. It is not just about Government and policy; it is about partnership working and individuals making choices for themselves.