Contents
- Portfolio Question Time
- Deposit Return Scheme
- A9 Dualling
- Shark Fins Bill
- Business Motion
- Parliamentary Bureau Motions
- Decision Time
- Special Tribunal on Russian Aggression in Ukraine
Portfolio Question Time
Rural Affairs and Islands
Good afternoon. The first item of business is portfolio question time. The first portfolio is rural affairs and islands. I remind members that questions 3 and 7 are grouped together, so I will take any supplementaries on those questions after both have been answered. If members wish to ask a supplementary on any of the other questions, I invite them to press their request-to-speak button during the relevant question.
I advise members that there is a considerable amount of interest in asking supplementaries; therefore, I make the usual plea for brief questions and answers. If they are not brief, I will be cutting you off, so be warned.
Proposed Agriculture Bill
To ask the Scottish Government when it will publish the final details of its proposed agriculture bill. (S6O-01900)
The Scottish Government is committed to introducing a new agriculture bill to Parliament in 2023. A public consultation on the bill, seeking views on proposals to assist in delivering the vision for agriculture and the legislative framework that is required to replace the current common agricultural policy from 2025-26 onwards, closed on 5 December. We are now carefully considering the diverse range of views that were provided and aim to publish those responses in the spring.
I note that information is both being gathered and emerging in stages, but what is important is that any scheme is sufficiently robust to give confidence to food producers. Will the conditionality measures that are proposed allow for that confidence to be maintained?
I know that our farmers and crofters want more of that detail and clarity. I made an announcement on 10 February about the publication of a route map, as well as the publication of a list of measures and where our thinking is currently at on measures for the new framework. I hope that that gives some of the confidence that the member is asking for, as well as additional clarity.
Although the route map does not yet answer all the questions that I know there are, it provides a clear set of programme dates to explain when current schemes will transition or end and when more information will become available. It also sets out the framework diagrams that were first published as part of the agriculture bill consultation, which outline what future support will look like. In particular, that is the base tier of support, which is aimed at providing financial certainty for farmers and crofters who are engaged in food production and are actively managing land.
As we transition to the future, I reiterate my previous commitments that there will be no cliff edges when it comes to support, and we will continue to develop the details of that future support with our farmers and crofters.
In committee this morning, we heard from stakeholders from the agriculture sector who said that they do not want to go off the cliff edge—they used that term. Farmers want clarity and confidence in order to go forward with the new agricultural payment plan.
Although there is a route map, I believe that farmers want to have a seat at the table—they want to have engagement with the cabinet secretary and the Scottish Government. Will the cabinet secretary commit to doing that to give farmers the confidence to move forward with their plans?
Absolutely; I am more than happy to do that. That is where the process that we are taking forward is really important. I know that people are desperate for more detail and more clarity, but, as I said in my first response, I hope that what we have published gives more of that information.
Fundamental to our whole approach is that co-development and co-design and the discussions with farmers and crofters. When we implement new measures, I absolutely want to ensure that we get them right, that they work and that they can be implemented well. I am more than happy to commit to that engagement.
Although we have the agricultural reform implementation and oversight board, which is key in helping us to design some of that, I know that there are other stakeholder groups that will want to get involved in the conversation. Of course, I am happy to get out and about and engage with farmers and crofters directly.
Connectivity (Islands)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues and councils regarding improving connectivity for Scotland’s islands. (S6O-01901)
As the Cabinet Secretary for Rural Affairs and Islands, I am responsible for ensuring cross-government co-ordination on islands, and I regularly engage with my ministerial and local authority colleagues. A key forum for those discussions is the islands strategic group, which brings together ministers and the leaders and chief executives of the island local authorities.
The cabinet secretary will be well aware of the Orkney Islands ferry task force, and, as the islands minister, I hope that she is involved with that. What can she say to provide reassurance that that will not be yet another talking shop and that it will lead to tangible results—that is, to new ferries?
The member will be aware that the Deputy First Minister is involved in that task force. I do not think that anybody would want that to be a talking shop; we all want it to lead to action. Therefore, I do not think that it is fair to write that off at the moment. The task force met on 31 January. I am, of course, happy to take up the matter with the Deputy First Minister and to provide a further update on that work.
I have a number of requests to ask supplementaries. They will have to be brief, as will the answers.
Yet again, we have ferry chaos in the Western Isles. The relief ferry that is serving South Uist and Barra has technical issues, so it can sail only in daylight. Even with stretching daylight hours, that places a huge restriction on its operation. As I mentioned, we are talking about a relief ferry, but Uist is already facing disruption due to the Uig pier closures. What is the cabinet secretary doing to mitigate the impacts of the ferry chaos on islanders who cannot plan, work and socialise without—
I call the cabinet secretary.
I absolutely recognise how critical those links are. I am sure that the member will already have raised the point with the Minister for Transport, but I am more than happy to do that on her behalf and to come back with a response on her specific queries.
We heard from island councils in a recent Net Zero, Energy and Transport Committee meeting that Transport Scotland engages with councils only on its own pre-determined agenda, which has not included fixed-link or tunnel connections for islands to date. Some of the councils want to seriously engage on the potential of those measures. Will the cabinet secretary discuss with her ministerial colleagues how they might ensure Transport Scotland’s full and proper engagement on initial assessments of what might be possible?
I am more than happy to engage with my ministerial colleagues on that. I believe that Transport Scotland engaged with local authorities on the subject of fixed links as part of the second strategic transport projects review—STPR2—and that all local authorities have responded to the consultation that accompanied that draft publication in January last year. However, I am more than happy to take that up with my colleagues and to follow up on the matter.
Tunnels would greatly improve economic and social connectivity in Shetland and they would not be subject to closure due to adverse weather conditions. When will the Scottish Government sit down with local action groups, councillors and officials to seriously consider feasibility studies for short tunnels in Shetland?
Again, I am more than happy to raise that point with the Minister for Transport to see how any discussion on that could be progressed and I will follow up on the matter with the member.
Deposit Return Scheme (Drink Industry Supply Chain)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the potential impact on the drink industry supply chain of the introduction of the deposit return scheme. (S6O-01902)
I have kept ministerial colleagues updated with developments during the implementation process. Most recently, earlier this month, I sent a letter to all MSPs that provided a comprehensive update ahead of the launch of the United Kingdom’s first deposit return scheme. I will continue to keep Parliament up to date as we head towards the go-live date in August.
I ask Sharon Dowey to adjust her microphone slightly before she comes back in.
I have spoken to rural businesses, which have raised concerns about the 24 substantial steps that are required to register for the deposit return scheme. The first step requires businesses to sign up to a three-year legal commitment, which will significantly change their operations and could even bankrupt them. If businesses fail to sign up by next week, they risk no longer being able to sell in Scotland, which could significantly impact the rural supply chain. Will the minister engage with those businesses to limit the impact on the rural supply chain and ask her Cabinet colleagues to listen to and address those concerns?
I am taking very seriously the concerns that small producers have raised, as the member will note from the significant intervention for all producers, with a focus on small producers’ needs, that was announced on Tuesday—an increase in cash flow and simplification of labelling for small quantities.
Tomorrow, I will meet small producers again to see what else we can put on the table to help them to comply with the legislation. I would encourage all producers to begin their registration process with Circularity Scotland by the deadline of the end of this month.
Deposit Return Scheme (Impact on Small-scale Drinks Producers)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the potential impact of the deposit return scheme on small-scale drinks producers. (S6O-01906)
As I confirmed in my response to Sharon Dowey, I have kept ministerial colleagues updated with developments during the implementation process. The letter that I sent to all MSPs earlier this month details measures that we have put in place to support businesses, including small producers. I will continue to listen to the concerns of small producers and to hear whether there is any further action we can take to support them ahead of the scheme going live.
As part of that listening exercise, the minister could listen to this. Philip Sisson runs Simple Things Fermentations, a small craft brewery in Glasgow. He has written to me today and would like me to say this to the minister:
“DRS will have a catastrophic impact on my business and the craft sector. We survived the pandemic by producing quality products and offering excellent service, but that won’t be enough to get us through the chaotic implementation of a badly flawed DRS”.
He further says:
“small producers are being thrown under the bus”.
Is he wrong?
I met small producers a week ago on Friday, when we discussed their concerns in great detail, including their specific concerns around cash flow for their businesses and the costs around labelling of small quantities. On Tuesday, Circularity Scotland announced an intervention of £22-million worth of support for the cash flow of small businesses and a solution for labelling, specifically to support craft brewers, small wine importers and craft beer producers. That is a significant intervention to support those businesses, and I look forward to meeting them again tomorrow to find out whether there is anything further that we can do to support them to participate in the scheme.
There are a number of supplementaries. I make the same appeal for brief questions and answers.
I must agree with Jamie Greene. I have been written to by Traquair House Brewery in my constituency. Famous for its craft brews, it has been operating since 1965. It has a global reputation and exports around the world. All of its materials are sourced locally, and the malt is even put into a cattle feed. It tells me that, if nothing else is done, the deposit return scheme will have a devastating effect on its business in all respects. I hear what the minister said, but—
Question, please, Ms Grahame.
—will the minister please listen to the small craft breweries?
I take the considerations and concerns of small businesses very seriously. That is why I met them a week ago Friday, and why this week we have put in place a significant intervention. Circularity Scotland has announced £22 million of cash-flow support and a specific response to the concerns around labelling. Those were the issues that were raised with me by small business, and those are the solutions that have been put in place by Circularity Scotland. I will meet those businesses again tomorrow to take forward any further concerns.
The minister will know that a Scotland-wide tender was issued to American hedge fund-owned Biffa to provide collections under the deposit return scheme. What assessment has the minister made of the impact on the small and medium-sized businesses in rural communities that are excluded from that decision, and which in some cases will lose existing contracts for recycling collections?
Circularity Scotland is a private business and therefore its procurement processes are for it to decide. It is not a Government procurement process and Circularity Scotland may conduct procurement as it wishes to do. [Interruption.]
When the deposit return scheme comes online, the amount of glass and other recyclates in the system that is collected and cleaned for recycling will increase enormously. Kerbside recycling and other systems will still deal with non-scheme articles. Pasta jars, shampoo bottles and all such materials will still be part of the standard recycling scheme. [Interruption.] The deposit return scheme specifically increases the volume and the quality of recyclate of scheme materials, which will increase our overall recycling in Scotland.
Mr Lumsden, no more heckling from a sedentary position, please.
Can the minister outline the discussions that the Scottish Government and drinks producers have had? Will those discussions continue, particularly with small businesses, to ensure that the roll-out is a success?
As briefly as possible, minister.
As I have outlined to other colleagues, I am taking a pragmatic approach on the implementation of the DRS. I regularly meet industry stakeholders, including drinks producers, to get direct feedback on the scheme and to identify challenges and solutions. As a result of industry feedback, particularly from small businesses such as craft breweries, Circularity Scotland has announced a £22-million package of support for those producers.
I will continue to engage with businesses. Indeed, tomorrow I will meet small drinks producers again to discuss their readiness for launch.
Outdoor Education Centres
To ask the Scottish Government, in relation to its cross-government co-ordination on islands policies, what discussions the rural affairs secretary has had with ministerial colleagues regarding any impact on rural and island communities of the closure of outdoor education centres. (S6O-01903)
Ministers and officials across portfolios are aware of and consider the important role that outdoor centres have in rural and island communities. Outdoor centres can provide educational experiences, create employment and volunteering opportunities and support connections into the wider rural economy. Such considerations were a key element of decisions to provide £4 million in tailored emergency financial support to outdoor education centres during the Covid-19 pandemic.
It is welcome news that the Arran Outdoor Education Centre has been saved from possible closure by North Ayrshire Council’s Scottish National Party administration. Does the cabinet secretary agree that it is important to provide long-term guarantees regarding the retention of such facilities and that the staff, parents and young people, who strongly value such unique resources, deserve to know that, each year, they will not have to worry about potential closure?
I know that this will have been a concerning time and that, as the member says, those decisions are taken annually. It is not for Scottish ministers to intervene in local authority spending decisions. Councils are autonomous, and it is their responsibility to agree their annual budgets, taking into account their statutory duties as well as other national and local priorities. Of course, they are accountable to the public who elect them, and they have the financial freedom to operate independently while taking account of local need. However, I would encourage North Ayrshire Council to consider staff and service users in the decisions that it makes, as I am sure that it does at the moment.
Inshore Fisheries
To ask the Scottish Government whether it will provide an update on the steps that it is taking to improve the management of inshore fisheries, in light of the reported increasing pressures on fishers and fish stocks in Scotland’s coastal regions. (S6O-01904)
Scotland’s fisheries management strategy sets out the Scottish Government approach to sustainable and responsible sea fisheries management in Scotland. A delivery plan was published in September last year, setting out how and when we will deliver the range of actions in the strategy. There is a clear signal on front-loading actions that will deliver enhanced environmental benefits and significant improvements to our fisheries management approach, including inshore fisheries. The plan contains a mix of actions from the strategy, alongside the commitments in the Bute house agreement. Those will all be delivered in partnership with our stakeholders.
It is heartening to note the commitment to place the fisheries management and conservation group—FMAC—on a more strategic footing. Given the importance of the inshore region for livelihoods and biodiversity, what plans does the Scottish Government have to develop ecosystem-based inshore fisheries management plans, including spatial or temporal management measures, to help to achieve our legal duty of managing our seas to good environmental status? What are the timescales for that work?
The member has rightly outlined our legal obligations as set out in the joint fisheries statement, and the types of approaches that are set out in that. In our response and in that document, we have committed to an overarching strategy across the United Kingdom that we can all sign up to. That provides us with flexibility and recognises the devolved responsibilities in each of the areas.
The fisheries management strategy that I talked about is critical in relation to that, as are a number of pieces of work that we are currently taking forward. The member talked about the refresh of FMAC that has been undertaken. We have also been looking at the role of our regional inshore fisheries groups, as well as doing a number of pieces of work on our future catching policy. We have had a consultation on remote electronic monitoring technology, as well as looking at other measures in relation to inshore fisheries. I hope that that offers some assurance about the work that we are taking forward, which ultimately will meet our objectives.
I will not get in all the members who have requested supplementary questions, but I will get in as many as I can.
Does the cabinet secretary agree with her Green coalition partner Ariane Burgess that fish stocks around Shetland are “in rapid decline” as a result of
“destructive methods of inshore fishing”,
or does the cabinet secretary instead agree with the Shetland Fishermen’s Association’s well-evidenced response that her comments are ignorant of the fact that
“Shetland’s inshore waters still teem with the same fish and shellfish stocks that have helped sustain our community for generations”,
as a result of sustainable fishing practice?
Sustainable fishing practices are exactly what we want to see. A key part of my role is going out and about visiting our islands and speaking to fishers and farmers. I know that people greatly care about the environment in which they operate. In my initial response to Gillian Mackay, I outlined the work that we are taking forward, why it is so important and the objectives that were set out in the joint fisheries statement. We are legally obliged to adhere to those, which is why the measures that we are proposing are so important.
In all the work that we are taking forward, it is critical that we engage with our fishers and other stakeholders. It is in all our best interests to ensure that we have a healthy marine environment with healthy fish stocks so that, in future, we have fishers and a fishing industry to provide that valuable food source for us.
The Government has already committed to introducing legislation to make remote electronic monitoring mandatory on scallop dredge and pelagic vessels. Does the cabinet secretary agree that, during a period in which there are likely to be changes in how we interact with the marine environment, we must ensure that fishers are recognised for the valuable role that they play?
I could not agree more with Alasdair Allan’s point. We recognise the vital role that fishing plays in our economy and how many jobs it supports in our coastal communities. It also contributes to Scotland’s hugely successful food and drink sector. Quality Scottish seafood is prized right around the world, and we will continue to do all that we can to support the industry.
Avian Flu
To ask the Scottish Government whether it will provide an update on avian flu in Scotland. (S6O-01905)
In Scotland, since the start of October last year, there have been 21 confirmed cases of highly pathogenic avian influenza H5N1 in poultry and captive birds and 107 findings in wild birds.
We continue to monitor the number of cases in poultry and wild birds. The latest evidence suggests that we are beginning to see a decrease in the rate of cases across Great Britain. In response to the decrease, we have adjusted the reporting thresholds for surveillance of wild birds to support the on-going monitoring of the level of the disease that is circulating in wild species.
We now know that avian flu can be transferred to seals, after four Scottish seal carcases tested positive for the virus earlier this month. One of those seals was found dead in Aberdeenshire in 2021. Will the cabinet secretary confirm when she first learned about the transfer of avian flu to seals and outline what action she has taken to mitigate the impact of that?
The first point that I want to make is that the risk to human health from the virus is low. Food Standards Scotland advises that avian influenza poses a very low food safety risk to people who consume poultry products, including eggs.
In relation to what the member said about cases in other mammals, in samples that were taken last year as part of routine wildlife surveillance, the presence of avian influenza was detected in four otters and four seals from Scotland, as well as in five red foxes from England and Wales. Those animals were found in areas with a high incidence of H5N1 in wild bird populations, and scavenging on wild birds is thought to have been the source of infection. However, the detection of the virus does not mean that the virus caused the deaths of the animals.
We know that wild birds and animals can carry several diseases that can be transmitted to people, so people should not touch or pick up dead or visibly sick birds. I know that the issue is of concern, but the risk that we are associating with it is still considered to be extremely low, so I offer assurances on that front.
Our chief veterinary officer and our animal health teams are working flat out on the issue. They are continuing their surveillance to see what action, if any, can be taken to try to stop the spread of the virus.
I ask for very brief supplementary questions.
When will the response plan for wild birds be published? Will it contain tangible measures for protecting and conserving wild birds, and on carcase collection, during the HPAI outbreak?
The response plan is still under development, but I am happy to follow up with Ariane Burgess and provide, I hope, a more indicative timescale.
In the light of avian flu being discovered in Stirling last week, will the cabinet secretary briefly outline the biosecurity steps that people can take to reduce the spread of the disease?
I doubt that you will be able to outline them briefly, cabinet secretary, but please do so as briefly as possible.
It is really important to highlight and remember that biosecurity measures are critical and offer the best protection against the spread of the disease. Such measures include cleaning and disinfecting clothes, footwear and equipment; reducing the movement of people and vehicles; and preventing contact with wild birds. Those are just some of the measures that people can take. It is really important that people take biosecurity seriously.
Independent Food and Drink Businesses (Rural Areas)
To ask the Scottish Government what it is doing to support local, independent food and drink businesses in rural areas. (S6O-01907)
We are providing a broad range of measures to support local, independent food and drink businesses in rural areas. That includes £15 million of funding towards the Scotland food and drink recovery plan from 2020 to 2023; £17.5 million over the past two years for businesses across Scotland through the food processing, marketing and co-operation grant scheme; and £500,000 towards the Scottish Grocers Federation’s go local programme, which we know has helped many independent convenience operators in rural areas to transform their stores and to stock more locally sourced produce.
That will all be for nought if the Government does not sort out the deposit return scheme. Ultimately, what small producers and retailers want is the simplification of stock keeping unit—SKU—registration and bar codes, an opt-in possibility and the removal of the arbitrary hard deadline that is coming up.
Has the cabinet secretary had a formal meeting with Lorna Slater to discuss those options? If so, when?
I have of course discussed those matters with my ministerial colleagues, given their impact and the nature of the responsibilities in my portfolio. In the responses that the minister has given to previous questions, she has already outlined some of the really important measures that have been introduced.
The minister has engaged with a wide variety of businesses that the DRS has impacted and is taking their concerns on board; a debate covering the issue is taking place this afternoon.
The minister is listening and taking action.
That concludes portfolio questions on rural affairs and islands.
Health and Social Care
The next item of business is portfolio questions on health and social care. I remind members that questions 1 and 3 are grouped. I will take supplementaries on those questions after both have been answered. Anyone seeking to ask a supplementary question on any other question should press their request-to-speak button during the relevant question.
As there is considerable interest in asking supplementaries, I make the same appeal as I made previously for members to keep their questions brief if they are invited to ask a question and for the ministerial team to keep answers brief as well.
Student Nurses
To ask the Scottish Government what steps it is taking to increase the number of student nurses. (S6O-01908)
The Scottish Government has increased nursing student numbers every year for the past 10 years. However, we know that the undergraduate programme is not the only solution for increasing the number of nurses in our national health service and other sectors, which is why we are working with partners to widen access to those vital nursing programmes.
We now have an education and development framework for NHS bands 2 to 4 healthcare support workers, which will allow them to develop within the scope of their role to support the registered workforce and, importantly, to achieve progression in their job family.
At the same time, we are exploring how to expand options for our healthcare support workers to continue to enter programmes on an earn-as-you-learn basis as well as access programmes for undergraduate nursing degrees.
The Universities and Colleges Admissions Service—UCAS—has reported that applications to study nursing in Scotland were down 24 per cent this year, with just over 5,000 applicants. There are more than 4,500 vacancies in nursing and, importantly, more than 2,500 nurses have left the profession in the 12 months to September 2022.
The Scottish Government’s announcement of a minister-led nursing task force is welcome, but any recommendations from it are a long way off. It is clear that student nursing numbers in Scotland are in crisis. What immediate action is the cabinet secretary taking to reverse that trend?
I thank Sue Webber for her really important question. She is right to say that the level of vacancies is not where we would want it to be—to put it mildly—which is why the nursing and midwifery task force, which came out of a discussion with the Royal College of Nursing, the Royal College of Midwives and other trade union partners, is exceptionally important.
Notwithstanding the point that Sue Webber has correctly made about the numbers being 24 per cent down, I ask Sue Webber to remember that recruitment into nursing programmes will continue until June, so we expect that number to increase as we get towards June.
Given the need for brevity, I will update Ms Webber in writing on how we are doing in relation to international recruitment.
Let me make it clear that there is a real opportunity for the nursing and midwifery task force to widen entry into nursing. The good work that we are doing on pay will help to retain nurses, too, and will make the exit door out of nursing very narrow indeed.
Nursing (Number of Student Applicants)
To ask the Scottish Government what action it is taking to ensure that the number of applicants applying to study nursing in Scotland does not drop further in the future, in light of Universities and Colleges Admissions Service data reportedly showing that the number of applicants has fallen by 24 per cent compared to the same point last year. (S6O-01910)
I will be relatively brief, because I answered some of that question in my previous response. I hope that Colin Beattie will be reassured that higher education institutes continue to recruit to the programmes until June, so we would always expect there to be an increase between the figures that are released in January and the figures that are released in June.
Not all funded places are applied for via UCAS—something that Colin Beattie will undoubtedly know. For example, Open University funded places and applications for those will also contribute to final student numbers.
Lastly, the pay offer that we have put on the table for 2023-24 will ensure that our nurses, as well as other NHS agenda for change staff, remain the best paid in the entire United Kingdom. That is a great draw to get those individuals working in the NHS.
It is important to ensure that we have provision for the future nursing workforce in our health service and that we encourage applicants to study nursing in Scotland. With that in mind, Scotland has seen a 5 per cent increase in acceptance of nursing and midwifery places since 2019. Will the cabinet secretary outline the steps that are being taken to encourage applicants, and will he confirm that we are recruiting at the level that the country needs?
I thank Colin Beattie for that question. I reiterate what I said to Sue Webber: the level of vacancies is not what we want to see, and we want to reduce that level as much as we possibly can. Our nurses make up the largest profession in our NHS, and I am proud that we have increased our funded nursing places for 10 consecutive years, but we are now very actively working on the widening access to nursing programme.
I go back to the point that I made in answer to the previous question, that the nursing task force recommendations might take some time to implement. Actually, we are looking for some really quick wins. I think that we can make some quick wins to widen access to the profession, and I will keep members who are interested updated on the work of the task force.
There are a number of supplementary questions. Those questions and the responses will need to be brief.
The 24 per cent reduction in the number of people applying to study nursing is the biggest drop in applicants for nursing in any part of the UK and the lowest figure at any point in the past five years. With 6,300 nursing vacancies in Scotland, the reductions in the numbers applying will add to the workforce crisis. Others have asked what the cabinet secretary intends to do to boost recruitment. Let me focus on the short term. Will the cabinet secretary bring forward a retention strategy to stop nurses leaving in droves because they feel exhausted and burnt out?
Jackie Baillie makes a reasonable point about the retention side of things. That is precisely why we set up the nursing and midwifery task force. It is there to look at, for example, flexible working. How many nurses have Jackie Baillie and I spoken to who have said that they feel that the NHS is simply not flexible if they want to change their shift patterns? The task force will look at, for example, what more we can do on and around retention. That will be a key focus.
Instead of setting up the strategy, the right way round to do it is to engage with the Royal College of Nursing, trade unions and employers, engage with the staff—hear from them directly their suggestions for what they want to see—and try to get some quick wins. [Interruption.] I do not think that there is much between us. I cannot quite hear Jackie Baillie as she shouts from a sedentary position, but—
Please ignore the sedentary comments.
I am happy to pick that up with her after the meeting.
The Royal College of Nursing exposes the crisis in nursing by underscoring the significant risk to patient care, with nine in 10 nurses—almost 86 per cent—reporting that their last shift was unsafe for them and the care of their patients. We cannot afford the nursing task force being a talking shop. As I am likely addressing our new First Minister, will he please outline—
Ask the question, please.
—how he will improve safety for patients and nurses?
I might not put that endorsement on my leaflet, but I thank the member for the comment. I say to Sandesh Gulhane that what would definitely not help us is the approach that the UK Government has taken, which is to not meaningfully engage with nurses, who then go on strike and feel that they are devalued. We are taking a different approach. We are engaging meaningfully with our nurses, we have avoided dispute, we have avoided strikes, and here we are ensuring that they are—that they remain—the best paid nurses anywhere in the UK.
We will continue to engage with our nurses. The task force will not be a talking shop. I am surprised that the member described the RCN as a talking shop. It will be an integral member of the nursing and midwifery task force, and it has welcomed it—[Interruption.] In fact, the nursing and midwifery task force idea—
Cabinet secretary—
—came from the RCN, and I am delighted to be a part of it.
Cabinet secretary, I asked for brief responses.
Paul McLennan has a brief supplementary question.
Does the cabinet secretary agree that the UK Government should match the £10,000 non-means-tested bursary that students in Scotland get, to attract students from across the UK to the sector? Does he agree that, if the UK Government were to match the pay deal that has been offered to nurses in Scotland, it would need to increase pay by 14 per cent? [Interruption.]
I do not know why the Conservatives are moaning about that. They ask about recruitment and retention, and that is fundamental.
I agree that other Governments should look to what we are doing to ensure that nurses do not start their working lives in debt. With our pay offer, an experienced nurse in Scotland will earn £37,664 compared to £32,934 in England, which is a 14 per cent difference.
We should not only reward nurses as best we possibly can, but ensure that those who are training to be nurses get all the support that we can possibly give them.
National Care Service (Scotland) Bill
I refer members to my entry in the register of members’ interests, as I am a member of the GMB and Unite trade unions.
To ask the Scottish Government what its response is to trade unions and charities forming a “coalition of concern” to request that the National Care Service (Scotland) Bill is paused to allow further co-design and consultation. (S6O-01909)
I declare an interest as a member of Unison.
We remain committed to the bill. People with direct experience of social care and community healthcare have repeatedly told us that the system needs to change. We must end the postcode lottery and drive up standards across Scotland. I welcome the engagement that trade unions and charities have had to date, and I strongly encourage the third sector, councils, the workforce, charities, unions and other people to engage in the co-design process.
The response from civic society in Scotland is catastrophic. It is not engagement that we need, but a minister and a Government that will listen. The list includes the Scottish Trades Union Congress, Unite, GMB, Unison, Who Cares? Scotland, Parkinson’s UK, Common Weal and even the Scottish National Party Trade Union Group. It cannot be ignored. We now have candidates for First Minister saying that the bill should be paused. What work is happening around Government tables to listen, learn from other bills and pause this?
In terms of valuing the workforce, a 40p pay rise is an insult. What will be done to deliver a credible pay rise of at least £15 an hour for our hard-working care workers?
We are committed to delivering the national care service bill by the end of this parliamentary session. I continue to listen—and I wish that folk would listen to others who may not share their views. Earlier, just before coming into the chamber, I met the dementia lived experience panel. Those people want to see the end of the postcode lottery of care. Those folk want to see national high-quality standards, and they want to see the national care service.
The national care service will allow us to ensure that there is sectoral bargaining over pay and conditions, which will be the case for the first time. Of the people who responded to the consultation, 72 per cent wanted a national care service, and we will deliver that.
I will take a brief supplementary question from Audrey Nicoll.
It is important to recognise the urgent need to make improvements to social care now and not to wait for the NCS to start that process. With that in mind, will the minister provide an update on the action that is being taken now to address challenges in social care?
Very briefly, minister.
We are taking action now to address challenges in social care. Our manifesto commitment was to increase social care funding by at least £840 million over the parliamentary session, and we are on course to substantially exceed that. Yesterday’s budget set out £1.1 billion in adult social care support from the health portfolio. The 2023-24 budget has increased social care spending by more than £800 million compared to 2021-22. That is working in the here and now to improve social care in Scotland.
My apologies to those members whose questions I was not able to take.
Patient Support
To ask the Scottish Government what action it is taking to address the “waiting well” agenda, in light of the recent round-table event on supporting patients that was hosted by Scotland Versus Arthritis. (S6O-01911)
The Scottish Government’s preventative and proactive care—PPC—programme is developing a waiting well framework and associated delivery action plan. That will help to improve health and wellbeing outcomes for people waiting for health and social care interventions. A steering group has been set up to steer that work, with the first meeting having taken place on 21 February 2023.
Scotland Versus Arthritis’s six-part support package for people who are waiting for joint replacement surgery suggests that the key elements of support are communication; personalised self-management support; access to physical activity programmes; mental health support; signposting to financial support and advice; and including waiting well support in the national health service recovery plan. Does the Scottish Government agree with that approach? To what extent are NHS boards being assessed on their delivery of support for patients?
The Versus Arthritis support package was tested by the Golden Jubilee national hospital around orthopaedic pathways. Following that, a proposal was submitted to the centre for sustainable delivery and our planned care improvement programme, which is now being considered as part of the waiting well workstream within the preventative and proactive care programme. Versus Arthritis is a member of the waiting well steering group, and the improvement areas that it has highlighted, such as communication, will be taken forward as part of that workstream. That will include monitoring of how waiting well is implemented.
On the Cabinet Secretary for Health and Social Care’s watch, we are facing a waiting times crisis. There are stories of people having to fundraise for private surgery, rather than wait in pain. Where is the Scottish Government’s urgency on treatment options and treatment centres? How will the health secretary ensure that people have access to meaningful waiting plans that are influenced by a waiting well strategy that is supported by the third sector?
Yet again, my Labour colleague has not mentioned or acknowledged the global pandemic that this country and the whole of the western world have come through. According to him, that has had no impact whatsoever.
To increase capacity and improve the situation for people who are waiting for surgery, we are investing in national treatment services, four of which will open very soon.
Accident and Emergency Department Waiting Times (NHS Fife)
To ask the Scottish Government what steps it is taking to eliminate long waits in accident and emergency departments within NHS Fife. (S6O-01912)
The national health service has experienced one of the toughest winters in its history. This winter, pandemic backlogs, Brexit-driven staff shortages and increased levels of respiratory viruses all coalesced to place significant demand on services. Performance against the four-hour target is clearly not where we want it to be or where the public would expect it to be. Nevertheless, performance has recovered since that really challenging period in the winter peak.
We are now working with NHS Fife to reduce A and E waits through our £50 million collaborative programme. We are focusing on three key areas for NHS Fife: the rapid triage unit for general practitioner referrals, which has now opened; increased use of the discharge lounge, to speed up the discharge process, which we know is so vital for the flow through the hospital; and reducing the length of stay and the number of boarders.
I thank the cabinet secretary for that answer, but progress is too slow.
Scottish Conservative colleagues recently met a group of constituents whose loved ones received appalling treatment in Fife. One of those constituents is Trish Nolan. Her husband John, who is suffering from terminal bladder cancer, was left on a trolley in accident and emergency for more than four hours. No nurses or clinicians came to check on him or gave him any pain relief. John came very close to dying of sepsis that day.
Will the cabinet secretary apologise to John Nolan for his A and E treatment? Will he, at the very least, agree to meet families who have lost loved ones due to the failure of Fife health services?
I take the opportunity to apologise to anyone—including the Nolan family—who has received an unacceptable level of treatment. As health secretary, that is not what I want to see. I am pleased that Roz McCall and other members raise such cases in the chamber. As Roz McCall would imagine, I regularly meet families who have not had a good service in the health service, and I never hesitate to apologise if they have not received the service that I would expect, let alone the service that they would expect.
We are seeing some improvements in NHS Fife. I do not know whether Mr Nolan’s experience was during the winter peak, which I mentioned in my initial response, but NHS eight-hour waits are almost 75 per cent lower, and 12-hour waits are almost 100 per cent lower, than they were in the week ending 1 January, which was the epicentre of the winter peak.
I am seeing shoots of improvement, but we still need to make more progress. Of course, I will be happy to continue to meet families who have not had the service that we would expect them to have in the NHS.
I can fit a couple of supplementaries in, but they will need to be very brief, as will the responses.
This week, I met health unions in Fife and they are clear that a key factor in the problems that they have is the rise in the size of waiting lists for social care. Does the cabinet secretary recognise that? Does he recognise that poor pay, terms and conditions are key factors in that, and that therefore, rather than wasting £1.4 billion setting up a centralised bureaucracy, will he put money in now—
Cabinet secretary.
—to pay care workers the rate for the job?
I call the cabinet secretary.
Alex Rowley raises a really important point and I will give him, I hope, some comfort by letting him know that the statistics that came out in December 2022 show that Fife recorded 118 delays. That is still far higher than Alex Rowley and I would like to see, but it is a decrease from the 131 of the previous month, so we are seeing some level of progress.
We will continue to invest in social care, and there have been a number of pay rises for social care staff. In the next financial year—2023-24—we are not spending £1.5 billion on the national care service; it would be incorrect to say that. On the amount of money that we will be spending on the national care service in 2023-24, we may well look to see how we can rebalance some of that into current spend, but it will be nowhere near the magnitude that Alex Rowley said. I will look to work with—
Briefly, Willie Rennie—
—to see what more we can do to support it.
The Royal College of Emergency Medicine Scotland has been quite clear that long waits in A and E can result in deaths and harm, as Roz McCall has just highlighted. Has the cabinet secretary done an assessment of the impact in Fife of those long waits? In the last week of January, 360 people waited for over four hours, and 50 waited for over eight hours. Has he done an assessment—
Cabinet secretary.
I do not disagree with the premise of Willie Rennie’s question. I know that the Royal College of Emergency Medicine has raised the issue. The excessively long waits in our A and E departments mean that patients will come to harm. That is why we are focused on reducing them.
I mentioned not-insignificant reductions in 12-hour and eight-hour waits in Fife. That is where our focus is and our targets are. I agree with Alex Rowley: we must focus relentlessly on social care, to get discharges out of hospital and help the flow through hospital.
We are still seeing the challenges that we know that social care faces. People are still presenting with higher acuity. I will continue to work with the sector to try to find solutions—
Question 6 comes from Neil Bibby.
Prostate Cancer Diagnoses
To ask the Scottish Government what action it is taking in light of January’s Prostate Cancer UK data on regional inequalities in prostate cancer diagnoses. (S6O-01913)
We have noted the Prostate Cancer UK research and we are discussing it with clinical expert groups across NHS Scotland, including the national cancer recovery group. Prostate Cancer UK will host a meeting in the coming weeks with officials and primary and secondary care clinicians in NHS Scotland to further analyse the data and explore how best to support earlier diagnosis efforts for prostate cancer.
We recognise that staging prostate cancer is often complex, but when we compare survival rates, which is of course the most crucial measure for any patient, we see that Scotland’s five-year survival rate for prostate cancer is 84.3 per cent and in fact is not significantly different from the rate in other United Kingdom nations.
Tragically, Scotland has the worst figures for prostate cancer diagnosis in the United Kingdom. More than one in three Scottish men with prostate cancer are diagnosed too late for a cure; that figure is just one in eight in the south-east of England. What is more, the west of Scotland performs particularly poorly in terms of prostate cancer waiting times. NHS Greater Glasgow and Clyde significantly underperforms other health boards on treatment standards.
The Government previously assured us that it was investigating those figures. What has been the outcome of the Government’s investigation? What is the minister doing to end the shocking postcode lottery on prostate cancer diagnosis and—
Minister.
I would urge some caution and, I hope, offer some reassurance to people who might understandably be concerned about the matter. It is worth noting that the report itself highlights the risk of overdiagnosis, which is when there is a diagnosis of a cancer that the person would not otherwise have been aware of and would not have died from. The use of tests such as the prostate-specific antigen test, which is used more in the rest of the United Kingdom, increases the risk of that.
As I said, ultimately, the most crucial measure is that of survival, and the rate for that is similar across the UK. I hope that that offers some reassurance to the public.
Breastfeeding
To ask the Scottish Government what its position is on the recommendations in the 2023 series on breastfeeding by The Lancet, which include calls for Governments to provide more accurate and timely information about breastfeeding and infant behaviours, an end to any exploitative marketing used by the baby formula milk industry, and more recognition of any economic contribution that breastfeeding makes to society. (S6O-01914)
We welcome the 2023 series on breastfeeding in The Lancet, and will consider its recommendations in due course.
The Scottish Government is committed to supporting breastfeeding as the normal nutrition for babies. We have provided more than £7 million of additional funding over the past four years to national health service boards and partners to improve breastfeeding experiences.
Globally, it is recognised that breast milk and breastfeeding provide clear health benefits to both mother and baby over infant milk formula. We believe that every child should get the best nutritional start in life and that families should be able to make fully informed choices on how they feed their baby.
Part of ensuring that breastfeeding rates increase involves normalising it in our public spaces, which is what the breastfeeding friendly Scotland scheme aims to achieve, as well as providing staff and volunteers with key training and knowledge. After I raised awareness of the scheme and signed up my constituency office in Renfrew, take-up of the scheme in Renfrewshire increased massively, from one venue to more than 60.
How is the Government working with health boards to track national take-up of the scheme? How will it work to improve involvement in areas with low take-up? What steps will it take next to ensure that normalising and increasing support for breastfeeding remains as high a priority as possible?
Please answer as briefly as possible, minister.
I thank and commend the member for the work that she has done to promote the breastfeeding friendly Scotland scheme. We continue to encourage our infant feeding advisers to promote that scheme, and more than 2,000 venues have signed up.
We know that protecting, supporting and promoting breastfeeding requires a complex, multilevel approach, and the series in The Lancet sets out recommendations on ways in which focused action can have an impact at population level, including through regulation of the marketing of infant formula.
We will continue to prioritise investment in breastfeeding support and embed the UNICEF UK baby friendly initiative across health board settings.
Healthcare Provision (Barra and Vatersay)
To ask the Scottish Government whether it will provide an update on NHS Western Isles’ recruitment of a new permanent general practitioner and hospital doctor for the islands of Barra and Vatersay. (S6O-01915)
I understand that NHS Western Isles will be going out to recruitment this spring.
As the member will know, NHS Western Isles had to take on the Barra medical practice at short notice and its priority has been a smooth transition and the provision of a level of continuity for patients.
As the cabinet secretary is aware, our health service is under a huge amount of pressure, and the long-term use of locums, as has been the case in Barra for some time, is not ideal. Connected to that matter, can the cabinet secretary confirm when the Scottish Government will take a decision on the healthcare outline business case to allow the proposal for a new home for health and other services in Barra to move to stage 2?
The Barra and Vatersay campus project is important. The outline business case has been reviewed by the national health service capital investment group, which is considering options at the moment. In the interests of brevity, I will write to the member further on the issue. I will look to see what I can do to speed up the process but, as I know that the member understands, appropriate consideration must be given to the matter.