Plenary, 23 Sep 2004

Meeting date: Thursday, September 23, 2004

Official Report 759KB pdf

---

First Minister's Question Time

---

Cabinet (Meetings)

I know that this is becoming a bit of a tradition, but I start by congratulating Colin Montgomerie on sinking the winning putt in the Ryder cup. I am sure that all members in the chamber will agree that it was a stunning performance.

To ask the First Minister what issues will be discussed at the next meeting of the Scottish Executive's Cabinet. (S2F-1072)

One thing that we will discuss is how to recognise the efforts not just of Colin Montgomerie, but of those paralympians who have made fantastic efforts simply in competing—although those who have won medals deserve particular congratulations—in the current paralympics. They do themselves, their families and their countries proud.

At next Wednesday's meeting of the Cabinet, we will discuss how we can best take forward any potential bid that Scotland might make for the Commonwealth games in 2014. This evening, the Commonwealth Games Council for Scotland will meet to choose between Glasgow and Edinburgh for the preferred bid from Scotland. A period of about six to nine months will then be needed to assess that bid. If the preferred city is chosen, we will be centrally involved in that. We have a strong vision that Scotland should host the Commonwealth games at some stage in the near future. However, if we are to do that, unlike in 1986 we will do it properly, we will do it well and we will make Scotland proud.

I share the First Minister's ambition in that regard. I also agree that watching the paralympics is an absolute inspiration.

The First Minister made the following simple commitment in the Scottish Executive's partnership agreement. The first line of its first paragraph states:

"Growing the economy is our top priority."

In light of that statement, does the First Minister share my concern that businesses in Scotland pay a higher level of business rates than businesses south of the border do? Does he have any plans to cut business rates to help the Scottish economy to flourish and grow?

Businesses in Scotland do not pay a higher rate of business rates than businesses south of the border pay. The calculation based on the rate poundage in Scotland produces an equivalent take. In fact, given that on two occasions in the past three years the Executive's decisions have reduced the proportion of business rates, I think that we have put the majority of Scotland's businesses at a competitive advantage in comparison with their colleagues south of the border.

We will announce the direction for our decisions on business rates for next year, the year after and the year after that in the spending review statement next week. The detail of those decisions will be announced in the normal course of events in November and December later this year.

Scottish business pays more. That is a statement of fact. I find the First Minister's answer very interesting. The end of his answer was illuminating because it is not quite what his own office says about that policy. Perhaps I will return to that later.

In the meantime, I remind Mr McConnell of the commitment that he gave last year to be open and transparent and to accept new ideas wherever they came from. Let me ask him about another policy idea. I want to see a non-means-tested citizens pension to tackle the scandal of pensioner poverty in Scotland. Will the First Minister speak up for Scotland's pensioners by asking the United Kingdom Government to examine that proposal?

The issue is vaguely reserved, but Mr McConnell may proceed.

Sorry, Presiding Officer, what did you say?

We may be straying into reserved matters.

In answer, I point out that Mr MacAskill, who is not here but who sits on Ms Sturgeon's front bench—or, more accurately, on Mr Salmond's front bench—is reported in today's newspapers as supporting not just means-tested pensions but means-tested access to the health service and to a number of other benefits and services, too. Given that Ms Sturgeon and I have agreed that we are in the process of raising our game and, I hope, of developing a national consensus in Scotland on such issues, I suggest that Ms Sturgeon should start by developing that consensus on her own front bench. Mr MacAskill—he is not here today, but he normally sits on her right-hand side—supports means testing not just for pensions but for the health service and for benefits. Will Miss Sturgeon back her shadow justice minister? Or is there a lack of consensus on the Scottish National Party front bench?

It is little wonder that people in Scotland are fed up with politics when politicians like the First Minister cannot give straight answers to questions. I have in my hands an analysis of my SNP leadership election manifesto, which the First Minister's office has produced. The analysis suggests pre-empting the SNP's plans to cut business tax, and the First Minister's office is so enamoured of our plan for the citizen's pension that it suggests that the Secretary of State for Scotland's right-hand man, Iain Gray, might want to cost it. In addition, the analysis suggests that a range of other SNP policy ideas might be worth considering.

Let me ask the First Minister this: is he willing to make good his pledge to be open and transparent, and to accept good ideas wherever they come from? Clearly, his office thinks that the SNP ideas are good ideas. Or is the First Minister intent, as he has been today, on putting petty, party-political point scoring over the national interest?

I am afraid that one of the aspects of leadership that Nicola Sturgeon will have to learn is consistency, which is absolutely vital across the SNP front bench as well as in what is said from week to week. We need to have consistency. We need to know what the SNP's policy is.

I absolutely support a non-means-tested basic pension for people in this country. I also support, as the SNP does not, targeted support for the poorest pensioners who need it. I will absolutely support the continuation of the targeted additional allowances and benefits that pensioners in Scotland now have, which have seen at least a third of pensioners being taken out of poverty in the past seven years and which will see many more taken out of poverty in the years to come.

I will continue to support the good work that has been done in this Parliament, with our powers, for pensioners in Scotland, such as the central heating programmes, the free personal care for the elderly and the free bus travel. We will say some more about that next week. Those are the policies for pensioners that this Parliament has supported, complementing the action of the United Kingdom Government, so that two Governments are working together consistently, building a national consensus to ensure that pensioners are well respected, given dignity and supported throughout Scotland and elsewhere.

---

Prime Minister (Meetings)

To ask the First Minister when he will next meet the Prime Minister and what issues he will discuss with him. (S2F-1074)

I have no plans for a formal meeting with the Prime Minister.

I thank the First Minister for that answer. I am sure that he would like to join me in extending a welcome to the Parliament to the campaigners from West Lothian who are trying to prevent the loss of vital services from St John's hospital. As I am sure the First Minister is aware, that is a matter for which the Scottish Parliament and the Scottish Executive have responsibility, unlike the things that the Scottish National Party wants to talk about.

Will the First Minister confirm that St John's hospital was opened in 1990 under a Conservative Government, built up under the Conservatives and is now being run down by Labour? Is it not the case that Labour's cuts are real cuts, that they are really hurting in communities in Scotland and that the national health service in Scotland is certainly not safe in Malcolm Chisholm's hands? [Interruption.]

Order. I simply say to the public gallery that we do not have applause from the gallery.

I welcome the campaigners—who, as I have said before, are very welcome in this Parliament—not just those from West Lothian, but those from Argyll and Clyde, who are also here to make representations on behalf of their local health services and to relay their concerns to us.

I suspect that there is nobody in this Parliament who is more aware than I am of the importance of the accident and emergency department in St John's hospital. Members will recall, just 15 or 16 months ago, me having perhaps an over-display of emotion in the chamber when I described how the fantastic staff in that hospital saved my nephew's life. Therefore, I take the situation in St John's hospital in West Lothian very seriously indeed.

It is entirely appropriate that Lothian NHS Board consult at this moment on the best provision of acute services throughout the Lothians. I want our Minister for Health and Community Care to ensure—and he will—that the recommendations that we receive from Lothian NHS Board undergo the most robust scrutiny possible and that the needs and concerns not only of West Lothian, but of the populations of Edinburgh, Midlothian and East Lothian, are taken on board when a final decision is made.

The decisions are not easy, but there cannot be a policy of no change. There must be improvements and progress in our health service, but those decisions must be taken seriously and patient care must be at the centre of the rationale that we use. Increasingly, we need to see beyond the boundaries of the individual health boards; that is as true in the Lothians as it must be in the west of Scotland. I am increasingly coming to the view that there are far too many health boards in Scotland, and that, in the east, west and north of Scotland, co-ordination of provision is a problem partly because of the fact that the artificial health board boundaries cause difficulties between health board areas.

I am sorry that that was a long answer, Presiding Officer, but the situation is complex and needs rational thought. I hope that, in the decisions that we make on the Lothians, we take on board the wider issues in the Borders, Fife, and perhaps even in central Scotland and Lanarkshire, just as we must take on board the wider concern throughout the west of Scotland in any decisions that are made in Argyll and Clyde.

I am sure that that answer will have given some hope or comfort to people from West Lothian, but, as the First Minister is aware, the situation in St John's hospital is far from an isolated case. What about Caithness general hospital, which was built by the Conservatives and cut by Labour? What about Ayr hospital, which was built by the Conservatives and cut by Labour? What about Queen Margaret hospital in Dunfermline, which was built by the Conservatives and cut by Labour?

Why is that happening? I put it to the First Minister that it is happening because of Labour's centralisation of our health service. His comment about cutting the number of health boards goes in precisely the wrong direction. Will the First Minister confirm that it was the merger of NHS trusts in 1999, which was supported at Westminster by Labour, the Liberal Democrats and the SNP, and the complete abolition of those trusts in this Parliament, which was supported by Labour, the Liberal Democrats and the SNP and opposed by only the Scottish Conservatives, that led to a loss of local control and to the centralisation of services that we are now seeing throughout Scotland?

I try to be rational about such matters. I understand the concerns that exist at a local level and do not want to minimise those concerns. Where it is appropriate for the Minister for Health and Community Care to make decisions, he will take on board local concerns and ensure that the analysis of, and recommendations in, decisions that are proposed to him are robust.

However, it is simply wrong to describe the situation as Mr McLetchie does. For example, there is an issue in Vale of Leven hospital, but there is also a brand new dialysis unit that was opened in May, which is an indication of our commitment to the future of health services in that area. There are issues in various centres throughout Scotland in which the technical specialisation of services might be appropriate to secure the highest possible quality of care for individual patients, but in each case, I want further services to be decentralised to the local community. That is precisely why we have had 67 new or modernised hospitals since the Parliament was first established in 1999 and 59 more will be completed between now and 2007. It is why we have modernised 104 local health centres since 1999 and a further 54 will be modernised between now and 2006. We are opening and growing health centres and local health facilities throughout Scotland, because the nature of care is changing.

One thing has really changed since 1999: the balance between the staff and the senior management. I will give Mr McLetchie an acute example of that—I was going to use the example later in answer to Mr Morgan's question, but I hope that he will not mind if I use it now. The number of senior managers in the health service, which rocketed under the Tories with all their health service bureaucracy during their 18 years in power, has reduced by 16 per cent since 1999. The number of ambulance service staff has increased by 16 per cent. That is the sort of change that the people of Scotland want and it is the sort of change that we will continue.

I was encouraged by the remarks that the First Minister made in his initial response to Mr McLetchie, when he said that the views of people in West Lothian—indeed, in the whole of the Lothians—will be taken into account fully in the changes that are proposed by NHS Lothian.

To date, NHS Lothian, by saying that the problem is due to training inadequacies in St John's hospital, has been trying to hide behind the views of the postgraduate dean. However, the postgraduate dean advised me and my colleague Robin Cook that he would have been perfectly satisfied for St John's to be one of two emergency surgical sites in the Lothians. In the light of that advice, will the First Minister ask Malcolm Chisholm to require NHS Lothian properly to consult on the issue and not to refuse to consult, as it is currently doing?

I will not comment on conversations that I was not party to, but it is important that politicians do not interfere in clinical decisions. When those decisions are made on clinical grounds, it is important that politicians do not try to second-guess those who have that responsibility. Those who have that responsibility also have a responsibility to take their decisions in a serious manner that has an overview of the whole area concerned. Malcolm Chisholm—and the chair of the health board, as far as I am aware—is checking that part of the process to ensure that that decision was made on proper grounds and can be properly justified.

It is important that we have a proper debate in the Lothians about the future of acute services. Even under the proposal for St John's hospital, which I understand, in the case of the local members and the local community, might be controversial, there would still be a full, 24/7 accident and emergency department and observation ward in St John's; there would still be full acute medical admissions, including a coronary care unit; and there would still be a series of other services. We need to have an open and transparent discussion about that, to determine the best health care for the 21st century and put patients at the centre of that, and we all need to be willing, as Ms Sturgeon correctly said, to listen to the new ideas that might have to be adopted.

---

Secretary of State for Scotland (Meetings)

To ask the First Minister when he will next meet the Secretary of State for Scotland and what issues he intends to discuss. (S2F-1062)

I have no plans for a formal meeting with the Secretary of State.

When the First Minister next meets the Secretary of State, I have no doubt that they will discuss the G8 summit that is taking place next year in Scotland. Prime Minister Blair has said that climate change should be an urgent priority. Does the First Minister agree?

Yes, I certainly do.

Why, then, do the latest annual Scottish environment statistics, published this week, show that Scotland's greenhouse gas pollution is increasing? Why is road traffic up a further 1 per cent? Why does the First Minister continue to press ahead with the building of the M74 extension, which will only increase traffic levels and increase climate-wrecking pollution? Does the First Minister agree that he needs to raise the game on climate change, not raise pollution; to give vision and leadership at G8 rather than green spin; and to set a real example, instead of the almost comical and frankly embarrassing gloss that is presently proposed for the G8 summit?

Although the main content of the G8 summit will be based around the work of the commission for Africa and the need to deal with global aid and development, part of that is to ensure that that development is sustainable. We cannot have sustainable development if we continue to pollute our atmosphere to the levels that we currently do and if we continue to fail, as many countries do, including the United States of America in particular, to take appropriate action to tackle that pollution. I am certain that not just I, but the British Government, in the run-up to the G8 summit, will raise those matters publicly, and with the American Government in particular. We need to see change throughout the world if we are going to tackle the deterioration of our climate and the threat to our world. Here in Scotland, we need to play our part in that and to make our contribution. That is precisely why the Executive, in the past five years, has made a significant shift in transport investment from private transport to public transport; that shift will be confirmed in the budget that will be announced by Mr Kerr next Wednesday.

---

Care Homes (Standards)

To ask the First Minister what action the Scottish Executive is taking to address recent reports on standards in care homes. (S2F-1069)

The establishment of the care commission with national care standards and improved care for the elderly have been among the achievements of devolution for Scotland. We expect care providers to meet the standards that have been set and ministers will continue to act to ensure that they deliver on that.

I welcome the First Minister's answer. I am sure that he is aware that residents returned to the Rosepark nursing home in Fallside in my constituency this month. Will he join me in welcoming that development and recall that commitments were made to ensuring confidence in the residential care sector following the tragedy in January? Will he therefore ensure that the recent reports into standards in care homes will not be viewed as a cup half full and that the failings that have been found in half Scotland's care homes—some of which have been exemplified in media campaigns such as that in the Daily Record—will be considered to be an intolerable situation that he will recommit to addressing?

We will certainly take further action on that. Ministers have worked before and since the publication of those reports to take further action. We will act to close the loophole that means that the care commission is not allowed to inspect and approve agencies that employ staff who might be used in care homes. Michael McMahon is right to say that one of our national newspapers highlighted that matter, which has received attention.

We will also take other action. Until recently, the care commission charged for copies of its national care standards. The cost was one excuse that care home owners gave for not having a copy of those standards. We will remove that excuse by sending them copies free. We also want to ensure that clients are in control of the process. We are discussing with social work directors how we can ensure that clients have, at the time of assessment, information on the care standards that they can expect, so that they can complain and report to the care commission if care homes let them down.

I am sure that the First Minister agrees that key to the quality of care in our care homes is the quality of staff, and that Disclosure Scotland's role is therefore central. I refer him to the written answer that was given to my colleague Richard Lochhead in August, which revealed the 100 per cent failure to meet the target that 90 per cent of basic applications through Disclosure Scotland should be processed within six calendar weeks. Will the First Minister comment on that failure and on the fact that care homes are now employing some staff without undergoing those procedures?

I share Christine Grahame's concern about Disclosure Scotland with regard to the position that prevailed at the beginning of the summer. That is why ministers have received, every week of the past few months, a written report from Disclosure Scotland on the progress that it has made towards not only meeting a target, but reducing the number of outstanding applications. I think that something like 20,000 applications were outstanding at the beginning of the summer and that that figure is down to about 4,000, but I am happy to write to Christine Grahame with the details. The significant improvement that was made in July, August and September is only the first step towards ensuring that Disclosure Scotland can turn round those applications as speedily as possible.

Michael McMahon asked what action the First Minister will take on the care home sector. When will the First Minister meet care home providers to discuss with them the delay in implementing their current contract, which means that many of them are trying to offer full-scale care at less than its cost? That is the basis of many of the problems. Will he agree today to meet them?

Ministers are in regular contact with all those who have an interest in the sector. We discuss not only finance matters, but the standards that are employed in care homes. I hope that David Davidson's comments show a slight change in his approach and that he will not only back private care home providers, but insist on the same standards on which we insist.

Does the First Minister agree that to maintain high standards of care, privately run homes and council-run homes should have a level playing field on funding?

The allocation of finance sometimes reflects the quality of care in those homes, which is the point that is consistently made. Working in both directions would be possible and it would be wrong of local authorities to reduce their quality of care. There is a need to continue to revise the budget—we will say more about that in our spending review statement next week—and to ensure that the proper resources are allocated. There is also a need for proper decision making, at local authority level, on the level of service that is provided locally and the quality and quantity of places that are available. It is also important that we continue to drive up standards in the private care home sector and the voluntary care home sector and that we finance that accordingly.

Does the First Minister agree that the treatment of elderly residents on the sudden closure of care homes—most recently in Bearsden, Fort William and Edinburgh, which involved inadequate notice being given and very little or no suitable alternative accommodation being provided—is disgraceful and contravenes the national care standards? What action will the Executive take to resolve the crisis in the care home sector?

Again, we must get the balance right between local and national responsibilities. We want to set national standards and continue to pursue them, but we also want to ensure that each local authority in Scotland meets its responsibilities. In a free society, it is not possible to regulate such matters entirely, but we must do all that we can to ensure that private or voluntary providers of care home places meet their responsibilities and treat their residents with the dignity that they deserve. People who close care homes without proper notice being given and who treat elderly citizens with the disdain that has been seen, or which has at least been perceived, in recent incidents need to reconsider the way in which they practise their business. We certainly want to do all that we can to urge those people to improve their practices and, where possible through the national standards, to get commitments in advance that such things will not happen.

---

Scottish Ambulance Service (Resources)

To ask the First Minister whether adequate resources are available to the Scottish Ambulance Service, given consequential effects of changes elsewhere in the NHS. (S2F-1079)

Given what the First Minister said earlier, I assume that he has a second answer up his sleeve.

Earlier, I made a point about the number of staff in the ambulance service in Scotland increasing by 16 per cent in the five years of devolution. We have also increased funding to the Scottish Ambulance Service by 13 per cent, to £128 million a year. Last year, the service was able to train 168 paramedics to the new standard, and 66 technicians. Those are considerable improvements, which I am sure that we will build on in the years to come.

Of course, it is not only the absolute level of resources that is important—the match of those resources against demand is important, too. In Dumfries and Galloway, there have been two serious cases in the past couple of weeks that have raised grave concerns about ambulance cover. In one case, a patient had to wait three hours in the general practitioner's surgery after the GP had phoned for an emergency ambulance. The patient was then driven 50 miles by her husband to hospital, where she underwent a four-hour emergency operation. I do not expect the First Minister to comment on an individual case, but will he admit that the ambulance service is under severe pressure at the moment? Will he further concede that changes to out-of-hours services and hospital closures in some areas could well stretch the service to breaking point? Will he personally ensure that the Minister for Health and Community Care gets a grip of the problem?

I am always wary of any attempt to exploit serious individual cases for political gain and hope that that is not the case in this instance. The two cases to which Mr Morgan refers were potentially serious and must be properly investigated by those who are responsible. I understand that both cases are being investigated and I will ensure that the Minister for Health and Community Care receives a report on both and writes to Mr Morgan with the analysis that is provided.

On the general issue, it is undeniable that the number of staff in the ambulance service has increased significantly and that the equipment that they use and the service that they can provide have improved dramatically in the five years of devolution. Critically, the Scottish Ambulance Service is now centrally involved at a local level in discussing with GPs and others involved the provision of out-of-hours services in a way that did not apply in the past, when GP surgeries had that responsibility and were obliged voluntarily to provide those services. A proper service can now be provided throughout Scotland, with the right arrangements in place and with GPs, the Ambulance Service and others working together. That should be an improvement in the service, not a deterioration, and we will monitor the situation in each part of Scotland as it develops.

---

Disability Discrimination Act 1995

To ask the First Minister whether the Scottish Executive is prepared for the Disability Discrimination Act 1995 fully coming into force. (S2F-1064)

Yes, we are. Executive departments and agencies are preparing for the 1995 act coming fully into force on 1 October. We take our responsibilities under the act, as an employer and as a service provider, very seriously. We expect all employers and service providers in Scotland to do the same.

The Disability Discrimination Act 1995, which comes into force next week, is an important piece of legislation for social inclusion. Will the First Minister ensure that all service providers are aware of their responsibility to comply with the 1995 act and that the legislation is promoted as a positive opportunity, rather than as an obligation?

Mike Pringle's last point is a strong and positive one. Throughout Scotland, there are businesses and organisations in the public sector and elsewhere that are concerned about the 1995 act and see it as a threat to their position. If there is any truth in the statistics showing that one in five Scots has some form of disability or long-term illness, every business and organisation in Scotland should see the act as a positive opportunity to improve the work of their business and to improve their relationship with customers and potential customers. We will certainly ensure that people are aware of the act and that they are being encouraged to follow it properly. We will give every assistance that we can to the United Kingdom Government to ensure that the act is being implemented properly.

On a point of order, Presiding Officer. My point of order, which concerns rule 13.7 of our standing orders, refers to the length of time that has been taken for this question session. Do you consider it in order that 60 per cent of the time that was available today was given over to the party leaders? That meant that you had to run over time to ensure that the last question—that of Mr Pringle—was taken. Last week, Mr Mundell lost his question. I ask you for a statement on whether we might better organise how questions are put to the First Minister.

I am always hesitant about giving homilies, particularly to party leaders, but I have some sympathy with what you say, Ms MacDonald. You are quite right, in that rule 13.7.8 says that supplementary questions should be kept brief. It is silent on the subject of answers. As the First Minister has made clear, there are occasions—as in the case of national health service hospitals—on which a long answer is required in the public interest. In general, however, if the party leaders' questions and the answers to them are kept short, there will be more time for more questions and answers. That will free up time for that very important constituency in this Parliament—back benchers. It is their chance to question the First Minister.

Meeting suspended until 14:00.

On resuming—