Engagements
To ask the First Minister what engagements she has planned for the rest of the day. (S4F-02966)
Engagements to take forward the Government’s ambitious programme for Scotland, including our plans to protect free school meals in Scotland from the impact of Tory cuts to tax credits.
Today, Audit Scotland published a withering assessment of Scotland’s justice system. The people in our courts work tirelessly, but they are being let down by Government failures. The report points to budgets slashed, increased delays, performance targets missed and wasted spending totalling £10 million. When Audit Scotland says that the Government has cut the Scottish Court Service’s budget by four times the rate of cuts to central Government, does the First Minister think that it is wrong?
I think that it is not comparing like with like. I will explain exactly what I mean by that.
First, the total funding allocation to the Scottish Court Service in 2010-11 included a substantial capital allocation towards the redevelopment of the Parliament house court complex here in Edinburgh. Work on the refurbishment of that complex was completed in 2013; therefore, that is reflected in the 2014-15 figures.
Secondly, the Government has taken steps to provide additional funding to the court service in response to particular pressures. In 2014-15, we committed an additional £1.47 million for extra fiscals, judiciary and administrative staff to address delays and speed up access to justice. During the current year, we have provided a further £2.4 million to ensure the efficient progress of cases involving domestic abuse and sexual offences. I hope that Kezia Dugdale will welcome that funding, which will continue in the next two years.
Those two amounts of funding were in-year allocations, so they were additional to the baseline figures on which the Audit Scotland figures were calculated. I therefore end where I started. I do not think that quoting those figures, as Kezia Dugdale has just done, is fairly comparing like with like.
Those are Audit Scotland’s numbers. Audit Scotland does the numbers; the First Minister does the spin on those numbers. The reality is that the budget for the Crown Office has fallen by 14 per cent and the budget for the court service has fallen by 28 per cent. Even taking into account her comments about capital spending, that is a 12 per cent reduction in revenue and a 17 per cent reduction for the court service, in particular.
Putting the numbers to one side, we are talking about seven courts across Scotland having been closed last year. We warned the First Minister about the impact of that decision; now, Audit Scotland confirms that our courts are under pressure.
Although the First Minister did not promise to protect the justice system, she promised to protect the national health service. In 2011, the First Minister told the Scottish National Party conference that patients in Scotland spent 200,000 days in hospital beds when they did not need to because the right care was not available in the community. At that time, the First Minister rightly said that that was too many days. Can she tell us what the number is now?
If Kezia Dugdale does not mind, I will finish on courts and then move on to the health service. It is interesting that she did not have any real comeback on courts once she had the facts that I gave her.
Kezia Dugdale mentioned court closures specifically. Audit Scotland does not address essentially the issue of court closures, but it confirms that the courts that were closed were dealing with a relatively low volume of business—in most instances, fewer than 100 cases a year—or were located close to other courts. The court service’s chief executive has said that any attempt to link court closures with increased waiting times “simply muddies the water.” He says that the current courts have the capacity to deal effectively with existing volumes of civil and criminal cases.
I welcome the Audit Scotland report. We will study it carefully and learn any lessons to be learned from it. One of the most interesting points in the report is the observation that one of the issues at play is the increase in the prosecution of more complex cases involving domestic abuse and sexual offences. That is because there is more proactive detection of those cases, with increased confidence on the part of victims in reporting them. I would have thought that we should welcome that, and that the Opposition should get behind the Government as we continue to ensure that those cases come to court.
I move on to the subject of delayed discharges. I have said, and the Government has said, repeatedly that getting the level of delayed discharges down is one of the key things that we can do to reduce pressure on our acute hospitals. That is why I think that it is to be welcomed that the number of bed days lost in July, as we saw in statistics earlier this week, was down by nearly 10,000 since December 2014. Just to put that in context, that is the equivalent of every acute medical bed in NHS Highland for an entire month. Of course there is still work to do, but real progress is being made.
Here is the answer that the First Minister was looking for in her book. Last year, patients in Scotland spent more than 612,000 days in hospital beds when they were fit to go home. That means that the figure has more than trebled under the Scottish National Party Government, since the current First Minister admitted that there was something badly wrong. By any measure, that is unacceptable. Thousands of patients, the majority of whom are elderly, are ready to go back home or into the community but they cannot, because the extra support that they need is just not there.
I do not doubt for a second the First Minister’s sincerity when it comes to this issue. She says that she wants to tackle the problem. In February, her health secretary said that she wanted to completely
“eradicate delayed discharge ... this year”.
We welcome that ambition. Is her health secretary on track to meet that target?
The health secretary is working and is on track to eliminate delayed discharges.
Members: What?
Order.
This is a serious issue and Labour, having raised the matter—[Interruption.]
Order.
In July 2006, there were 1,242 patients—
Oh, come on.
Order.
—delayed over three days—[Interruption.]
This is important. I will exercise patience so that members can hear these figures.
In July 2006, there were 1,242 patients delayed over three days; in August 2015, that figure was down to 731 patients delayed over three days. In July 2006, there were 1,055 patients delayed over two weeks; in August 2015, there were 481 patients delayed over two weeks. It is not just that. The average length of delay in July 2007 was 52 days. By August 2015, that had been halved to 23 days.
Yes, there is more work to be done to eliminate delayed discharges, as we have committed to do, but any reasonable, objective person looking at the figures would know that significant progress has been made.
At the outset of her last question, I think, Kezia Dugdale mentioned the health budget. In her first question, she was keen to take the word of Audit Scotland as gospel. Let me therefore end with a quote from the Auditor General for Scotland in October 2014:
“The Government has managed to protect the NHS budget”.
There is a trend here. Time and again, the SNP Government introduces lots of targets with great fanfare, but ministers then run for cover when they fail to deliver on them.
It was in deepest winter when Shona Robison pledged to abolish delayed discharge. Patients in Scotland spent 46,873 days in hospital beds when they did not need to be there. According to figures published this week, that increased to 47,797 days at the peak of summer. Patients are rightly concerned about what will happen this winter.
That is another target set by SNP ministers that they have failed to meet. They are failing on health, they are failing on justice and, as we know from recent weeks, they are failing on education, too. The First Minister says that she wants to be judged on her record. Does she really think that that is a record to be proud of?
Let me just recap some of this, and let me put it in a different way, if that is easier for Kezia Dugdale. [Interruption.]
Order.
We think that the issue of delayed discharges is hugely important. That is why we have made it such a focus of our efforts.
Members: It is going up.
Order.
Since 2007, there has been a 52 per cent reduction in delays of over four weeks; a 55 per cent reduction in delays of over six weeks; the number of delays of over three days is down by 50 per cent; and the number of delays of over four weeks has been reduced as well. Having delivered the target of zero delays of over six weeks, we have progressively toughened the target—
You have not!
Dr Simpson!
We are now focusing on ensuring that patients are discharged within 72 hours.
As long as one patient is delayed longer in hospital than they should be, we have more work to do, because that is wrong for that patient and does not do a service to our national health service. However, I say again that any reasonable person looking at all those figures would say that we are making considerable progress. [Interruption.]
Order.
Ten thousand fewer bed days were lost in July than in December last year. I will continue as First Minister with the Government to do the job of improving our public health service, but I have to say that, if Kezia Dugdale cannot even get to grips with the art of opposition, she does not have much hope of getting into government.
Secretary of State for Scotland (Meetings)
To ask the First Minister when she will next meet the Secretary of State for Scotland. (S4F-02959)
No plans in the near future.
Today, the Royal Society of Edinburgh published a highly critical paper on the Scottish Government’s decision to ban genetically modified crop cultivation. Although there may be a debate about GM crops, the RSE paper concludes that the decision was not taken on the basis of scientific advice and
“does nothing to enhance Scotland’s longstanding reputation for scientific creativity.”
More than that, it also warns that the decision could
“disadvantage the growth of important Scottish businesses”.
We know that the First Minister did not consider anything as trivial as science when she made the decision, but the Royal Society demands that the Scottish Government publish whatever advice or evidence it took. Will she do that?
We will consider the report from the Royal Society of Edinburgh carefully and take whatever action we think is required. However, let me repeat what I have said previously in the chamber. Kezia—I mean Ruth Davidson; I am sorry, I am getting them confused. Ruth Davidson is perfectly entitled to disagree with it, but she should listen to what I have said previously and say again today.
Our scientific adviser was consulted on the scientific background—
Who?
Order!
That advice was made available to ministers prior to the decision, but it was not the primary factor for us in reaching a conclusion. We took the decision on GM crops because we wanted to protect our food and drink sector and the clean, green environment on which the success of that sector depends.
There are now 18 countries in Europe that have followed Scotland’s lead. They include Germany, Hungary, Austria, Latvia, Cyprus, Slovenia and Northern Ireland. Is Ruth Davidson seriously saying that all those countries are somehow anti-science?
The First Minister has just repeated the trope that the ban is to protect the reputation of Scotland’s food and drink industry. Therefore, why did the chief executive of Scotland Food & Drink say only last month that GM was “not an issue” and
“never part of the discussion”
on Scotland’s clean and green reputation?
This is about not only GM crops but the First Minister’s approach to government. It is vote-chasing political calculation; it is not science, industry or jobs. In the decision on GM crops, there was no prior consultation with Scotland’s scientific community, no prior discussion with Scotland’s food and drink industry and no consideration whatever of Scotland’s farming industry. The First Minister has said that she wants to change her Government into some sort of listening Government. Apart from the Royal Society of Edinburgh, 30 scientific, academic and agricultural organisations are urging her to listen. Will she hear their concerns and review that poorly thought-out decision?
I say to Ruth Davidson that GM is not an issue for our food and drink sector because we are not doing it. If we were doing it, it would be an issue for our food and drink sector.
Ruth Davidson said that our decision was not about science; I have addressed the science point. She went on to say that it was not about jobs or industry. Actually, it is everything to do with jobs and it is everything to do with industry. I do not know whether Ruth Davidson is aware of how important the food and drink sector is to this country’s economy. It is a £14 billion sector that employs around 380,000 people if we take into account the entire supply chain. The report on the sector that the Bank of Scotland published in August said that food and drink producers forecast average turnover growth of 19 per cent and—this is an important point—that 63 per cent of producers said that provenance was
“an important factor for export markets”.
That is why we have taken our decision. We want to protect the clean, green environment on which the success of the sector is based.
I say again that if Ruth Davidson thinks that the decision that the Scottish Government has taken is so wrong and so against all the factors that she has spoken about, I presume that she thinks the same about the 18 other countries that have followed Scotland’s lead.
The First Minister may be aware of the discussions about the impending removal from Ayr hospital of the stroke unit, trauma services, nuclear medicine, pharmacy services and the delivery of chemotherapy services. Given the Scottish Government’s stated opposition to the centralisation of hospital services and given the need to maintain local access, does she share my concerns and those of my constituents about those and other plans for the downgrading of Ayr hospital?
I agree that services should be in the right place and as close to people as possible. I know that the member will recall, as all members do, that it was this Government and me as the Cabinet Secretary for Health and Wellbeing who stopped the closure of the accident and emergency department at Ayr hospital.
John Scott raises important matters. Such decisions require to be taken within the context of a national clinical strategy, and the health service will be very happy to meet him, as the local member, to discuss the issues in more detail.
Cabinet (Meetings)
To ask the First Minister what issues will be discussed at the next meeting of the Cabinet. (S4F-02958)
Matters of importance to the people of Scotland.
Yesterday, the Cabinet Secretary for Health, Wellbeing and Sport faced eight questions on Scotland’s general practitioner crisis, which were met with such responses as
“a full review ... within six months”;
“on-going discussions”;
“keep a close eye on those matters”;
“a close interest”;
“There is an opportunity to discuss”;
“continue to discuss”;
and
“encourage Bob Doris to continue to liaise”.—[Official Report, 23 September 2015; c 2-4, 6, 9, 7.]
Is it not about time to bring an end to the talks about talks about talks and start to take action to tackle the GP crisis?
Indeed, so let me run through exactly the action that the Government is taking.
As Willie Rennie will recall, in June the health secretary announced that the primary care development fund would be expanded to £50 million. That fund is supporting the investment of £20.5 million in the primary care transformation programme, which allocates money to practices to test new ways of working. The fund is also providing £6 million for the development of digital services, which everybody recognises is important to the transformation of primary care, and £16.2 million for the recruitment of 140 new pharmacists who will work directly with GP practices and support the care of patients with long-term conditions. Why is that important? It is important because it frees up GP time for other patients. In addition, £2.5 million is being spent on a GP recruitment and retention programme; £1 million is being spent on supporting a leadership programme for GPs, which is developing different ways to equip GPs with the skills that they need to play a leading role in the development of integration work; and another £1.25 million is being provided for the Scottish school of primary care, which is supporting research capacity, which is also very important in reforming and transforming primary care.
I hope that Willie Rennie would accept that that is a fairly impressive list of actions.
We have heard it all before. [Interruption.]
Order.
The First Minister should listen to this: 99 per cent of GPs who knew about the Government’s plan said that it was simply not enough. This week, we heard new reports of problems in Perth and Glasgow. Glasgow GP Lynsay Crawford said:
“There is a GP crisis.”
Crucially, she added:
“This has been a long time coming.”
When is the First Minister going to take real action to put an end to this crisis?
If Willie Rennie had heard it all before, why did he try to pretend in his first question that nothing was happening? He also said that GPs say that they have looked at all this, dismissed it and said that it is not enough. Dr Alan McDevitt, who is the chair of the British Medical Association’s Scottish general practitioners committee, said:
“I welcome this funding which will help in taking forward our vision for the future of general practice in partnership”
with the Scottish Government.
“The additional resource will enable us to try out new ways of working that can deliver first class care for our patients and improve the working lives of GPs.”
If Willie Rennie had listened to my statement on the programme for government, he would have heard me talk about the 10 test sites that we are taking forward over the next year to look at different ways of delivering primary care so that we shape primary care—the renegotiation of the contract is an important part of this—and it is up to meeting the challenges of the future. Willie Rennie should by all means get involved in that, but he should go to the bother of getting involved in the detail. If he does not think that that is enough, he should come up with some ideas, rather than just carping from the sidelines.
Dementia Research
To ask the First Minister what the Scottish Government is doing to assist research into dementia. (S4F-02962)
The Scottish Government remains strongly committed to supporting research into dementia. The Scottish dementia research community is playing a significant role in the global effort to find a cure or a major disease-modifying treatment for one of our foremost public health challenges. The Scottish Government’s support includes funding the Scottish dementia clinical research network to bring dementia clinical trials to Scotland and engaging with third sector organisations, such as Alzheimer’s Research UK, to co-fund research that will improve the understanding of the causes of dementia.
According to Dr Matthew Norton, who is head of policy at Alzheimer’s Research UK,
“Research has the power to transform lives, and our actions now will help determine the future for children born today
.”
I am grateful for the First Minister’s comments, but can she advise what further assistance the Scottish Government can provide to progress research in Scotland and, indeed, internationally into this devastating disease?
The collaborative research project with Alzheimer's Research UK is progressing well, and the Scottish Government currently provides funding of £486,000 a year for the Scottish dementia clinical research network to provide infrastructure support for clinical dementia studies in Scotland. More generally, investment through the chief scientist office means that Scotland-based dementia researchers have access to a wide range of research funding opportunities. The support that is provided by the Scottish Government will help to maintain our position as a leading centre for research into dementia, The Scottish Government will continue to do everything that we can to support that.
Foster Children
To ask the First Minister what the Scottish Government’s response is to the recent report by Action for Children that one in every six foster children in Scotland moves homes two or more times a year. (S4F-02973)
While Action for Children’s research shows that fewer children in foster care in Scotland move homes than elsewhere in the United Kingdom, we know that there is much more to do, as we have to ensure that vulnerable children get a secure and stable home life as quickly as possible. To help to ensure that children receive the best possible care in foster arrangements, we have provided over £280,000 last year and this year to fund fosterline and a range of other support services. I can also confirm that, following the closure of the British Association for Adoption and Fostering, we are providing £75,000 to allow the adoption and fostering alliance in Scotland to take on vital support services.
Does the First Minister share my concern that in many areas of Scotland, such as West Lothian and Renfrewshire, a staggering one in three foster children has to move family two or more times a year and that the figure rises to one in two in Dumfries and Galloway? The result is that one in four foster teenagers lives with at least their fourth family, and one in 20 is in their 10th placement. Obviously, that has a lasting detrimental impact on children and young people and their behaviour, relationships, educational outcomes and mental health.
Given the continuing shortage of foster carers that Scotland faces, what additional steps will the First Minister now take to encourage more people from a wider range of backgrounds to consider fostering and to spread the message that it does not matter what a person’s age or gender is or what type of relationship they are in, if they have a spare room and the ability to stand alongside children and young people to help them to recover and to offer security, they should consider being a foster carer?
I agree with that and I commend Cara Hilton for raising the issue, as it is an important one. We should all be judged on how we care for the most vulnerable in our society. Children who require foster care fall into that category, and one of our most important responsibilities is to ensure that they are looked after properly.
What I am about to say is not meant to underplay at all the importance of that, but it is probably also appropriate to point out that large variations in the figures are possible and more likely where sample sizes, such as those in some of our smaller local authorities, are quite small compared with those of bigger local authorities. That is true of local authorities such as Dumfries and Galloway.
Nevertheless, we know that too many children and young people in care can experience drift and delay, which leads to multiple placements. Local authorities work very hard to find suitable foster families for looked-after children, often under very challenging conditions. We support local authorities through the actions that we are taking following the foster care review, and we will continue to do that.
I end by echoing Cara Hilton’s comment that there are many people out there who would make excellent foster parents, and I hope that those who think that they are in that category will seriously consider becoming one.
I know that the First Minister recognises the positive, stable relationships that kinship carers can provide, and I note in particular the Government’s £10.1 million allocation that was announced to bring them into line with foster carers. Will she add her voice to that of the Midlothian kinship carers organisation, which I know she has met, and ensure that its publication “Through Our Eyes” is circulated, particularly to social work departments? It would let them see the challenges but also the value of kinship care, which provides such stable relationships to children—relationships that foster children often do not have.
Yes, I agree with all of that. As Christine Grahame will be aware, the Government is committed to supporting kinship carers. Indeed, I announced in the programme for government that we had reached an agreement with the Convention of Scottish Local Authorities to improve financial support to kinship carers, and specifically to provide them with the same level of financial support that foster carers get.
We also fund Children 1st and Citizens Advice Scotland to provide support and advice to kinship carers across Scotland, and we provided a strategic funding partnership grant from 2013 to this year to Mentor UK to deliver projects that help to break what is often an intergenerational cycle of children becoming looked after and having poorer outcomes.
Across all of these issues—supporting foster carers, supporting kinship carers and supporting local authorities, which have to find the best care for these vulnerable young people—the Scottish Government will continue to provide whatever support we are able to.
School Rugby (Safety)
To ask the First Minister what discussions the Scottish Government has had with the Scottish Rugby Union about the safety of pupils playing rugby in schools. (S4F-02960)
First, I take the opportunity to congratulate the Scottish rugby team on their fantastic win over Japan yesterday. [Applause.] I am sure that we all wish them the best of luck for the rest of the world cup.
The Scottish Government has worked closely with the Scottish Rugby Union on safety issues. In May this year, our discussions with medical experts including Dr James Robson, chief medical officer of the Scottish Rugby Union, resulted in Scotland becoming the first country in the world to introduce standard guidelines for dealing with concussion in sports. The guidelines provide advice to those who are involved in grass-roots sport, including school sport, to enable them to identify the signs and symptoms of concussion and take appropriate steps.
I think that we can all agree that there is a delicate balance between protecting the players’ safety and maintaining the characteristics of the game that have made it so popular, particularly yesterday afternoon. I am sure that the First Minister will also agree that the Scottish Government has a role to play to increase the awareness of the medical issues. Will her Government consider taking advice from the United States, where 49 of the 50 states have introduced the Lystedt law, making concussion education compulsory among coaches, pupils and parents of all those who are involved in contact sport?
Of course I am happy to look at that and to let Liz Smith know the outcome of that deliberation. I think that she is right—and I commend her for putting it in this way—that we want to encourage more young people to get involved in sport, but we have to balance that with ensuring that they are not facing unacceptable or disproportionate risks in doing so. It is important and noteworthy that we are the first country in the world to have produced the guidelines that I spoke about, but I think that she is right—which is why I will consider her suggestion—that education about those guidelines is important so that we raise awareness of them.
Liz Smith may or may not be aware that, last year, ministers wrote to all schools and all governing bodies in Scotland and sent out the youth sport concussion leaflets, which contain guidance on recognising concussion and concussion management. We have not just produced the guidelines but taken active steps to make sure that there is wide awareness of them throughout the country. However, we will continue to look at what more we can do, and I am happy to write to Liz Smith once I have had a chance to look in detail at her suggestion.