Plenary, 25 Sep 2008

Meeting date: Thursday, September 25, 2008

Official Report 669KB pdf

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Question Time

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SCOTTISH EXECUTIVE

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Health and Wellbeing

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Young Carers

To ask the Scottish Government what key issues arose from the recent young carers festival in West Linton. (S3O-4280)

Adam Ingram and I were pleased to take part in Scotland's first young carers festival on Sunday 14 September. As well as providing an enjoyable break for 350 young carers from across Scotland, the event provided the largest single consultation with young carers. It generated significant media coverage, helping to raise the profile of this vulnerable group. Initial feedback from the event includes calls for more secure funding for local young carers projects and for the festival to continue in future years.

Last week, the Princess Royal Trust for Carers said that only 5,000 out of 14,000 carers in Dumfries and Galloway are accessing carer support services. Clearly, a substantial proportion of those 14,000 will be young people. What steps can the Government take to ensure that all young carers are aware of the support services that are available?

Much of the support for young carers is the responsibility of local authorities and health boards, working in partnership at local level. The Scottish Government has developed measures to support that local partnership. For example, the national health service carer information strategies that are in place in all health boards must include measures to identify and support young carers, and we are investing £9 million over three years to support the implementation of those strategies. We have urged boards to prioritise front-line services when allocating that funding, and we address carer issues in our annual reviews of boards.

In addition, we have secured agreement with the Convention of Scottish Local Authorities for an additional 10,000 respite weeks over the next three years. Finally, we will consider additional support for young carers as we develop the young carers section of the revised carers strategy next year.

The minister may be aware of the excellent work that has been carried out by Wilma Philpot and her colleagues in Carers of West Lothian. They visit schools, identify young carers, such as those whom Alasdair Morgan referred to, and offer them support. Some of those young people accompanied Wilma to the young carers festival last week. The main challenge for Carers of West Lothian is funding. It is currently part funded by the Big Lottery Fund. What can the minister do to ensure that its funding is put on a more secure footing?

As I said in response to Alasdair Morgan, one issue that was raised at the young carers festival was that young carers projects are funded in a variety of ways: some are funded by the Big Lottery Fund, some by charities, and others by local authorities. The support is a mixed bag.

The message that I got from young carers was that there needs to be a look across Scotland at where young carers projects are strong and where they need more support. As I said in response to Alasdair Morgan, we want to take that work forward as part of the development of the important young carers section of the revised carers strategy. I am keen for that section to become almost a stand-alone policy on young carers, although it has to be within the wider context of the carers strategy. Funding is one issue that we want to take forward as part of that work.

I assure the minister that the festival would be warmly welcomed back to West Linton in my constituency. I suspect that it is the only time the minister and I have been part of political speed dating in our careers, but it was nevertheless a great success.

One point that was made by a young carer was that the ratio of supporters to young carers is 1:60. Does the Government have any best practice in respect of the ratio between supporters and young carers? A ratio of 1:60 really is not tolerable.

It was an interesting experience that we shared. I cannot promise that future young carers festivals will return to Jeremy Purvis's constituency, but we will bear his offer in mind.

It is extremely important that we take a Scotland-wide look at the support that is provided to young carers. As I said in my earlier reply, that work will identify where there are strengths and where there are gaps in service provision. To my knowledge, there is not a set ratio, but we must examine situations in which young carers might be waiting for support from particular projects because those projects are under pressure. I want to progress that work as part of our work on the young carers element of the carers strategy.

I recently watched a young carer being told that they could go to the festival and saw the look of excitement on their face. However, I knew that the care worker who supported that young person was to be removed from post as a result of a lack of funding, and that another care worker had already lost their job. The Government giving £200,000 to the festival seemed a bit hollow to that group. I ask the minister to consider core funding that would keep such groups working. I know of three really good groups in my constituency. Every young carer should have the support of such a group, which should be funded properly.

I have asked officials to find out why some young carers were not able to come to the festival and to establish whether that was because they did not have enough support in the home to enable them to do that. I have also asked officials to find out whether the more vulnerable young carers are in that situation.

The backdrop is that we have provided local authorities with record levels of funding and that we have an agreement with them to provide a higher level of respite care than ever before. We have also provided health boards with new funding to identify young carers. None of that work has been done before now. However, I acknowledge that there are gaps in the service, particularly in on-going support for young carers projects that provide vital continuing support to vulnerable young people. I want to address that as part of our work.

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General Practice (Opening Hours)

To ask the Scottish Executive how much flexibility is available to GP practices with regard to the organisation of their extended opening hours. (S3O-4319)

A range of specific flexibilities have been built into the extended hours arrangements in Scotland. In addition, health boards have the discretion to exercise additional flexibility on a case-by-case basis, to take account of the specific circumstances of each particular GP practice.

I am pleased to hear that. I and other MSPs recently met local GPs, who advised us that they are prepared to offer extended opening hours. However, they are extremely concerned that the hours that the health board has permitted them to offer are not sufficient to meet the needs of their communities. Will the minister provide further guidance to health boards on giving individual GP practices the ability to structure extended opening hours around the needs of their patients and the size and composition of their practices?

I am happy to look into the circumstances that Elaine Murray describes. We have offered flexibilities nationally and locally to ensure that the specific arrangements that GP practices put in place meet the needs of their local communities. I highlight the fact that Dumfries and Galloway has the highest uptake of extended hours of any health board area in Scotland—some 31 out of 35 practices have signed up to participate in extended hours. On the face of it, that suggests to me that arrangements locally are working well.

I congratulate GPs on their participation in the extended hours scheme. Across the country, more than 50 per cent of GP practices have already signed on the dotted line or are about to operate the scheme. The fact that a higher proportion of practices are participating in the scheme here than is the case south of the border is a vindication of the highly flexible approach that we have taken in Scotland.

I, too, welcome the GP extended hours scheme but I have concerns about how it operates. A health centre in my constituency is open by only an extra 50 minutes a week. Although it sees patients during that time, it does no screening, it does not issue repeat prescriptions and it does not even allow people to make appointments. The Scottish Government's payment of about £2.95 per patient per year is a considerable sum for less than one hour's extra consultation a week. Are we sure that we are getting value for money from the scheme? If not, what can we do to ensure not only that we get value for money but that patients get the service they need and deserve?

Notwithstanding the comments that I have already made about flexibility, the core requirement for a GP practice that is participating in the extended hours scheme is to provide an additional 30 minutes per 1,000 patients. I know from talking to GPs and patients throughout the country that the scheme is appreciated and that it is beginning to open up access for patients outside core hours. A couple of weeks ago, I visited a GP practice in South Queensferry that is offering early morning extended opening every day in the week, which is being taken up enthusiastically by patients.

I am on record as saying that I want to build on the foundations that we have laid with regard to more flexible access for patients. We have made a good start. The fact that so many GPs are participating—I hope that many more will decide to do so—means that an enhanced service for patients is being delivered. As we do for all other services that are provided in the NHS, we will keep a close eye on cost-effectiveness and value for money.

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Scottish Football Association (Youth Football)

To ask the Scottish Executive what discussions it has had with the Scottish Football Association about the development of youth football. (S3O-4321)

The Scottish Government and sportscotland meet the Scottish Football Association regularly to discuss a wide range of matters, including the implementation of the action plan for youth football.

I thank the minister for his response. I also thank the cabinet secretary, Nicola Sturgeon, for writing to me in the summer about concerns I had expressed about the situation that is faced by Dundee, Dunfermline Athletic and Ross County football clubs regarding entrance into the performance league for youth football.

There is a wider concern, however, about how clubs raise finance, and how that finance matches up to their youth structures. Will the Scottish Government guarantee that it will consider the support that clubs in the Scottish Premier League receive compared to clubs in the lower divisions? Will the Government also consider how the criteria are met, in order to show those clubs that they have the full support of the Government and so that they can have every confidence in the structures that are in place?

Many members will be pleased that the SFA has reviewed its decision and that the clubs can reapply in October and November this year. Beyond that, we are investing substantial sums—£12.2 million over 10 years—for the action plan for youth football. I am assured that there is an unbiased application process into the scheme. All auditing is carried out anonymously so that it is conducted fairly and so that there is no bias in the process. If John Park has particular concerns, I will be more than happy to take up those concerns with the appropriate bodies. If he wishes to write to me about specific concerns, I will be more than happy to discuss those with him and perhaps the correct authorities.

Does the minister recognise the excellent work that has been done by Supporters Direct, and has he met it recently to discuss the positive role that it is playing in supporting the development of youth football?

I am aware of the organisation to which Jamie McGrigor refers—in fact, I have praised it in Parliament in the recent past. Officials have been in discussions on funding for Supporters Direct, and we have come to an agreement about future support for the organisation, which does a marvellous job of representing supporters' views. I am happy to put on the record again my support for that organisation.

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NHS Dentists (Roxburgh and Berwickshire)

To ask the Scottish Executive how it intends to improve access to national health service dentists in Roxburgh and Berwickshire, given that only 17 per cent of adults in the constituency are registered with an NHS dentist. (S3O-4274)

NHS Borders is committed to improving access to NHS dental services in Roxburgh and Berwickshire. Of course, patients may be registered with a dentist in a neighbouring constituency, so John Lamont's figure is therefore likely to be an understatement of the number of residents who are registered with NHS dentists. However, access remains a challenge and that is why work has started on the creation of two dental units—one in Coldstream and the other in Hawick—that will improve access in Roxburgh and Berwickshire. It is hoped that work on those centres will be completed by early 2009.

I understand that Borders NHS Board has plans to upgrade the existing dental suite at the Borders general hospital and to submit dental proposals under the recently announced primary and community care premises modernisation programme for 2009-10 and 2010-11.

Will the minister confirm that, once the new dentists become available in Coldstream and Hawick, no patients will be waiting for an NHS dentist in Roxburgh and Berwickshire?

The dentists will certainly go a long way towards helping the access problems. We have asked NHS Borders and the other health boards to ensure that they continue to expand their commitment to NHS dentistry either by having salaried dentists on their premises or through support to general dental practitioners. The modernisation fund gave a clear steer to health boards that dental premises were to be a priority. We know from the figures—John Lamont cited 17 per cent—that we still have some way to go to fix the problem so that no one in Scotland who wants access to an NHS dentist is denied that. We have made good progress along that road, but we still have some way to go.

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NHS Grampian (Hospitals)

To ask the Scottish Executive what steps it is taking to ensure the highest standards of cleanliness in NHS Grampian hospitals. (S3O-4290)

NHS Grampian, in line with all NHS boards, is required to report on compliance with the national cleaning services specification. The last quarterly report for the period April to June this year shows that NHS Grampian is performing at 97.2 per cent. A revised cleaning compliance specification is currently out for consultation to ensure that it continues to set rigorous and demanding standards for NHS boards.

NHS Education for Scotland develops hospital acquired infection— related training and education programmes, most notably the cleanliness champions programme. I am pleased to say that that programme continues to expand and has been used in postgraduate and undergraduate training for health professionals. To date, 561 staff members at NHS Grampian have completed the programme and 1,117 staff members have registered for it.

Is the minister aware that there has been a marked increase in cases of Clostridium difficile at Aberdeen royal infirmary and that it has been identified as a factor in 34 deaths? What action is she taking to drive down those figures and improve hospital cleanliness, and how will she monitor progress by NHS Grampian?

I am concerned by the rate of C difficile cases, not just in Grampian but throughout Scotland. We have discussed the matter in this chamber on many occasions in recent months and it is very high up—if not at the top—of my priority list. As I am sure people know, tackling infections is not easy, but it must be given the greatest priority because it strikes at the heart of patient confidence in our NHS.

The member will be aware that following the inquiry into the situation at the Vale of Leven hospital and the related Health Protection Scotland report into cases of and deaths from C difficile throughout the country, we published a new action plan to supplement the existing HAI action plan. The new plan contains a range of actions and although I will not go through them all, as far as C difficile is concerned, we need to continue to improve standards of hand-hygiene compliance. I have made it clear that I want to develop a zero tolerance approach in the NHS in that regard.

Antibiotic prescribing in relation to C difficile in particular is extremely important. We have published an antimicrobial policy and additional funding is being made available to all NHS boards to ensure that they have antimicrobial teams in place. We will continue to take all those actions and a range of others so that we are doing absolutely everything possible to ensure cleanliness standards in our hospitals and that we drive down infection rates.

In addition, as I said previously, we are considering what steps we will take to ensure that external inspection of hospital facilities, including cleaning standards, is transparent and robust and in a shape in which people can have total confidence.

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One Scotland, Many Cultures

To ask the Scottish Executive what progress it is making on the one Scotland, many cultures campaign. (S3O-4314)

The Scottish Government is fully committed to building on the good work of the one Scotland campaign in promoting the diversity of Scotland and in tackling racism and discrimination within our society.

Development work has now begun on the next phase of the campaign. We expect the campaign to continue to challenge the damaging and unacceptable effects of racism and discrimination and to promote the benefits of a culturally diverse Scotland.

The minister will be aware that in March 2004, Margaret Curran, the then Minister for Communities, initiated a strategic review of local race equality work in Scotland and that that review was carried out between June 2004 and January 2005. Recommendations for a way forward were presented for consideration in November 2005 and we got a response to those recommendations at that time. One of the outcomes was the establishment of the race equality, integration and community support fund, which was worth £2 million over two years. What was the take-up of that specific fund? How much funding, in whatever guise it is now delivered, is available to meet the recommendations of the review? For how long will that funding remain available? Has it been assessed to determine whether it has been distributed on a pro rata basis among minority ethnic communities?

I will answer now, but I will also give Mr McMahon a detailed response in writing to the several questions that he asked. The race, religion and refugee integration fund, of which he is well aware, has four key objectives: to improve opportunities for people from minority ethnic, refugee, asylum seeker and faith communities; to encourage better and more responsive service provision for those communities; to build lasting connections between people from different ethnic and faith communities; and to help achieve more active and vibrant communities and increase participation by people from minority ethnic and faith communities. In total, 136 organisations applied for RRRI funding this year. The total amount of funding that was requested exceeded £25 million, but we had only £5.6 million to award. Projects from 33 organisations will receive funding from that funding stream over the next three years.

I am sure the minister will join me in welcoming the United Kingdom Government's commitment to sign up to the United Nations Convention on the Rights of the Child after 17 years of opting out. How are refugees and asylum seekers being seen in the one Scotland, many cultures campaign?

The one Scotland campaign sought previously to include asylum seeker and refugee issues. One of the adverts that is most recognised by the public is the one entitled "Canada", which was launched in 2005 and which specifically targeted attitudes to asylum seekers and refugees. Those attitudes, which are abhorrent, and issues around asylum seekers and refugees, will continue to be a big consideration in the further development of the campaign. We are analysing the outcomes of the previous part of the campaign to ensure that the work that we take forward will address the current priorities of Scottish communities. We will announce details of that future campaign shortly.

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Junior Doctors

The cabinet secretary—sorry, that is my supplementary question.

To ask the Scottish Executive what progress is being made on the recruitment of junior doctors across Scotland. (S3O-4306)

If the member had got a bit further, he would have given me a head start in providing the answer.

Recruitment to specialty training posts has gone well this year. In the first round of recruitment 86 per cent of all vacancies were filled, including 99 per cent of run-through training posts. As expected, there remain fixed-term and locum appointment for training vacancies and further recruitment processes are under way at local national health service board level.

The cabinet secretary might be aware that some boards—particularly my local board, Lanarkshire NHS Board—are cautioning us about significant pressures around the recruitment of junior doctors, particularly in relation to modernising medical careers and implementing the final stages of the European working time directive by August 2009. Boards describe the position as challenging and the British Medical Association describes the position in the west of Scotland as a particular problem. I would be grateful to know what plans are in place in terms of monitoring and supporting local health boards to ensure that services continue and that we have service sustainability. Will the cabinet secretary advise me about the decision to appoint only to locum appointment for training posts, rather than substantive specialty training posts? Some doctors have taken the decision to go elsewhere in the United Kingdom, particularly England, where they can get substantive posts, as opposed to the different, locum appointment for training posts?

Andy Kerr is absolutely right to point out that NHS Lanarkshire is facing challenges. It is not the only health board that is doing so. My officials remain in close and on-going contact with all boards as they manage their way through those immediate challenges. Most recently, at its annual review, I had direct discussions with NHS Lanarkshire about this very issue.

Two separate but related issues have a bearing on this discussion, both of which are being managed by health boards. The first is vacancies for short-term training posts. As I said in my initial answer, recruitment for run-through training has gone well, but vacancies remain for fixed short-term training posts and locum appointments.

The second issue is the reduction in the pool of doctors who are qualified to cover middle-grade rotas. A significant reason for that—although not the only reason—is recent changes to immigration rules that make Scotland a less attractive destination for international medical graduates.

All boards have in place contingency plans to manage such pressures in the short term and ensure on-going service delivery. We are working with boards to find solutions in the medium term. One issue that we are considering is ensuring that Scotland is not less attractive for fixed-term specialty training appointments than England is.

Andy Kerr will appreciate that, in the longer term, we are seeing a transition from a service that has depended on doctors in training to a service that is delivered by trained doctors. That is at the heart of the MMC philosophy. That will mean that, in the longer term, boards will have to redesign their services. Work to do that continues. The hospital at night initiative is one example of the redesign that we are considering.

I hope that I have reassured Andy Kerr and other members that we are working closely with boards to ensure that they can face up to the challenges in the short, medium and long term.

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Scoliosis

To ask the Scottish Government how many adults have been diagnosed with scoliosis. (S3O-4368)

That information is not held centrally. However, 281 patients over the age of 16 were referred to the scoliosis surgeons in Edinburgh during 2007-08.

What progress is being made towards establishing specialist surgery services for adult scoliosis sufferers?

The national service for adult scoliosis surgery has been approved and will come into effect in April 2009. As the service develops, treatment will become available to young people with neuromuscular conditions, including spinal deformity. I hope that the member is reassured that the national service will improve the situation for patients.

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Edinburgh Royal Infirmary (Spinal Injury Unit)

To ask the Scottish Executive what the current waiting times are between referral by a general practitioner and consultation with a specialist at the spinal injury unit at the Edinburgh Royal infirmary. (S3O-4352)

The national maximum waiting time target is 18 weeks following a GP referral to see a consultant at the spinal injury unit, which provides a national service for the whole of Scotland.

I recognise the importance of waiting times to patients, which is why we have set a whole-journey maximum waiting time target of 18 weeks from GP referral to treatment, which is to be delivered by the end of 2011. As a milestone towards delivery of that target, the NHS is working towards a 15-week target for out-patient consultation and in-patient and day-case treatment by 31 March next year.

Does the cabinet secretary agree that it is wholly unacceptable for my 15-year-old constituent who has suspected scoliosis, visible curvature of the spine and a twisted ribcage and who is in severe pain to wait 21 weeks for an initial hospital appointment, given the detrimental consequences of untreated scoliosis in adolescence?

As Angela Constance appreciates, it is inappropriate for me to go into the details of individual cases. She has corresponded with me about the case that she cited and I understand that the patient to whom she referred has now been seen, although I stand to be corrected if that is not the case.

Aside from a minority of cases in which the patient's condition might mean that it is not possible, I want patients to be treated within national waiting time guarantees. We are working to ensure that and I want that to continue to be the case as we reduce waiting times further with the referral-to-treatment waiting time target.

If Angela Constance wants to raise additional issues about the case to which she referred, I am more than happy to deal with them in correspondence.

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Suicide

To ask the Scottish Executive what action it intends to take in relation to the prevention of suicide. (S3O-4285)

Lead national action on implementing our national strategy and action plan to prevent suicide—choose life—is being taken by NHS Health Scotland. As part of that, each local authority area now has an identified suicide prevention co-ordinator, who works with community planning partners to ensure that local suicide prevention activities are tailored to local circumstances and needs.

Some 240 suicide prevention trainers are running courses across Scotland and more than 14,000 people have been trained. We are also committed to training 50 per cent of key front-line staff in mental health, primary care, accident and emergency and substance misuse services in the use of suicide assessment tools. We aim to do that by 2010.

Depression Alliance Scotland told me that in the Lothians there is a 12 to 18-month wait to access psychological support from referral by a general practitioner. That is far too long a wait. Will the minister investigate the situation and get back to me on what can be done about it?

I will investigate the issue that the member raised.

We are taking action to improve the provision of psychological support through a number of initiatives. The member might be aware of initiatives such as the living life pilot service—a telephone-based support service. There is also the breathing space service, which is geared towards people who are experiencing low mood or depression and has been very successful. Support mechanisms are in place and more are being initiated and piloted.

I congratulate the minister on pursuing the anti-suicide work of the previous Administration. Is she aware that choose life funding has been reduced in four of the 23 local authorities who replied to me on a freedom of information inquiry? Will she comment on that?

Has the minister or her team discussed a possible legislative consent motion in relation to the United Kingdom Government taking powers to control suicide sites on the internet?

Our officials are discussing what more can be done to control such sites and I will be happy to keep the member informed on the matter.

On local authority funding, local authorities have allocated about £3 million in 2008-09 to suicide prevention action. All local authorities are committed to delivering the suicide prevention strategy. Good work is going on throughout Scotland and we very much value the partnership with local authorities in delivering the strategy.

I hope that we have all members' support in taking forward the don't hide it, talk about it campaign, which tries to ensure that we are a nation in which people can talk about their feelings more than perhaps we did in the past—particularly young men, who are a target audience for the choose life strategy.

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Vitamin D

To ask the Scottish Executive what action it is taking in response to the report, "Scotland's Health Deficit: An Explanation and a Plan", published by Dr Gillie on Monday 15 September 2008, which identified low levels of vitamin D in people in Scotland. (S3O-4284)

Oliver Gillie has made an important contribution to the debate on Scotland's health. The Scottish Government has been considering the evidence on vitamin D and has arranged a meeting of experts in the field, which will take place later this year, to consider the significance of existing research and to recommend further action.

It appears that conditions such as diabetes and impaired cardiovascular function might be part of the evidence to suggest that vitamin D deficiency exists and is causing damage in Scotland. Dealing with the problem could therefore provide a solution to some of the 10,000 deaths a year in Scotland from heart attacks. Does the minister intend to take action to improve vitamin D levels through existing policies on diet, such as encouraging people to eat oily fish and take cod liver oil, or does she believe that direct supplementation—either through diet or prescribed supplements—might be necessary?

Vitamin A and vitamin D supplements for children and vitamin D and folic acid for women are available through the healthy start scheme. As part of the follow-up to the ministerial task force on health inequalities, the health directorate has begun a review of the evidence on vitamin D as a promoter of better health. A meeting of experts has been arranged to consider what actions might be taken in the light of that evidence, but we need to gather clear evidence.

A meeting will be held on 25 November to bring together researchers and funders to review all the current research, discuss the practical issues of giving supplements and advice throughout the whole population, and draw up a research programme that links with others who are involved in such work around the world. I am happy to keep the member informed of progress in that area.

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Health Facilities (Transport)

To ask the Scottish Executive what steps it is taking to improve transport facilities at and services to and from health facilities. (S3O-4327)

The national transport strategy and the "Better Health, Better Care" plan include actions for national health service boards to develop and publish operational travel plans by April this year.

Is the cabinet secretary aware of the difficulties that my constituents and other Lanarkshire residents face in attending Monklands hospital due to the lack of sufficient car parking spaces, which often makes a trip to hospital even more stressful? Is she aware that the situation also impacts on people who live close to the hospital? They are regularly unable to access their homes because a car has been abandoned by an owner who has failed to find a space in the hospital car park.

Has NHS Lanarkshire raised the issue with the cabinet secretary, and will moneys be made available to address the problem?

NHS Lanarkshire has not, to my knowledge, raised that specific issue directly with me. It is free to do so at any time, although I point out to the board that it has responsibility for ensuring that it puts in place appropriate arrangements so that patients, visitors and staff can easily get to and from hospitals.

As I said in my initial answer, NHS boards were required to have travel plans in place by April this year. The boards are all in the process of reporting to officials in the transport directorate on the status of and progress made against those plans, which must be done by the end of this month. My officials will work closely with the transport officials to analyse the reports to date.

I will put my hand up and admit that the problem might be an unintended consequence of Scottish National Party policy, since patients in Karen Whitefield's constituency still have an accident and emergency department at Monklands to visit, which might be increasing the traffic flow. Thanks also to Scottish National Party policy, there is no prospect that patients at Monklands hospital will have to pay car parking charges in future.

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Talking Therapies

To ask the Scottish Executive what action it intends to take, in addition to the introduction of two telephone-based cognitive behavioural therapy pilots, given the need for people to be able to access a wide range of talking therapies. (S3O-4330)

The Scottish Government is working with our national health service, local authority and voluntary sector partners to deliver an ambitious programme of change and improvement and to increase the availability of evidence-based psychological therapies—including, but not restricted to, CBT—for everyone who needs them, where and when they are needed.

What is the Executive doing to reduce waiting times for psychological therapies and to improve the recording of those times, which appear to be anecdotal at present?

As the member will probably be aware, I have commissioned work to examine how we can improve the scope of waiting time targets in the area of mental health. That on-going work will consider what can be achieved and what the time frame will be.