SCOTTISH EXECUTIVE
Health and Community Care
National Health Service<br />(Quality of Administration)
To ask the Scottish Executive what arrangements are in place to check the quality of administration in the national health service, such as contact between hospitals and general practices in respect of individual patients. (S2O-7824)
Each NHS board is under a statutory duty to ensure that the health care that it provides to all its patients is of sufficient quality. Supporting that general approach are initiatives such as patient-focused booking and the Scottish care information gateway, which are aimed at improving administration links between hospitals and primary care services. Those initiatives are designed to improve the quality of appointment administration by involving patients directly in decisions about their hospital appointments and to deliver more effective services by reducing the number of patients who fail to attend appointments.
I am sure that all members can give examples of individual constituents who, after coming out of hospital, have found that it takes several weeks for their general practitioner's surgery to be told—if it is ever told—that the person has come out of hospital or for the results of any test to be transferred. I accept the points that the minister made, but will he try to improve the quality of administration in the health service by monitoring or inspecting?
That gets to the heart of this morning's debate on Professor David Kerr's report. In response to the report, the Executive will invest further in health care information technology. The member is absolutely right that it is inconvenient for patients when information is not transferred, but it can also on occasion be dangerous.
National Health Service Boundaries<br />(Argyll and Clyde)
To ask the Scottish Executive what progress is being made with its consultation on redrawing national health service boundaries in Argyll and Clyde. (S2O-7856)
The public consultation about new administrative boundaries for the area that is at present covered by NHS Argyll and Clyde began on 8 August. An associated series of 16 public meetings, supported by focus groups and workshops with key local organisations, has been attended by several hundred members of the public. Under the options on which we are consulting, the local hospital, community and other health care services on which people rely will continue. The consultation was due to end on 4 November, but I have agreed to extend it by seven days until 11 November to give those who attend next week's public meetings a little more time to submit their views. I will consider carefully the responses to the consultation before announcing my decision on the new administrative boundaries.
I commend the minister and his team for the consultation, especially the public events in Helensburgh and Dumbarton, both of which I attended. Does he agree that the views of ordinary people are of primary importance? In that context, will he note the overwhelming public opinion that Helensburgh and Lomond should be covered by Greater Glasgow NHS Board?
I hear what the member says, but I need to wait for the outcome of the consultation process. I receive on-going reports about those meetings and am aware of the views that have been expressed, but my decision must be based on the totality of the consultation process. The consultation is being undertaken extremely well in terms of its format, style and level of engagement. I hear what the member says but, as she would expect me to say, my decision must rest on the totality of the consultation.
As the consultation has proceeded in the way that has been indicated, the minister will be aware that legitimate concerns are being expressed about the absence of sufficiently robust information on the funding implications for the adjoining health boards that may have to assume patient quotas from the current NHS Argyll and Clyde area and on the strategies for dealing with the extended patient obligation and geography of those adjoining areas. Given the fundamental importance of preserving confidence in the administration of health care in the current NHS Argyll and Clyde area, will the minister once again look to the possibility of the Executive maintaining interim administration of the area until far more detailed information has been made available? Will he consider doing that before people are asked to try to make informed choices about options?
We are trying to ensure that people can make informed choices and we are providing them with the appropriate information so that they can do so. I will consider the specific points that the member makes in relation to the financing of the successor board, whatever the design of that board happens to be. We will consider what information can be provided to the community.
Smoking (Pregnancy)
To ask the Scottish Executive what progress is being made in reducing the number of women who smoke while pregnant. (S2O-7828)
The latest figures suggest that good progress is being made. The incidence of smoking recorded at first antenatal booking has decreased from 29 per cent in 1995 to 23.8 per cent last year. We are therefore on course to meet the national targets of 23 per cent in 2005 and 20 per cent in 2010.
That is welcome news. Is the minister aware of good practice such as the stop for life project in Livingston, which takes cessation services into the community and provides one-to-one advice from specially trained midwives in whatever setting is necessary and convenient for pregnant women? Does he agree that good work of that type could easily be replicated across Scotland and could have a significant further impact on the health of mothers and children in Scotland? Will he look to study such best practice?
I am certainly aware of it. Mr Robson may be aware that the stop for life project in Livingston recently won through to the final round of the United Kingdom national Quit awards for the best and most innovative smoking cessation scheme. It is one of the schemes of which we can be proud. We want similar initiatives to be taken across Scotland. In the context of this morning's health debate, those are precisely the sort of measures that we can take, focusing particularly on the most deprived areas.
Given that 36 per cent of pregnant women in Dundee smoke, and given that Dundee has the highest teenage pregnancy rates in Scotland, will additional resources be made available to ensure the availability of more smoking cessation programmes and other support targeted specifically at such groups, especially in the light of the Kerr report, which we debated this morning?
As Shona Robison has acknowledged, the thrust of health policy is to tackle health inequalities. Smoking during pregnancy is one area in which there is a particularly marked inequality: rates have fallen in all areas, social classes and neighbourhoods, but they have fallen faster in more affluent areas. The points that were made this morning about the need to target the interventions that we make in the community on those areas where they will make the greatest difference and reduce inequalities are reflected in this policy area.
Dental Services (Dumfries and Galloway)
To ask the Scottish Executive what action it is taking to increase the availability of dental services in Dumfries and Galloway. (S2O-7884)
We have given health boards new powers to deploy salaried dentists to address loss of access to national health dental services in their local areas. NHS Dumfries and Galloway is making full use of those powers. We have also put in place additional funding of £295 million over three years, much of which will be used to encourage general dental practitioners to continue to provide NHS treatment to all categories of patients.
I know that the minister is aware of the serious shortage of dentists, both NHS and private, in Dumfries and Galloway and that he has similar problems in his constituency. Why is Dumfries and Galloway not to receive any of the 12 Polish dentists who were recruited by the chief dental officer? Did NHS Dumfries and Galloway not apply because it is undertaking its own recruitment drive in Europe, as well as being in negotiation with Integrated Dental Holdings to provide 10 dentists in three centres in the region? Will NHS Dumfries and Galloway be able to apply for future allocations of dentists recruited by the chief dental officer should it wish to do so?
Absolutely. NHS Dumfries and Galloway will be able to take advantage of future recruitments. The dentists who have been assigned and whose appointment I announced a week or two ago were 12 of 32 highly qualified dental practitioners whom we hope to recruit from Poland in the next few months. They will be employed by health boards across Scotland. The 12 in the first batch have been allocated, as the member mentioned, but Dumfries and Galloway did not apply for them. However, two further groups of 10 will arrive for whom NHS Dumfries and Galloway will be able to apply. We have deliberately given health boards powers to address those issues in whatever way best suits their needs. I know that NHS Dumfries and Galloway is actively pursuing the matter to ensure that patients in Dumfries and Galloway have access to NHS dental services. That is something that we want across Scotland.
I hear what the minister says, but does he know why NHS Dumfries and Galloway did not apply for those dentists? Can he help me to explain to my constituents, who are in the second-worst affected area in Scotland, how the placement of the first tranche of Polish dentists to the Fife, Forth Valley and Argyll and Clyde health board areas can be anything other than party political? Does he recognise that organisations such as IDH, which may be coming to Dumfries and Galloway to provide some sort of dental cover, always have a high staff turnover and that that is not conducive to effective dental treatment? Will he confirm that such measures will be for the shortest time only?
That is an extraordinary statement from the Conservative party. I am taken aback to discover that it thinks that such matters are decided on a party-political basis—quite the contrary. Mr Fergusson should be aware that whoever is responsible for dentists choosing to withdraw NHS services from their patients, it is not the NHS and it is not NHS Dumfries and Galloway.
The minister's boss, in answer to question 1, said that health boards have a statutory obligation to provide health treatment of sufficient quality. Regardless of Mr Macdonald's waffling answers to other supplementaries, the hard fact is that NHS Dumfries and Galloway is not fulfilling its statutory obligation and shows no signs of doing so soon. Will he advise the people of Dumfries and Galloway to sue the health board for failing to meet its statutory obligation?
Mr Morgan should cease misrepresenting the position. The position is that individual dental practitioners are legally entitled and empowered to choose to withdraw NHS services; that is not about a legal requirement on the part of the NHS. The NHS is, however, required to make dental services available and that is what NHS Dumfries and Galloway is seeking to do. I am sure that it would welcome Mr Morgan's support as well as the support of members of the Executive parties.
Belford Hospital (Acute Care Services)
To ask the Scottish Executive whether it supports the continuance of acute care provision 24 hours a day, seven days a week, at the Belford hospital, Fort William and whether it will provide the necessary support to the hospital, its staff and NHS Highland in enabling that objective to be achieved in the long term. (S2O-7848)
Health boards are responsible for planning and ensuring the delivery of safe, sustainable and high-quality services for their populations, within the framework of priorities and guidance provided by the Executive. The range of services to be provided in future at Belford hospital has been the subject of careful study by the west Highland health solutions group, which brought together NHS Highland and NHS Argyll and Clyde to review the work of that hospital and of the Lorn and Islands hospital in Oban. The group's report supports the continuation of services at Belford hospital, but their precise configuration and the resources to be applied are clearly a matter for NHS Highland, having regard to the priorities outlined in "Delivering for Health".
Surely the minister recognises that many components of the group's report require action by the Executive. Measures such as those that relate to the retention and recruitment of staff, joint working between health boards and the importation of elective surgery from other health board areas are not within the sole competence of NHS Highland. Does he accept that the Executive should give a clear commitment that all those measures will be addressed as required by the Executive, working with the health board?
I am not sure whether the member was present for this morning's health debate. If he was, he will know that, having previously embarked on this journey, we reinforced our commitment to it today by emphasising what requires to take place in our health service around regional planning. That is a requirement for all health boards in Scotland, which are running up to meeting it in the work that they are doing now. The initiatives that we outlined in this morning's debate—on remote and rural medicine, incentivisation, the skills agenda, the retention of skills in local communities and the development of the virtual rural medicine school—contribute to meeting the objectives that the member outlined. However, to go back to first principles, it is the role of health boards to reflect their populations' needs and it is the Executive's role to support them in that, which is exactly what we do.
National Health Service Dentistry
To ask the Scottish Executive what progress it has made on the new contract for NHS dentistry. (S2O-7853)
Good progress is being made in line with the timetable that was announced in March and I expect to be able to report on further progress in the next few weeks.
What steps has the minister taken to ascertain what it will take to encourage dentists to return to NHS work? Also, what proportion of the recently announced additional funds is available to pay for treatments rather than for overheads such as equipment and facilities?
The answer to the first question is that I have engaged in discussion with members of the British Dental Association and a range of other dental practitioners to ascertain their views of the kind of investments that we are making. It is important to emphasise the point that I made in answer to an earlier question, which is that we are investing record sums—£295 million over three years—to improve dentistry and oral health in Scotland. By the third year, we will be investing £150 million more than we have invested this year, of which £120 million—80 per cent—will go to high street dentists. I made it clear in writing to every dentist in Scotland last week that the bulk of that additional funding will be made available to those dentists who maintain a commitment to the NHS and continue to treat adults as well as children on the NHS.
I am sure that the minister was as pleased as I was that an agreement was reached with Optometry Scotland for free eye checks. That is on schedule to be delivered. Does he agree that that important development has highlighted the need for a similar outcome with the dental profession? He referred to funding of £295 million and said that 80 per cent of the additional funding in the third year will go to high street dentists. Will he confirm that he is engaging constructively with the BDA? I am sure that, like me, other members want to know the height of the bar that the Executive has set for NHS commitment. How high is that bar?
That is an interesting question, to which I will come in a moment.
What is the answer?
I note that Shona Robison is also interested in the question. I take the opportunity that Mr Rumbles has given me to reflect on the constructive working partnership between the Executive and Optometry Scotland, which allowed us to make yesterday's announcement on free eye tests and on a new engagement with NHS high street opticians to provide a door through which all patients with eye health issues can come into the NHS. That is exactly the kind of thing that we want to see.
To ask the Scottish Executive what progress has been made in delivering NHS dentistry in Scotland. (S2O-7873)
Since 1 April 2004, the Scottish Executive has offered 49 grants to help towards the setting up of new, or the expansion of current, NHS dental practices under the Scottish dental access initiative. The grant offers range between £50,000 and £100,000 per practice. In addition, as I have said, we are investing £295 million over the next three years in dentistry and oral health. We will seek to use that record funding to secure access to NHS dentistry as well as to improve Scotland's oral health.
Does the minister welcome the fact that Integrated Dental Holdings is now actively seeking planning permission to set up a substantial practice in Inverness—and perhaps one in Dingwall later—which will deliver NHS dental services? Does that not show that there is a strong future for NHS dental services in Scotland? What is his opinion of dentists—one of whom used to practise in Wick—who are currently touring the country endeavouring to persuade dentists to leave the NHS?
I agree with Maureen Macmillan and accept the point that she makes. The initiative that NHS Highland has taken, which is in parallel with that taken by NHS Dumfries and Galloway, to talk to IDH about putting in place NHS dentistry services in its area is very much to be welcomed. Highland NHS Board is one of the health boards to have taken advantage of the new powers that they have had since April to seek their own solutions by appointing salaried dentists and by talking to potential suppliers. That is a good thing. Other areas have been mentioned, but it is well known that Highland has a particular problem with access to NHS dentistry, beyond the issues that are faced elsewhere. We welcome that initiative and think that it is the right way to go.
What advice can the minister give to a 77-year-old constituent from Kirkcaldy who last week found that she had been deregistered from her dental practice and was refused reregistration by three dentists? When I spoke to Fife NHS Board yesterday, all that it could offer me was the number of a dental helpline that she could phone in an emergency. Is he not ashamed that that is how our old-age pensioners are being treated? What advice can he give me that I can pass on to her so that she can receive regular dental treatment in Fife?
I am very concerned that a small number of dentists have chosen to treat their patients with such disrespect as to deregister them without providing them with alternative options. The funding that has been put in place and the powers that have been given to health boards will be taken up by, among others, NHS Fife, which is putting in place a number of salaried practices throughout Fife. I encourage NHS Fife to proceed with that as quickly as possible.
Environment and Rural Development
Sprat Fishery (Firth of Forth)
To ask the Scottish Executive whether it will reopen the sprat fishery on the Firth of Forth. (S2O-7825)
No. The closure of the Firth of Forth to sprat fishing will be maintained because it is a known nursery ground for herring, a species that is important for Scotland and which has difficulties in relation to its current assessment. Given the complex issues that are raised by the sprat and herring fisheries, I will write to the fishermen today to give a full explanation of the decision to the relevant stakeholders. Of course, I will also write to the member today.
The minister will understand that there will be great disappointment about that announcement. Does he agree that the survival of fishing villages such as Pittenweem requires the identification of alternative sustainable fisheries to supplement the limited income that is now available through the traditional nephrops fishery? Does he accept that Pittenweem fishermen, supported by Fife Council, have done everything that they can reasonably do to show that the commercially viable sprat fishery in the Firth of Forth can be sustainable without threatening stocks such as herring? Does he accept that that view is based on valid independent research from Napier University? Will he explain the evidential basis for the rejection of the outcome of that research? Will he allow further evidence of the viability and sustainability of the sprat fishery to be ascertained over the winter by agreeing to at least a limited commercial pilot involving a limited number of boats with full scientific monitoring?
I well understand the member's frustration and disappointment, but the matter is complex. The herring fishery is managed not only by us, but on an international basis. The current assessment of herring stock, particularly in relation to the poor record of recruitment, gives rise to real concerns. Because of that, a requirement has been imposed to demonstrate that there is no tangible evidence of danger to the spawning stock that occurs in the Forth.
I am sure that the minister is aware that 2005 has been a disastrous breeding year for seabirds along the entire east coast. It is believed in many quarters that that is due to the collapsing sand eel population and that some seabird colonies have survived only through eating sprats. Is the minister confident that his department has enough current research and knowledge about the role of that key species in the wider ecosystem to make a decision on reopening the fishery at all?
Given that I have just said that I will not reopen the sprat fishery, that question, which was prepared earlier and which clearly did not anticipate the answer that I have just given, may have left the member with a slight difficulty.
Sewage Dumping (Ayrshire)
To ask the Scottish Executive what the latest position is in respect of sewage dumping at Auchlin and Upper Beoch in Ayrshire. (S2O-7808)
The Scottish Executive is not aware of current dumping of waste of any kind on either site. As the member is well aware, operations were carried out to recover sewage sludge at the sites, by spreading, under appropriate regulatory exemptions that were notified to the Scottish Environment Protection Agency, which is the regulatory authority in the matter. The agency advises that operations have now stopped at both sites.
I thank the minister for his response. A letter to me from SEPA, dated 7 October, states that previous requirements on quality and depth of sewage and all other aspects of the dumping at Auchlin and Beoch have not been complied with to the agency's wishes, despite the fact that, time and again, the minister has protested that all was well on those sites. Is it not time that the minister accepted the difficulties that arise through the fertilisation programme and ensured that there is no more of it until steps are taken to ensure that all aspects, including the quality of the sewage that is dumped and sampling matters, are thoroughly guaranteed?
I acknowledge Phil Gallie's continued genuine interest in the matter but, as the member will be aware from the response that he has received, SEPA has drawn attention to what it believes may have been a number of occasional breaches by the operation in question. As the regulatory authority, SEPA is proceeding to prosecute such breaches. It would be inappropriate for me to comment on any legal process in which SEPA may be engaged on that matter.
Given SEPA's tougher stance—which I applaud—on granting exemptions in waste management licensing for large-scale disposal of sewage sludge, does the minister agree that the absence of a long-term strategy for the safe and sustainable disposal of sewage is a serious concern? What steps is he taking to address the issue as a matter of urgency?
There are three issues. The member is correct that, since the Waste Management Licensing Amendment (Scotland) Regulations 2004 (SSI 2004/275) came into force in January of this year, the regime has been strengthened and SEPA has had powers to take tougher action.
Scottish Water
To ask the Scottish Executive what measures are being taken to ensure that Scottish Water makes significant improvements in its efficiency and performance, following recent reports that Scotland still lags behind England and Wales in respect of customer performance. (S2O-7859)
The Executive has set Scottish Water objectives that will result in further substantial improvements in service standards being made over the next four years. The Water Industry Commission is required to place limits on water charges that enable the highest standards to be delivered as efficiently as possible. The commission will announce on 30 November the charge limits and efficiency targets that it has set Scottish Water for the next four years.
Can the minister reassure the Parliament that the processes that are in place will continue to deliver improvements in Scottish Water's efficiency and performance levels? More specifically, is the minister confident that Scottish Water can improve on the quality of water that it delivers and keep charges to domestic and business consumers at the most economic rate possible?
Absolutely. The WIC has legal duties to promote the interests of all water customers in Scotland and to ensure that charges for customers are set at the lowest reasonable level. I have met Sir Ian Byatt, who is the WIC's chair, and I have no doubt that the organisation will discharge those duties diligently and that customers in Scotland will be asked to pay no more than is necessary for their water services.
Jobs (Livingston)
To ask the Scottish Executive how many jobs it anticipates will be created by a new salmon processing facility in Livingston. (S2O-7882)
We expect some 50 full-time jobs and 10 part-time jobs to be created by the development of the new Macrae Edinburgh Ltd salmon processing facility in Livingston.
I thank the minister for that welcome news, which follows the awarding of a grant of more than £500,000 earlier in October.
Absolutely. I am pleased by the investment, by the location of the new facility and by the fact that a major investment of £3.6 million was assisted by the Scottish Executive's grant. I can confirm to Bristow Muldoon that the proposed development at Livingston highlights the importance of the aquaculture sector to Scotland and that it will play a role in ensuring that people throughout Scotland can access a healthy diet.
Avian Flu
To ask the Scottish Executive what recent assessment it has made of the threat to the United Kingdom poultry industry from avian flu. (S2O-7814)
Whilst there is a risk of further global spread of avian influenza, the risk to Scotland remains low. We will, however, continue to monitor the situation and work with stakeholders to ensure that adequate measures are in place to minimise the likelihood of disease occurring in Scotland and, should it happen, to ensure that we are prepared to respond quickly and effectively.
Bearing in mind that the results of a survey that was conducted recently in England indicated that at least half of all poultry farmers have received no advice on how to prepare for and react to any potential epidemic, what specific advice is being given to Scottish farmers and other groups with large bird populations, such as wildlife centres, on the identifying, reporting and containing of any potential bird flu outbreak?
We have had extensive meetings and discussions with stakeholders—those who are engaged in the industry and the representatives of organisations that deal both with wild birds and with poultry. We have taken steps to issue a plan in the event that we have to put in place further measures. Again, we have discussed the plan with stakeholders.
Does the minister accept the essential requirement for quality public information to be made available on the issue? There is a danger that misinterpretation of the situation and a lack of appreciation of the measures that the Government is taking to protect people from the spread of avian flu could lead to serious economic damage being done to a number of fundamental businesses that are crucial to the rural economy. Will the minister give Parliament an assurance that he will increase the level of public information that is being made available to allow consumers and producers to take wise decisions?
Yes. I fully accept the underlying reason for the question. There has been a great deal of misinformation, which has been profoundly unhelpful. Certainly, the Minister for Health and Community Care and I are anxious both that accurate information should be available and that avian flu should be distinguished from the separate but potentially related matter of a flu pandemic.
Brownfield Sites
To ask the Scottish Executive what advice its Environment and Rural Affairs Department gives to local authorities and communities concerning the environmental aspects of developing brownfield sites. (S2O-7864)
Although the Environment and Rural Affairs Department does not give general advice of that nature, the Development Department provides planning advice on the development of brownfield sites. Both departments also provide financial assistance to local authorities and their partners to help secure the improvement of vacant, derelict and contaminated land.
The minister will be aware of the former Royal Ordnance factory brownfield site at Bishopton in my constituency. With regard to the clearing of hazardous waste from that site to enable it to be developed, I am concerned that there seems to be no consensus on the depth of cleaning that is necessary or on the size of area that needs to be tested to ensure absolute safety. I am concerned that constituents who genuinely wish to become involved in the consultation appear to be left floundering and that no one can answer the serious and important questions on the issue. Who is responsible for the publication of publicly available criteria for the cleaning of brownfield sites?
I am very much aware that that is an issue of concern to the local community. In broader terms, I understand that BAE Systems has no immediate plans to submit a planning application for the site. Once a planning application is submitted, however, the matter becomes one for the local authority in its role as planning authority. The local authority must ensure that the remediation is enforced through compliance with the planning conditions.
High Hedges (Nuisance to Neighbours)
To ask the Scottish Executive what steps it is taking to tackle any nuisance caused to neighbours by high hedges. (S2O-7876)
Although we support in principle the need for a statutory remedy of last resort for people who are unable to resolve disputes over high hedges, due to competing legislative priorities we are not in a position to introduce legislation during this parliamentary session. However, we have previously indicated our support in principle for the proposal for a member's bill that is being progressed by Scott Barrie.
I am sure that the minister is aware of the frustration, distress and annoyance that are caused to people by neighbours who have overhanging branches or overly high hedges. He will also be aware of my whole-hearted support, as well as that of other MSPs, for my colleague Scott Barrie's proposal for a member's bill. However, does the minister agree that individual MSPs face difficulties in lodging members' bills? Will he consider again using an appropriate Executive bill, such as one of the planning measures, to introduce proposals to tackle the nuisance along the same lines that have been followed in England and Wales?
We are aware of those concerns and I fully acknowledge the interest that members have expressed in the matter. However, the legislative programme is tight. Although our minds are never closed, our current thinking is that there will not be an appropriate opportunity. I stress, however, that we are in discussions with Scott Barrie. Executive officials last met him in August this year to discuss a potential consultation paper and it is now up to Scott Barrie to progress that paper as soon as he thinks it appropriate.
Previous
First Minister's Question TimeNext
Homelessness