Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business this afternoon is portfolio question time. The first portfolio is rural affairs, land reform and islands. I advise members that there is a lot of interest in supplementary questions. I will try to get in as many as possible, but questions and responses will need to be brief.
Muirburn Licensing
To ask the Scottish Government what action it is taking to address the reported concerns of stakeholder organisations within the muirburn code working group regarding the commencement and practicalities of muirburn licensing. (S6O-04704)
NatureScot has been working closely with stakeholders through the muirburn code working group to ensure that their concerns have been accounted for in the development of the muirburn code and the licensing scheme. On 4 June, I am due to meet stakeholders who represent the muirburn code working group and are concerned about the content of, and conditions in, the code and the associated licensing framework. Although I understand that some stakeholders have concerns, the code and the associated licensing framework have been introduced to ensure that muirburn is undertaken in a safe and environmentally sustainable manner.
It is now very clear that NatureScot’s approach to muirburn licensing is unworkable and is causing serious concern among stakeholder groups. Eight organisations that represent various opinions on the matter, including Scottish Land & Estates, NFU Scotland, the Scottish Crofting Federation and the Scottish Gamekeepers Association, have written to the minister on two occasions, and have proposed good-faith solutions to help to ease the burden that is associated with surveying land for peat depth. Current survey requirements define peatlands as areas where peat is deeper than 40cm, but no national data exists on that 40cm threshold, thereby rendering the peatland maps that NatureScot produces completely meaningless. Will the minister urgently consider temporarily amending the definition of peatlands to reflect a peat depth threshold of 50cm, which would considerably assist land managers?
Clearly, we are in the early stages of this process. The legislation that was passed on the issue included a threshold of 40cm. A number of tools are being used to gauge the difference between the 40cm and 50cm thresholds. As I said, I will meet members of the muirburn code working group next week, and those issues will be raised and aired then.
What reassurance can the Government provide to land managers on the implementation of this legislation and on seeing that NatureScot works with land managers timeously to ensure that the legislation is workable and that the vital management tool of burning is accessible?
NatureScot has been working closely with land managers since September 2023 to ensure that the legislation is workable in practice. It has produced the methodologies for identifying peatland and non-peatland areas. Those methodologies have been made available to land managers to allow them to prepare for the legislation that is coming into force. A simple application process is being developed, and feedback has been sought from stakeholders. Users have tested a prototype, and feedback is being used to ensure that the process is user-friendly.
Furthermore, NatureScot has agreed to allow practitioners to fulfil the legislation’s training requirements by completing only the online part of the muirburn training course this season, to provide more time for the practical elements to be completed. NatureScot will remain on hand to assist applicants for muirburn licences. As I mentioned in my answer to the previous question, next week I will meet stakeholders who have expressed concerns.
Will the minister commit to there being no delay in implementing the new regulations, which were due to come into force this April? I am really concerned about his comments on peatlands. Will he categorically rule out changing the threshold from 40cm to 50cm, given that we have not even implemented what the Parliament agreed to?
There are no plans to change anything at this stage.
Given the importance of muirburn, its role in managing fuel loads to mitigate wildfire risks, and the timescales that we have heard about, what will the minister do to ensure that licensing applications are as informed and as accurate as possible?
In the interests of brevity, I will very quickly point out to the member that protection from wildfire is a licensable purpose for muirburn.
Wildlife Crime (Beaches)
To ask the Scottish Government whether it will take action to deter wildlife crime on beaches, particularly over the summer months. (S6O-04705)
The Scottish Government works with a number of partners to raise awareness of wildlife crime, and Scotland is part of operation seabird, a police-led operation that focuses on deterring the disturbance of marine wildlife across coastlines in the United Kingdom. Police Scotland wildlife crime officers will proactively patrol coastlines in the summer months, engaging with and educating the public and recreational tour operators as well as enforcing legislation that has been introduced to protect our sea life.
If a member of the public is concerned that they have seen someone commit a crime, they should contact Police Scotland.
Tentsmuir nature reserve in my region welcomes a huge number of visitors every year. Although many visitors are respectful towards wildlife, some remain unaware that their behaviour or conduct might negatively impact on the animals, and it could result in their committing a wildlife crime. For example, in a recent reported incident, a couple walking their dogs disturbed seals, causing panic and distress for the seals—which sought refuge in the sea—which could potentially cause them harm.
Further to the minister’s response, what more can the Scottish Government do to ensure that the public are fully aware of the risk of inadvertently committing wildlife offences? Will it consider holding further public awareness campaigns over the summer months?
As I said, operation seabird is a national operation focused on deterring the disturbance of marine wildlife across UK coastlines. Police Scotland will ask its wildlife crime officers to proactively patrol their divisional coastlines in the summer months, engaging with and educating the public and enforcing the legislation that has been introduced to protect our sea life. That proactive engagement will be made with boat and tour operators and with members of the public who engage in seaside recreational activity, to ensure that they are adhering to the relevant legislation.
What more can the Scottish Government do to reinforce the message that people who visit beaches, such as those in my Carrick, Cumnock and Doon Valley constituency, must act responsibly and must not interfere or inappropriately interact with wild animals when they encounter them in and around our seas? Our beaches are very busy. I think that the issue must be tackled early, and in the school setting.
Whether folk are visiting beaches, forests, local parks or any other outdoor space, we expect them to act safely and responsibly when they encounter wildlife. The Scottish outdoor access code sets out useful guidance on minimising disturbance to wildlife. We ask everyone to familiarise themselves with the steps that they should take to enjoy the outdoors appropriately. As regards our coastline, the Scottish marine wildlife watching code provides further recommendations and advice on responsible wildlife watching.
Fisheries
To ask the Scottish Government what new action it will take to support fisheries, in light of the European Union-United Kingdom agreement. (S6O-04706)
As set out in the programme for government, we will continue to champion and support Scotland’s world-leading fishing sector to maximise fishing opportunities and to modernise, by delivering technical and management improvements through the future catching policy and our inshore fisheries management improvement programme.
The EU-UK trade deal agreed by the UK Government disadvantages the Scottish catching sector. The deal merely perpetuates the arrangements that had been agreed by the previous Conservative Government and their failure to protect our fishing communities.
I am therefore calling for a fair share of the fishing and coastal growth fund budget allocation to be devolved and administered in partnership with Scottish stakeholders, reflecting the size and importance of fishing to Scotland.
That answer confirms that the Scottish National Party Government does not have a clue whether it actually supports Scottish fishing. On the one hand, John Swinney has said that the UK Government has “surrendered” the Scottish fishing industry. On the other hand, he is campaigning to rejoin the European Union, which would result in a return to the disastrous common fisheries policy and would be even more damaging for Scottish fishing. What is worse for Scottish fishing—the sell-out by the Labour Government or the hypocrisy of the SNP?
I would say that it is the sell-out by the Tories and the UK Government. The Tories wish to touch on our position once we are an independent country, which I am more than happy to talk about and set out. We have set out our position clearly in a paper that we published as part of the “Building a New Scotland” series, and Mr Kerr might like to take a few moments to read it. In that paper, we discuss our marine industries and the benefits of Scotland being an independent country—independent in its own right, with a seat at the negotiating table in the EU. One thing is for sure: we can negotiate for our interests there when we are independent. Whether it is Labour or Tory, the UK Government cannot be trusted to do it.
Following Brexit, the Tories delivered a disastrous deal to our fishermen, and Labour has locked them into the same deal for 12 years. That is something that both parties should apologise for.
Can the cabinet secretary set out how the Scottish Government has supported fishers and fishing and coastal communities over the course of this parliamentary session?
We are committed to supporting our fishing sector in Scotland and we have a strong track record on that. We have set out our overarching policy as part of our future fisheries management strategy. The updated delivery plan, which we published a couple of months ago, set out how we are delivering on that.
Since 2021, we have continued to invest around £9 million each year in our science capabilities, which underpin the important work that our catching sector does. On top of that, the marine fund Scotland has delivered more than £55 million to more than 300 projects since 2021.
Therefore, we have delivered for our Scottish fishing industry and communities and we will continue to do so.
The distribution of fishing quota remains the responsibility of the Scottish ministers. How will the cabinet secretary ensure that that public asset remains in public hands and is used to ensure that inshore operators and new entrants have better access to the industry in such a way that ensures that cases of modern slavery and human trafficking are consigned to history?
Rhoda Grant raises several important matters that I am more than happy to follow up on specifically. We consulted on some of those matters recently and we always aim to do so in a fair and equitable way. On some of the substantive matters, I am happy to follow up in writing.
Crown Estate Scotland (Borrowing Powers)
To ask the Scottish Government, in light of the Crown Estate in England, Wales and Northern Ireland being granted borrowing powers so that it can, for example, invest in energy infrastructure, what its position is on similar powers being granted to Crown Estate Scotland. (S6O-04707)
Further detail on the arrangements under the Crown Estate Act 2025 will not be known until later this year. The Cabinet Secretary for Finance and Local Government has written to the Chief Secretary to the Treasury on those matters to stress the importance of parity of treatment for relevant Scottish bodies, including in relation to any borrowing and investment powers that may be afforded to the Crown Estate.
That sounds as if the Scottish ministers are seeking for those powers to be granted. If that is the case, some questions need to be answered.
Before the ScotWind auction was delayed, the maximum cap was set at just £75.6 million, only for it to increase tenfold weeks later, after consultants were hired. That secured Scotland an extra £680.4 million. Global comparisons suggest that even that final figure was substantially undervalued.
Can the minister explain on whose advice Crown Estate Scotland, a wholly publicly owned body, came within days of losing out on that substantial increase in revenue, and to whose potential benefit was the initial undervalue?
The member raises questions that I would have to look into and follow up in more detail. Ms Regan—and other members across the chamber—will be aware of the vital role that Crown Estate Scotland plays in maximising the value of its assets, many of which we continue to benefit from. That includes the moneys that we received from the ScotWind process and the investment that resulted from it. I am happy to follow up with Ash Regan on the specific point that she raises.
Glasgow City Food Plan
To ask the Scottish Government what engagement it has had with Glasgow City Council regarding support for the reported development of community food production and short supply chains, as outlined in the Glasgow city food plan. (S6O-04708)
We engaged with partners who are involved in the Glasgow city food plan during the development of our first national good food nation plan, which covers all aspects of the food system, including community food production and short supply chains. We look forward to working with Glasgow City Council as it develops its future good food nation plan, as will be required by the Good Food Nation (Scotland) Act 2022.
In order to tackle food insecurity in Glasgow, the council is looking at new models—such as buying consortia and local supplier co-operatives—that can help to grow food closer to where it is needed. The council is already doing work in that space. Will the Government commit to working with Glasgow City Council and other urban councils to embed those models in future rural and agricultural policy?
Pam Duncan-Glancy raises some important matters, and we really want to see everything that she has outlined. I have talked about the good food nation plan, which we should be introducing to the Scottish Parliament shortly. That is exactly the type of thing that we would like to see and encourage. I am happy to follow up on her question and ensure that my officials are engaged in that work. We will see what else we can do to further support that work and help it to spread across Scotland.
Question 6 has been withdrawn.
European Union-United Kingdom Agreement (Impact on Rural Economy)
To ask the Scottish Government what assessment it has made of any potential impacts of the EU-UK agreement on Scotland’s rural economy. (S6O-04710)
We very much welcome the UK Government’s attempt to rebuild relations with the EU following what can only be described as the disastrous hard Brexit that the people of Scotland never voted for. We have unceasingly called for an improved relationship and although the UK-EU summit has been unnecessarily constrained by the UK Government’s self-imposed red lines, it is a step in the right direction. Many of the details of the agreement are still to be negotiated, never mind actually implemented. Meanwhile, the effects of Brexit, including on our rural and island economy and communities in Scotland, continue to make any sense of congratulation wildly premature.
As a start, if the UK Government was serious about addressing the scale of the damage done by Brexit, it would immediately discard its self-defeating red lines on a single market, a customs union and freedom of movement with our European neighbours. Further, given how much the actual implementation of the agreement will require devolved competencies, the UK Government’s first action should be to engage proactively with the devolved Governments, including here in Scotland.
Although the agreement, which goes some way to improving some of the harms of Brexit, has to be welcomed, will the minister highlight for members how remaining outside the single market and the customs union, and without freedom of movement, continues to damage the interests of our rural economy?
The red tape that increased costs to businesses has hit Scotland’s trade with our largest international export market. Scotland’s rural economy bore much of the impact of the loss of EU funding, new barriers to trade and reduced access to labour.
The Government’s own figures show that the deal will add £9.9 billion to UK national income by 2040, which is just 0.2 per cent of gross domestic product. The loss of GDP caused by Brexit is estimated to be 20 times that, at 4 per cent of GDP, according to the Office for Budget Responsibility. There is no good deal in this for Scotland without being an independent member of the EU, which would give us unfettered access to the markets that we are looking to be part of.
NatureScot (Seagull Control Licensing)
To ask the Scottish Government what its position is on whether NatureScot considers and respects the views of local people and businesses when considering applications to control seagulls. (S6O-04711)
NatureScot considers and respects the views of local people and businesses, which can vary widely, when considering licence applications to control gulls. However, NatureScot can issue a licence only in accordance with the law. I recently met stakeholders to discuss how we can minimise gull impact; the conclusion was that further actions would be taken this year by NatureScot to deal with the immediate problem. I have also agreed to chair a summit of key partners later this year to put measures in place in relation to preventing those issues from arising again next year.
I am sorry, minister, but NatureScot does not respect the views of local people and businesses. It ignores the views of local people and businesses.
On Monday, I received a response to a freedom of information request asking for the most common reason that licence applications for gull management are refused. NatureScot says that it is because the applicant does not demonstrate that gulls are posing a risk to public health or safety. That is utter rubbish. I know the people who are putting in those applications, and they are at the end of their tether. Those birds are causing significant worry, they are physically damaging individuals, and they are putting people off going into certain businesses because of their behaviour.
Will the minister finally get a grip on NatureScot and tell it to start delivering for those communities by approving those licences, so that we can get some control over gulls in our areas?
I absolutely accept that there are areas where gulls are causing a problem in relation to public health and safety. As the member is well aware, NatureScot can issue the licences only on the basis of public health and safety issues, and not nuisance issues.
It is a public health and safety issue.
That is the fundamental point that we are trying to get across—[Interruption.]
If members want to listen—
Members: Oh!
I have told them on a number of occasions that I am prepared to intervene when there is an area that needs to be looked at right away. Then, I will have a summit next year—[Interruption.]
Next year!
I will have a summit later this year to discuss with members and the people who are raising those issues how we can control the birds in the way that we need to, without damaging the population.
I will take a supplementary question, but I ask members to listen to the questions and then also the responses.
It is not only a public health and safety issue. I have repeatedly warned the Scottish Government, in this chamber, that serious injury or fatality could arise from massive gulls swooping down on elderly people and infants; I have even warned about the consumption of seagull faeces causing horrific disease. After those warnings, a 74-year-old man in Nairn was injured by a seagull.
When will the Scottish Government get a grip and respond—not to NatureScot, but to what the people say? Will the summit to which the minister referred be open to the public, the press and MSPs? Will there be presentations by business improvement districts and will the summit be co-designed by BIDs? They are the ones that have to sort out the mess.
I reiterate that I am well aware that there are issues with gulls swooping down and causing problems for people in the areas that have already been mentioned. That is why I made sure that licences were issued earlier this year. We are holding the summit to ensure—[Interruption.]—that measures are taken to protect people as we go forward from this point.
Could I please ask members to resist the temptation to shout out while ministers are seeking to respond?
That concludes portfolio questions on rural affairs, land reform and islands. There will be a brief pause to allow front-bench members to change over.
Health and Social Care
The next portfolio is health and social care. There is a lot of interest in supplementaries, so brevity in questions and responses would be appreciated.
Audiology Waiting Times
To ask the Scottish Government whether it will provide an update on what action it is taking to improve waiting times for audiology appointments. (S6O-04712)
Our 2025-26 budget provides record funding of £21 billion for health and social care, and national health service boards are receiving an additional £200 million to reduce waiting lists and to help support reduction of delayed discharge.
With that funding, we will deliver more than 150,000 extra appointments and procedures across a number of specialities in the coming year, which will ensure that people receive the care that they need as quickly as possible. Ear, nose and throat services will be an important part of that work, to which more than £9 million of the funding will be allocated. That will increase the number of new out-patient appointments that are available in 2025-26 and will ensure that patients receive the treatment that they require.
I have been contacted by one of my constituents, who said that her husband waited 19 months for a hearing assessment. He was then advised that he had moderate hearing loss and that he would benefit from hearing aids. The assessment took place in October 2024, yet he still does not know when he will receive his hearing aids. Meanwhile, my constituent has pointed out that her sister-in-law in Northern Ireland waited only six months for an assessment and was able to have her hearing aids fitted at the same appointment.
A lack of hearing assessments and hearing aids can lead to one’s quality of life deteriorating. How can something so simple yet so important take so long?
Pam Gosal is absolutely right—that is not the right way to support people who are living with hearing loss. They should not have to wait so long. If Ms Gosal would like to write to me directly about the situation, I would be happy to look into it. We remain absolutely committed to our vision of an integrated community-based hearing service in Scotland.
Preventative Initiatives and Services
To ask the Scottish Government what discussions it has had with the Edinburgh integration joint board, NHS Lothian, the City of Edinburgh Council and any other relevant organisations regarding any impact on patients, communities and statutory services of reported reductions to preventative initiatives and services. (S6O-04713)
I, along with ministerial colleagues and Government officials, regularly meet with Edinburgh colleagues. In those meetings with local partners, the Scottish Government continues to stress the paramount importance of putting outcomes for people at the centre of all decision making.
I am aware of the agreed and proposed actions that are contained in the Edinburgh integration joint board’s savings plan for 2025-26 and am confident that every effort is being made to ensure that all stakeholders, including service users, are properly consulted and that services continue to provide essential support.
As the minister and her colleagues will be aware from First Minister’s question time on 8 May and other correspondence before and since then, there is deep concern in our capital city among many charities and third sector organisations, including in my constituency, over the review of contracts and service level agreements by the integration joint board and the Edinburgh health and social care partnership. The proposed cost savings from the review could lead to a loss of early intervention and prevention services, which we all know are important, particularly given the demographic pressure in the capital.
I would therefore be grateful if the Scottish Government could continue its efforts and use its convening power to help find solutions to ensure that meaningful engagement and partnership take place and that services that are at risk of cancellation are given the reassurance that they require and are able to continue doing their important work.
I absolutely recognise the concern of the sector in Edinburgh, and I thank Ben Macpherson for raising those issues with us in the chamber. However, I must point out that, although the Scottish Government has overall responsibility for health and social care policy in Scotland, it is appropriately for IJBs to ensure that social care support services are in place, and that decisions on how best to deliver services to local communities are ultimately and appropriately for integration authorities and locally elected representatives to make.
The Edinburgh IJB is in the process of updating its strategic plan, in which prevention and early intervention feature prominently. IJB officials have engaged in extensive consultations with third sector representatives, and I understand that further decisions on savings have been delayed to allow for additional engagement.
On Monday evening, I attended a packed public meeting, organised by Change Mental Health, to discuss the concerns of many service users. Given the well-established link between early mental health intervention and suicide prevention, what is the Scottish Government doing to address the potentially life-threatening consequences of cuts to community mental health services in Edinburgh? As mental health minister, is Maree Todd content that Edinburgh would become one of the only cities in western Europe without community mental health services?
I absolutely recognise the concern expressed by Change Mental Health and its valued stakeholders and partners. I work with and meet the organisation regularly, and I hear those concerns for myself.
As I said in answer to Ben Macpherson, these decisions are appropriately and rightly devolved to locally elected representatives. As I understand it, there has been a series of engagements and a pause in decision making to ensure that appropriate decisions are made.
As for the very serious issue that my colleague has raised, a whole suite of work is going on across Government to tackle suicide prevention. We are focused on that work and are keen to continue the long-term improvements in the statistics.
The proposed cuts are causing massive concern, particularly for mental health services, which are estimated to save £7 for every pound invested. The EIJB recognises that cuts to Thrive mental health contracts could increase pressure on services and leave users without support. Does the minister agree that that goes against the Scottish Government’s target of prevention? Will she meet me and the cross-party group of MSPs to find a solution?
I am certainly content to meet colleagues to try to find a way forward. The member will understand that, as I have said in previous answers, these decisions are appropriate for the IJB and locally elected representatives to make.
However, the Scottish Government is absolutely focused on early intervention and prevention, including for serious and enduring mental health problems. We are investing in community support for children, young people and adults directly through local government funding and third sector voluntary funds, and I will ensure that members are aware of those sources of funding for the areas that they support.
Question 3 has been withdrawn.
National Health Service Complaints (Backlogs)
To ask the Scottish Government what action it is taking to support regional national health service boards to tackle any backlogs of complaints. (S6O-04715)
Overall responsibility and accountability for the management of NHS complaints lies with individual boards’ chief executives, their executive directors and the appropriate senior management. The boards must ensure that complaints teams are adequately resourced to meet their statutory duties in relation to complaints handling.
The Scottish Government has been clear about the importance of a timely and effective response in order to resolve a complaint. However, we are aware that not all investigations will be able to meet the 20-day target. The regulations make provision for timescales of responses to complaints to be extended where appropriate, provided that complainants are informed of the reason for the delay and given a revised timescale for a response.
I am currently representing a constituent who lodged a complaint with NHS Forth Valley back in October 2024. Other than three holding replies that were received up to the beginning of January, my constituent is still waiting.
When I approached NHS Forth Valley, I was informed that, because of staff shortages, it was now working only on complaints that were received during August 2024 and that it would be unlikely that my constituent would receive a response until at least October 2025, which is a whole year after the initial complaint was made. Given what the cabinet secretary has just said, I hope that he will agree that that is completely unacceptable and that it is certainly not within the 20 days that it is supposed to be the case for investigation. What action will the cabinet secretary take?
I thank Liz Smith for raising her concerns about her constituent in Forth Valley. I am obviously not aware of the full circumstances, so I cannot comment specifically, but what Liz Smith has narrated to Parliament is deeply concerning. I would appreciate it if she could furnish me with the details of the case so that I can raise it with NHS Forth Valley and get an explanation of what is happening.
In general, as I said in my initial answer, I would expect a timeous response. There can be reasons why that can be delayed, but from what Liz Smith tells me, it has gone beyond that point with that complaint.
What we have just heard about is not a one-off. Complaints that should be taking 20 working days to handle are now being measured in months, not days. That adds extra distress to patients who have had a poor experience with the NHS, compounding their stress and turmoil and reducing even further their confidence in the health service.
It also leads to greater burnout in the NHS patient complaints team, as lack of adequate staffing levels leads to backlog and overworking. Does the cabinet secretary agree that many NHS boards need to allocate more funding to their complaints teams? If so, will he commit the Scottish Government to making sure that all NHS boards’ patient complaint teams have adequate staffing levels to reduce the backlog?
Mr Sweeney will be aware, as I set it out in my initial answer to Liz Smith, that it is the responsibility of individual boards to ensure that their public affairs and complaints teams are adequately resourced.
Overall, the number of complaints has fallen 7 per cent to 33,273 from a position of 35,000 in 2022-23. However, although the overall number of complaints has reduced, I recognise that the complexity of some cases means that, sometimes, it takes longer for them to be investigated and responded to. However, the position that I put to Liz Smith with regard to my expectation of complaints teams handling complaints quickly is paramount.
Long-term Conditions Framework
To ask the Scottish Government what discussions it has had with cardiology patients, clinicians and other relevant stakeholders as part of the development of the recently published long-term conditions framework consultation. (S6O-04716)
The Scottish Government carried out engagement and consultation with a wide range of stakeholders during the development of the long-term conditions framework consultation.
That included a heart disease lived experience focus group, a third sector event—attended by heart disease organisations—and a meeting with the heart disease clinical leads. There have also been ministerial meetings with British Heart Foundation Scotland and Chest Heart & Stroke Scotland.
The consultation is now live, and I encourage clinicians, health professionals, those in the third sector and people with lived experience to respond.
Last week, British Heart Foundation Scotland published figures that showed that Scotland has seen the first sustained rise in heart disease deaths in a generation. We must halt that trend. Collaboration between everyone who is involved in tackling heart disease is crucial. The long-term conditions framework could result in a deprioritisation of conditions such as heart disease. Will the minister guarantee that collaboration will take place between those stakeholders and the Scottish Government to ensure that the 730,000 people in Scotland living with heart disease are not forgotten about?
I agree that it is important that third sector clinicians and people living with heart conditions are properly consulted. The long-term conditions framework will focus on ensuring equitable and sustainable access to the services that all people with long-term conditions need, while still allowing for targeted action on condition-specific care and support where necessary. That is exactly the message that I passed on to British Heart Foundation Scotland and Chest Heart & Stroke Scotland.
I agree that we need to continue our approach, and that is exactly the way that I will continue working as we gather information from the consultation.
A number of members want to ask supplementary questions. I will try to get everyone in, but they will need to be brief.
Figures that were published last week by British Heart Foundation Scotland showed that incidents of cardiovascular disease in working-age adults aged 20 to 64 in Scotland have risen by 14 per cent. The impact of heart disease on people early in life is increasing, particularly in our most deprived areas, where premature deaths are five times higher than in our least deprived areas. Will the minister commit to addressing that through the creation of a fully resourced plan that is co-produced with clinicians and the third sector?
We are awaiting the results of the long-term conditions framework consultation, but we must also recognise that we need to go further on the preventative side. That is exactly where the Scottish Government has been increasing its investment in health.
I absolutely recognise the points that Carol Mochan made about inequalities and ensuring that people from all areas of Scotland get the right support. That is why we are increasing the number of general practitioner appointments that are available. We have also been working closely with the Convention of Scottish Local Authorities on a population health framework that is absolutely focused on prevention.
The latest figures, which were published yesterday, show that a record 149 people in my health board area of NHS Ayrshire and Arran have been waiting more than a year to see a cardiologist. Will the minister reassure me and the around 13,000 people who are living with cardiovascular disease in my constituency that CVD will remain a priority for the Scottish Government, with a dedicated resource to support the improvement of cardiology services?
I agree that we must focus on the prevention of cardiovascular disease. That remains a priority for the Scottish Government, which is why we have designed a service that focuses on proactive case finding of cardiovascular disease issues. Through our £10 million investment in the new CVD enhanced service agreement, we are encouraging innovative ways through which general practices can engage with individuals who might be at higher risk of cardiovascular disease.
Some 38 per cent of Scotland’s population have a long-term health condition. How is the Scottish Government working to ensure that the outcomes of the long-term conditions framework consultation will build a framework that cuts across all conditions but recognises when it is important to be more condition specific?
As I said earlier, the new long-term conditions framework will focus on ensuring equitable and sustainable access to the services that all people with long-term conditions need, while still allowing for targeted action on condition-specific care and support where appropriate.
Responses to the current framework consultation will be carefully analysed, alongside other available evidence, to establish opportunities for actions that benefit all people with long-term conditions. Where condition-specific work is appropriate, that, too, will be informed by evidence, including that from the consultation, which is currently live.
People living with arthritis and musculoskeletal conditions make up a large number of people who have long-term conditions. In Glasgow, some of them have been waiting for trauma and orthopaedic support for more than 52 weeks. What measurable difference will the long-term conditions framework make for people living with arthritis and MSK conditions?
I have set out the long-term conditions framework in a way that recognises that every condition can benefit from learning from others and that there will be certain golden threads that run through all conditions.
As I said in two previous responses, if there are certain areas of the strategy that require specific strategies—similar to our 10-year cancer strategy, which focuses on certain cancers—that will certainly be considered.
Ambulance Delays (NHS Grampian)
To ask the Scottish Government what its response is to reports that NHS Grampian is ranked the worst of all mainland national health service boards for ambulance delays. (S6O-04717)
Data on turnaround times for ambulance resources across Scotland by hospital site and by national health service board are shared with the Scottish Government and published weekly, so we are well aware of the challenges that both NHS Grampian and the Scottish Ambulance Service are facing in that regard. We continue to work closely with both organisations to improve turnaround times in the region.
The cabinet secretary will be aware, because he visited NHS Grampian in February and—along with his usual apology for the Government’s failure—he promised to improve things. Here we are in May, and one in 10 people is waiting four hours or more for an ambulance, with delays steadily rising. That is nearly double the target figure of two and a half hours.
What, precisely, has the cabinet secretary done since February to reduce ambulance wait times in NHS Grampian, and when does he project that those measures will result in NHS Grampian hitting its targets?
I saw for myself the challenges that NHS Grampian is facing, specifically at the Aberdeen Royal infirmary, from my visit there, to which Liam Kerr referred. I understand the challenges there—I have family members living in Grampian, so I understand the specific issues intensely.
We have escalated NHS Grampian on the escalation framework to level 4, both for its performance and delivery and in relation to the financial picture. That escalation provides additional support and scrutiny to ensure that the board is meeting its financial and delivery imperatives. At the top of my list are the unscheduled care pathways in Grampian, so that the board starts to see improvements, because the current position is unacceptable.
“Whole person medical care: The value of the General Practitioner”
To ask the Scottish Government what its response is to the new report from the Royal College of General Practitioners Scotland, “Whole person medical care: The value of the General Practitioner”. (S6O-04718)
I thank the Royal College of General Practitioners Scotland for its report, “Whole person medical care: The value of the General Practitioner”, which highlights the value of GPs and the contribution that they make to the nation’s healthcare. I look forward to discussing the report further with the RCGP at one of our regular meetings.
We remain committed to increasing the number of GPs working in Scotland. In November last year, I published a plan setting out 20 measures to improve GP recruitment and retention.
The report states categorically:
“The Scottish Government’s current target is to increase the number of headcount GPs in Scotland by 800 by 2027.”
It goes on to say:
“It is the view of Audit Scotland and RCGP Scotland that this target will not be met.”
Does the cabinet secretary agree?
I do not think that that is inevitable. I am still committed to meeting that target. We currently have a record number of GPs in training, and I want to work with both the RCGP and the British Medical Association general practice committee on how we see increased resources going into general practice to support greater employment.
We have seen a rise in the head count, but I recognise that the whole-time equivalent position has been more challenging post Covid, as people have—understandably—taken different decisions on work-life balance. I want to see the capacity of, and the provision from, general practice increase. Our vision for the health service has shifted the balance of care into community and primary care and to a more preventative model, and we arrive at that only by having increased services in general practice.
We have a number of supplementaries. I will try to get them all in, but I need brevity.
A new 80-bed nursing home is about to open in Largs, and concerns have been raised about the impact on the town’s only GP practice, Largs Medical Group. Despite the practice’s proactive efforts, the nursing home has allegedly declined to participate in any local enhanced service agreement that would assist in the delivery of sustainable care to its residents.
Can the cabinet secretary advise what support is available to GPs in managing a new care home population? Will he join me in encouraging all new care home developments to opt into local enhanced service agreements to address specific local healthcare needs?
As Kenneth Gibson will know, the premise of local enhanced service agreements is that they are agreed on a local basis, so it would not be appropriate for me to intervene directly in that case. I welcome the expansion of social care provision in Mr Gibson’s constituency, but we need to ensure that there are good working arrangements between social care and primary care, so I encourage that to continue. If he continues to see that as an issue, I would—while I cannot get involved directly—welcome correspondence from him setting out the issues, and I will ensure that we look into the matter further.
I declare an interest as a practising national health service GP. The RCGP report discloses that
“adding one GP for 10,000 people equates to an estimated reduction”
of more than £82,000.
Eighty to 90 per cent of patient contact is in primary care, but GPs have only 7 per cent of the NHS budget. GPs are the cheapest form of healthcare, yet GP practices are in trouble. They have been neglected by this Scottish National Party Government and are struggling to stay afloat, and Labour’s national insurance rise is killing practices. What is the Scottish Government doing to protect GP practices from going under?
We continue to work with the Royal College of General Practitioners and the BMA’s general practitioners committee. We have invested in general practice through the budget and provided increased support to GP practices for recruitment and retention. However, I recognise that, given some of the challenges that Dr Gulhane has rehearsed, challenges remain when it comes to the recruitment and retention of GPs.
That is why we continue to work with the Royal College of General Practitioners and the BMA in order to ensure that greater resource goes into general practice, so that it can recruit more GPs and wider practice staff and continue to provide the incredible service for our communities that it does.
The report says:
“Embedding continuity of care into everyday GP practice in Scotland has been underprioritised ... The GP Voice tracking survey found that under half of GPs (48%) felt they were able to deliver continuity of care which meets their patients’ needs.”
After 17 years in power, why are we in this sorry state?
I absolutely value the role that general practitioners play in providing continuity of care and having the knowledge and understanding to meet a person’s health needs, often over their lifetime. That is absolutely critical, which is why we will continue to work with the BMA and the royal college to ensure that they have the support that they need to continue to provide services and continuity of care to our communities. We need to shift the balance of care from acute hospital-based services to more general practice-based services in the community. That is my vision for the health service, which I intend to deliver on.
Premenstrual Dysphoric Disorder
To ask the Scottish Government how its policies support people with premenstrual dysphoric disorder. (S6O-04719)
The Scottish Government’s ambition is for a Scotland where women enjoy the best possible health throughout their lives. Premenstrual dysphoric disorder—or PMDD—and its impact on mental health is recognised in the women’s health plan.
Our mental health and wellbeing strategy lays out our vision for improving mental health so that anyone who needs help can get the right help in the right place at the right time. We expect that mental health care and treatment will be delivered in a person-centred manner to meet the needs of each individual, including those who are affected by PMDD.
PMDD is a severe form of pre-menstrual syndrome, which is characterised by debilitating psychological systems, and it is heartening that PMDD is included in the Scottish Government’s women’s health plan. Dr Lynsay Matthews of the University of the West of Scotland and Ms Julie Riddell of the University of Glasgow have led the first significant research in this area, and it indicates that there is a lack of knowledge and understanding among key professionals and services in the United Kingdom.
Will the Scottish Government engage with that important research and consider the priorities that are identified such as awareness raising, training, early diagnosis and holistic psychological support?
I thank Clare Adamson for raising the topic in the chamber. We know that work is still to be done to address the stigma and lack of understanding that surrounds menstrual health, including PMDD. Through our women’s health plan, we have already undertaken steps to raise awareness and support better understanding of PMDD among healthcare professionals, by commissioning NHS education for Scotland to create training on menstrual health, which includes PMDD.
Our NHS Inform women’s health platform provides women and girls with access to information on menstrual health and PMDD. I was not able to meet the researchers, but some of the women’s health team did. We are considering Dr Matthews’ findings as we develop the next phase of the women’s health plan.
That concludes portfolio questions for health and social care. There will be a brief pause to allow front-bench members to change over before we move to the next item of business.
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