Meeting of the Parliament [Draft]

Meeting date: Thursday, September 28, 2023

Official Report 1032KB pdf

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First Minister’s Question Time

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Ovarian Cancer Services (Waiting Times)

This week, Margaret McColl, who is from Lanarkshire, described her ordeal when she was diagnosed with ovarian cancer. She faced a three-month wait for national health service treatment in Scotland. However, Margaret did not know if she had that long, so she used £27,000 of her life savings for faster private treatment in England. She said:

“Cancer kills if left untreated and the Scottish Government is allowing this to happen. We shouldn’t have to go to London or elsewhere.”

First Minister, Margaret is right, isn’t she?

Margaret is right that nobody should have to feel that their only option is to pay privately and to go anywhere outside Scotland for cancer treatment. I pass on my sympathy to Margaret for the unacceptable ordeal that she has had to go through.

I will try to give some context. I know that Douglas Ross and others in and outside the chamber are aware of the significant impact that the Covid pandemic had on our health services across the United Kingdom, including on cancer services. One of the most difficult decisions that the Government had to take during that Covid period was to have to pause cancer screening for a number of months; we are still dealing with the impacts of that difficult decision.

On ovarian cancer more specifically, let me try to offer some assurance, if I can. The latest figures show that, in Scotland, 94.7 per cent of women—more than nine out of 10—are receiving their first treatment for ovarian cancer within 31 days of a decision to treat. However, in those situations where that is not happening or, in Margaret’s case, has not happened, I fully accept Douglas Ross’s proposition that that state of affairs is not acceptable.

The First Minister has mentioned Covid, as I thought he would. However, they had Covid in England as well, where Margaret got treatment because she could pay £27,000 for it—she went south of the border to get it.

The First Minister wanted to offer his reassurance to ovarian cancer sufferers. Target Ovarian Cancer has said that

“Scotland has one of the worst survival rates in Europe”.

People need urgent treatment to save their lives but, in the Scottish National Party-run NHS, they wait months. Margaret is worried about what happens if her cancer comes back, and she is also worried for people who do not have life savings to pay for treatment. Public Health Scotland statistics show that people from the most deprived areas of Scotland are 74 per cent more likely to die from cancer than people in wealthier areas. What are people meant to do if they get cancer but cannot afford to go outwith Scotland for treatment?

The NHS in Scotland will be there to assist and treat where it possibly can. Unless I misunderstood Douglas Ross—I am willing to correct the record if I did—Margaret went for private treatment in England, but NHS services in England have been impacted, too, as have the services in NHS Wales and undoubtedly in NHS Scotland.

Douglas Ross is absolutely within his rights to ask the question around ovarian cancer, and I am more than happy, given the time limits that we have in First Minister’s question time, to write to him with far more detail. We are taking the specific issue of ovarian cancer with the utmost seriousness.

The Scottish cancer network will establish a new ovarian cancer clinical network, which will ensure equity of access to treatment for all women with ovarian cancer. That is specific to the point that Douglas Ross raised about the inequality that might exist in relation to accessibility of services.

We have also committed £10.5 million to help health boards to improve their capacity and access to systemic anti-cancer therapy by 2027; £3 million of that additional funding has been released this year. As I said, I could give a lot more detail about what we are doing specifically on ovarian cancer but, in the interests of brevity, I will write to Douglas Ross with that further detail.

I will welcome that response when it comes, and I will share it with another member of the public to whom we have spoken. Irene Hartshorn from Ayr was told that she needed to wait 12 weeks for ovarian cancer surgery. She told us this morning:

“I felt powerless ... you know that all the time the illness is getting worse and worse. If I had waited, I think I would be dead by now.”

Her sister paid for her to get treatment in London, but Irene wanted us to ask the First Minister why the resources are not in place in Scotland for the treatment that she had to go south of the border for.

We are investing in our national health service, which is why, this year, we gave an additional £1 billion to the health service, taking investment to £19 billion. We are investing not just in the health service but, importantly, in the people who provide the treatment. That is why we did everything that we possibly could do to ensure that they are paid fairly and that the NHS did not lose any days to industrial action.

Since the SNP took power, there has been an almost 100 per cent increase in the number of consultant oncologists. We are investing in the individuals in our health services, we are investing in ensuring early detection of cancer with our rapid cancer diagnostic services and, specifically on ovarian cancer, which is the issue that Douglas Ross has raised, we are seeking to explore what more we can do for faster treatment.

I go back to the latest statistics that were published and, although I fully accept that they will be cold comfort for those who have already had to pay for treatment, I hope that they provide some level of reassurance. They show that 94.7 per cent are receiving their first treatment for ovarian cancer within 31 days of a decision to treat. We want to consider what more we can do to improve that figure further.

Those answers will be bitterly disappointing for Margaret and Irene and the hundreds of others who are so distressed at having to pay so much money to go outwith Scotland to get their treatment.

The experts are echoing what the patients are telling us. Dr Hume of Cancer Research UK says that the problems in cancer care are fixable if the new cancer strategy is “fully funded and implemented” now, but the evidence shows that the resources are not in place. Official statistics that came out this week show that one in 4 Scottish patients who are suspected of having cancer does not start their treatment within the 62-day target. A new freedom of information request that we have had answered shows that, this year, one patient in NHS Grampian has waited 156 days, which is more than five months, to start chemotherapy.

Humza Yousaf was health secretary for two years and cancer waiting times grew. He is now the First Minister, so what is he going to do to sort it out?

As I have referenced, the 31-day cancer stat has improved on that of the previous quarter. I hope that that shows that we are on a journey of recovery. We have to accept that recovery will take a number of years.

Douglas Ross made a few points that I agree with when he was speaking on behalf of those who work in the NHS who say that the 10-year cancer strategy that we have published must be fully funded. We agree. We accept that very point. That is why, for example, this year we have increased our investment in the health service substantially and, later this year, we will give Parliament an update on our 2024-25 budget. I fully accept the premise that the strategies that we set up must be funded.

I also accept that we must improve the figures for the 62-day target. There is no doubt that they were affected by the pandemic but, to be frank, there were challenges with the 62-day target before the pandemic, which is why the cancer strategy will seek to target those cancer types for which we struggle to reach the 62-day target.

From a Scottish Government perspective, we will continue our record investment in the NHS, we will make sure that our staff are paid fairly and we will make sure that we continue to have adequate staffing in our health service. I give an absolute assurance, not just to Douglas Ross but to everyone who is watching or listening, that the treatment of cancer—early diagnosis and early treatment—is an absolute number 1 priority for the Government that I lead.

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Cancer Treatment (Delays)

Cancer remains Scotland’s biggest killer, and we know that there is a direct link between speed of diagnosis, treatment and survival rates.

This week, statistics revealed that one in four cancer patients had faced delays in treatment—that is 1,130 people starting treatment late in the past three months alone. Every one of those people is a son or daughter; every one of them is a loved one—someone who is loved by a family waiting anxiously. In fact, none of Scotland’s health boards met the 62-day standard for starting cancer treatment.

Macmillan Cancer Support has warned that

“staff are being stretched to breaking point”,

and Cancer Research UK called the delays “unacceptable”, so does the First Minister agree with the experts, or has his Government become complacent in the fight against Scotland’s biggest killer?

We absolutely have not become complacent. I hope that we can demonstrate that through the work that we have done with key stakeholders in relation to the cancer strategy.

Douglas Ross and Anas Sarwar are absolutely right to raise what is a crucial issue for people right across Scotland. Let me, in turn, try to give some assurances that we are recovering from a global pandemic. That global pandemic has absolutely had an impact, not just on our health service but on our cancer services.

However, when I look at the statistics on the 62-day pathway, I see that we are treating 41.2 per cent more patients on that pathway than we did 10 years ago, and when I look at the 31-day pathway, on which there has been an improvement, I see that we are treating 19.6 per cent more patients than we did 10 years ago. We are seeing more patients—the throughput has increased over the past decade. We are not complacent—it is clear that there is more to do, particularly around the 62-day pathway.

Anas Sarwar also raised the importance of diagnostic waiting times. Again, the latest statistics show an improvement in that regard. We are not complacent, and we will continue to invest. As I have said, we will continue to invest in ensuring that we have an adequate number of staff so that we can get people into treatment as early as possible.

Covid started three years ago. This Government has not met the 62-day standard for 11 years—so cut the complacency and cut the excuses. We know that every delay risks lives, and we know that the number of cancer deaths is higher than it should be. So far this year, there have been 398 more cancer deaths than experts would have expected. Those deaths were avoidable and unnecessary.

This week, it was also revealed that life expectancy in Scotland has dropped again; it has fallen back to a level that has not been seen for more than 10 years. There is no starker indication of failure than that. Therefore, will the First Minister take the opportunity to apologise for the lost decade on the Scottish National Party’s watch?

When people do not get treatment as quickly as they should or when targets are missed, of course the Government apologises—we have deep regret when that is the case.

Anas Sarwar forgets to mention what has happened over the past decade—we have had more than a decade of Westminster austerity. [Interruption.] Every external organisation that has an interest in poverty will tell you—

Members!

—that poverty is a clear determinant of, and a clear factor in, health inequality. We will do our best to try to mitigate the impact of that Westminster austerity. We have put hundreds of millions of pounds from our budgets on the table to protect people from that Westminster austerity.

With regard to what we are doing in relation to the national health service, I go back to the central point that we are putting in record investment. We are ensuring that we pay our staff fairly, which is why there have not been strikes in Scotland, when there have been strikes in health services across the United Kingdom, including in Wales and in England. We will continue to invest in our staff to ensure that patients get the treatment that they deserve as quickly as possible.

The First Minister does not need to persuade me about how woeful the UK Tory Government is. However, that does not excuse the woeful record of this SNP Government over the past 16 years. Every cancer delay raises the chance of avoidable death, which is why patients should be diagnosed and start treatment within 62 days.

A freedom of information request has revealed the dire reality for too many patients. Some cancer patients have waited 191 days for diagnosis and treatment; a cervical cancer patient waited 217 days; a prostate cancer patient waited 334 days; and there was even a cancer patient who waited 385 days for diagnosis and to start treatment. The First Minister cannot blame someone else for that; that is the SNP’s record. That cancer patient had more than a year of anxiety before getting the help that they needed.

Why can the First Minister not see what many members on the SNP benches can see: that the SNP has lost its way and got complacent and no longer puts the interests of the Scottish people first?

That is simply untrue, which is why, when it comes to who is trusted with the NHS, we tend to leave the verdict to the people of Scotland. Time and again, the people of Scotland have given the verdict to the SNP. [Interruption.] I can hear Anas Sarwar shouting something about polls. In most relevant polls, if not every single one of them, the SNP continues to lead Labour and other political parties. The reason for that, after 16 years in government, is our stewardship—[Interruption.]

Members!

—of vital public services such as the national health service.

I remind Anas Sarwar of a couple of points. I do not disagree with the central premise, which neither he nor Douglas Ross have raised, that there has to be improvement on the 62-day standard. I agree with and accept that. There has obviously and undoubtedly been an impact from Covid on it but, as things stand, we have seen an improvement on the 62-day standard compared with the previous quarter. More than seven out of 10 patients are starting treatment within 62 days, but that has to be improved. There is no complacency. In relation to the 62-day standard, the median wait was 49 days.

We will continue on the journey of recovery, we will continue to invest in our health service and staffing, and we will continue to do what we can to ensure that patients and the public are seen and treated as quickly as possible.

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Outdoor Swimming Sites (Contamination)

To ask the First Minister what action the Scottish Government is taking in response to reports of widespread contamination at many of Scotland’s outdoor swimming sites. (S6F-02404)

I take some exception to the use of the term “widespread”. The Scottish Government is committed to improving water quality in bathing waters across Scotland. Recent reporting of the statistics has not interpreted the Scottish Environment Protection Agency’s bathing water monitoring data correctly. Since we introduced more stringent European standards in 2015, we have worked with SEPA, Scottish Water and key stakeholders to ensure that more bathing waters than ever before are classified as good or excellent, with 98 per cent now meeting water quality standards. Scottish Water is working to install monitors on all its sewer outfalls in or near bathing waters to provide near-real-time spill data by December 2024. Those actions will help to inform bathers and support SEPA and Scottish Water’s work to prioritise investment where it will most benefit our environment and communities.

I am a bit surprised by that answer. The most recent investigations at Lower Largo in Fife tell us that it is the most polluted beach in Scotland. It has breached the regulations on seven occasions so far in 2023 and, on three occasions, it was at 50 times the contamination limit, which is a very serious health hazard. What will the Scottish Government do to increase the frequency of checks on those beaches?

In addition, is the First Minister as concerned as I am about the number of community swimming pool closures, given that such pools are seen by many families as a safer alternative just now?

The situation in Lower Largo is serious, but my understanding is that there are identified reasons for that potential contamination. I know that it is an issue that Scottish Water and SEPA are looking at seriously. I am happy to write to Liz Smith, or ensure that the appropriate cabinet secretary writes to her, with the detail of what actions are being taken on that specific example.

However, I return to the reason why I took exception to Liz Smith suggesting that contamination is widespread, which is that 98 per cent of Scotland’s bathing waters currently achieve the bathing water quality standard, with more being rated excellent than ever before. We have good monitoring and good-quality water in Scotland.

As I said, on the specifics of Lower Largo, I am more than happy to write to Liz Smith with the detail.

I am astonished by the First Minister’s answer, which is astonishingly complacent when 50 out of 89 of the most popular beaches in Scotland fail to meet the standard for safe bathing. That should ring an alarm bell for the First Minister. When will he implement the proper measurement of all sewage outflows and when, at last, will he set legally binding targets to end sewage dumping?

That is an issue that Scottish Water and SEPA take seriously. In previous First Minister’s question times, I have given answers about how, for example, water and sewage outflows are being monitored in a comprehensive programme that has cost considerable amounts of public investment and has been under way for a number of years. There is action to increase that monitoring in the time to come and I am happy to give Willie Rennie more detail about that.

No one is complacent. I fully accept that there are particular instances that must be investigated and where action must be taken, but I return to the point that 98 per cent of bathing waters currently achieve the quality standard, with more being rated as excellent than ever before. Regarding the specifics that Willie Rennie raises, I am more than happy to provide him with detailed answers about what further monitoring is expected to take place.

I have previously raised the issue of sewage contamination in Scotland’s water, notably in the Water of Leith in my region, and have asked the Scottish Government for a meeting. In August, the cabinet secretary advised me that she did not think that a meeting would be useful. Given the clear severity of the issue across Scotland, will the cabinet secretary now agree to meet urgently with me?

I am more than happy to consider that meeting and to ensure that the cabinet secretary considers it.

On outflow monitoring, Scottish Water carried out a comprehensive and Scotland-wide environmental study programme to assess the impacts of its assets on water quality during the period 2015 to 2021. Scottish Water invested £40 million during that period and the computer model that it developed allows it to understand when combined sewer outflows will spill and under what rain conditions, and the impact that those spills will have on the environment. SEPA regularly monitors the water environment to ensure that it is not impacted by sewage spills. In 2019, it took 19,000 monitoring samples across Scotland to safeguard the quality of our rivers, lochs and coastal areas.

There is significant monitoring of those overflows, but, given Foysol Choudhury’s question, I am more than happy for the Government to consider a meeting if he would find that useful.

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Juryless Rape Trials

To ask the First Minister what the Scottish Government’s response is to some members of the judiciary expressing opposition to juryless rape trials. (S6F-02405)

The Victims, Witnesses, and Justice Reform (Scotland) Bill includes proposals for a time-limited pilot of judge-only rape trials. The response by the senators of the College of Justice clearly shows that they have split views on the proposal. We know that organisations including Rape Crisis Scotland, Victim Support Scotland and Scottish Women’s Aid support the pilot. They, like many, are concerned by the experiences of complainers, the influence of rape myths and the lower conviction rates for rape.

The senators’ response states that there is

“a serious problem with what happens in a jury trials for rape”

cases.

The pilot stems from the recommendations made by Lady Dorrian, whom Christine Grahame will be aware is Scotland’s second most senior judge, as part of her review and report into how we can improve the justice system, particularly for victims and survivors of rape, while also—this is crucial—protecting the rights of the accused.

I, too, have read the submission from the senators, both those in favour and those against. I am not quoting, but I will paraphrase it. The evidential difficulty that most alleged victims and the accused were in a relationship, sometimes even after the alleged crime, may be an influence on the low conviction rate, no matter what we do. The right to a fair trial under the European convention on human rights, as far as that may affect the accused, is embedded in the Scotland Act 1998.

Crucially, the Government is, I understand, to assess the efficacy of the pilot. For me, that trespasses on the principle of the separation of powers between the legislature and the judiciary, which is an extremely serious issue. Will the First Minister confirm that there will be robust scrutiny of the proposal and that his Government has an open mind and is reflecting on those concerns, which are indeed my concerns?

Yes. Of course we will be open minded in our consideration of the legislation. That is why the committee stage of the bill—the evidence-gathering stage—is such a crucial part of the legislative process. It allows us to hear quite robustly, and often quite powerfully, the various arguments being put forward.

I go back to my point that the recommendation for a time-limited pilot of juryless trials is coming from a review conducted by the second most senior judge, Lady Dorrian—a very experienced judge and, I think, a judge who commands wide respect right across the political spectrum. It is therefore important that we give that weight, as we also give weight to those voices that have expressed concern—not just in the judiciary but, as we know, many members of the legal profession, too. We will of course give that weight. We will also give the voice of victims and survivors weight in this decision and the passage of the bill.

We need to improve the experience of rape complainers. I think that we all absolutely accept that. I think that we would all also accept that rape myths do exist within juries. I end with a quote from Rape Crisis Scotland that has stayed with me since my days as justice secretary, and to this very day. It said:

“Many survivors ... describe the process of going to court as more traumatic than the rape itself”.

That is an unacceptable position in any justice system, let alone in ours.

The case for juryless trials in rape cases often cites the work undertaken by Professor Fiona Leverick and her 2020 report on juries and rape myths. However, that report concludes by stating:

“Before suggesting anything as drastic as removing juries from criminal trials, however, it is worth considering whether the answer might lie in addressing problematic attitudes via juror education”.

The report argues that that is

“the way forward before more radical measures are considered”.

Does the First Minister agree?

I do not think that it is a case of either/or. It is absolutely acceptable to explore both. It is incumbent on us in government to provide education and try to tackle rape myths in society more generally, but also to consider the pilot.

Ivan McKee is right to reference what is an excellent piece of work—the most comprehensive jury research undertaken, I think, in the entire UK—by Professor Fiona Leverick, James Chalmers and others. I will be happy to correct the record if I am wrong, but my understanding is that Professor Leverick supports the proposal for a pilot. I welcome the steps that the judiciary has taken to improve jury education. I highlight the comments from the senators on the testing of rape myth directions with juries this year. I will quote. When it came to judge directions, they

“did not prevent acquittals which appeared to the trial judge to be conspicuously generous on the evidence adduced.”

There is definitely a role for education around rape myths—

Briefly, First Minister.

—but there is also the option, which I think we should be exploring, of juryless trials.

Lawyers across Scotland say that they will boycott the SNP’s planned juryless trials, with senior judges also raising concerns that removing jurors constitutes political meddling in the independence of the judiciary by this SNP Government. As I asked his justice secretary yesterday, will Humza Yousaf ignore those concerns, pass his bill and simply hope for the best?

Of course we will listen to the views of the legal profession, listen to the weight of opinion of the judiciary and give appropriate weight to the voices of victims and survivors, too. However, I go back to the central point—I would make this point quite robustly to Russell Findlay—that the proposal for a pilot of juryless trials is coming from Lady Dorrian. It is not Government interference to simply explore a recommendation from the second most senior judge—the Lord Justice Clerk—of Scotland. It does no justice to an issue that requires great sensitivity to throw around terms such as “political interference”, regardless of who that comes from. Let us absolutely give consideration to the voices of the judiciary, but let us not forget the voices of victims and survivors on this issue.

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Antidepressants (Assessment of Use)

To ask the First Minister what assessment the Scottish Government has made of the use of antidepressants in Scotland. (S6F-02411)

I understand the impact and suffering that depression can cause sufferers and their families. I am committed to improving care, support and access to treatment. It is important that we recognise that many people in Scotland benefit from the use of antidepressant therapy.

We established a short-life working group on prescription medicine dependence and withdrawal, which reviewed the use of antidepressants across Scotland and involved clinical stakeholders and people with lived experience. In response to that group’s recommendations, we will shortly publish a prescribing guide on antidepressants, which will provide practical and evidence-driven guidelines on safe and effective prescribing through the promotion of person-centred medicine reviews.

The number of adults and young people who are prescribed antidepressants has significantly increased over the past 10 years, to more than 1 million. Prescriptions are for a wide range of disorders and illnesses. At the same time, national health service spending on mental health, as a percentage, declined between 2011 and 2022. Does the First Minister accept that there is a clear link between the failure to access mental health services and the subsequent increase in prescriptions? Patients are asking for more than pills. What will ministers do to provide that critical access to mental health services?

I cannot be the only one who listened to that question who is disturbed by the insinuation that antidepressants are not a legitimate treatment for those who require them. They, too, can be part of a treatment. [Interruption.]

Members.

People do not only have access to medicine or only have access to, for example, psychological therapies. [Interruption.]

Let us hear the First Minister.

For many people, there will be a mixture of both.

I am proud of the Government’s record of investment in mental health services over the past number of years. There have been significant increases not just in mental health services but, crucially, in mental health staffing. I am more than happy to ensure that the Minister for Social Care, Mental Wellbeing and Sport writes to Sue Webber with the detail of that.

I end by saying that, ultimately, these are clinical decisions, and we should leave to clinicians, not politicians, decisions on who is prescribed antidepressants and who is not.

Research from the Royal College of Psychiatrists that was released today has shown that 58 per cent of people in Scotland think that mental health services receive too little of the healthcare budget. By the Scottish Government’s own measure, that 58 per cent are correct, aren’t they? The Government’s commitment that 10 per cent of the overall healthcare budget be spent on mental health is not being met. Currently, just 8.7 per cent is allocated. In cash terms, that means that we are £180 million a year short. Will the First Minister confirm whether that 10 per cent target for mental health spending is still a priority for his Government and, if so, how he personally will ensure that it is met?

It is still our aim, our ambition and our target. Since 2007, mental health spending has doubled in cash terms from £651 million to £1.3 billion. If Paul Sweeney does not want to take my word for it, paragraph 70 of the latest Audit Scotland report on mental health says:

“Between 2017/18 and 2023/24, the Scottish Government’s Mental Health Directorate budget increased significantly”.

That is a direct quote. Again, I am more than happy for the minister to furnish Paul Sweeney with further details of the significant investment in the recruitment of child and adolescent mental health services staff in particular, and of the fact that record numbers of young people are being seen through those services. I want those improvements to continue.

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Safer Drug Consumption Facility (Support for Pilot)

To ask the First Minister whether he will provide an update on the work that the Scottish Government is undertaking to support the establishment of a pilot safer drug consumption facility. (S6F-02415)

I welcome the decision that was taken yesterday by Glasgow city integration joint board. Following the position that was taken by the Lord Advocate, the safer drug consumption facility proposal now allows Glasgow to move ahead with the pilot. We have been consistent in our commitment to supporting the setting up of a safer drug consumption facility, which included facilitating work between Glasgow health and social care partnership and Police Scotland to develop the proposal that was then submitted to the Lord Advocate.

We provided Glasgow with an absolute assurance around funding in advance of yesterday’s meeting of Glasgow’s integrated joint board to discuss the establishment of such a facility. We will also continue to play an active role in the planning and implementation work to ensure that the facility is delivered in a timely manner and, of course, that it is also fully evaluated.

Alongside other Glasgow MSPs, I wrote to the Home Secretary regarding the issue last month. The response suggests that the Home Office will not stand in the way of the Lord Advocate’s authority on the matter, provided that it is exercised lawfully. Although that is welcome, it is disappointing that the United Kingdom Government seems unwilling to work with the Scottish Government to actively progress this public health measure. Does the First Minister agree that it appears that the UK’s inaction on the matter is political rather than pragmatic, and that true co-operation from the Home Office would help to provide even better care and support?

I agree with Kaukab Stewart. She is right that the easiest, simplest and quickest way to have had such a facility up and running would have been if the Home Office had given approval. [Interruption.] I am not sure why Labour seems to be acting as a human shield for the Conservatives—

Members!

—but I say to Labour and Conservative members in that regard that, even with the Lord Advocate’s statement of prosecution policy, there are limitations on the pilot. The safer drug consumption facility can be focused only on this narrow pilot in Glasgow. I know that there have been calls for other pilots to be established, but the statement of prosecution policy is for simple possession offences within this particular pilot.

I welcome the fact that the Home Office and UK Government have said that they will not stand in the way, but I would urge them to take a public health approach to tackling drug deaths, as we have done here in Scotland, and to give approval so that we can, I hope, use safer drug consumption facilities as one tool in a whole range of tools to fight what are still unacceptably high levels of drug deaths in Scotland.

We move to constituency and general supplementaries.

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Infrastructure Investment

In evidence to the Finance and Public Administration Committee, leading economists emphasised how crucial it is for the Scottish Government to invest in Scotland’s infrastructure if our economy is to grow and our living standards are to improve. What is the First Minister’s response to the statement in the Auditor General for Scotland’s report, published today, that the United Kingdom Tory Government is expected to impose, at a time of high interest rates and inflation, a real-terms 7 per cent reduction in Scotland’s capital block grant over the next four years, while the Prime Minister continues to dither over the tens of billions being squandered on the HS2 rail project?

Kenny Gibson is absolutely right to raise the UK Government’s real-terms cut of 7 per cent to our capital budget. We know that infrastructure investment is key to securing inclusive economic growth and delivering high-quality public services. We have been consistent and very open about the challenges facing our capital investment plans and the tough decisions that we will need to take in relation to the 2024-25 budget.

The challenging economic conditions of the past few years—resulting from Brexit, the disastrous mini-budget and the UK Government not inflation proofing the capital budget—have resulted in that 7 per cent real-terms fall in our Barnett capital funding over the medium term. We will of course look at what innovative finance models we can use to power infrastructure investment in the years to come, but that job has been made considerably harder by the 7 per cent real-terms cut from the UK Government.

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Ayr Station Hotel Fire

A fire has devastated the former Ayr station hotel, causing massive disruption to the rail network in the south-west of Scotland. I put on record my thanks to the firefighters who fought the fire and all the emergency workers involved. It is crucial that the rail station is reopened as soon as possible. What financial help will the Scottish Government give stakeholders to help pay for the substantial costs that they face to make the area safe and reopen this vital rail network?

I add my appreciation for our emergency services, in particular the Scottish Fire and Rescue Service, which battled not just throughout the night but into the next day to ensure that the fire was under control.

Our emergency services have always had my utmost respect, which has only increased after the events at Ayr station hotel. The Scottish Fire and Rescue Service has remained in attendance, but there are no further signs of fire. As I understand it, the site should be handed over to South Ayrshire Council today. Sharon Dowey may know that ScotRail has introduced alternative arrangements, with an emergency timetable and train services running from Prestwick town, supported by replacement bus transport.

In response to Sharon Dowey’s direct question, the Government will be open to discussions about what support we can provide to secure the site as well as make sure that services are running as close to normal as possible.

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Reinforced Autoclaved Aerated Concrete (Tillicoultry)

The First Minister may be aware that tenants and homeowners were moved out of their homes in Tillicoultry on Tuesday evening due to safety concerns after the identification of reinforced autoclaved aerated concrete in the roof of their block of flats. Clearly, that is very upsetting and worrying for my constituents. What discussions is the Scottish Government having with Clackmannanshire Council following the identification of RAAC in those homes? Will financial assistance be made available to local authorities and registered social landlords that discover RAAC? What assistance and advice can be given to homeowners who find themselves in that situation?

My thoughts are with the families who have had to leave their homes. I recognise the impact that that will have on them and I commend the quick action that was taken by Clackmannanshire Council to make sure that those households are safe.

There is regular dialogue between the Scottish Government and the Convention of Scottish Local Authorities about RAAC. Risk assessments related to RAAC are under way across the housing sector, and information will be provided as it becomes available. We are working closely with housing stakeholders to ensure that the necessary action is being taken when risks are identified. Claire Baker will know from previous ministerial statements on the issue that we have not received any additional funding from the United Kingdom Government to address RAAC concerns. Of course, if there are additional requests for funding from local authorities to deal with RAAC, we will give them due consideration.

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A96 Dualling

In the programme for government, the First Minister reaffirmed the welcome commitment to dual the A96 between Inverness and Auldearn, including the Nairn bypass. In November last year, the then transport secretary assured the chamber that the necessary statutory orders relating to compulsory purchase and ancillary roads would be made in a matter of weeks. Nearly a year later, my constituents are still waiting. Will the First Minister ask the transport secretary to bring an oral statement to the Parliament in order to explain why there has been a further delay? The good people of Nairn and, indeed, the whole of the north of Scotland are surely entitled to know what is or is not going on.

The people of Inverness and Nairn are due an update. I am more than happy to consider a ministerial statement or, if it is more appropriate, a written update to the member and other members who have an interest in the A96.

Of course, our manifesto commitment remains to dual the A96—in particular, the Inverness to Nairn bypass. For reasons that are known to Fergus Ewing, outside the Inverness to Nairn section there is a review of options, which is taking place for a number of reasons, including our commitment to our climate obligations. The member is right that we are duty bound to give updates to members of the public in relation to our infrastructure projects, including the A96. I will give consideration to the ask that he has made and will decide what is the most appropriate way to update him, as well as members in the chamber and the public, on our latest plans for the A96.

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Fatalities on Scotland’s Roads

Tragically, last year, there were 174 fatalities on Scotland’s roads. That number has increased by 23 per cent, year on year, and it is at its highest level since 2016. I am sure that many in the chamber, as well as our constituents, have been touched by those tragic accidents. However, that also comes against the backdrop of a 14 per cent drop in the number of police road traffic officers over the past decade. Many prominent road safety campaigners say that there is a clear link between that and the number of fatalities, as does the Scottish Police Federation.

Does the First Minister share my concerns and the concerns of road safety campaigners about those tragic statistics, and what is the Scottish Government going to do about them?

I absolutely agree with Jamie Greene that any life lost is a tragedy, and my condolences go out to every family and every community that has been impacted by a death on our roads.

What I would say to Jamie Greene is that we have increased funding to Police Scotland this financial year—there has been a significant increase to Police Scotland in terms of its resource budget—and, of course, we will continue to consider what more we can do to support Police Scotland. However, we also know that capital interventions on our roads can be quite important in this regard, whether they involve signage, appropriate speed cameras or other initiatives, and we will consider what more we can do to make our roads as safe as possible.

We have ambitious targets in relation to reducing deaths on our roads, and I will ensure that the Cabinet Secretary for Transport, Net Zero and Just Transition writes to Jamie Greene with further details on action that we are taking on the issue.

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Rosebank (Licensing)

Yesterday’s decision by the United Kingdom Government to grant a licence to the Rosebank oil and gas field is nothing short of a climate catastrophe, condemning us to a future dependent on fossil fuels while the planet around us burns. It shows utter contempt for our environment and the future generations who will live with the consequences. Will the First Minister join me in condemning this decision, and can he say whether the UK Government carried out the necessary climate compatibility assessment before the licence was granted?

I have gone on record as saying that I think that it is the wrong decision to approve Rosebank at a time when the world is literally on fire, when the planet is burning and when we have seen the most devastating impacts of the climate catastrophe. Instead of climate leadership, what we have from the UK Government is complete and utter climate denial.

The future of the north-east is as a net zero capital, not the oil and gas capital. It is transitioning from that to a net zero capital. That is the future that I want to see for the north-east. [Interruption.]

Members, let us hear the First Minister.

That is why we have invested £500 million in the just transition fund.

While the Conservatives believe in unlimited—infinite—oil and gas extraction, we believe in a greener, more sustainable future for Scotland. As ever, on this issue, as on many other issues, the Conservatives will be on the wrong side of history.