Plenary, 28 Oct 2004

Meeting date: Thursday, October 28, 2004

Official Report 755KB pdf

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Question Time

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SCOTTISH EXECUTIVE

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Environment and Rural Development

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Sewage Sludge

To ask the Scottish Executive what investigation it has carried out into the spreading of sewage sludge on land and the environmental implications of such operations. (S2O-3744)

The Scottish Environment Protection Agency will register activities involving the spreading of sewage sludge on land only if it is satisfied that doing so will not harm either the environment or human health.

I thank the minister for that answer. To preface my next question, I note that I recently visited such an operation in Breich and was pleasantly surprised at how successful it was. However, juxtaposing that with all the publicity that there was about Blairingone, does the minister agree that one of the main problems is that people do not understand the distinctions, are not being told about them, are worried about planning consents and have a suspicion about health? Would it not be better if SEPA, the Scottish Executive and councils were much more proactive in letting people know the differences between schemes and what exactly is going to be put into their area?

Anyone who makes proposals has a responsibility to do that themselves. SEPA's responsibility is to grant an exemption only if it is satisfied that there is no implication of harm. In the cases of which I am aware, I believe that that has been done.

It is a pleasure to begin my stint as a minister responsible for the environment by answering a question on a subject that addresses recycling as well as other matters.

Does the deputy minister remember the question that I asked of Mr Finnie on 30 September with reference to sludge dumping? At that time, the minister advised me that dumping had not gone ahead on the Beoch site because of SEPA's diligence. Does the deputy minister now accept that, at that very moment, dumping was proceeding? Will he now advise what tests have been done on the sludge that is being dumped at Beoch and whether those tests cover bacteria and viruses as well as metals?

I am not familiar with all the details of the Beoch case, but I am familiar with the current testing of land, which involves taking core samples to test for metals in the soil. Before it grants an exemption from the application of regulations, SEPA will satisfy itself that there is no threat either to human health or the environment. I have no doubt that SEPA will follow that procedure in the case to which the member refers.

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Greenhouse Gases

To ask the Scottish Executive what measures it has in place to reduce greenhouse gases, in particular by reducing energy consumption. (S2O-3699)

The Executive has a number of measures in place to reduce greenhouse gas emissions, including energy efficiency, as detailed in our Scottish climate change programme. We are reviewing the programme and will consult on that soon. We will publish a revised programme in the first half of 2005.

In reviewing the climate change programme, I ask the minister to emphasise the importance of energy efficiency and to put in place a comprehensive energy efficiency strategy to help Scottish businesses, the public sector and individuals. What part will the £20 million that he has allocated to energy efficiency play in that process?

I am grateful to Sarah Boyack for that question. We are promoting a number of schemes across the Executive. The public sector energy efficiency initiative is a fund available to all Scottish local authorities and health boards, Scottish Water and others to allow them to implement capital investment and other measures. Loan action Scotland provides interest-free loans to small and medium-sized enterprises, and the regional business manager network provides local access to support business resource efficiency.

Measures are in place but, as I indicated in my first answer, we are reviewing those measures in the context of the climate change programme for the United Kingdom, which will require Scotland to make further revisions.

On the moneys that we recently allocated, I do not wish to make commitments in advance of revising the strategy. I assure Sarah Boyack that energy efficiency will play a large part in the programme's revisal.

Many people in Scotland who believe that we need increased energy efficiency are calling for green heating targets and energy consumption figures for Scotland so that we know where we are starting from. The absence of such figures and targets seems to be a huge gulf in the Government's strategy. Does the Executive have any plans to produce them?

In the context of the review of our climate change programme, I am conscious of the wide debate on how to measure the targets and figures to which Mr Lochhead referred. I am also conscious that although a large number of environmental non-governmental organisations wish us to have specific Scottish targets, others recognise that the point at which one measures energy emission is the transmission of energy rather than usage. Scotland is a net exporter of electricity, so difficult calculations are involved in assessing energy efficiency. However, I certainly have an open mind on the issue as it might be better—or easier—to say precisely where we are trying to get to. I emphasise that I have cited only one example of the complications of getting the figures, but I am certainly considering the matter as part of the review.

Does the minister agree that the best long-term way of cutting greenhouse gas emissions in Scotland is to develop further the nuclear power industry? Will he join me in welcoming the positive comments this week from the MP for Edinburgh Central—the Secretary of State for Scotland—on the potential for future development of nuclear power in Scotland?

The Executive has made its position clear on the subject. We are keen to develop renewable sources, particularly in relation to wind, wave and tidal power. To that end, as the member knows, we have made considerable investment in research stations in Orkney and in the intermediary technology institute for energy in Aberdeen. We do not necessarily agree with Mr Mundell's point, because the issue of the cost of nuclear power must come into play. We must balance the cost of production with the costs at the end of a nuclear power station's life. We must view that not only in economic terms but in environmental terms.

The minister will be aware that the Prime Minister has clearly stated that he wants the G8 summit in Scotland next year to focus on climate change, which he—not me—describes as

"a challenge so far-reaching in its impact and irreversible in its destructive power, that it alters radically human existence."

The minister might regard that as more green rhetoric, but will he give us an assurance that the Executive's review of its climate change policy will be completed before the G8 countries gather in Scotland in June next year to discuss climate change? Does he agree that it would be a national embarrassment if the G8 summit were held in a country that did not have its own target for reducing greenhouse gas emissions?

No, I do not necessarily agree with Mr Ruskell that that would be an embarrassment. As I explained in my response to Richard Lochhead, it is not easy to define the United Kingdom targets. I have indicated clearly, not just today but previously, that I am keen to have targets if I can see a means of calculating them. On the timing of the review, I am anxious that the Scottish review, which will place significance on the impact of Scottish elements in the climate change review, should be available before the G8 summit. I certainly agree that that would be preferable and helpful in the context of that international debate. However, there is a huge amount of work to be done in putting the review together and we will try to do it in a co-ordinated way with the UK Government. I take Mr Ruskell's point—I, too, would like the review to be completed before the G8 summit.

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Fishing

To ask the Scottish Executive when it plans to meet fishing industry representatives in advance of the December meeting of the European Union agriculture and fisheries council. (S2O-3736)

The Executive maintains close contact with fishing industry representatives throughout the year. We expect to meet regularly in the run-up to the December council and we have planned a dedicated stakeholder conference for 15 November.

I thank Ross Finnie for his answer and I welcome the proposed stakeholder conference. I know that he is well aware of the specific concerns of the smaller fishing communities, such as Pittenweem in my constituency, which have been caught up for years in quota regimes designed to solve a problem that is not of their making. Given that the International Council for the Exploration of the Sea report has identified very healthy stocks of haddock and sustainable stocks of east coast nephrops, what assurances can he give the fishermen of the east neuk of Fife that they will not be penalised by any regime to protect cod stocks in 2005? What further progress does he hope to make on the regional and local management of fisheries as part of the reform of the common fisheries policy?

In any of the scientific evidence that has been adduced in the matter of mixed fisheries and the possibility of protecting cod stocks—the only stock that is seriously under threat, as reiterated in the ICES report—it is not the mixed nephrops and haddock fishery that is at issue but the mixed nephrops and cod fishery. In the past few years, we have successfully pointed out to the Commission that its concerns on that matter were overstated, and I think that we managed last year to get a nephrops quota for the east coast of Scotland that more properly reflected the scientific view and also allowed fishermen to prosecute that fishery.

I can give absolutely no assurances. All that I can say is that I am anxious that we are able to push forward some of the key principles that we established last year on the decoupling of the direct relationships not only between nephrops and cod but between cod and haddock. That will allow us to come up with proposals that will facilitate the fishermen in prosecuting the fishing of the haddock and nephrops stock in ways that do not also threaten the cod stock.

Does the minister recall the real difficulties that arose after some of the decisions that were made at last December's fisheries council in relation to the boundaries that were drawn up without fishing input? If he were asked to do so by fishing interests, would he be prepared to engage a practising fisherman as one of his advisers for the duration of the council? If that is not possible, will he at least give a commitment that any proposals that are developed at the council are put before practising fishermen before a final position is taken and decisions arrived at?

I have to say to Stewart Stevenson that I have tried very hard this year to start the consultation process on how we propose to deal with any potential situation much earlier. The engagement between myself and the industry and between my officials and the industry began just after the summer term. In those meetings, we have tried to postulate a range of possibilities. We did not have the ICES advice when we started the process. We have been trying to suggest to the industry what our reaction would be to scenario A, scenario B or scenario C and what kind of proposition we would be prepared to consider to try to meet those difficulties. We have been engaging with the industry on the potential for those negotiations. We have been considering what the boundaries would be and what would delineate areas if such situations were to emerge, even if that is not the option that the industry would have preferred.

We intend to carry on that process. We now have the ICES advice and we must now wait for the scientific and socioeconomic committees of the Commission to review the scientific advice and come forward with a proposal. As they do that work, I will continue to engage with our industry. We shall continue to have members of the industry with us through to the council meeting. Whether we can consult the industry on the precise timing of the meeting itself is a question about which I cannot give an undertaking. I have tried hard in recent years to meet the fishermen at all hours of the day and night. Indeed, I met Mr Lochhead at a very unseemly hour last year, when both of us might have been better in our beds, but in the interests of Scottish fishing we remained alive and alert. I cannot give an undertaking on the timing of the meeting, because it would be most unfortunate if ministers were not in the room when the decision was being taken because they were anxiously seeking to do something else.

I welcome the minister's reassurances about the regular meetings that he has held with the fishing organisations. Can he explain why he has had no meeting so far with the Fishermen's Association Ltd? FAL wrote to him on 30 August, but a meeting has yet to take place. Will FAL be invited to the meeting that he plans to hold on 15 October? How many times has he met FAL during the five years that he has been in office?

In response to the final question, off the top of my head, I cannot recall the number. In any industry, organisations put themselves forward to Government as being what might be called "the" organisation that represents the vast majority of the industry. That is what the Scottish Fishermen's Federation does on behalf of the Scottish fishing industry. Although Mr Brocklebank might suggest that that is an inaccurate representation, I have no reason to doubt the validity of the SFF's claim to represent the overwhelming number of fishing interests. I have therefore thought it fit and proper to deal in the main through its offices. That is not to say, however, that I have not met many other organisations: I have met the Cod Crusaders and various other organisations that have a specific interest in a constituency or area.

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Land Management Contract

To ask the Scottish Executive what progress it is making in working out the details of the land management contract. (S2O-3707)

We are currently in discussion with the European Commission on the detailed measures that are to be included in the land management contract menu scheme. I hope very soon to be in a position to make an announcement.

Can the minister give an undertaking that the range of options that will be made available in the menu are adequate to attract the interest of the vast majority of farmers? Furthermore, can he confirm that adequate funding will be made available over time to make the scheme attractive and to encourage farmers to believe that the money that has been taken from them in modulation is being returned to them so that they take the actions that the Government wishes to prescribe?

If Alex Johnstone had read the initial consultation document, he would have realised that we have made great strides in trying to extend the range of options. Indeed, following representations that were made during the consultation process, we extended the menu to broaden the overall range of the measures.

Essentially, as Mr Johnstone is aware, the funding comes from modulation. That said, in respect of our own state modulation—as opposed to compulsory modulation—pound-for-pound additionality was granted through the Treasury and the Executive. The rate of modulation has to be progressive in order to allow people to adjust.

Although we start from a poor base, I hope that, over time, we will get more adequate funding. Compared to the settlements that were granted elsewhere, the 2000 settlement for the United Kingdom, and therefore for Scotland, was disproportionate, but I think that it will improve. The range of options in the LMC menu means that a broader range of farmers will be able to participate in the scheme.

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Water Charges

To ask the Scottish Executive whether it will abolish the discount on water charges for single-adult households. (S2O-3750)

The consultation on future charges and discounts for Scottish Water's customers closed on 12 October. We expect to announce our conclusions early in the new year.

One of the guiding principles of the Executive's consultation document "Paying for Water Services 2006-2010" was:

"All charges should be set on a harmonised basis, so that customers in the same group and using the same services should pay for these services at the same rate".

Given that principle, will the minister explain why big companies are the recipients of special deals from Scottish Water?

I asked Scottish Water about its special non-published tariffs for large companies. In its reply, Scottish Water confirmed that those deals saved large companies £8.6 million in 2002-03 and a further £3.3 million in 2003-04.

Question.

Does the minister agree that charities, the disadvantaged and single-person households are more deserving of special deals on their water charges than are large, profitable companies that can well afford to pay the proper rate for the water they use?

Mr Maxwell has clear views on the matter and I am sure that he will have made his response to the consultation process in good time. It would be a shame if he has not done so, but if that is the case, I am sure that we will take his comments into account when we consider the wider responses to the consultation process.

On Mr Maxwell's question on single-person households, we should examine not a stand-alone proposition within the context of the consultation paper, but the need to consider whether a discount system for low-income households should be introduced. Looking at single-person households as if they stand in isolation, or as if they relate to big industrial users, is perhaps missing the point, because they relate to low-income households. The way in which domestic and non-domestic customers are charged will be considered when we examine the principles for future charging. I am sure that we will address the issues equitably and on a level playing field.

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Water Infrastructure (Development Constraints)

To ask the Scottish Executive what action it is taking to ensure that Scottish Water's capital investment plans address the issue of development constraints on rural housing projects caused by lack of water or sewage infrastructure. (S2O-3724)

During the current investment period, £200 million will secure positive benefits in addressing current constraints and an additional £41 million will address development constraints and first-time connections in rural areas. We recently consulted on what Scottish Water's future investment priorities should be. We will issue our response to that consultation early in the new year, when we will outline the objectives that we wish Scottish Water to address in the next regulatory period.

I thank the minister for that encouraging response, but he will be aware that in a number of Highland communities, much needed small developments of affordable housing have been blocked because of shortcomings in the water and drainage infrastructure. Can he assure me that when the next phase of capital spending goes ahead, small rural communities will not be overlooked?

I am happy to give that assurance. We are conscious of the development constraints that have arisen during the current investment period and we are keen to do what we can to ensure that similar constraints do not continue into the next investment period, particularly with reference to the challenges that face small rural communities.

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Health and Community Care

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Flu Vaccine

To ask the Scottish Executive what steps it is taking to ensure that there are adequate supplies of flu vaccine available this winter. (S2O-3741)

Members will be aware that production problems were experienced by one of our major suppliers of the flu vaccine. As a result, the Executive took immediate steps to ensure that alternative supplies from other manufacturers were made available. Those supplies are coming progressively on stream. The situation is being kept under close review, in collaboration with the Scottish Pharmaceutical General Council and the British Medical Association, to ensure that the immunisation programme proceeds as smoothly as possible and that any delays are minimised.

That is encouraging. Anecdotally, widespread concerns have been expressed that people have been asked not to attend appointments for flu jabs. Will the minister ensure that the best possible public information is provided on the measures that are being taken to sort out the issue, which he encouragingly tells us is being sorted out? The public information aspect is important.

I assure all those who are eligible for the vaccine that 166,000 doses were received this week, 200,000 doses will be available next week and the outstanding doses will be available by 8 November.

A judgment had to be made about our promotional campaign on the flu bug. We are confident that a wise decision was taken to continue with the campaign, albeit that we understood that there would be local supply difficulties. However, boards, general practitioners, community pharmacists, public health officials, immunisation co-ordinators and NHS 24 have been kept apprised of the situation with the distribution of the vaccine. While there are some delays, they are being kept to the absolute minimum.

Is the minister aware that many of my constituents in Falkirk East have not had access to the flu vaccine? Is he aware of a particular problem in Forth valley? When will the situation be resolved?

I am not aware of particular problems in particular localities, because the situation with the supplies affected the whole of Scotland and each area was under pressure. However, we have sought to resolve that through having immediate access to further supplies, which I mentioned, and I am happy to look into the Forth valley situation.

It is reassuring that the Scottish Centre for Infection and Environmental Health has not reported any cases of flu, and flu-type illnesses are below the level that we have experienced in past years. All the indicators are okay. I accept that the situation is not perfect, but I assure everyone that the vaccines will be available and that we are dealing with this matter as best we can.

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Dental Services

To ask the Scottish Executive when a further round of measures to improve the availability of national health service dental services will be announced. (S2O-3714)

Our forthcoming response to the consultation document "Modernising NHS Dental Services in Scotland" will include further measures to support NHS dental services in Scotland.

I welcome the minister to her new portfolio. Her predecessor spent a lot of time engaging with the problems in NHS Grampian with NHS dental services. I draw to her attention the front page of The Press and Journal from 12 October, which carries the headline "Revealed: Scandal of our Dental Care Crisis", which refers to a dangerous new dimension to the problem. Because fewer parents register with local NHS dentists than used to be the case, they are not taking their children to the dentist and as a result the level of child dental decay is rising rapidly. A community dentist has said that one in three children who visit him have to have an extensive number of teeth removed. Will the minister investigate this worrying trend, which has arisen from the lack of NHS dentists, and bring forward urgent measures to address it?

We acknowledge that we need to take a longer view in areas such as Grampian. We are considering an analysis of the consultation that we undertook earlier in the year, which closed in April, and we will make information on that available.

I am more than happy to meet the member to discuss the issue in relation to Grampian in particular. Additional money has been made available to the NHS and it is up to NHS Grampian to deliver the adequate number of dentists.

I ask the minister to note that I sent her predecessor scores of letters and a petition, which I also sent to the chief executive of NHS Fife. Will she note that my constituency does not have a single NHS dental place left? Will she meet me to discuss that matter? My constituency is probably the poorest and most disadvantaged constituency in the whole of Fife, and we all know that dental, and general, ill health always affects the most disadvantaged people most.

I would be delighted to meet the member, but it is important to note that we have already introduced a significant number of measures and are taking a longer-term look at the future of NHS dentistry in Scotland. In March we announced £3 million for dental practice improvements and there was £10.3 million for such improvements in the four previous financial years. On 22 March we announced that the general dental practice allowance would be increased by 50 per cent. We have introduced a number of measures, such as golden hellos, to encourage retention and recruitment, but we acknowledge that we have to take a longer-term view. I am aware that there are still problems in parts of Scotland and I repeat that I am more than happy to meet the member to discuss the particular problems in her area.

It is essential to train new dentists for the long term. How many more dentists are undergoing training in Scotland and when will the commitment in the partnership agreement to consult on the need to develop the outreach centre in Aberdeen into a full dental school be met?

There are 15 per cent more dentists undergoing training. Mike Rumbles will probably know this, but funding has been provided to draw up a business case for the outreach training centre in Aberdeen and officials are in discussions with NHS Grampian to progress that development. I am more than happy to meet Mike Rumbles to consider possible further developments.

The minister will be aware that a number of members raised this issue with her predecessor Tom McCabe and that he announced a number of useful initiatives. Does she share my concern that the situation seems to be getting worse still? We are now in a position where 2.5 million Scots are not registered with NHS dental practices—that is more than half the adult population and more than one third of the children in Scotland, which is a worrying state of affairs. What steps can she take to restore access to NHS dental services, particularly in small towns in rural areas throughout Scotland?

Steps have already been taken to improve access to dental services through the introduction in April 2000 of a scheme to reward financially the commitment of dentists to the NHS. That accounts for approximately £3 million per annum, which is available for improvements to NHS dental services and for the dentists' remote areas allowance, which doubled to £6,000 from 1 April. There is also the £1 million golden hello package. We recognise, however, that we still have a long way to go. A major package of reforms will be brought to the Parliament as soon as possible.

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Perth Royal Infirmary (Acute Services)

To ask the Scottish Executive what plans it has for the development of acute services at Perth royal infirmary. (S2O-3676)

NHS Tayside is responsible for planning and providing health services for the people of Tayside. As part of its acute balance of care programme, Tayside NHS Board intends to invest well over £25 million in developing acute services. Most of that resource has been earmarked to enhance acute and other services at Perth royal infirmary.

As part of the announcement of the acute balance of care proposals by NHS Tayside, a commitment was given, in recompense for the removal of children's and women's health services at Perth royal infirmary. There was to be an increase of 3,675 patients in in-patient and day-case activity and of 10,260 patients in out-patient activity, across a wide range of specialties. Will the minister take this opportunity to confirm that those targets remain valid for the acute balance of care review? How many more cases have been treated as a result of the steps that have been taken and the changes that have been made?

Mr Swinney asks some very detailed questions, on which I will come back to him in detail. I know that the losses that occurred at PRI were the subject of substantial public campaigning, particularly the closure of the consultant-led obstetrics facilities. Those have now turned into a midwife-driven maternity service which, I understand, is working extremely well.

If Mr Swinney is referring to the additional work that will take place, the lion's share of the investment not only relieves pressure on Ninewells hospital; I would argue that it substantially reinforces our and the NHS board's commitment to PRI by way of an increase in the number of critical care beds, improvements in kidney dialysis, new oncology and haematology facilities, new gastrointestinal endoscopy facilities, enhanced laboratories, a new gamma camera, the ultrasound room, the upgrade of two operating theatres and 12 new beds. All that would suggest to anyone who is interested in the health service that substantial investment is taking place. Fewer people are travelling from Mr Swinney's constituency to go elsewhere for treatment. That is good news for the patients, which is what we seek to bring through all our objectives.

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Home Care (Older People)

To ask the Scottish Executive what progress is being made in providing older people with home care services. (S2O-3694)

All the evidence is that older people want to stay in their own homes as long as they can. We are working closely with local authorities to deliver that. The proportion of older people receiving intensive home care has risen over the past three years and now stands at 26 per cent of all those who are receiving long-term care. In the spending review, we announced our target of increasing that to 30 per cent by 2008.

I welcome that increase in support for older people staying in their homes for longer. What work is the minister doing to ensure that we have enough qualified staff to provide an enhanced level of service throughout Scotland, particularly in places such as Edinburgh, where there are severe employment pressures on the national health service?

I very much agree with Sarah Boyack that the work-force issue is important. Many among the home care work force are in the 40-to-60 age group, and their retirement is a key issue for providers. As she says, in places such as Edinburgh, where there is a competitive economic environment, councils can find it hard to recruit some care staff. It is important that we work closely with representatives of the work force. The national work-force group, which I chair, is leading on developments across the sector as it examines work-force issues.

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Air Ambulance Service (Highlands)

To ask the Scottish Executive whether it can provide reassurance to people in the Highlands that the proposals for the provision of air ambulance cover from spring 2005 will not lead to any reduction in service levels. (S2O-3722)

The Scottish Ambulance Service is currently consulting on the proposed service provision for air ambulance services, which would be effective from 1 April 2006. The proposals would represent an overall improvement on the current level of service, and the helicopter provision in the Highlands would remain the same. There is an air ambulance helicopter base in Inverness, which would be supported by dedicated fixed-wing aircraft based in Aberdeen.

I thank the minister for that encouraging answer. I will describe a scenario for the minister. If—perish the thought—NHS Highland were to downgrade the 24-hour, consultant-led maternity service in Caithness and if, as happens every winter, the A9 were to be blocked by snow, would that not further stretch the Ambulance Service? Surely the minister would agree that that would be thoroughly undesirable.

In reviewing the delivery of any of our services, we ensure that we involve the whole of the NHS family in discussions. I fully expect that the Scottish Ambulance Service would be an integral part of discussions on changes to any service that it was required to provide. The standards of service that the service is required to provide, and we continue to consult on, are very severe. In categories A and B, 95 per cent of flights require to be airborne within two minutes, 90 per cent to be on site within 30 minutes and 95 per cent to return to the hospital within 45 minutes.

The purpose-built, pressurised, fixed-wing aircraft will enhance the service, as they will be able to fly above the weather and get to locations more speedily. I would argue, from what I have seen, and while consultations are continuing, that not only will we retain current service levels but those levels will increase. Any service change that occurs at a local level will be required, through contract, to be delivered safely. The Scottish Ambulance Service will be involved in that discussion.

In the interests of safety and economy, is the minister satisfied that there are consistent procedures in place before clinicians can call for air ambulance cover to be given?

From my understanding of how the service works, I am satisfied that that is the case. In the proposed new service there will be dedicated personnel within each call centre to ensure that matters are handled appropriately. In my book, the provision of purpose-built, pressurised, fixed-wing aircraft suggests that we will have a much safer method of ensuring that passengers get the high quality of care that they deserve as part of their treatment, while they are in the air and at the appropriate location.

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Ear, Nose and Throat Appointments (Waiting Times)

To ask the Scottish Executive what action it is taking to improve waiting times for ear, nose and throat appointments. (S2O-3685)

We are committed to ensuring that no patient waits more than 26 weeks for a first out-patient appointment with a consultant, following general practitioner referral, from December 2005. Earlier this year, the centre for change and innovation launched a £3.5 million national redesign initiative that is targeted at ENT out-patient services. That will support NHS Scotland in reducing waiting times and progressing towards sustainable delivery of the 26-week target through locally owned and initiated solutions. Participating NHS boards will test new ways of delivering out-patient services and I expect that that successful and innovative practice will be shared across all NHS boards in due course. In NHS Lothian for example, patient-focused booking is being implemented at a cost of £117,000. Together with nurse-led ENT services, that should have a very positive impact on the waiting list.

I raise the matter after a constituent of mine was told that she would have to wait 83 weeks—more than a year and a half—for treatment. She was told that she could be treated more quickly if her condition deteriorated. We should be aiming to treat conditions earlier, not carry out more complex treatments when conditions deteriorate. Will the minister look into the situation in the ENT department of NHS Lothian's university hospitals division and address the issue of the recruitment of staff? New locums are just not good enough.

I share the member's frustration on behalf of his constituent. However, the resources that are required for the delivery of modernisation initiatives will change the patient flow and improve the service for the individual patient. The two locum consultants who have been working in Lothian are reducing some of the pressure on the waiting list and someone is being recruited for the substantive consultant post. Nurse practitioners are in position, assistant technical officers are doing the job that consultants used to do and we are using the NHS family in an effective way in an attempt to reduce waiting times and waiting lists. I am not satisfied with the situation and I will happily consider the individual's situation. In its correspondence with me, the board acknowledges that it is not satisfied with the service either.

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NHS Waiting Lists

To ask the Scottish Executive in what circumstances a patient on a national health service waiting list would be given a financial inducement to use private health care. (S2O-3745)

I am not aware of any such circumstances. NHS Scotland is committed to meeting our national maximum waiting time guarantees. Individual NHS boards may make use of the independent health care sector, when necessary, to ensure that those guarantees are delivered and sustained for the benefit of NHS patients throughout Scotland.

I know that the minister is aware that Lanarkshire NHS Board has offered such an inducement in at least one case for a condition that could have been treated easily and cheaply in Scotland if the clinical procedure had been approved here as it has been approved in England. The main thrust of my point is that in such cases people have been offered a certain amount of money—a few thousand pounds—towards the cost of treatment, depending on their funding the rest, and—

Question.

They have to pay out the money and then claim it back. Does that promote equal access to health care for all?

Given the performance of the SNP leader, I have to look closely at such assertions regarding these matters. Again, I am happy to look into the individual case to which the member refers. It is not the practice of the national health service to give cash to an individual to go away for a service. It is the board's job to find a suitable location for the delivery of that service and any payments would be made direct from the board to the individual private contractor who provides the service. I am happy to receive correspondence on the matter from the member. I restate our position that it would be very unusual for such a situation to occur.

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General Questions

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Road Tolls (Edinburgh)

To ask the Scottish Executive what the economic impact on Fife would be of Edinburgh introducing road tolls. (S2O-3749)

The City of Edinburgh Council has not yet finalised its draft charging order or submitted it to ministers. Due to the Scottish ministers' statutory role in relation to the order, it would be inappropriate for me to comment further at this time.

I will try to tease something out of the minister. Is he aware that many people who live in Fife commute in daily to make a valuable contribution to the Edinburgh economy and that for many of them public transport is not a suitable alternative? Does he consider it acceptable that under Edinburgh's proposals people who live in North Queensferry will have to pay a toll to enter the city while people who live in South Queensferry—who cause every bit as much congestion—will get off scot free? Will the minister make the strongest representation to the City of Edinburgh Council that that discrimination against Fifers is completely unacceptable?

I am aware of the views of Fife Council, for example, on the issue and I am aware of the work that has been done to analyse the impact that a road user charge would have on businesses in Fife. All that I can do at this stage is assure Murdo Fraser that if a road user charging scheme is submitted in due course to Scottish ministers the views of businesses and local communities in Fife will be taken into consideration when Scottish ministers reach a view on the proposal.

My views on the unfairness of the detail of Edinburgh's tolling proposals are well known. In the context of the possible economic impact on Fife, does the minister agree that there might be an opportunity to attract businesses to locate or relocate north of the Forth, where charges would not apply? That might have the twin benefits of decreasing unemployment rates in Fife and cutting down commuter traffic on the Forth road bridge.

I agree that all those issues need to be carefully considered. That includes the issue that Scott Barrie fairly raised and the interaction between the toll on the Forth road bridge and any road user toll. Ministers will consider those issues in due course, but we have made it clear that under the powers for road user charging in the Transport (Scotland) Act 2001, if a local authority wishes to propose such a scheme, Scottish ministers will be willing to consent if the scheme is reasonable and appropriate and there is clear evidence of local support for it. We must examine this particular scheme in due course; our options are to reject it, to approve it or to amend it and we have powers to do any of those things.

I hope that today the minister will at least confirm that he is aware of the deep hostility that exists in Fife, particularly among businesses, because of the impact on the Fife economy. Is he aware that businesses in Fife are screaming about the drain on their bottom line that is the daily nightmare of travel across the Forth estuary? Is the minister planning a new bridge, the introduction of new ferry services or additional park-and-ride facilities? People in Fife simply want to know whether the Scottish Government has the vision and courage to start making decisions. Fife businesses can wait no longer for decisions to be made. For instance, building a new bridge will take 10 to 15 years.

Question.

When will the minister act? When will he tell the people of Fife what is planned?

That was pretty wide of tolls, but Mr Stephen may answer as he will.

We are anxious about congestion levels throughout Scotland. As members know, most of the transport budget used to be spent on roads, but the budget was small—it was just over £300 million per year in 1999, when the Parliament was established. The transport budget is now somewhere over £900 million a year and will rise to £1.4 billion a year by 2007-08. A considerable amount of that budget will be spent on public transport initiatives. The simple answer is that I want better public transport, better park-and-ride schemes and better rail connections throughout Scotland. The Executive is investing in exactly that.

Does the minister agree that we must tackle congestion, in part through congestion charging? Congestion has a twin negative impact on the quality of life and the economy for people in Fife and the Lothians. Will he rule out a second Forth road bridge, which would only add to congestion in Fife and the Lothians while gobbling up all the Executive's transport budget, which needs to be spent on public transport alternatives to take people out of the traffic jams that are causing a lot of damage to our economy and quality of life?

We must tackle congestion, which is an increasing problem in Scotland. It has a major impact on people and communities and has a significant impact on business. One issue on which business lobbies all ministers is the need for transport infrastructure improvements, which I am determined to deliver. To get rid of congestion, improve the situation and make transport connections flow, I rule out no approach. It is important to examine all the options.

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Teachers

To ask the Scottish Executive what effect a shortage of teachers is having on fully implementing reductions in class contact time in primary schools in line with the McCrone agreement. (S2O-3661)

None. The reductions have been implemented.

Is the minister aware of the problems in the Glasgow area, which has a shortage of teachers to cover the extra hours in which primary teachers are to be out of class? The Educational Institute of Scotland has told its members that if they have not had their cover on a Friday afternoon, they should remove themselves from their school. What will the minister do to resolve the problem?

As I said, the reductions in class contact time have been put in place. Glasgow had 90 vacancies at the beginning of the school term, but Glasgow City Council has now recruited more than 100 additional staff. Matters are well on the way to resolution in all respects.

The member asked about the EIS and a suggestion about how staff might behave on a Friday afternoon. I am conscious that the EIS has formal arrangements in place and has advised its members that they should stay in the classroom, record a protest about what is happening and subsequently follow a grievance procedure if necessary. I expect teachers to behave professionally in relation to the teaching of the kids in their classes.

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RAF Kinloss

To ask the Scottish Executive what representations it will make to Her Majesty's Government in respect of the impact of closure of the Royal Air Force base at Kinloss on the economy of the Moray firth area. (S2O-3746)

The Scottish Executive is in regular contact with the United Kingdom Government on a wide range of issues, including the review of defence airfields.

Is the minister aware that, even as we speak, Moray Council representatives are meeting the minister of state from the Ministry of Defence in Whitehall to discuss the matters that I raise? Has the Scottish Executive received a similar invitation to discussions? How would it respond to such an invitation? The subject is vital to the whole Moray firth area. The uncertainty is already having an impact on local businesses throughout the Moray constituency and beyond.

I would be pleased to meet Moray Council and the member, as I recognise the genuine constituency concern that exists. It is not for me to tell the local campaign how best it should go about its business to secure the retention of the airfield, but I would wish to work with the local authority, the enterprise agencies and all other concerned parties to ensure that any potential economic impact is addressed. However, I stress that this review is part of a review of 50 airfields throughout the UK and that no decision has yet been made. It is up to those who are campaigning for the airfield's retention to make their case in all the forums, and I would be pleased to meet them.

Given that council rents in Moray are among the lowest in Scotland, that the average wage there is the lowest in Scotland and that there may be a surplus of MOD property, will Moray be placed at the top of the list for the next dispersal of jobs from Edinburgh or elsewhere in Scotland?

I am not the minister with responsibility for jobs dispersal—more is the pity, it might be said—but I am sure that the case for Moray will be made in the appropriate forums. I am genuinely concerned, as are the constituents in that area, about the prospective economic impact of any defence review and its impact on civilian and service jobs in the area. I genuinely wish to hold discussions with all the relevant agencies to ensure that their interests are put to the MOD at the highest level.

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Nursery Service (National Review)

To ask the Scottish Executive what progress has been made towards the initiation of a national review of the nursery service. (S2O-3662)

We announced the national review of the early-years and children's work force on 9 June. A steering group made up of representatives from trade unions as well as the public, private and voluntary sectors met on 2 July to agree how to take the review forward. The group is scheduled to meet again on 26 November. The steering group's working group on roles and responsibilities has met three times. I am pleased to report that work is progressing well and that the steering group will provide a report to ministers next summer.

I am pleased to hear that the review is progressing, given the commitment that was given by the Executive earlier this year during my members' business debate. I note from the Executive's press release at the announcement of the review that the review aims to consider

"the potential implications … for pay and conditions."

Can the minister inform me whether workers can genuinely expect to see a material improvement in their pay and conditions as a result of the review, especially given the gender issue?

Pay and conditions are matters for employers. We will need to wait for the outcome of the review. However, the review will consider the potential implications of its work on pay and conditions.

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Schools (PPP Funding)

To ask the Scottish Executive what proportion of the draw-down of public-private partnership funding for schools indicated in its budget equates to capital spend. (S2O-3735)

All the Executive's support for school PPP projects is targeted on capital spend, for example, on the building costs and capitalised interest.

I refer the minister to pages 6 and 39 of the draft budget document, which indicate a low capital investment proportion of the costs of the private finance scheme. In 2005-06, the figure is £35 million out of £100 million. Does he agree that that reflects a high degree of service bundling in the contracts, which is likely to accelerate over time, and that that will seriously inhibit future budgets and the provision of direct services to pupils, as most of the money will be spent on servicing the revenue costs of PPP and not on capital spend on buildings?

No, I do not agree at all. The draft budget document carries forward figures that are our best estimate at this time of the actual cash flow that we require to bring about a colossal improvement in our school estate. I know that the SNP would seek to scrap our school estate strategy, but we intend to move forward with it.

It is entirely wrong to suggest that the PPP programme in some way provides less value for money than previous forms of procurement of capital spending. The great advantage of PPP is that it brings the whole-life cost of a building up front and makes provision for a mortgage on the building and for all the maintenance of the building over a 25 to 30-year period. A project will proceed only if it is perceived to provide value for money. More than that, PPP transfers the risk of things going wrong with the building to the private sector, which has to pay for that—something that never happened in the past. I am aware that, for ideological reasons, the SNP would cancel such contracts, but we will press on so that we can ensure that young people are given the best environment in which to learn.

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Prisons

To ask the Scottish Executive what action it will take on the recommendations that are contained in the annual report of Her Majesty's chief inspector of prisons for Scotland. (S2O-3719)

I take the chief inspector's annual report and the recommendations in his individual inspection reports very seriously. The Scottish Prison Service recently agreed with the chief inspector that responses to recommendations in individual reports will be published on the SPS website. We will continue to take action to improve the prison estate and to reduce reoffending.

In his report, Dr McLellan once again expresses the frustration that many of us feel at the lack of sufficient progress in combating what he calls the three vices of the Scottish Prison Service. There has been insufficient progress on eradicating the degrading practice of slopping out, on reducing chronic overcrowding and on increasing access to rehabilitation programmes. Will the minister explain what grounds there are for optimism that the targets and timescales that have been set will be met, given that so little progress has been made and given that cuts are planned in the service's operational budget for the coming year?

On slopping out, the Executive and the SPS are investing the equivalent of approximately £1.5 million per week in the prison estate to provide fit-for-purpose accommodation. I have pointed out the need for that time and again in the chamber, so I hope that Opposition members, including Colin Fox, will welcome that. New house blocks have already been completed ahead of schedule and within budget at Edinburgh prison and at Polmont young offenders institution. Construction of further house blocks is already under way at Glenochil and at Edinburgh and additional construction work is on-going at Perth and at Polmont. We are also dealing with the problems of women in prison through the time-out centre.

On the so-called cuts that Colin Fox mentioned, I have met the chief inspector to discuss the issue that he raised in his report. Under the efficient management scheme, there is a requirement on the SPS to try to achieve savings of 5 per cent across the prison estate. However, we are clear that those savings are not cuts but efficiencies that will be reinvested into the prison system to ensure that we have prisons that are fit for purpose in the 21st century.

Does the minister agree that staffing levels are crucial to the Prison Service's effectiveness and to security? What guarantees can she give to local residents at Castle Huntly prison that the proposed increase of 141 prisoners will be matched by an increase in staffing?

I recognise that the member has a constituency interest in the matter, which he has written to me about.

If we are to tackle the problems of slopping out and overcrowding, we require to increase the availability of prison places. We need the two new-build prisons, but we also need to provide additional places within the existing estate. Of course staffing is critical for the better transitions that we want to see between the open estate and the community and for the improvements that we desire in the quality of programmes in the open estate. I recognise the local issues that face Andrew Welsh, but I hope that he will welcome those additional spaces, which are a key part of the prison modernisation process that is required to deal with the problems in our prisons.

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Energy Efficiency

To ask the Scottish Executive how it is boosting energy efficiency. (S2O-3740)

The Scottish Executive is committed to encouraging improved energy efficiency across the public, private and domestic sectors. For example, the Executive is providing £20 million in new funding over the next two years to improve energy efficiency in all local authorities and health boards and in Scottish Water. The initiative is expected to save the public sector £70 million and to reduce carbon emissions by 500,000 tonnes over the next five years. In addition, the Executive funds the work of the Carbon Trust and the Energy Saving Trust in Scotland. Last year, the free energy audits that were provided to business identified potential savings of over 200,000 tonnes of carbon.

I thank the minister for that positive answer and for those very large figures.

Is the Scottish Executive on track to implement by January 2006 the European Union directive on the energy performance of buildings, which will require that prospective buyers, owners or tenants of a property should be provided with an energy performance certificate? Is the Executive considering whether it might be sensible to link the implementation of the directive with primary legislation on seller surveys?

Yes. We intend to implement the European directive on the energy performance of buildings by January. Several options are being considered but the recent Executive consultation on the proposed private sector housing bill, "Maintaining Houses—Preserving Homes", gives consideration to linking the energy performance certification aspect of the directive with the single survey proposition.