Contents
- Portfolio Question Time
- Relationships and Behaviour Policy in Schools
- Gender-based Violence
- Business Motions
- Parliamentary Bureau Motions
- Decision Time
- Age Scotland (80th Anniversary)
Portfolio Question Time
Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business is portfolio question time. I remind members that, if they seek to ask a supplementary question, they should press their request-to-speak button or enter the letters RTS in the chat function during the relevant question.
Fisheries and Coastal Communities
To ask the Scottish Government how the proposals outlined in its latest “Building a New Scotland” paper, “Our marine sector in an independent Scotland”, will support Scotland’s fisheries and coastal communities. (S6O-02798)
Scotland’s marine sector plays a critical role in creating jobs and prosperity in coastal and island communities. As set out in the “Building a New Scotland” marine paper, the full potential of the sector can be realised only with independence. Unlike the United Kingdom Government, the Scottish Government will always champion Scottish marine sector interests. With independence and European Union membership, Scotland would enjoy full access to the EU single market for our seafood exports, freedom of movement to address post-Brexit labour shortages, and the ability to negotiate directly for priorities such as fisheries at the heart of Europe.
Scotland’s marine sector is a key contributor to Scotland’s success; in 2019, it generated £5 billion in gross value added and accounted for 3.4 per cent of the overall Scottish economy. We know that Brexit has had and continues to have adverse impacts on Scotland’s coastal and island communities, businesses and industries. What recent and on-going engagements has the Scottish Government had with fishers regarding the future of the industry?
The Scottish Government regularly meets representatives of the Scottish fishing industry in pursuit of our shared vision of a vibrant, prosperous and sustainable fishing industry that will provide opportunities and good jobs for generations of fishers to come and continues to help our coastal and island communities to survive and thrive.
Recent engagement has included close partnership working with the industry at annual fisheries negotiations to secure the best possible deal for Scotland, as well as Mairi Gougeon’s attendance at an event to celebrate the 50th anniversary of the Scottish Fishermen’s Federation and identify opportunities for future collaboration.
As environment minister, I have responsibility for inshore fisheries, and I engage every week with representatives of that most varied of sectors. Ms Adam knows, of course, that my first engagement in that area of my portfolio was in her constituency—at Peterhead harbour in June—with multiple sector stakeholders.
While the Government continues to speculate about hypothetical scenarios, our coastal and island communities need support right now. One way in which the Government could support our coastal and island communities is by ensuring that fishing in Scottish waters works for the benefit of Scottish communities. Given that only 50 per cent of Scottish fish are landed locally, how is the Government using the powers that it currently has to increase that proportion and ensure that our coastal and island communities benefit from fishing?
The answer to that question will be wide and varied. I will write to Rhoda Grant on the full suite of measures.
The cabinet secretary deals with the pelagic aspects, and I deal with inshore fisheries. I will talk about inshore fisheries in particular.
We are working with inshore fisheries organisations to collect more data with remote cameras on vessels so that we have a clear picture of what is out in the Clyde areas and inshore fishing waters, and we can see where there are vibrant fishing grounds that could be better monitored and where the species are. Obviously, climate change is having an effect on where species of fish are moving, in particular around the inshore waters.
That important piece of science and data collection from working with the industry is really important in having a sustainable inshore fishery. Working with the fishers is the only way to do that.
Scotland’s largest seafood sector—and, indeed, the UK’s largest food export—is Scottish salmon. That supports 2,300 jobs directly and up to 10,000 indirectly in Scottish coastal communities.
Innovation is essential to the future of the sector and its ability to compete internationally—indeed, aquaculture is identified specifically in the Scottish Government’s innovation strategy as a key sector. However, recent reports indicate that the future of the Sustainable Aquaculture Innovation Centre may be under threat. What is the Government doing to guarantee the future of that centre to ensure that the sector continues to grow, create jobs and compete internationally?
We set out our support for the sustainable growth of Scotland’s aquaculture earlier this year, recognising that innovation is a key enabler to delivering our vision for sustainable aquaculture. In light of the outcome of the Scottish Funding Council’s review of the innovation centre programme, the Scottish Government is working closely with the Scottish Funding Council, the Sustainable Aquaculture Innovation Centre and other partners to explore transitional and future funding arrangements.
Wildfires
To ask the Scottish Government what it is doing to tackle the increasing risk of wildfires in rural areas. (S6O-02799)
We are working with the Scottish Fire and Rescue Service on the implementation of its wildfire strategy. We have asked it to continue to invest in the provision of specialist resources, technological advancements and forward-thinking operational practices. We know that wildfire incidents are likely to increase due to climate change, so it is vital that we continue to work together to plan for and deliver an appropriate response. That is why we committed in this year’s programme for government to explore what more can be done to prevent and manage wildfires.
As the minister said, it is highly likely that wildfires will continue and grow bigger. During the summer, I visited the site of one of the largest wildfires, at Cannich. It is well accepted locally that it was gamekeepers, who used their many decades of experience of fighting fire with fire, who responded and stopped the fire. The Parliament will discuss the issue of muirburn tomorrow. Does the minister agree with me on the importance of muirburn for firebreaks and of ensuring that gamekeepers are allowed to continue to fight fire with fire?
I am happy to reassure Ms Forbes that the Wildfire Management and Muirburn (Scotland) Bill contains provisions that would allow the continuation of muirburns by practitioners to prevent or reduce the risk of wildfires. The bill also contains provisions that would allow practitioners to undertake muirburn without a licence in emergency circumstances, such as those that Ms Forbes has described. That flexibility is absolutely necessary and important.
We recognise the knowledge and skills that are held by practitioners such as gamekeepers, and NatureScot has ensured that they are a key part of the development of the new code of practice that accompanies the bill. I take the opportunity to commend the swift action taken by the gamekeepers that Ms Forbes mentioned.
I am happy to discuss that aspect of the bill or any other concerns that Ms Forbes has about muirburn provisions. However, as she said, we will have an opportunity to debate the matter in full tomorrow.
In its recent “Firestorm” report, the Fire Brigades Union Scotland found that 93 per cent of its members who participated in a survey believed that the Scottish Fire and Rescue Service is not adequately resourced to deal with the increase in climate-related incidents such as wildfires. Does the minister accept that assessment? What is the Scottish Government doing to ensure that the fire service is properly equipped?
I will refer the information that Katy Clark has asked for around the funding of the fire service to the minister whose portfolio covers that matter.
The Scottish Government has continued our commitment to support Scottish Fire and Rescue Service delivery and reform with a further uplift of £10 million of resource for 2023-24. In recognition of the pay and inflationary pressures that the Scottish Fire and Rescue Service faces, we have provided it with an additional budget of up to £4.4 million on top of the allocations that were set in that budget announcement.
The minister mentioned the use of muirburn without permission in an emergency. However, is it not the case that, if we wait for an emergency, it is too late? Everyone whom I speak to in rural Scotland who deals with wildfires says that, if muirburn is reduced, the risk of loss of human life increases. Does the minister share my concern that any such diminution of muirburn, particularly on a significant level, will significantly increase the loss of human life in Scotland?
I do not wholly share those concerns. Fergus Ewing has pointed out that we need a flexible system that allows a speedy response to any potential emergency without a licence. I think that the issue will be in the detail of how we define an emergency.
A muirburn licensing scheme is required by the Wildlife Management and Muirburn (Scotland) Bill in order to ensure that muirburn is undertaken in accordance with the code of practice in an environmentally sustainable manner. We intend that applying to the licensing scheme will be straightforward.
We recognise that muirburn has a positive impact by helping to reduce fuel loads and lower the risk of wildfires. The bill contains provision to enable NatureScot to issue licences for that purpose on non-peatland and peatland.
The practice will be allowed to continue, but the scheme will ensure that those who are undertaking it are trained and that we have a full picture of where and how it is being done. Of course I recognise that the practice can prevent wildfire. I give Mr Ewing assurances that there will be flexibility around emergencies in order to mitigate the potential issues that he described in his question.
Food Security Unit
To ask the Scottish Government whether it will provide an update on the work of the food security unit in relation to the monitoring of food system resilience. (S6O-02800)
The initial focus of the new food security unit is to develop evidence-based systems to monitor risks or threats to supply chains and to mitigate future shocks and impacts on food security. It is still early days for the unit, but enhanced monitoring should mean that the Government and industry can be on the front foot and are able to react as quickly as possible to future shocks as they arise. Although it is not possible to predict all impacts, improved monitoring should, in turn, help to bolster industry confidence during these hugely challenging times.
In my South Scotland region and beyond, food insecurity and hunger are becoming increasingly prominent issues that have no place in a modern Scotland. Although I welcome the establishment of a food security unit, it is my belief that a right to food should be enshrined in Scots law as independent legislation, because that is critical to ensuring food security. Why does the Scottish Government continue to reject calls from Labour members to introduce that important right?
There are quite a lot of drivers of people not being able to eat, which relate to poverty. The Scottish Government has tried to identify meaningful and efficient measures that we can take to alleviate poverty. The Scottish child payment of £25 a week has been hailed as making a “significant difference” by the Scottish Federation of Housing Associations in the report that it published this week. I recommend that Carol Mochan has a look at the report if she has not already done so.
The energy part of my portfolio delivers the fuel insecurity fund, which has been tripled since the current First Minister took office. The biggest drivers of poverty are the costs of food and energy. We are calling for a social tariff on energy bills and for the two-child benefit cap to be lifted. Those measures would tackle at source the issues that Carol Mochan rightly brings to the chamber and would alleviate the poverty that many families in her region are experiencing. That is where we are putting our efforts.
Each week, butchers in Orkney buy locally reared beef and lamb at the auction mart and ship it to Dingwall for slaughter, with carcases returning to Orkney by refrigerated lorry. Reliable ferry services are key to that trade and to butchers fulfilling their contracts with local schools, care homes and NHS Orkney. However, the Government’s failure to provide cover during the dry docking of MV Hamnavoe in January puts all that at risk. Previously, a Ropax—roll on, roll off passenger—vessel was used, and then Scottish National Party ministers approved the use of a freight vessel. Now, the Government has abandoned the route completely during the refit. Will the minister explain how that meets the requirements of food system resilience or, indeed, a lifeline ferry service?
Although Liam McArthur’s question strays away from my portfolio and into the transport portfolio, he raises an important point about the geographical locations of abattoirs, which is in my portfolio. We are actively looking at that with the chief vet. Although my constituency is not across any body of water, we, too, have an issue with getting animals to slaughter in a way that is not distressing for them and does not involve long journeys. We are looking at a range of measures that might improve that situation.
I will take this back to the original question about the food security unit. A few weeks back, there was a debate in the chamber, which the Labour Party tried to stifle, that touched directly on our ability to create a secure and resilient food system. In the debate, I pointed out to members that berry farmers had, in fact, given up on growing soft fruit and that Brexit was undoubtedly sitting at the heart of that problem.
What is the Scottish Government’s latest assessment of the impact of Brexit on our food security? Does the cabinet secretary agree that the hypocrisy of Labour’s current pro-Brexit stance proves that Labour is not what Scotland needs?
I thank Jim Fairlie for the questions. I absolutely recognise the issues that he has outlined, particularly about the soft fruit-growing industry. The food and drink sector as a whole has undoubtedly borne the brunt of the United Kingdom Government’s hard Brexit, which has brought with it disrupted supply chains, new trade barriers and the costs of higher food prices. We are all paying for a Brexit that Scotland did not vote for.
Of course, access to labour is a fundamental part of the issue that Jim Fairlie outlined. That is what makes Labour’s position all the more cynical. Labour knows that Brexit is hugely harmful, yet it will continue to impose it on Scotland if it wins the next Westminster election. That fact shows that it does not matter who is in power in Westminster—neither Labour nor the Tories will stand up for Scotland.
The only route for food producers in Scotland to once again enjoy the benefits of access to the European Union labour force, removal of export red tape and unfettered access to the European single market is to have an independent Scotland, whose first priority would be rejoining the EU.
Question 4 has been withdrawn. Question 5 was not lodged.
Agricultural Funding (Engagement with United Kingdom Government)
To ask the Scottish Government when it last engaged with the United Kingdom Department for Environment, Food and Rural Affairs and other relevant UK Government departments regarding the provision of future agricultural funding for Scotland. (S6O-02803)
The Scottish Government has regularly pressed the case that rural Scotland has been short-changed as a result of Brexit and that the United Kingdom Government must ensure certainty around rural funding for the future and give Scotland an equitable share of available funds that meet our needs and interests.
Mairi Gougeon wrote to the new Secretary of State at the Department for Environment, Food and Rural Affairs, Steve Barclay, this past week. She also raised the issue at interministerial group meetings with the previous secretary of state, and our Deputy First Minister raised it with the Chief Secretary to the Treasury in June this year.
The Tories cannot be silent on the scandal that is leaving our farmers in the dark over future funding. They are complicit in Westminster’s treatment of the sector with utter contempt, while at the same time they cast themselves as champions of Scottish agriculture without any credibility.
Farming is a long-term endeavour, and people need clarity now to plan for the future. Has there been any indication that the new DEFRA secretary of state understands those concerns? Does the minister know whether Labour is promising anything different?
Agriculture is devolved, and it is crucial that Scottish Government policies are unhindered by any threats that are posed by the United Kingdom Internal Market Act 2020, the subsidy control regime and the lack of long-term replacement European Union funding.
We have not yet received any response from the new secretary of state at DEFRA, Steve Barclay, on Ms Gougeon’s recent letter to him, in which she stressed that we need to work together closely on the certainty of future agricultural funding. We continue to raise the issue regularly and urgently with the UK Government. We will, of course, also do so with any Labour colleagues who might be looking to be in the Government after this one.
The Scottish National Party-Green Government’s disdain for our farmers and crofters is all too clear to see. One columnist even described Mairi Gougeon’s approach as something that one would see at the “Mad Hatter’s Tea Party” in “Alice in Wonderland”.
It is little wonder that one of the rabbits that was pulled out of the hat last week in Shona Robison’s budget statement was the slashing of £28 million from the agricultural budget. Further, £61 million of agricultural funds that were allocated to the SNP by the UK Treasury have gone missing over the past two years. Where has the money gone and when will it be returned?
I say to Rachael Hamilton that the most pressing issue for farmers—certainly in my constituency—is the long-term certainty of funding. His Majesty’s Treasury has provided yearly allocations for the current UK parliamentary session, but there is no funding commitment for 2025.
Where is the money?
I will continue my answer if I can do so without interruption.
That has direct implications for the management of current agricultural programmes, including the Scottish rural development programme and the work that is under way in the agricultural reform programme.
Agriculture requires future funding certainty due to its multi-annual funding commitments and long lead-in times for farmers, crofters and land managers—a fact that I am sure that Ms Hamilton is absolutely aware of.
Of course, it would be helpful if the Westminster Government gave some clarity, but it would be equally helpful if the Scottish Government did not cut £28 million from the agriculture budget. That is not providing any certainty for the farmers in my constituency or in the minister’s. When will she restore the money that has been cut; indeed, when will she restore the £61 million that should be in farmers’ pockets?
Willie Rennie’s point is probably for the Cabinet Secretary for Rural Affairs, Land Reform and Islands to answer. I will refer his question to the cabinet secretary and I am sure that she will write to him with the detailed answer that he requires, giving assurances.
Sixty-one million pounds of ring-fenced money that was allocated to the Scottish Government by the United Kingdom Government has been withdrawn. The scale of the Scottish Government’s hypocrisy has no bounds. Does the cabinet secretary—sorry, I mean the minister, because the cabinet secretary is not here. Does the minister not share the anger of farmers and crofters right across Scotland about the fact that the Scottish Government is asking for money from the UK Government but, when the Scottish Government gets £61 million, it disappears? As a matter of urgency, will you find out when that £61 million will be returned to the agriculture budget?
We need to speak through the chair.
I will tell Finlay Carson one thing on which I absolutely share the anger of farmers in Scotland, and it refers back to the question that Jim Fairlie asked about how the hard Brexit has impacted on our farmers. We were assured that multiyear funding allocations would be given. [Interruption.]
Members!
That is the most pressing issue for farmers in Scotland.
Flooding (Mitigation of Crop Losses)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding action to mitigate any future crop losses due to flooding, including by updating its water management plans. (S6O-02804)
The cabinet secretary has witnessed and discussed at first hand the impact on crops on farms affected by the severe flooding that the country experienced in October. Roz McCall will know that the cabinet secretary’s constituency was the worst affected. The issue has been central to her discussions with ministerial colleagues on our collective response. At the AgriScot conference on 22 November, the cabinet secretary confirmed that the Scottish Government has now established and funded a scheme for agricultural flood bank repair. A budget of £1.8 million has been set aside and the scheme will be open for applications shortly, offering up to £30,000 per individual farm business to reinstate flood banks to their pre-damage levels.
At a recent meeting of the Fife branch of NFU Scotland, the issue of adverse impacts of recent flooding on food security was raised. We know that the general increased groundwater and the submersion of vast areas of land after intense flooding are having a detrimental impact on all winter crops. What is the Scottish Government doing to mitigate further against future crop losses in the light of current environmental policies that are preventing farmers from using tried and tested methods of water management?
The weather events of recent weeks have affected communities and farms right across our water catchments. It is right that we take a holistic approach to our work on flood risk reduction and recovery response. We are committed to promoting and advancing our understanding of natural flood management programmes. As part of that commitment, we are funding the long-term Eddleston Water research programme and the Allan Water improvement project—which, I believe, is in Ms McCall’s region. Those projects are helping to develop an evidence base to improve our understanding of how floods operate and to help stakeholders to understand the potential value of alternative flood prevention measures.
Through the farm advisory service, the Scottish Government funds a range of support for farmers, crofters and land managers, which is delivered through events, videos, technical notes and advice line support—to name just a few—as well as bespoke specialist advice on dealing with floods.
I can squeeze in question 8 if we have a brief question and answer.
Pesticides (Impact on Rural Environment)
To ask the Scottish Government, regarding its pesticides policy, how it monitors any impact of the use of pesticides on the rural environment, including watercourses. (S6O-02805)
A range of pesticide monitoring strategies operate in Scotland. The Scottish Government performs annual surveys to monitor patterns and estimate Scottish pesticide use on agricultural and horticultural crops. Pesticide records are inspected as part of cross-compliance inspections to ensure that pesticides are used in line with their approval conditions. The Scottish Government also participates in analysis of pesticide residues in food and wildlife.
The Scottish Environment Protection Agency monitors the chemistry and ecology of surface waters, which are indicative of pesticides and their impacts. Monitoring has recently been carried out at nearly 100 freshwater locations.
I recently joined experts at the James Hutton Institute to discuss the Dee catchment management plan, which aims to protect the river catchment ecosystem. Among the issues that were raised was the recent discovery in a remote stream in the Cairngorms of imidacloprid, an insecticide that has been banned for use in agriculture but that is still used in domestic pet flea treatments. A dog or another treated animal entering the stream is the most likely source of the pollution.
Given that nature is our first line of defence against climate change, what action is being taken to ensure that agricultural pesticides are used in accordance with regulations? What action is being taken to halt the use of banned pesticides in domestic pet flea treatments?
I thank Audrey Nicoll for highlighting those important issues and for the good work that is being carried out as part of the Dee catchment management plan.
The issue of pet treatments is reserved, but I emphasise that all pet owners should follow the guidance that is provided with such a treatment, which says that pets should not enter water for a period of time after it has been applied.
I agree that non-chemical control of weeds should be considered wherever possible, which is why the Scottish Government promotes integrated pest management and encourages a limited and targeted approach to pesticide use. My officials and I have contributed to the development of a United Kingdom national action plan for the sustainable use of pesticides, which is due to be published this year.
NHS Recovery, Health and Social Care
Mental Health Directorate (Impact of Spending)
To ask the Scottish Government, in light of the budget for its mental health directorate having increased substantially in the past three years, how it plans to measure the impact of this spend, including outcomes for people with mental health conditions. (S6O-02806)
The new 10-year mental health and wellbeing strategy, which is jointly owned by the Scottish Government and the Convention of Scottish Local Authorities, was published in June. It includes outcomes that describe the differences or changes that we want to see as a result of the strategy. We will use those outcomes to monitor and evaluate progress as the strategy is implemented. That will build on work that we have already delivered to improve data collection by health boards and to publish new core standards for mental health.
As the minister will be aware, my question relates to one of the central recommendations in Audit Scotland’s report on adult mental health. In the Public Audit Committee’s evidence sessions, it has been noted that people are unclear about the range of options that are available to them and are rarely surveyed about the quality of service that they receive and whether they feel that their outcomes are improving. Can the minister offer reassurance that that will be a priority in the coming years?
Absolutely. The mental health standards that I referenced are crucial to ensuring that everybody—those accessing care and those delivering care—knows what standards are expected from them. Those standards will be really empowering for people who try to access support services, because they will ensure that people understand what to expect in the way of care.
The strategy sets out national sources of support. In the first instance, people are encouraged to phone their general practice, which is, of course, the front door to the national health service. However, there is also the NHS 24 mental health hub, which is available 24 hours a day, seven days a week, on 111. Staff from that service will direct people to the right help. We also provide online resources, such as the mind to mind service, which is situated on NHS Inform—the Scottish NHS on the net. All of that sits alongside a range of community support.
The member for Kilmarnock and Irvine Valley mentioned an increase in funding for the directorate, but that does not reflect the reality on the ground. Last week, the Scottish Government confirmed an in-year cut of £30 million to mental health funding. This is the second year running that in-year cuts have been made to mental health spending. How does the Government expect patients to have confidence in mental health services when the only consistent thing about its approach is budget cuts?
The financial pressures that we face as a result of rising inflation and the on-going impacts of Covid and Brexit are by far the most challenging since devolution. As a Government, we have had to make difficult decisions to balance and prioritise the budget, including making a record pay offer to our national health service staff to support them through the cost of living crisis and to avoid industrial action.
The new “Mental Health and Wellbeing Strategy” strongly signals the priority that we place on mental health. Despite the 2023-24 savings, we have supported overall increases to mental health spending over a period of years. The mental health directorate’s programme budget has more than doubled since 2020-21, from £117 million to nearly £260 million in 2023-24. Between the Scottish Government and national health service boards, we expect spending on mental health to be well in excess of £1.3 billion.
We continue to focus on the delivery of our new mental health and wellbeing strategy, as well as supporting delivery plans for learning disability and autism services and cross-cutting trauma work.
Type 2 Diabetes Drugs (Supply Issues)
To ask the Scottish Government whether it will provide an update on any supply issues with drugs for people with type 2 diabetes. (S6O-02807)
The Scottish Government is aware that there are global supply issues with glucagon-like peptide-1 receptor agonists, which are licensed for treating patients with type 2 diabetes. It is anticipated that supplies of all GLP-1 RA products will be limited and intermittent until at least mid-2024. The supply of medicines and the associated legislation are reserved matters for the United Kingdom Government. NHS Scotland has robust systems in place to manage medicine shortages when they arise. I recognise the impact of those global shortages, and anyone who is affected by them should speak to their clinical team.
I am aware that people can get help from the Diabetes UK helpline.
Will the minister detail any collaborative efforts with pharmaceutical manufacturers and distributors to mitigate the supply issues with drugs for people with type 2 diabetes? What steps are being taken to enhance the resilience of the supply chain in order to prevent future disruptions?
As I mentioned, the UK Government remains responsible for the supply of medicines. The UK Department of Health and Social Care has a dedicated team that has been working with the companies concerned to establish the current supply position by modelling demand and supply and to consider how to mitigate shortages. I am pleased to say that our chief pharmaceutical officer attends those meetings and that the Department of Health and Social Care is carrying out modelling and drawing on intelligence that is received from the devolved nations.
I refer members to my declaration in the register of members’ interests as a practising national health service general practitioner.
Access to diabetes technology is a postcode lottery, with patients having to battle to get it and having to justify why they deserve to get it. That is demeaning for my constituents Rachel and John and for everyone involved, and the process adds mental strain to their struggle. Will the Scottish Government provide an update on its plan to address the unequal access to diabetes technology for people living with type 1 diabetes, as highlighted in Diabetes Scotland’s “Diabetes Tech Can’t Wait!” campaign report?
We are working closely with NHS boards to deliver effective evidence-based options for those who are at risk. In 2023-24, we have provided health boards with core funding of just under £6 million to deliver various services in relation to diabetes. We aim to reduce unequal access and we are working closely on how we can include closed-loop mechanisms in those discussions with health boards.
As always, there are supply issues for those with type 2 diabetes. The recent report by Diabetes Scotland on its “Diabetes Tech Can’t Wait” campaign highlighted that only 14.5 per cent of adults with type 1 diabetes are using an insulin pump and only 5.9 per cent are using continuous glucose monitors. Does the minister agree that more funding is vital to provide fair and equal access to life-saving diabetes technology across Scotland?
As my colleague Ms Todd highlighted, we are in probably the most difficult financial circumstances that the Government has found itself in. I agree with the member that we need to find innovative ways of improving technology support for those living with diabetes, which is why I have been working closely with various third sector organisations and health boards.
Long Covid (Children)
To ask the Scottish Government what it is doing to support children with long Covid. (S6O-02808)
Across NHS Scotland, local primary care teams are providing assessment and initial investigation for children and young people with symptoms that are consistent with long Covid. Primary care clinicians can give advice about the management of symptoms and any potential treatment options for those in the first instance. They can also refer people to occupational therapy and physiotherapy for further support where that is appropriate. In cases where referral to secondary care is required, children and young people may be referred to general paediatric services for investigation and on-going management.
The Scottish Covid inquiry has heard that children with long Covid have been dismissed and ignored by those who are supposed to support them. The charity Long Covid Kids told the inquiry that healthcare professionals were not appropriately trained, that there is a postcode lottery of care and that healthcare professionals had been given no education regarding the condition. Does the minister agree that the Covid inquiry should be an opportunity to learn lessons from the poor treatment of people with long Covid? What training is being provided to healthcare professionals now so that they can adequately support children who are living with long Covid?
The member might be interested to know that, earlier this month, I met a range of organisations that represent people who are impacted by long Covid, including Long Covid Kids, which is part of our national strategic network that has been set up to inform our approach to long Covid. I have committed to holding a follow-up meeting with Long Covid Kids to discuss that important subject in further detail. I do not think that it would be appropriate for me to comment at this stage on detailed evidence that is presented at the inquiry.
Jackie Baillie, who is joining us remotely, has a supplementary question.
Long Covid Kids Scotland has raised concerns that the Scottish Government has produced no detailed report on the development of long Covid services for children and young people in the national health service. No dedicated services are up and running or even close to opening nearly four years after the start of the pandemic. Will the minister advise when paediatric long Covid services will be fully up and running? Given the growing numbers of children and young people who are developing the condition, can she confirm the forecast spending requirements for treatment over the next 10 years?
I reiterate that I will be meeting Long Covid Kids to discuss the issues that the member has highlighted. With regard to her more detailed questions, I will be happy to respond to her in writing.
Will the minister provide further information on the work that the long Covid national strategic network is undertaking to improve treatment for children and young people with long Covid?
The long Covid national strategic network has a dedicated workstream that is looking at the needs of children and young people and it includes representation from the Royal College of Paediatrics and Child Health and the charity Long Covid Kids, which I have already referenced. The group is reviewing and updating the information that is available to NHS board colleagues and primary care clinicians on the appropriate assessment, referral and management pathways for children and young people with long Covid symptoms. Once updated, the information will be shared with NHS boards as a clinical pathway for local implementation. The aim is to improve consistency of approach across Scotland.
People with Gambling Addiction (NHS Support)
To ask the Scottish Government what work the national health service is undertaking to support people with gambling addiction. (S6O-02809)
People with gambling addiction in Scotland can get support through a range of services including those that are signposted on the NHS Inform website, primary care services and, where appropriate, mental health services in secondary care. We have established a gambling-related harms working group with Public Health Scotland to consider what needs to be prioritised in gambling harms research, prevention and treatment.
The United Kingdom Government white paper “High Stakes: Gambling Reform for the Digital Age” includes proposals on a levy to fund research, prevention and treatment. The Scottish Government continues to engage with the UK Government to ensure that Scotland will benefit from those proposals.
Problem gambling and debt often lead to relationship breakdown, homelessness and mental ill health, and they can even lead to suicide. It is galling that the UK Government has failed to introduce a gambling reduction bill. Will the minister outline what discussions she has had with the UK Government about the proposed gambling levy that would feature in such a bill? I would also like to know how she envisages that the money that a levy would raise would be spent on boosting NHS services in Scotland in order to support problem gamblers in relation to their addiction.
I recognise the description that Mr Stewart gives in his question, because I met a young man who is living with a gambling addiction and he explained the situation that he is in.
I met my counterparts in the UK and Welsh Governments on 21 November to talk through the proposed gambling levy. At that meeting, we discussed the fact that the proposed levy would need to take account of the different landscapes across the three nations and that the devolved Administrations must be involved in decision making at all levels. Health is devolved and any decisions on the use of funding to support prevention and treatment for gambling in Scotland must remain with the Scottish Government.
The NHS is one avenue for support for people with gambling addiction. We will continue to work with the UK Government on the levy post-consultation to ensure that individuals can find support and advice that addresses their needs and circumstances.
Gambling harms and addiction can destroy lives, families and communities. According to the 2021 Scottish health survey, in the least deprived 20 per cent of Scotland, 2 per cent of people had or were at risk of having gambling problems. In the most deprived 20 per cent of Scotland, the figure was 11 per cent of the people who were surveyed, which is more than five times higher. Does the Government have plans to introduce a public health-based approach to tackling gambling harms? Will such a plan have measurable objectives that will seek to eradicate the divisive health inequalities that exist?
The Scottish Government treats gambling as a public health issue and we know that the voices of those with lived experience are critical to developing policy, especially in areas where the harms are often hidden—I refer to women gambling, the increase in online gambling and the possibility of stigmatisation. We are working with the gambling-related harms working group to bring in the voice of lived experience.
Mental Health Services (Winter)
To ask the Scottish Government what services people experiencing poor mental health can access this winter. (S6O-02810)
People who experience poor mental health and wellbeing will continue to be able to access a range of specialist services and community-based supports over the winter. As I mentioned in a previous answer, people who require clinical support should first telephone their general practitioner’s surgery or, where possible, their usual mental health team in the first instance. If they are unable to access mental health support that way, the NHS 24 mental health hub is available 24/7 on 111.
There is further information and support, including the mind to mind section of our NHS Inform website, which is useful and can be found in our mental health and wellbeing strategy. I would be more than happy to share the details of those resources with Mr Simpson.
I will certainly take up that offer.
Too many people are falling through the cracks, as we have heard on the Public Audit Committee recently. Audit Scotland’s recent report on adult mental health referenced a person-centred model of mental healthcare in Trieste in Italy. It is a 24-hours-a-day, seven-days-a-week service that requires no appointments and is a one-stop shop. As well as being better for those who need help, it has saved money. Would the minister be willing to consider that model as a way forward in Scotland?
I am always keen to learn from other countries where we can. Undoubtedly, there are challenges in lifting strategies from other healthcare and support systems and putting them into ours but, as ever, I am keen to learn from other systems.
Audit Scotland reported positively on the mental health and wellbeing strategy that the Government has produced. It said:
“It recognises the importance of a whole-system approach to supporting mental health and wellbeing and provides a foundation for better joint working.”
Admittedly, as was referenced in the previous answer and as Audit Scotland pointed out in that report and others, we are doing that in very challenging financial circumstances.
Poor mental health and long waits for treatment are affecting national health service staff, too. In Fife alone, the NHS sickness rate is 7 per cent, and much of that is mental health related. That is contributing to the current overspend of £15.86 million. The Scottish Liberal Democrats secured £120 million for mental health support in the 2021 budget, so why are mental health waits still so long?
Mental health waits are improving. The statistics that I am seeing, which will be in the public domain very soon, show a continuing decrease in the waiting time for psychological therapies. That indicates a sustained improvement in recent times. Our new psychological therapies and intervention specification will ensure that psychological therapies are delivered to a high quality and with consistent standards across Scotland.
I absolutely acknowledge that, for somebody who has been waiting for a long time to get an appointment, that is not the answer that they want to hear, but I assure members that things are improving in mental health. The steps that we are taking are working, and we are managing to improve the situation.
The minister mentioned the mental health strategy delivery and workforce plan, which is welcome. Can she say more about how the plan will help to ensure that we are meeting changing mental health needs across Scotland?
Absolutely. As the member said, the delivery plan and the workforce action plan that were published on 7 November jointly with the Convention of Scottish Local Authorities are key if we are going to make the progress that we want to see. The strategy’s vision and outcomes take a whole-systems approach. We know that mental health ranges from severe and enduring mental illness to everyday worries and feelings of distress and hopelessness. Mental health is a cross-Government priority, and it is supported by a strong collective ambition in the Government and leadership to influence the range of issues that contribute to whether we are mentally healthy or not. Those include poverty, employment, housing, our communities and many more. A diverse range of services and supports will ensure that people can access the right support in the right place at the right time.
Healthcare Services (Edinburgh)
To ask the Scottish Government what action it is taking to ensure the sustainability of healthcare services in Edinburgh, in light of the significant increase in the population of the Lothian region in recent years. (S6O-02811)
It is for territorial national health service boards and their planning partners to organise and provide high-quality services that meet the needs of local people in line with national guidelines and frameworks. Those services will be developed over time to account for a range of factors such as population growth, alongside others such as changes in clinical best practice and significant technological developments.
On the Government’s commitment to and investment in local health services, NHS Lothian’s resource budget, which is currently more than £1.7 billion, increased by 28 per cent in real terms between 2010-11 and 2023-24; and by just over 100 per cent, or £874.6 million in cash terms, between 2006-07 and 2023-24.
Population growth in Edinburgh has been significant and future projections are also significant. The Granton waterfront development in my constituency is projected to bring an additional 10,000 patients to the area by 2028. As I have raised previously, there is a proposal to create a new general practitioner practice in the Ocean Terminal shopping centre, and that could be a quick, accessible and cost-effective way of meeting current demand and creating much-needed additional capacity, as the Minister for Public Health saw on a recent visit to the vaccination centre. I appreciate the current public finance pressures, but will the Scottish Government work constructively with NHS Lothian and the Edinburgh health and social care partnership to seriously consider the proposal for a GP practice at Ocean Terminal?
The member raised that issue with me in September this year, and I am conscious of the significant pressures on primary care services in different parts of Edinburgh, including in the member’s constituency. He will recognise that the Scottish Government’s approach to capital infrastructure projects is to use existing buildings rather than to build new buildings for the provision of health services where possible.
As I have highlighted to the member in previous correspondence, a decision on whether a particular development at Ocean Terminal could be used as a GP facility would be a matter for the health board and City of Edinburgh Council. However, I can advise the member that I understand that NHS Lothian will be looking again at that issue as part of its capital reallocation and reprioritisation process at its December board meeting. I encourage the member to continue to engage with NHS Lothian as it considers the matter in the coming weeks.
I am glad that the cabinet secretary mentioned capital. The First Minister committed to a new eye pavilion when he was Cabinet Secretary for Health and Social Care, yet the eye pavilion is still in a building that has been condemned. The Royal Edinburgh hospital is still only in phase 1 of a three-phase plan. The national treatment centre at St John’s is supposed to be a national priority. A new sterilisation unit must be built. My constituents in Lothian are asking where those things are. They are all projects that have been promised in the past. I am not asking where the money will come from—I am asking where the money has gone.
I recognise the member’s interest in issues such as the eye pavilion, the proposed national treatment centre and the Lothian cancer centre. However, as she will be aware, the capital allocation review has had a direct impact on capital projects throughout the country, not just in health but across the public sector. That has happened principally as a result of the United Kingdom Government cutting our capital allocation. That is why so many capital projects are not able to progress. Alongside that, Liz Truss’s disastrous budget resulted in significant increases in the cost of capital projects. [Interruption.]
Members!
That means that projects are now well over what they would previously have cost. That, along with the cut in capital, makes it very difficult to take forward capital projects of that nature.
Renfrewshire Health and Social Care Partnership (Meetings)
To ask the Scottish Government when it last met Renfrewshire health and social care partnership, and what was discussed. (S6O-02812)
The Minister for Social Care, Mental Wellbeing and Sport met the integration joint board chief officers on 2 November this year. The chief officer for Renfrewshire health and social care partnership was in attendance at that meeting, at which the substantive agenda item was the national care service. The director of social care and national care service met the chief officer of Renfrewshire health and social care partnership on 21 November this year to discuss delayed discharge performance and unmet community need.
The Scottish Government frequently claims that it is protecting health services and giving local councils a fair deal, but the Renfrewshire health and social care partnership faces a £14.7 million black hole, which will likely lead to the closure of Montrose care home, Hunterhill care home or Renfrew care home, the merging of Mirin and Milldale day services, and the closure of the Flexicare service, as well as the use of vital reserves. What will the Scottish Government do to protect those vital services, which so many people in Renfrewshire rely on?
The Scottish Government has been putting in additional investment to support the provision of social care across the country. From the health budget alone, we provide £1.7 billion for social care and integration, which means that social care spending has increased by more than £800 million compared with 2021-22. That is well ahead of the trajectory of an increase of some 25 per cent that we intend to deliver over the course of the current parliamentary session.
Notwithstanding that, I recognise the significant challenges that our social care partners are facing, and we continue to engage with them to provide support where we can. However, Neil Bibby will be well aware of the very difficult financial environment in which we are operating. In last week’s autumn statement, little more than £11 million was provided as health Barnett consequentials. That has the direct consequence of making it much more difficult to invest in key parts of our public services.
We can squeeze in question 8, if members are succinct.
People with Chronic Hepatitis B (Financial Support)
To ask the Scottish Government whether it will provide an update on what it is doing to provide financial support to those infected with chronic hepatitis B due to receiving contaminated blood. (S6O-02813)
In its second interim report, the United Kingdom infected blood inquiry recommended that there should be a UK-wide compensation scheme for people who had been infected or affected by infected national health service blood or blood products, which should include compensation and support payments for people who were infected with chronic hepatitis B.
The UK Government is currently considering those recommendations, but it has made it clear that it needs to see the inquiry’s final report, which is now expected in March 2024, before confirming its plans. The Scottish Government understands the concerns of the people who have been affected by this terrible tragedy, which is why I have written to the new Paymaster General to request a four-nations meeting to discuss the issues.
My constituent was infected by hepatitis B and now has cirrhosis of the liver, but she has missed out on all financial support. She wishes to remain anonymous due to the still pervasive and profound stigma around her personal situation. In the second interim report, the chair of the infected blood inquiry stated that people who had been infected would be eligible for support. What assessment has the Scottish Government made of the inquiry’s interim recommendations? Will the minister meet me and my constituent to discuss a way forward for hepatitis B victims who are missing out on urgent financial assistance?
I understand how difficult the long wait for the conclusion of the infected blood inquiry has been for all those who were infected and affected, including anyone infected with hepatitis B.
The report specifically recommends a UK-wide compensation scheme. As I have already said, I wrote to the UK Paymaster General earlier this week to ask for another four-nations discussion on next steps. That follows two four-nations meetings earlier this year with the previous Paymaster General. I have asked that we specifically discuss hepatitis B, as well as a number of other matters, including interim compensation payments for certain bereaved relatives, and I have requested action on that as soon as possible. Once I have met the Paymaster General, I would be happy to meet Ms McNair and her constituent to discuss the particular issues that have been raised.
That concludes portfolio questions on NHS recovery, health and social care. There will now be a short pause to allow front-bench teams to change positions, should they so wish.