Plenary, 30 Sep 2004

Meeting date: Thursday, September 30, 2004

Official Report 739KB pdf

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First Minister's Question Time

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Prime Minister (Meetings)

To ask the First Minister when he will next meet the Prime Minister and what issues will be discussed. (S2F-1097)

I have no immediate plans to meet the Prime Minister, but when I next do so I will certainly wish to offer him support for the commission for Africa and the efforts in planning for next year's G8 summit in Scotland, which was highlighted yesterday so well by a certain guest speaker at a certain conference in Brighton.

I begin by saying how relieved I am that the campaign to save the Queen mum's hospital has today succeeded. That proves what we can achieve when patients, the public and politicians unite in defence of our health service. Last week, the Minister for Health and Community Care pledged to put on hold further cuts and closures but, this week, emergency surgery at St John's hospital in West Lothian closed. If the First Minister can intervene to keep the Queen mum's open, why has he refused to save emergency surgery at St John's?

As the Minister for Health and Community Care made perfectly clear earlier, ministers can say no as well as yes to proposals from health boards that are properly for the consideration of ministers. I noticed that members of the Opposition on both sides of the chamber made this very point during the debate, which is that what we need in the health service is slightly less interference by politicians and slightly more decision making based on clinical judgments, which is the right way ahead in the eyes of those who work on a day-to-day basis inside the service.

As I said in the chamber last week, the decision that has been made in St John's hospital in West Lothian is of great personal interest to me. That decision has been made on the basis of a clinical judgment, in which the minister would be entirely wrong to intervene, as to do so could threaten clinical safety.

Let us get this right: in relation to St John's, the First Minister is saying that a big, bad doctor did it and ran away. I remind him that Greater Glasgow NHS Board was saying for months that the Queen mum's had to close on clinical grounds, and we know that that was not true. So, if it is right—and it is—to save the Queen mum's, why is there no consistency of approach and why is Malcolm Chisholm not lifting a finger to save services at St John's or at the many other hospitals across Scotland that face service cuts?

That is entirely untrue. As I said two weeks ago, the Minister for Health and Community Care rejected proposals from Argyll and Clyde NHS Board last year because he wanted the board to think again. He can and will do the same thing again. Government is working closely with people in the Highlands, for example, to try to find solutions to difficult, complicated problems and to ensure that rural services remain in as many parts of Scotland so that people receive services in their area, without clinical safety being endangered.

Politicians should make those difficult judgments on the basis of strong advice. There was a clear difference of opinion on the Queen Mother's hospital among clinicians in Glasgow. The Minister for Health and Community Care spent months listening to those opinions and to local people and, ultimately, he made the right decision, not just for Glasgow, but for the rest of Scotland. I accept that Miss Sturgeon welcomes that decision and I hope that other members will welcome it. The decision is the right one and it will secure a strong future, not just for the health service and for those who work in it, but for the mothers and children who will use the service in the years to come.

Does the First Minister appreciate that the public see a complete lack of consistency in the Minister for Health and Community Care's approach? The Executive's health policy is a complete and utter shambles. The Executive says first that it cannot halt cuts, then that it might postpone some and now that it will save the Queen Mother's hospital, although it cannot explain why emergency services at St John's hospital have been closed. At 5 o'clock tonight, we will have a chance to call a halt to the piecemeal approach. I have one simple question: in that vote, will the First Minister allow his MSPs to vote with their consciences, for constituents and to save our hospitals?

There might not have been an awful lot of people listening at the SNP conference, but not one Labour or Liberal Democrat MSP has ever said at a conference that they would deliberately break consensus in Scotland just for the sake of a disagreement. However, that happens far too often in the Parliament, on health and other issues. The Labour and Liberal Democrat members will put Scotland first, not party interests, and ensure that their constituents are represented properly.

The Minister for Health and Community Care has laid out the fundamental principles of our approach. The maximum amount of care that can be delivered locally will be delivered locally. Where specialist centres are required, they will have the most modern up-to-date equipment and the right staffing levels to ensure that they deliver for patients. If health boards should co-operate across boundaries in patients' interests, they will be made to do so. If clinical decisions are made about training and the safety of patients, the Minister for Health and Community Care will back the clinicians, but if there is a difference of opinion, we will ensure that the patients' case comes first, as we did in Glasgow through the decision that was announced this morning. That is a consistent approach; it is not based on raising false disagreements for party-political reasons—which we see in the Parliament, week after week—but on a firm commitment to ensure that we raise our game, put Scotland first and have a health service of which Scotland can be proud.

This afternoon, the Parliament has an opportunity to unite to save hospital services. Shona Robison's amendment comes word for word from a motion that was lodged by the Labour back bencher Bristow Muldoon. Will the First Minister allow his MSPs to vote with their consciences to save hospital services throughout Scotland and to act in the interests of Scottish patients and the Scottish public?

This afternoon, we will have a clear choice. We can vote for the Tories' plans to privatise the Scottish health service and ensure that those who have money and can buy their way into the private system get subsidised for doing so. We can vote for the SNP, which does not want any change and would rather people were treated in old hospitals with old equipment, by staff who are not in the right place at the right time and in a system in which patients do not come first. Alternatively, we can vote for a policy that involves a national strategy that ensures that the right decisions are made one at a time throughout Scotland and carefully considered by the minister when he has to do so, but which at all times recognises that the world is changing round us and that we can use new technologies to save lives and the new skills of nurses, doctors, consultants and many others to ensure that our health service is far better than it was when that lot—the Conservatives—were in charge.

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Cabinet (Meetings)

To ask the First Minister what issues will be discussed at the next meeting of the Scottish Executive's Cabinet. (S2F-1088)

Among other issues that will be discussed, we will be congratulating the Minister for Health and Community Care on his announcement today about the Queen Mother's hospital in Glasgow.

I am happy to join in those congratulations. It just goes to show that we get results in the Parliament when the Conservatives hold a debate on the subject of the national health service.

Last week, the First Minister said that there were far too many health boards in Scotland and that the artificial health board boundaries caused difficulties between health board areas. Can he explain to us how many boards he envisages there being in future? How big will they be? In what way will his lines on the map be any less artificial than the present ones? Is it not the case that the cuts in local hospital services, which we have been debating in Parliament today, have come about through the progressive centralisation of the NHS under this Government and that having fewer boards, which he advocates, means more cuts, which will simply rub salt into the wounds?

No reduction in the number of health boards is proposed by the Executive, but there is a clear indication that the health boards have to start working together across boundaries to ensure that their decisions take account of the regional dimension, or else we will have to consider that option. There is a clear signal for the health boards that they need to do that.

I want to make absolutely clear, as I did in the chamber last week, that it is not that there are cuts in health service budgets or the level of service that is available across Scotland but that there are changes that are being proposed by the health boards. In some cases, those changes will be the right changes; in others, they will be the wrong ones. Where wrong changes have been made, the Minister for Health and Community Care will change them to ensure that the health boards do the right thing, as we have done today.

Across Scotland, there needs to be change in the health service. Technologies, skills and knowledge are available to us in the 21st century that were not available to us even in the last decade of the 20th century. We have to ensure that we can make best use of that knowledge, those skills and that equipment. We need to ensure that we have the right specialist centres and also that more and more care is provided on a local, decentralised basis. That is what is going on across Scotland. We are ensuring, decision by decision, that we get the right balance within a national strategy.

The First Minister will have to get it right from one week to the next for the sake of consistency. He tells us today that there are no proposals for a reduction in the number of health boards. However, last week, he said to me:

"I am increasingly coming to the view that there are far too many health boards in Scotland".—[Official Report, 23 September 2004; c 10548.]

If he thinks that there are far too many health boards in Scotland, the logic would be that he wants there to be fewer, which would indicate that he is going to reduce the number. Could we perhaps get a little bit more consistency?

It is not only the Conservatives who think that the First Minister has been centralising the NHS in Scotland. Robin Cook has praised John Reid's paper, "Keeping the NHS Local—A New Direction of Travel", saying that it

"challenges many of the centralising assumptions behind health policy in Scotland"

and adding that

"the whole point of devolution was to keep decisions local."

However, that is not the First Minister's policy. When will he realise that his policy, as he outlined it this week and last week, is going further and further in the wrong direction and that we need a health service that is far more responsive to the needs of local communities than one that is delivered by the boards appointed by the Minister for Health and Community Care, who abolished the local trusts that were keeping local services going?

Will the First Minister acknowledge that the man who is right about the centralisation of the health service is Robin Cook and that the men who are wrong are the First Minister and the Minister for Health and Community Care?

Not at all. Even if there were a case—as I suggested last week that there might increasingly appear to be—that there are too many health boards in Scotland, the health service in Scotland has suffered from many reorganisations, restructurings and increases in bureaucracy under the Conservatives and it is time to change that approach.

That is precisely why, in the five years for which the Parliament and the coalition Government have been in existence, we have seen a reduction of 15 per cent in the number of administrators and managers in the national health service and a consequent increase, by the same amount, in the number of ambulance staff. I mention that because the Conservatives were equally vocal about the changes that took place in Tayside back in the early days of the Parliament. We heard that there was to be centralisation as a result of changes in the configuration of hospitals there, but today members in all parts of the chamber hold up Tayside as an example of where we all want to be. There is a specialist service in Dundee, but there are also improved local services out in the community and ambulance personnel deliver life-saving treatments on the spot when someone has a heart attack rather than having to carry them into the city. Those are the sorts of changes that are required in a modern health service. Mr McLetchie must realise that we need not only increases in investment but reform to make sure that our health service delivers for all patients.

I say to the First Minister that he is the one who wrecked and restructured the health service when he came into power. Does he seriously think that a Caithness health trust running the Caithness general hospital, which was built by a Conservative Government, would order women in Wick to travel 100 miles to Inverness to have their babies? That is what will happen under his proposals.

The Conservatives should look back to May last year. In their manifesto, they said that fewer decisions should be made by politicians and more by clinicians in the NHS, but that is directly contradicted by the Conservative motion and by the point that Mr McLetchie makes. He wants a situation in which everything is run and decided here rather than our taking advice from those at a local level who want services to be improved. We are determined to back them when they are right, but when there is a division of opinion in the recommendations we will choose the right side on behalf of patients. We have done that today in relation to Glasgow and I am sure that we will do so again.

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Relative Income Poverty

To ask the First Minister how many Scots live in relative income poverty and what percentage of the total population this represents. (S2F-1108)

Since 1997, the number of Scots who live in absolute poverty has reduced by 42 per cent and the number of Scots who live with relative low income has reduced by 8 per cent. The most recent figures on poverty were published on 30 March 2004 but they do not take full account of the new tax credit system and further benefit rises.

As usual, the First Minister avoids the question that I ask. On Monday, he said that his vision was of "one Scotland". Is he embarrassed that, after seven years of new Labour in the UK and five years of the Labour-led Executive in Scotland, 570,000 adults and 320,000 children still live in poverty in a country as rich as ours? Why has the Government failed so many families?

I have said before in the chamber, and I say again today, that there have been significant reductions in child poverty, pensioner poverty and adult poverty in the years of devolved government in Scotland. In that time, 210,000 children have been lifted from absolute poverty, 100,000 children have been lifted from relative income poverty and 170,000 pensioners have been lifted out of poverty too, but—and this is an important "but" for any elected representative to remember—that is not enough. We must continue our efforts and ensure that we invest in jobs, education, skills, regeneration and the opportunities that help people to come out of poverty and produce a working income for their families. We must not rest on the fact that we have made so much progress so far. We must continue our efforts to ensure that we can abolish child poverty in this country within a generation. We are well on our way to achieving that aim, but there is still an awful lot more to do.

Is the First Minister aware that, even on the Executive's own doctored figures, poverty levels in Scotland are four times worse than in Denmark, five times worse than in Finland, seven times worse than in Norway and 10 times worse than in Sweden? If other small nations can reduce poverty and inequality to such radical levels, is it not the case that, until we have national independence with redistributive and socialist policies, the Executive will continue to abandon one in four pensioners, 570,000 adults and one in three kids in what is a deeply divided nation, not "one Scotland"?

If Mr Sheridan's principled words were in any way reflected in his policies or in his actions, I would welcome them every time that he utters them in the chamber. If his warm words about poverty in Scotland meant anything in terms of the policies that he wants to pursue, they might mean something for those families in Scotland that still require assistance from us.

The truth is that not only would Mr Sheridan go as far as the Scottish nationalists in ensuring that Scotland's economy was weaker than it is today by ripping Scotland away from our markets and from the jobs that are created through our connections with the rest of the United Kingdom but, worse still, if he had that independent state, he would take the spending on education, health, child care, jobs, regeneration, housing and all the other priorities that we announced yesterday and use it to renationalise companies and do the sort of things that he wants to see because of his ideological and so-called principled position. He is wrong in his analysis. He may be right in his aims, but he is never going to get there.

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Spending Review (Tertiary Education)

To ask the First Minister how the Scottish Executive's spending review will help further and higher education colleges and universities meet their forthcoming challenges. (S2F-1095)

As has been said by those who listened to it, including people from the universities, yesterday's budget announcement was outstanding news for Scotland's higher and further education sectors. Our annual investment in our colleges and universities will exceed £1.6 billion by 2007-08. That record level of investment will help to ensure that we have highly motivated, highly qualified staff who work in sustainable, 21st century buildings where they can develop world-class research and deliver high-quality learning and teaching to students not just from Scotland but from all over the world.

That is indeed the news that the further and higher education sectors have waited for.

As the First Minister will be aware, earlier today in Midlothian the Deputy First Minister launched the Edinburgh science triangle, which brings together universities and research institutes in the Edinburgh city region to create a world-class scientific cluster for Scotland. Does the First Minister share my belief in the importance of science in growing a modern, dynamic Scottish economy?

It is very important for Scotland today that we do not try to compete with those economies elsewhere in the world in which wages and skills are significantly lower than they are here. We need to compete in the modern world on the basis of our talents, knowledge, ideas, innovations and, yes, our university and company research. Today's announcement by the Deputy First Minister on the Edinburgh science triangle is another step forward towards ensuring not only that we have world-class universities and companies here in Scotland but that they talk to one another and work together to deliver the jobs that will be so important for Scotland's future.

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Devolution (Immigration Powers)

To ask the First Minister what the up-to-date position is on his discussions with the Home Secretary in respect of the devolution of some immigration powers from the UK Government to the Scottish Executive. (S2F-1098)

I am in regular discussions with the Home Secretary about ways in which he can support our fresh talent initiative. Indeed, he could not be more helpful in giving us that support.

Thanks for that unpredictable reply.

In his speech to a fringe meeting on Sunday night in Brighton, the First Minister said:

"There needs to be more flexibility in UK immigration policy to allow Scotland to address its falling and ageing population."

What additional flexibilities does the First Minister believe are required, especially to increase the number of work permits and skilled immigrants to Scotland? What progress is he making with the Home Secretary on those two points? When does he hope to be able to announce progress on those matters, either in the papers or in the Parliament?

I will make two points in response to Alex Neil's question. First, I am in discussion about these matters with the Home Secretary. As soon as there are decisions, I will be happy to announce them to Alex Neil personally, in the Parliament or elsewhere. It is important that we use the decisions that have already been made, which give our country, our universities and our companies a competitive edge in the international overseas student market by allocating specific visa provisions to Scotland. There is also scope for us to have an advantage in the work permit system and the other elements of managed migration that can benefit Scotland.

Secondly, it is important that we set the right tone and atmosphere for this debate. It is critically important that we send a signal not just in Scotland, that we want Scots to stay in their own country, or across the world, that we are welcoming of people from other races and cultures who come to Scotland, but inside the UK. The population figures announced this morning show that increasing numbers of people are coming from elsewhere in the UK to Scotland. The attitudes and atmosphere to which I refer will not be helped by a Conservative party that opposes fresh talent coming to Scotland. Mr McLetchie and one or two of his other colleagues who have been more positive about the population issue in the past should be ashamed of the comments that were made last weekend by Peter Duncan. If he is trying to stoke up racial hatred in advance of a general election, he is very wrong indeed.

The First Minister will be aware that NHS Highland recently hired two Polish consultants. They received no induction and days later they were sacked. Does he agree that it is crucial that, when we welcome people to our country, we give them the support and induction that will enable them to start work in the way in which they should?

I am sure that Jamie Stone will understand that I have no wish to comment on individual cases or employers' decisions about the skills, abilities or attitudes of those whom they have employed. However, it is important that when people are here legitimately to work and to contribute to Scotland they should be given full support so that they can do so. That is why next month we will open a relocation advisory service that will give people advice on accommodation, employment, education for their children and all the other things that ensure that people realise that they can enjoy a great quality of life in Scotland if they choose to stay.

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Gaelic

To ask the First Minister how the Scottish Executive will protect and promote the status of Gaelic. (S2F-1096)

I congratulate John Farquhar Munro on his campaigning on this subject over many years. I am sure that he and many others in the chamber were pleased when this week we fulfilled our partnership commitment—a commitment by Labour and the Liberal Democrats in the Scottish Parliament—to introduce a Gaelic bill to the Parliament. The Gaelic Language (Scotland) Bill will promote the use of Gaelic and confirm that at long last Gaelic has official recognition in Scotland.

Like everyone else, I was delighted to witness the significant support for Gaelic language and culture that the introduction to the Parliament this week of the Gaelic Language (Scotland) Bill represents. I am sure that the majority of members will support the bill when it is debated in the Parliament.

Does the First Minister agree that the Government and the Executive should take a lead on Gaelic, so that local authorities and public agencies not only construct Gaelic plans under the terms of the bill but whole-heartedly embrace its spirit and provide a long-term future for Gaelic language and culture?

In passing what I hope will be the Gaelic language (Scotland) act during the coming year, the Parliament will send a strong signal across Scotland that not only do we intend to implement the bill's provisions and expect local authorities and all other tiers of government to support them, but we expect every organisation in Scotland to embrace the idea that our ancient language is not dead and must not die. If we all work together, we can ensure that it not only survives but thrives in the years to come.

Does the First Minister agree that the best way to promote Gaelic language and culture is through education and by giving them a higher profile in the media? What will the Executive do to fast track Gaelic teacher training? Will it promote a dedicated Gaelic television channel in Scotland?

Additional resources were allocated in the budget, which was announced yesterday, both for Gaelic-medium education and, for the first time in many years, for Gaelic broadcasting. The minister responsible will announce the details of those soon.

Meeting suspended until 14:00.

On resuming—