Chamber and committees

I thank Mr Ewing for his advocacy on behalf of Mary Ramsay, who was on “Good Morning Scotland” this morning, giving very good testimony about the situation. I represent a constituent who has had essential tremor for some time, and I know that an ultrasound service, such as the one that Mr Ewing mentions, is being provided in Tayside. I recognise that travelling for treatment is a challenge for some people. If someone cannot get to Tayside, for whatever reason, the potential for travel to Liverpool or London is available, although I imagine that most people who are able to get to Liverpool or London are able to get to Tayside.

I will keep under review whether that provision needs to be broadened beyond being a specialist service in Tayside. We will work in concert with National Services Scotland, and, if it were found that a service had a level of demand that would merit provision being expanded beyond one specialist service in Scotland, that is something that we would consider.

I will need to check that. I am not aware of the answer, but I am happy to provide a response.

You will understand that both those dates predate not just my time as health secretary but my time in the Parliament. However, I absolutely agree that there is a need to address the issue. As I said, we expect the public consultation to start early next year.

As Jackie Baillie will be aware, we stepped in to support the provision in Glasgow. We have also established a national review of the community link worker programme for exactly the reasons that she set out: in order to ensure that its sustainability can be afforded.

First of all, it is not the case that there is an 8 am rush in all GP practices. Same-day appointments are not the order for all GP practices. It is the responsibility of the GP practice to manage how their appointment system works. However, I recognise that, for many, that is the situation and that that is too often the case.

The way to resolve that is to support the expansion of the availability of practitioners—both general practitioners and those in the multidisciplinary team, who can often see patients, as it is not always the case that it needs to be the GP who sees them.

We have expanded the multidisciplinary network and we support, I think, more than 5,000 staff through the various resources that we have put in. As I think that I mentioned to the convener earlier, I am currently in discussion with the British Medical Association and the Royal College of General Practitioners on their long-term funding position in order to ensure that they are able to recruit from the record number of GPs who are in training—there are 1,200 of them. That greater level of employment will mean that greater levels of appointments can be offered, which will reduce the rush for appointments that Ms Baillie mentioned.

In recent years, we have made substantial investments in child and adolescent mental health services in order to deliver a substantial increase in the number of CAMHS practitioners. As a result, for the first time, we have met CAMHS waiting times standards for more than three consecutive quarters. There is a continued challenge around psychological therapies, which I recognise, but that is being worked on.

We have also provided substantial money—I would have to be reminded of the exact amount—via the communities mental health and wellbeing fund for adults. That investment relates to treatment as well as interventionist wellbeing support. As I pointed out in answer to Ms Baillie, we want to move upstream into a more preventative space. We need to respond to the demand as we see it now and get through the backlogs that we have, but we also need to move upstream. In the interests of the sustainability and viability of our health service, we must move to a more preventative model. We cannot see hospitals as the first port of call—they must be the last port of call—and we need to move much further upstream to ensure that we are providing health and wellbeing services that support people’s wellbeing, rather than treating the symptoms in an acute setting.

I appreciate Mr Golden’s question. I have probably seen many of the facilities that he is referencing, because I have committed to go into a substantial number of primary care facilities in order to see the current provision, particularly some of those that are most challenging, where there is a demand either for a replacement of buildings or renovation.

I recognise that, not just in relation to the immediate delivery of services and the capacity that we require in primary care but in order to fulfil the policy direction that this Government has set around shifting the balance of care, a move to the community hub model that Mr Golden outlined is important. That is what is contained in the health and social care service renewal framework—it is exactly the approach that I want us to move to.

We will need to see greater investment going into primary care facilities to allow that to happen and to enable more hospital-based services to be delivered in the community. That is under consideration at the moment, as part of the spending review, budget and infrastructure investment plan processes that I outlined in my first answer.

Of course, some of what needs to be done is determined by the capital allocation that we receive. I strongly encourage the UK Government to expand its capital investment. That is good for the economy and for public services, and it would certainly allow us to do much more.

We have clear areas of priority where we could use that investment. However, the issue that Mr Golden raises is under active consideration and is a clear priority for me at the present time.

First, on Davy Russell’s point, no, they were not.

Secondly, on Mr Ewing’s point, we had a productive collaboration in order to resolve some of the issues around the pause for Grantown in his constituency. I was able to visit the fantastic Grantown medical practice as a result of collaboration with Mr Mountain and Mr Ewing, and I was very pleased to be able to bring that forward.

I encourage Culloden to engage with NHS Highland on its prioritisation of capital projects, because we have asked all health boards to set out their relative priorities as part of the infrastructure investment programme, which will help to guide our priorities. I encourage Mr Ewing and his constituents to engage with NHS Highland on its relative prioritisation of that particular project.

I absolutely agree with Mr Mountain’s point about insulin pumps, which are transformational for children’s lives. We have made significant investments in order to expand access to them. I will write to the committee to set out the exact figures that are involved in the investment, because I do not want to provide figures from the top of my head that I believe to be correct but might not be. I absolutely agree with Mr Mountain that the pumps are transformational, particularly for children and young people but also for adults who have diabetes. I will set out the detail in response to the committee.

The plans that we set out are part of the infrastructure investment plan process. He will be able to see our plans for the immediate period that runs through the budget process and through the infrastructure investment plan and spending review period.

I appreciate the opportunity to speak about the legislative consent memorandum that was lodged by the Scottish Government on 27 August, which recommends that the Scottish Parliament gives its consent to clause 43 of Kim Leadbeater MP’s Terminally Ill Adults (End of Life) Bill.

Let me be clear that I am here due to the provision described in the LCM and my recommendation for it. It is not, in any way, a comment or opinion on Ms Leadbeater’s Bill, which is for the UK Parliament to decide upon. The committee will be aware that nothing in Kim Leadbeater’s bill has any effect on Liam McArthur’s bill in the Scottish Parliament, which is going through an entirely different process. The LCM process is part of our constitutional settlement, and that is what I am here to provide information on, namely the effect of clause 43 in Scotland and why I am recommending support.

Turning to the LCM, clause 43 of the Terminally Ill Adults (End of Life) Bill imposes a duty on the Secretary of State for Health and Social Care in the UK to make regulations to prohibit the publication, printing, distribution or designing of advertisements whose purpose or effect is to promote the England and Wales voluntary assisted dying service. The purpose of clause 43 is stated to be to prevent pressure from being put on vulnerable people or the undermining of national suicide prevention strategies through the unethical advertisement of the England and Wales service.

By consenting to that provision, the Scottish Parliament would be agreeing that the service introduced could not be promoted in Scotland. That is the wish of the UK Parliament, which I believe should determine if and where the English and Welsh assisted dying service is to be advertised. The Scottish Government’s view is that clause 43 is for a purpose that falls within the legislative competence of the Scottish Parliament, considering the schedule 5, section C7 reservation in the Scotland Act 1998, which covers the regulation of, among other things,

“misleading and comparative advertising, except regulation specifically in relation to food, tobacco and tobacco products”.

It does not reserve advertising generally. As such, we believe that the Scottish Parliament’s consent is required for clause 43, and that it should be given so that we do not find ourselves in a situation where the English and Welsh assisted dying service can be advertised in Scotland but not in England and Wales.

I hope that the committee finds that explanation and outline of the Scottish position helpful, and I am happy to answer the committee’s questions.