Chamber and committees

You mentioned that the NHS is under pressure; we know that. However, it is always under some form of pressure, and it was always under pressure during all the years that I worked in that environment before coming to Parliament.

The Audit Scotland report notes that

“There is not enough detail in the plan to determine whether ambitions can be achieved in the timescales set out.”

Given the scale and complexity of the challenges that face Scotland’s NHS, do you agree that much greater detail is needed if we are to get the NHS back on an even keel?

The question was about detail, not data.

You mentioned that we must change the way that we deliver our health and social care while maintaining access to services. You have also said that you and John Burns are still discussing how the recovery plans will demonstrate ambition for reform, but that there is still a lot to do on cementing milestones for that delivery plan. As you said, it has been 8 months since the Scottish Government published the recovery plan. What is your assessment of progress, if any has been made, since its publication?

We all understand that there is no quick fix, but the daily statistics on accident and emergency, cancer, delayed discharges and diagnosis are bleak. Is the plan working? What confidence can we have in it?

My question is in a similar vein to the previous one.

Across Scotland, many women are struggling to access hormone replacement therapy due to complex issues in the supply chain. Although the shortages are largely the product of increased demand, it is unacceptable that many women are experiencing severe discomfort and anxiety as a result.

It is welcome that the UK Government has established an HRT task force to get to the bottom of these issues, but what work is the Scottish Government doing to ensure that the short-term and long-term supply of HRT can meet the rising demand in the future? Can the minister confirm whether the Scottish Government is working with the Scottish Medicines Consortium, health boards and community pharmacies to improve the flow of medicines between suppliers, wholesalers and pharmacies?

Scotland has been trailing behind other parts of the United Kingdom for some time on the resumption of breast cancer screening for those who are aged over 71. That is having a real impact on women who are aged over 70. Just last week, I was contacted by a woman from Edinburgh whose request for a mammogram was twice refused by NHS Lothian. However, Margaret was able to get an appointment in Newcastle, where screening revealed an invasive lobular breast cancer, which needed to be removed by surgery and follow-up radiation.

I will ask the First Minister three simple questions. If other UK nations can continue to screen, why cannot Scotland do it? In the meantime, does the First Minister think that it is acceptable for Scots to have to travel to England for screening? Does the First Minister agree with my constituent, Margaret, that her cancer might have been detected much earlier and with a much more favourable outcome if her request for screening had not been refused in Scotland?

I thought that one of the intentions was to reduce the amount of alcohol that people are drinking. What I am suggesting is that that has not happened; they are still drinking the same, if not more, alcohol, but they are buying it in a higher-value category.

Thank you for drawing attention to the inequality that women face in accessing services. If 51 per cent of the population are struggling to access services that are being developed, that should probably be the number 1 priority, given the make-up of this committee.

The number of alcohol-related hospitalisations and deaths is eight times higher in the most deprived areas of Scotland. We should all be ashamed about that. We really need to figure out how to target and support those communities. Support mechanisms for alcohol misuse are often far more sparse in deprived areas than they are in the most affluent areas. What can we do to narrow the gap and target deprived communities?

My question follows on from Gillian Mackay’s point. It has been revealed that one of the impacts of minimum unit pricing is that Scottish consumers have contributed £270 million more than was projected, in terms of their spending on alcohol. What consideration has the Scottish Government given to the possibility of ring-fencing proceeds from alcohol to be spent on rehabilitation and treatment? The current model feeds the revenue straight back into the supply chain.

To follow that up, we have heard that alcohol-related deaths have increased by 10 per cent since 2020. The minister said that the most recent year with data on ABIs is 2019-20, when the level was 23 per cent higher than the expected standard. However, between 2013 and 2020, the number of ABIs declined by 28 per cent. We heard that you are reviewing evidence, but what can we do immediately and in the short term to really produce an uptick in ABIs, which are critical—particularly in deprived areas?

You spoke about displacement. A report from the Institute of Economic Affairs has suggested that minimum unit pricing is responsible for a certain amount of displacement to higher-value categories. It says that the policy has resulted in an extra 8.2 million litres of pure alcohol being sold in the 50p to 64p per unit category and a further 0.4 million litres being sold above 70p per unit. What investigatory work has the Scottish Government commissioned into that level of displacement, and do you recognise the argument that the policy has pushed consumers towards the mid-range rather than away from alcohol in its entirety?