Chamber and committees

Does the minister accept that there are now parts of Scotland where primary care has completely broken down and people are unable routinely to see a GP? How can a programme like this one work without that key linchpin?

Through my own, albeit limited, life experience and my work as a constituency MSP, I am well aware that, for many people, hospital is not the best place to be. Of course, no one really wants to be in hospital at all if they can avoid it, but, for some people, the disruption and change that is involved when admitted to an acute setting can teeter on the brink of outweighing the benefits of medical treatment. For those individuals, this initiative is and has the potential to be transformative.

However, if the initiative is to work, it must be promoted on that basis. It should be for the patient’s benefit, not merely to serve the system. Indeed, as Professor Andrew Elder has stressed, as mentioned by Alex Cole-Hamilton, access to acute hospital care for older people has been a hard-won right and it should not just be given away because an alternative is there. That alternative must meet the needs of every patient who is pushed towards it.

Looking now beyond the individual, I have to say that I am always fearful when I hear this SNP Government promoting the expansion of relatively new initiatives. Those concerns stem from the staffing and cash crisis in our NHS, and from my experience of a persistent lack of rural proofing when it comes to policy implementation.

The chief of NHS Dumfries and Galloway, which covers my constituency, has told this Parliament that the level of financial challenge is such that

“technically, I cannot afford one in 10 of my workforce”.—[Official Report, Health, Social Care and Sport Committee, 2 May 2023; c 13.]

Therefore, when I hear my colleague Finlay Carson asking about the future of cottage hospitals, it is hard to trust the decision that the health board is making because it is operating in financial circumstances in which it is making the best of the resource that it has got rather than doing what is best for its patients.

We already see patients unable to access core day-to-day services such as GP and dentistry services. We see challenges around recruiting and retaining specialist medical professionals. Who are the consultants who will be helping with patient care? Social care and care home beds are being rationed, with care deserts emerging in some parts of the region.

I set that out not because I do not support the concept of hospital at home but because many constituents, patients and hard-working staff will be questioning the capacity to pull that off at any significant scale in the current climate.

I am also concerned that, when it comes to stabilising our local health service, this SNP Government is not willing to confront the realities on the ground. All the strategies and policies that have been laid out today speak to that, as they simply do not match with the scale of the challenge that lies ahead. In place of a laser-like focus on, for example, getting people who are already in hospital home, we come up with new ideas and initiatives rather than trying to resolve the existing serious underlying issues.

I am equally worried about how the policy can be delivered in a constituency such as mine, where people live a considerable distance from the hospital that is overseeing their treatment. They may even be being treated outside the region altogether, never mind having to travel for pushing an hour from Dumfries and Galloway royal infirmary in Dumfries. Care at home should mean that they have access to good-quality local healthcare in their region. We must take account of the additional costs, pressures and time constraints that rurality brings in order to deliver projects such as hospital at home across vast and sparsely populated rural areas. Given the Scottish Government’s record, I am not convinced that it has got that right.

It is often easier to ban things and demonise people who are overweight than it is to encourage and empower people to make positive lifestyle choices. With only one in five adults in Scotland eating the recommended five portions of fruit and veg a day—a figure that has remained unchanged since this Parliament was created—what practical steps is the Scottish Government taking to ensure that people who live in Scotland, a food-rich nation, can benefit from affordable local produce, which promotes good health and supports our farmers?

I will give way to the cabinet secretary.

I do welcome that, but not when it comes with unknown conditions, which I will come to later, and not when it comes from a Government that is happy to raid the agriculture budget in Scotland when it suits it and is willing to be partners with a party that wants to carpet our country in trees and push our farmers off their land.

It is time for this Government to get off the fence and get behind food production. Today is the perfect opportunity to back the NFUS’s call, tell us that 80 per cent of the funding in future will go to tier 1 and tier 2, and tell us what it will expect from farmers in order for them to get their payments.

We get interventions with all these smart points and attacks on the UK Government and on Brexit, but when it comes to matters that are within the Scottish Government’s control, we get silence, sloping shoulders and abdication of responsibility. It is just not right.

Rather than having our agricultural policy dictated by fringe groups that have never set foot outside the central belt, this Government should take on board the wise counsel of farmers. Unlike the Scottish Greens, our farmers understand that we cannot have sustainability while exporting our emissions and importing poorer-quality produce from the other side of the world.

When I previously mentioned avocados, I was told that that was stereotypical, but like southern hemisphere wine, there is no doubt that they travel some distance in order to sustain hard-working Scottish Government ministers.

We need to get behind home-grown and home-reared produce. We need to make it a priority to ensure that there remains room for farming in all parts of our country, particularly in our uplands, which, as I have said previously, are under real threat from both forestry and industrial-scale wind farms, which often see peat and important watercourses disturbed.

Rather than asking our upland farmers to make way for intensive commercial forestry, we should be championing their role in managing the landscapes and natural environment, as well as the important part that they play in sustaining our rural communities. Indeed, if we were serious about tackling climate change, we would be making it easier for such farmers to access grants to plant low-density native trees and hedgerows on their farms—some might say, “The right tree in the right place”.

Rather than chasing after cash cows and quick fixes, this Government should be pushing back against the demonisation of our farmers. It should be calling out the many myths that are bandied about and ask itself why, in a country such as ours, we want to turn our back on this important sector.

Red meat is not evil—it is produced to exceptionally high standards, and it is something that those who claim to be “stronger for Scotland” should be proud of. Dairy is not evil—it provides many families with nutritious and affordable food.

Farmers, far from being the climate change problem, are part of the solution. Although they might be an easy scapegoat, in my experience, farmers are often full of ideas when it comes to tackling climate change and biodiversity issues. They just need to be freed up and supported to do so. That matters in the context of this debate, because without the continuation of direct support, we simply would not have agricultural activity on a meaningful scale in many parts of our country.

We must remember that as new schemes take shape because we cannot afford to make it too difficult for farmers to meet eligibility criteria. There are real concerns among the farmers in my constituency that conditionality will be placed on future tier 1 payments. What will farmers be asked to do in return for payment? Will it be worth their claiming at all? There is a growing suspicion that the cabinet secretary and the Government may be looking to put onerous and unworkable burdens on our farmers in order to sell the concept of continued direct payments to non-governmental organisations and the professional climate lobby—and, of course, some of the cabinet secretary’s Government colleagues.

As a parliamentarian, I am anxious about being asked to pass a framework bill that does not spell out exactly what our farmers will be asked to do in order to get their hands on their money. In summing up, perhaps the cabinet secretary could give us some practical examples of what she envisages. I also put directly to the cabinet secretary the NFUS’s call that a minimum of 80 per cent of future funding should go into tier 1 and 2 payments. Is that the Scottish Government’s plan: yes or no? That seems a straightforward ask and it will be a chance for the SNP to prove its critics wrong, and to demonstrate that farmers matter more than Lorna Slater or Patrick Harvie.

I know that I would rather have food on my table every day than the presence of the Scottish Greens floating around the Scottish Government Cabinet table.

I thank the member for giving way and I apologise for not taking his intervention. Given that the member has said that there is widespread consensus, why does he feel that it is necessary for the Government to dictate to farmers what they will have to do in order to access payments?

Notwithstanding the different climate in Scotland, which I will put to one side, can the cabinet secretary set out, in practical terms, what conditions she will put on farmers in order for them to get their tier 1 payments? What is she looking for?

Another week, another debate on agricultural policy. I mean no disrespect to the committee, which I know is trying hard to be proactive in place of a lethargic and unenthusiastic Government, but in my view, we have been debating rather than doing for far too long.

If this Government put half as much time and energy into striking a partnership agreement with our farmers as it puts into maintaining the Bute house agreement, our rural communities would already know where they stand.

Our farmers need and deserve clarity as well as the whole-hearted support of this SNP Government. It is time to get off the fence, get behind food production and back the people with the expertise and understanding when it comes to protecting our landscapes and our environment.

Touching on that point, but more broadly, on 9 May we heard from legal academics including Professor Gretton and Yvonne Evans, who said that, in practice, a solicitor would just “draft around” a 25-year provision. This question may be for Chris Sheldon and Mike Blair: are we worrying too much about it? Would most trusts be drafted to give some leeway in relation to purpose?