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Chamber and committees

Meeting date: Thursday, September 5, 2019

Meeting of the Parliament 05 September 2019

Agenda: General Question Time, First Minister’s Question Time, Doors Open Days 2019, Portfolio Question Time, Drug-related Deaths, European Union Exit (No Deal), Points of Order, Decision Time


General Question Time

Population Decline (Inverclyde)

To ask the Scottish Government what discussions it has had with Inverclyde Council to halt population decline in the area. (S5O-03489)

Inverclyde is one of 14 local authorities that experienced depopulation last year. In February, my colleague Ben Macpherson met leaders of a number of local authorities, including Inverclyde Council, to discuss population decline. A further meeting with me has been agreed for 27 September.

We need to grow our population to ensure that we have sustainable, vibrant communities and to drive improvements in inclusive growth. The Government has therefore established a cross-portfolio ministerial population task force, which I chair, to identity work that is being taken forward across Government to address the challenge of population shifts and changes, identify new actions and intensify existing actions.

The cabinet secretary will be aware that population decline is one of the most important challenges—if not the most important challenge—that Inverclyde faces in the foreseeable future. Does the cabinet secretary agree that in addition to a consistent and improved marketing strategy to promote Inverclyde, the siting of public agencies can play a part in overturning population decline, and would she consider the siting of public agencies in my constituency?

Inverclyde is facing a significant population change. Its depopulation figure was the highest of all the 14 local authority areas—a reduction of 0.8 per cent. There is no single solution to the issue, but the new population task force that I am chairing will look across all policy areas to see where we can intensify particular work. Some of that work will be generational, but some of it can be dealt with sooner rather than later.

It is absolutely clear, given that all our future population growth in this country is projected to come from migration, that the United Kingdom Government’s proposal to end freedom of movement of people is deeply damaging.

Obviously, decisions on the location of public sector functions are taken on a case-by-case basis and we will consider all opportunities to optimise the benefits when doing so, but at the same time we need to ensure that we secure best value for public finance. The important thing is to ensure that depopulation issues are on the agenda, that we take them seriously and that we do so on a cross-Government basis.

General Practitioner Recruitment and Retention (Fife)

2. Alexander Stewart (Mid Scotland and Fife) (Con)

To ask the Scottish Government what measures it is taking to improve GP recruitment and retention in Fife. (S5O-03490)

Nationally, we are investing an additional £250 million in direct support for general practice by the end of this parliamentary period, delivering the new GP contract and delivering at least 800 more GPs over 10 years.

As I am sure Alexander Stewart knows, Scotland has more GPs per 100,000 of the population than the rest of the United Kingdom—the figure is 92 here, 73 in England, 70 in Wales and 71 in Northern Ireland.

In Fife, the health board that has specific local responsibility is taking a twofold approach: it is further developing its operational response to issues in practices as they emerge and, alongside that, it is taking a strategic look with a strategic group to ensure a co-ordinated approach across Fife to those practices that may need additional support. That involves working with GP representatives and the British Medical Association to explore both the implementation and impact of the new contract, and taking steps locally to increase the attractiveness of general practice, including capitalising on the Scottish graduate entry medicine programme course.

In my region, surgeries in Perthshire and Fife are either closing or are facing closure. In one case in Dunfermline, four GPs are looking after nearly 9,000 patients—that is completely unsustainable.

Audit Scotland recently indicated that the lack of workforce planning will mean that the recruitment of 800 new GPs will be fragmented and that

“for every GP that retires more than one will need to be trained and recruited to replace them.”

Therefore, the crisis is of the Government’s making. What urgent steps will the cabinet secretary take to rectify it?

Before I go on to answer that in detail, I point out to Alexander Stewart that part of the difficulty that GPs and others in our health service face are the pension changes that his party’s Westminster Government has forced on them, which for some means that it begins to cost them money to go to work. That is hardly a sensible and wise proposition from the UK Government, but then we are becoming increasingly used to that.

Mr Stewart will know—as will all members—that the point of the GP contract is to widen the multidisciplinary team to ensure that GPs can concentrate on those patients who need their particular skills for longer. Therefore that widening of those teams, along with recruitment and training of physiotherapists and pharmacists, pharmacological input and so on, is helping to manage the numbers that Mr Stewart has mentioned.

I take Audit Scotland’s report very seriously indeed. We have a number of initiatives to increase GP numbers. Presiding Officer, I am mindful of your exhortation not to take too long, so I will not mention them all, but I am sure that Mr Stewart knows about them. For medical undergraduates, there is the ScotGEM programme and increased GP training. Specific financial support is being given to GP practices, including those in rural areas. All those initiatives are designed to ensure that we manage that challenge as best we can. Only this morning, I discussed with one of Mr Stewart’s colleagues additional steps that we might take, and I stress that I am always open to hearing positive ideas that might come from any bench in the chamber.

The Cabinet Secretary for Health and Sport might have seen reports of concerns about the implementation of the new GP out-of-hours services model in St Andrews. The relationship between the healthcare partnership and local campaigners seems to have broken down and the campaigners now fear that the partnership is setting the model up to fail. Will the cabinet secretary investigate that important matter and provide some assistance?

I am grateful to Mr Rennie for raising that question. I would be very disappointed indeed if what seems to me to be a genuine, community-devised and community-led solution to problems with out-of-hours services provision in St Andrews is in any sense now in jeopardy, whether because relationships have broken down or for any other reason. I will certainly look at the matter with some urgency and ensure that Mr Rennie and other members whose constituencies are affected are informed of what I uncover and the steps that we might take to resolve any difficulties that exist.

I say to Alexander Stewart that if he wishes to know what is going on with GP recruitment in Fife and the efforts that NHS Fife is making, he might wish to attend the quarterly meetings that NHS Fife holds with elected members. The cabinet secretary referred to the pensions fiasco that the UK Government has created in the health sector. I would have thought that it would be better for the member to seek to work with the Scottish Government and others to try to sort out the fiasco that the UK Government has created in that regard and for him constructively to support the strenuous efforts that NHS Fife is making to resolve the problem.

I thank Ms Ewing for her contribution, but I am not sure that it contained a question. We will move on to question 3.

Kerb Crawling

To ask the Scottish Government how many arrests were made for offences relating to kerb crawling between 2016 and 2019. (S5O-03491)

Kerb crawling, as it is commonly known, is an offence that is prosecuted under section 1 of the Prostitution (Public Places) (Scotland) Act 2007. That act created two offences: one is soliciting and the other is loitering in a public place

“for the purpose of obtaining the services of a person engaged in prostitution”.

The Scottish Government does not hold data on relevant arrests made by Police Scotland. In 2016-17 and 2017-18, the police recorded 80 offences of soliciting the services of a person engaged in prostitution, but that number might include offences other than kerb crawling.

I appreciate the minister’s answer. Does she agree that prostitution is a form of men’s violence against women, that it is both a cause and a consequence of women’s inequality and that it makes the world less safe for women and girls? If she does so agree, when will the Scottish Government follow the lead of countries whose action in legislating has reduced violence against women, and also reduced trafficking, by seriously tackling men’s demands to purchase sexual access to the bodies of women and girls?

I recognise Ruth Maguire’s longstanding interest in the issue. The Scottish Government’s equally safe strategy for preventing and eradicating violence against women and girls adopts the position that prostitution is a form of gendered violence. In looking at how we should address prostitution in Scotland, it is important that we learn from different approaches that have been adopted internationally and what their impacts have been.

Last month, I visited Sweden to learn more about its approach to criminalising the purchase but not the sale of sex. I met representatives of the Swedish Government, police, prosecutors and support services. The information that was gathered from that visit will help to develop our approach to prostitution.

I am pleased that—as published in the programme for government this week—the Scottish Government will bring forward a consultation to gather views on Scotland’s approach to tackling prostitution. Views will also be sought on reducing the harms that are associated with prostitution and supporting women to exit.

Drug and Alcohol-related Deaths

To ask the Scottish Government how it plans to include third sector organisations in its plans to tackle the rise in drug and alcohol-related deaths. (S5O-03492)

I will give a statement on this later this afternoon, so I will try to avoid topics that I will cover in that.

The Scottish Government recognises and welcomes the support that third sector organisations offer. They played a key role in the development of “Rights, respect and recovery: alcohol and drug treatment strategy”, which was published in November 2018. We are now working with stakeholders, including the third sector, to finalise an action plan to support the strategy, which will be published in October. Third sector organisations are members of national working groups that advise ministers and provide advice on areas such as addressing stigma, workforce development and quality principles. They are also represented on the drug deaths task force, which will co-ordinate and drive action to improve health outcomes, reducing the risks of harm and death. I will speak more about that this afternoon.

Does the minister agree that many third sector organisations have the experience and capacity to tackle the prevention of drug issues upstream? Will the Scottish Government therefore commit to giving them an adequate proportion of funding in order to take advantage of that experience?

Since taking on the position of Minister for Public Health, Sport and Wellbeing, I have visited a huge number of third sector and other organisations. When those organisations work in partnership with public services, I always see that they are able to provide services that are welcomed by the community. It is important that we appropriately support organisations and make sure that people get the best possible treatment.

I know that Mr Whittle has visited the River Garden organisation, which I visited last year. It is an excellent example of a third sector organisation taking forward a groundbreaking principle—I think that it is the first example of its type across these islands. I am pleased that the Scottish Government was able to support River Garden to the tune of £125,000.

Will the minister advise the chamber how many drugs deaths were caused not by illegal but by legally prescribed drugs—such as sleeping pills and antidepressants—last year, and how third sector organisations can assist in raising awareness of those dangers?

The Scottish Government listens to experts from third sector organisations and other partners. Working with partners, we provide relevant and targeted information to the public to raise awareness of the dangers in order to improve health outcomes and reduce the risk of harm and deaths.

The National Records for Scotland “Drug Related Deaths in Scotland” report does not link to prescribing data. It is therefore not possible to identify whether a drug that was prescribed to a person was implicated in their death. However, NRS produces supplementary tables that show drug-related deaths by drug type. Those show that, for 2018, there were no drug-related deaths where the category of antidepressants was implicated in or potentially contributed to the drug-related death. However, other drugs—such as paracetamol—were implicated in or potentially contributed to a drug-related death in 23 cases. The NRS supplementary information lists nearly 250 drug types. I will write to Kenneth Gibson with a fuller answer in due course.

The reality is that third sector and many other organisations are grossly underfunded and stretched to the max by the drugs crisis that we have. The West Lothian Courier highlights today that, in that county, only 39 per cent of patients are seen by the local drug and alcohol services within three weeks, which NHS Lothian says is because of capacity and staffing issues.

Given that 1,200 people are dying on the streets, does the minister think that a paltry £10 million in additional resources is adequate to deal with the carnage that we see on the streets of Scotland today?

I am pleased to have been informed that there are plans in place to improve waiting times in West Lothian, as they are clearly not good enough. Around Scotland, waiting times have been improving, including across the NHS Lothian area, but the waiting times that people are experiencing in West Lothian are not acceptable and need to be improved.

Exam Results

To ask the Scottish Government what its position is on the recent Scottish Qualifications Authority exam results and whether they reflect the strength of the education system. (S5O-03493)

Scotland has a high-performing education system with credible and respected national qualifications resulting in approximately three quarters of candidates at higher securing a pass at A to C.

There has been an increase in entries, passes and pass rates at national 5, including a rise of 4.4 per cent in passes for English and 1.3 per cent in passes for maths.

The results include a range of successes beyond national qualifications, including more than 54,000 skills-based qualifications, which is more than double the level that was achieved in 2012. That shows that the education system provides learners with much more choice than ever before, allowing them to find the pathway that is correct for them.

We have just seen the second worst results at national 5, the worst results at higher—the fourth year of such a decline—and the worst results at advanced higher. The cabinet secretary was quick to take credit when, previously, pupils performed well. Will he now take responsibility for these worse results and for the Scottish National Party’s cuts to teacher numbers and subject choice limitations, which are holding back our young people from achieving?

Gordon Lindhurst should know me well enough to know that I take responsibility for my actions as a minister. I am also prepared to take responsibility for and pride in what young people in Scotland achieve. Seventy-five per cent of candidates are achieving a pass at higher and scoffing at that is the wrong approach for the Conservatives to take.

If the exam pass rate continually increased, the Conservatives would be the first people telling us that the exams were not rigorous enough, as Liz Smith tried to tell us yesterday about national 4. There will be volatility in exam results year on year in a high-performing education system, and we should celebrate the achievements of young people in Scotland.

Scottish Government Ministers (Public Engagement)

To ask the Scottish Government how ministers ensure that they engage with the public in all parts of Scotland, including the Highlands and Islands. (S5O-03494)

The Scottish Government is committed to ensuring that the voices of communities and businesses around Scotland are heard and included in the development of Scottish Government policy. That is enabled through ambitious community empowerment legislation, targeted community-led initiatives, consultations on specific policy proposals and through Scotland’s rural parliament.

Ministers engage with the public in all parts of Scotland in the course of their ministerial duties. For example, travelling Cabinets are an important example of the First Minister’s commitment to the Government being open and accessible. Those events, 17 of which have been held in the Highlands and Islands since 2008, have enabled ministers to engage directly with members of the public, who can meet and question ministers in a public forum about the local, national and international issues that matter to them.

The cabinet secretary will have noticed the First Minister’s three visits to Shetland during the recent by-election campaign. That is as many trips as there have been official visits to Shetland by Scottish National Party First Ministers during their whole 12 years in government. That is why many local people in Shetland and other communities in my region feel that this Scottish Government is interested in them only when there are votes to be won. Will the cabinet secretary tell me whether communities in my region can hope to see a little more of Government ministers, including the First Minister, outside of campaign periods, and whether, when they visit, they will commit to properly consult on, listen to and act on the many local concerns of those communities?

Cabinet secretary, did you hear the question?

I did not catch all that Jamie Halcro Johnston said, but I make the point that this Government acts on behalf of every community in all parts of the country and takes that very seriously. I also point out that one of my first acts in this post was to visit and engage thoroughly with Shetland Islands Council.

I should also point out that my in-laws are from Shetland and my husband is a Shetlander, so Jamie Halcro Johnston has picked the wrong person to tell that they are not engaging with the matter of visits to Shetland. [Laughter.]

I am delighted to see that members are in good spirits today.