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Chamber and committees

Meeting date: Wednesday, October 5, 2016

Meeting of the Parliament 05 October 2016

Agenda: Portfolio Question Time, Supporting Farming and Food Production, Employment Services (Devolution), Business Motion, Parliamentary Bureau Motions, Decision Time, HM Revenue and Customs (Bathgate), Correction


Portfolio Question Time

Crohn’s Disease and Colitis

To ask the Scottish Government what action it is taking to increase support for people with Crohn’s disease or colitis. (S5O-00211)

We are pleased to have supported and funded Crohn’s and Colitis UK in the production of “Scotland Leading the Way: a National Blueprint for Inflammatory Bowel Disease in Scotland”, which seeks to support national health service boards in improving care and treatment for people living with inflammatory bowel disease in Scotland. The main aim of the blueprint document is to suggest improvements across a wide range of areas including diagnosis at primary care level; improving patient access to advice and information; provision of specialist services such as clinics, paediatricians, dieticians and psychological support; and information technology strategies. Scotland is the only United Kingdom country that is doing that kind of work on behalf of this group of patients.

I thank the minister for that detailed answer. She will be aware that, for some reason, there is a higher prevalence of Crohn’s and colitis in Scotland than in the rest of the UK and that children in particular are sufferers. An estimated 26,000 sufferers in Scotland are benefiting from the work that she described.

First, will the minister endorse the work of the Catherine McEwan Foundation in Scotland? Secondly, is the minister open to meeting me to discuss how we can increase the number of IBD nurses in Scotland but also how we can refine those services to ensure that they meet the individual needs of patients and sufferers?

I would be delighted to meet Pauline McNeill and to learn more about the Catherine McEwan Foundation and the good work that it undertakes. I am also interested to learn what more we can do to help, in particular, children and young adults with the condition.

I would like to raise awareness in the chamber of a young girl who spoke in the Parliament yesterday, Grace Warnock, who has been instrumental in having the disabled toilet signs in the Parliament changed, with the help of Iain Gray. She spoke movingly about the work that she is doing to ensure that people have a greater understanding of invisible conditions that require people to have access to disabled toilets.

Further to what the minister said about Grace Warnock, is she aware of Miss Jenny Cook, a young girl from East Kilbride who, with the support of her family and Derek McEwan of the Catherine McEwan Foundation, has now raised more than £285,000 for the foundation and the Glasgow Children’s Hospital Charity, formerly Yorkhill Children’s Charity? Does she recognise that many children fundraise for others with conditions that they have suffered themselves and that they work tirelessly on that? Will she join me in wishing Jenny Cook all the best as she heads towards the £300,000 mark at the age of 13? [Applause.]

Absolutely. I think that all members in the chamber are united in congratulating Jenny Cook on that fantastic work. I am aware of the outstanding fundraising work that she has carried out to help to improve the lives of fellow suffers of ulcerative colitis.

Given my previous role as Minister for Children and Young People, I am well aware of the enormous effort that our fantastic young people make to put back into society if they have needed help themselves, and to ensure that others can benefit from their knowledge, their expertise and their fundraising endeavours. It is fantastic that Jenny has received the award of young Scot of the year 2016. That is well-deserved recognition of the selfless work that she has done and the difference that she has made to the lives of others.

Although the introduction of the national blueprint on IBD and the emphasis on increasing support for people with Crohn’s or colitis is highly welcome, will the minister update the Parliament on what the Scottish Government is doing to deal with the dramatic rise in the number of children in Scotland who are being diagnosed with IBD?

We continue to work hard to ensure that young people and anyone who suffers from these conditions are given the help and support that they need. We have continued to work with Crohn’s and Colitis UK and on the delivering out-patient integration together programme, which is a multistakeholder working group that includes patients, clinicians, specialist nurses and dieticians who are developing pathways for the treatment and care of patients who have IBD across Scotland. The member also pointed to the blueprint.

We need to continue to be vigilant on this issue and to take on board other people’s views and opinions. We have made great strides on this. Some of the work that I mentioned in my response to Pauline McNeill is being done in Scotland, and we are the only country in the UK that is doing this kind of work on behalf of this group of patients.

We will continue to make the progress that we need. We will continue to work with patients and young people, particularly the ones who are doing so much to ensure that others do not have to suffer unnecessarily, and we will continue to make the improvements that we need to make to these services.

Rachael Hamilton.

To ask the Scottish Government when the estimated completion date is for the new East Lothian Community—

I am sorry, Ms Hamilton. I thought that you had pressed your button because you had a supplementary question. I have you down for question 10. My mistake.

East Lothian Community Hospital

To ask the Scottish Government whether it will provide an update on the new East Lothian community hospital project. (S5O-00212)

I am delighted to announce that financial close was reached for this contract on 23 September and that construction will start in a few weeks on this £70 million project. The new hospital will be a significant addition to the local healthcare facilities that are available in East Lothian, bringing services back to the area and helping more patients to get treatment closer to home. I look forward to work getting under way and seeing this fantastic new facility become a reality.

It is great news that construction is about to begin on the new hospital in Haddington, given that it should have started almost 10 years ago and should have been completed seven years ago.

As a Haddington resident, I have to tell the cabinet secretary that local joy is tempered by the fact that day surgery under general anaesthetic, which is currently carried out in Haddington, has been cut from the new hospital before a brick is laid. Approximately 2,000 patients a year will not get surgery locally and clinicians tell me that there is nowhere in Lothian for them to go except, presumably, on to an ever-lengthening waiting list. Even at this late stage, will the cabinet secretary intervene, make a £70 million project into a £71 million one and retain day surgery at Haddington?

I am glad that Iain Gray welcomed the good news, because good news it is for the people of East Lothian.

Iain Gray talked about the issue of surgical services. As he is aware, a lot of work has been done by the group that was established to look at NHS Lothian’s use of the facility and the services that should be provided in the new hospital. There has clearly been a long discussion based on clinical decision making about what should be provided in the new hospital.

The hospital will provide a range of primary care and out-patient services, step-down care, mental health services and care of the elderly accommodation. I hope that Iain Gray welcomes the fact that the £70 million investment will deliver an improvement in patient care for his constituents. Of course, I am happy to continue to discuss the development of the hospital with Iain Gray.

As a member of the Health and Sport Committee, I welcome the news that work will soon be under way on the new East Lothian community hospital. Does the cabinet secretary agree that the services returning to East Lothian will result in an increase in the number of people being treated closer to home and in an overall improvement in the quality of care of patients?

It is important to the delivery of the national care strategy that more people are treated as close to home as possible. The new hospital will help to deliver that. As I said earlier, it is a fantastic project with £70 million of investment, which members across the chamber, including Iain Gray, should welcome.

NHS Highland (Waiting Times)

To ask the Scottish Government what action it is taking to reduce waiting times for urology and orthopaedics appointments in NHS Highland. (S5O-00213)

The Scottish Government continues to support all boards, including NHS Highland, to ensure that patients get swift access to the hospital care that they need. In 2016-17, we have increased NHS Highland’s resource budget by 5 per cent to £577.5 million, which is an above-inflation increase.

In addition, at the end of August I announced that a further £2 million will be made available to the national health service specifically to address long waits for out-patient consultations. That money will be allocated to boards shortly, and it is expected that NHS Highland will focus the additional funding that it receives on addressing long waits in orthopaedics and urology.

The Scottish Government has also announced its commitment to invest £200 million to create five new elective centres, including one in Inverness. Those new centres will help to ensure that procedures such as hip and knee surgery can be carried out more quickly, which I hope the member will welcome.

What I would welcome is plans to address the problem. At the moment in the Highlands, the target time of 18 weeks between seeing a surgeon and having an operation is, in most cases, met within the tolerances that are allowed. However, that hides the real problem, which is the time that it takes between someone getting a referral from their doctor and their seeing the surgeon. For example, in orthopaedics there is a 48-week delay between a patient being referred by their doctor and their seeing a surgeon, and in urology there is a 60-week delay in patients seeing a surgeon from when the need is identified by their doctor. That means that the time for which someone who needs a urology operation is having to wait is closer to two years than it is to one year.

Will the extra money that is being provided be sufficient to bring the Highlands into line with the rest of Scotland and to get the delays down from their present unacceptable length?

The member raises some very important questions. The urology service in NHS Highland has been an important subject of discussion between my officials and NHS Highland and it is extremely important that improvements are made. NHS Highland’s local delivery plan highlights urology services—in particular, prostate surgery—as a major area of concern. A recent agreement with NHS Grampian will result in NHS Highland patients being assessed in Inverness and operated on in Aberdeen. That will increase capacity on both sites for that complex surgery.

Further work is required to develop regional and national solutions to the provision of additional capacity. I mentioned the elective centres. Meanwhile, NHS Highland has stated clearly that it will focus its share of the additional money on addressing the long waits in orthopaedics and urology. I will be happy to keep the member updated on developments as they progress.

Will the cabinet secretary advise the chamber of what specific measures the Scottish Government has employed to recruit more doctors to rural areas, such as the NHS Highland area, which would reduce waiting times?

The future of general practice is, of course, very important and is at the heart of our NHS. We have increased the number of general practitioners by more than 7 per cent, but we recognise that in some parts of the country there are significant recruitment challenges.

We have taken a number of measures to attract GPs to rural and remote areas: we have increased the number of GP recruitment places this year from 300 to 400; we have created the Scottish targeted bursary scheme; and we have looked at a number of other initiatives, including a £2 million package to help a number of GP recruitment and retention projects, such as the Scottish rural medicine collaborative. I would be happy to write to Kate Forbes with more detail.

I am interested in the question that was asked about orthopaedic services in the Highlands. The cabinet secretary will be familiar with the fact that a decision was taken to remove trauma and orthopaedic services from Monklands hospital in the Central Scotland region that I represent. The Scottish Parliament has made it clear that the Government must call in that decision. Will the cabinet secretary respect the will of Parliament? Will she make an urgent statement to Parliament on that serious matter?

That is not a supplementary to the question that is on the order paper.

What recent steps has the Scottish Government taken to improve accident and emergency performance in NHS Highland? What is the current A and E performance in the health board area?

The performance of Highland hospitals in meeting their A and E targets has certainly improved, and the latest figures show performance at 95.5 per cent for Caithness general hospital, 93.7 per cent for Raigmore and 100 per cent for Lorn and Islands hospital. However, there is always more room for improvement, and we will be developing and working with boards on their winter plans, which will include helping them to take forward other measures to ensure that A and E performance is maintained during the winter period.

NHS Lanarkshire (Meetings)

To ask the Scottish Government when it will next meet NHS Lanarkshire. (S5O-00214)

Ministers and Government officials regularly meet representatives of all health boards, including NHS Lanarkshire, to discuss matters of importance to local people.

When the cabinet secretary gets the opportunity to next meet NHS Lanarkshire, I would ask that she raises with it the evidence sourced by the time for inclusive education—TIE—campaign, which shows that 95 per cent of young lesbian, gay, bisexual, transgender and intersex respondents report that being bullied at school impacted on their mental health. In conjunction with that, 58 per cent of LGBTI respondents admitted self-harming as a result of bullying, with 45 per cent doing so regularly. Does the cabinet secretary agree that adopting the inclusive educational approach advocated by the TIE campaign would go a long way towards reinforcing the Scottish Government’s progressive mental health strategy for young people not only in Hamilton, Larkhall and Stonehouse, but across Scotland?

I agree with Christina McKelvie that bullying of any kind is unacceptable and must be addressed. We know that children and young people’s wellbeing and attainment can be severely impacted by bullying. We want all schools to promote an inclusive approach to relationships, sexual health and parenthood education. Therefore, anti-bullying policies should be at the heart of a whole-school approach, and a positive and welcoming ethos should be created. In addition, health and wellbeing sits alongside literacy and numeracy as a responsibility of all staff.

I would be happy to write to Christina McKelvie if she wants more detail on the programmes that we support.

The cabinet secretary has had time to think about the answer to this question, which relates to Monklands hospital. The reality is that there was no consultation process for the closure of orthopaedics at that hospital. As my colleague has stated, the will of Parliament was clear last week: there was a clear majority to have the change called in for ministerial decision. Will the health secretary make an urgent statement to the Parliament to say that she will call in the decisions on Monklands hospital and the other hospitals and will reject them?

It was the Presiding Officer who decided whether the question asked by the member’s colleague was to be answered. I am sure that the member will respect the Presiding Officer’s will.

In answer to the member’s question, as I have said previously in this chamber, NHS Lanarkshire’s interim plans are about ensuring clinical safety and quality of care, as supported by clinical experts at the Academy of Medical Royal Colleges and Faculties in Scotland. I am sure that Anas Sarwar would not want to doubt the importance of what they have to say about clinical safety and the quality of care, given his own clinical background.

The plans will also help to address issues with the recruitment, retention and training of key clinical staff, as highlighted in reports from Healthcare Improvement Scotland and the postgraduate dean for medical education. As Anas Sarwar and others are aware, NHS Lanarkshire’s longer-term service plans are the subject of formal public consultation, which will run until 1 November. Again, I would encourage all local stakeholders to play a full part in the consultation.

As the First Minister and I have said, it is important to stress that no decisions have been taken on any of the proposed service changes. There is nothing in front of me to say anything about. Before any decisions are made, the proposals have to go through a well-established process, which includes the engagement and consultation of local people—something that I would hope that Anas Sarwar would support.

Following the conclusion of that process, I will be in a position to make a judgment. Of course, I will take last week’s debate and decision very much into account and I will report back to Parliament, as the First Minister has already confirmed.

As the cabinet secretary may know, the decision on orthopaedic and trauma services has been taken; it will come into effect at the end of this month without any consultation. Could she perhaps explain to Parliament and to constituents how, if the service is unsafe, it has become unsafe under her watch over the past 10 years of this Government?

As Elaine Smith knows, there has been significant investment in Monklands hospital over recent years, something that she consistently fails to recognise in this Parliament and which does a great disservice to the staff of Monklands hospital and, indeed, the patients who use it.

I have said time and time again to Elaine Smith and she understands well and good that the NHS Lanarkshire proposals that have been approved and are going forward are interim plans based around clinical safety. Also, the recommendations are supported by the Academy of Medical Royal Colleges and Faculties in Scotland. If politicians in this place think that they know better than the clinicians who raise clinical safety, they should think long and hard about whether they have the expertise that puts them in a position to know more than the clinicians who are making the recommendations.

As Elaine Smith also knows well, the longer-term plans beyond the interim plans are the subject of formal public consultation and will indeed come to me at the end of the day. I encourage Elaine Smith and others to play a full part in that consultation, which runs until 1 November.

NHS Ayrshire and Arran (Waiting Times)

To ask the Scottish Government what it is doing to reduce waiting times for initial hospital appointments following general practitioner referrals in NHS Ayrshire and Arran. (S5O-00215)

The Scottish Government continues to support all boards, including NHS Ayrshire and Arran, to ensure that patients get swift access to the hospital care that they need. In 2016-17, we have increased the NHS Ayrshire and Arran resource budget by 5.3 per cent to £669 million, which is an above-inflation increase.

In addition, at the end of August, I announced that a further £2 million will be made available to the national health service, and the money will be allocated shortly to NHS boards, including NHS Ayrshire and Arran.

The cabinet secretary will be aware of a lack of physiotherapy services and extended waiting times for surgery in areas such as orthopaedics in NHS Ayrshire and Arran, as well as the problems that were encountered last winter, when surgical beds were used for medical patients, resulting in extended waiting times for planned surgery.

Notwithstanding the cabinet secretary’s initial answer, for which I thank her, can she reassure my constituents and the people of Ayrshire that waiting times will reduce in the future and that plans are in place to deal with the expected increase in demand for hospital beds over the approaching winter period?

John Scott again raises some important issues. He will be aware that there is a clear process for developing winter plans. The plans are scrutinised carefully by officials to make sure that they are robust. I will make sure that, when we look at NHS Ayrshire and Arran’s winter plan, the issues that John Scott raises—particularly in relation to physiotherapy and waiting times—are addressed.

It is important, going into the winter, that boards are in the best position that they can be in. I reassure John Scott that we will certainly be interrogating NHS Ayrshire and Arran’s winter plan to make sure that we satisfied that it will be able to deliver a safe and good-quality service through the winter.

How does NHS Ayrshire and Arran’s budget compare with its budget when the Government took office?

NHS Ayrshire and Arran’s resource budget has increased by £172.1 million, or 34.6 per cent, since 2006-07. That is a real-terms increase of £65.1 million, or 11 per cent. Of course, demand has also increased, as has pressure on services, so it is important that, as new resources flow into the NHS, we also change how services are delivered to ensure that quality continues. We will do that through the national clinical strategy.

Social Care Staff (Working Conditions)

To ask the Scottish Government what action it is taking to improve working conditions for social care staff. (S5O-00216)

Terms and conditions of employment are matters for individual employers. However, the Scottish Government expects all employers to adopt fair working practices. The Scottish Government has taken action in a number of ways to address fair work practices: through the measures in statutory guidance on procurement, through the fair work framework, and by encouraging fair work more generally through the promotion of the Scottish business pledge.

The Scottish Government is providing significant investment to enable local authorities to commission care services that pay adult care workers, including those in the independent and third sectors, the full living wage of £8.25 per hour from 1 October this year. The codes of practice for employers that are published by the Scottish Social Services Council set out employers’ responsibilities for supporting their workforce to achieve the standards of practice and behaviour that are required of them.

The Scottish Greens fully support the provision of the real living wage in the care sector and throughout our economy, and we support the Government’s efforts in that regard.

Turnover in the sector is relatively high, and we know that a great many employers in the sector are actively recruiting in other European Union countries. What impact does the cabinet secretary think that people will experience with regard to their working conditions if employers are required by the United Kingdom Government to begin listing foreign workers in an effort to stigmatise and shame them? Can she tell us what impact will be felt by those who are already working in the sector if employers find it more difficult to recruit overseas workers, who are so vital in our care services, as a result of that blatantly racist policy?

Patrick Harvie raises some very important matters. First, I welcome his support for the living wage and his comments in that respect. He is right to identify retention and turnover as issues in the care sector. The living wage is so important because it is part of the solution in encouraging people to come into the care sector and to remain working there.

Without a doubt, a relatively large percentage of those who work in the care sector and in care homes in particular are from the EU. I have asked the SSSC to do some work on getting more and better data on how many of the people who work in the care sector are from the EU. If we were to lose that cohort of people who work here, that would create a significant gap for our care services. It is very important that we send out a message that those people are welcome here and are welcome to work here. I want the UK Government to ensure that those who are working and living here, and contributing to the Scottish economy, can remain doing so.

I agree with Patrick Harvie that the idea of businesses listing foreign workers is abhorrent. It is a terrible, terrible thing for any minister to say, and it creates division and the type of society that we would not want in Scotland. It is important that we unite across the chamber to send out a message that we do not think that that is a right and proper thing to do. We reject it, and we welcome those from the rest of the EU who are working in our health and care sectors.

On 27 September the Scottish Government wrote to integration joint board chief officers about the living wage for social care workers. The letter told them that IJBs did not need to pay the living wage for workers carrying out sleep-over shifts. Will the cabinet secretary apologise to those workers for failing to deliver the living wage to them on 1 October, as promised by the Scottish Government? Will she tell members today exactly when those workers can expect to be paid the living wage?

It is sad that Colin Smyth cannot welcome the fact that nearly 40,000 care staff, many of whom are women, are getting a pay rise from 1 October. Can those on the Labour benches not bring themselves to welcome that? It is very sad that they cannot.

On the issue of sleepovers, Dave Watson from Unison has said:

“With sleepovers, we want everybody to be paid the living wage but we accept it does require a bit more work.”

If Unison, in representing its members, can be constructive on the issue, why cannot the Labour Party?

National Health Service (Living Wage)

To ask the Scottish Government what progress it is making to ensure that national health service staff receive at least the living wage. (S5O-00217)

The requirement to pay the Scottish living wage in the NHS was introduced in 2011 and the lowest available pay point has been at or above the Scottish living wage rate ever since. In addition, the Scottish Government has provided significant investment to support the payment of the Scottish living wage to adult social care workers from 1 October this year and has been working closely with health and social care partnerships and providers to make delivery of the policy successful.

As NHS Scotland staff are guaranteed the real living wage, how much better off per year is someone in Scotland who enters the lowest point in agenda for change band 1 compared to somebody in the same situation in NHS England?

Someone who enters the lowest pay point currently available in NHS Scotland will be £881 per year better off than their English counterpart. That is a sign of the good partnership working that we have with the unions and the fact that we have accepted the pay recommendations from the independent pay review body, unlike other parts of these islands. We believe strongly that partnership working with the unions is an important aspect of ensuring that we deliver progress for staff working in our NHS.

Surgical Mesh (Counterfeit Material)

To ask the Scottish Government what its position is on the assurances that it has received from Boston Scientific regarding the possible use of counterfeit material in surgical mesh. (S5O-00218)

The Medicines and Healthcare Products Regulatory Agency regulates medical devices across the United Kingdom and has not issued a medical-device alert regarding the implants concerned. The MHRA has found no evidence to indicate that mesh implants are unsafe, and has not found it necessary to initiate any enforcement action against Boston Scientific or any other manufacturer in the UK. Should that situation change, we would expect the MHRA to take appropriate action.

The Scottish Government’s request to suspend procedures was the result of an independent review of use of mesh products, which was brought about by wider concerns about their use. It is not related to the allegations about counterfeit material.

I have here the letter that the cabinet secretary wrote to my constituent Elaine Holmes and to Olive McIlroy and other mesh survivors who are living with the appalling and unforeseen consequences of mesh implants. I understand what the cabinet secretary says about the MHRA, but I refer to its lamentable performance at the Public Petitions Committee in the previous session of Parliament, when it transpired that its examination of the issues had involved a desktop study by three people over two weeks costing £20,000. Is the cabinet secretary really satisfied that a phone call by the MHRA to the company concerned, which said that there is nothing to worry about, is an adequate examination of the suitability of the material, given the seriousness of the consequences of the problem?

I have some sympathy with what Jackson Carlaw says, but we cannot get away from the facts that it is the MHRA’s role to regulate use of medical devices in the UK and that it has not, as yet, issued an alert in relation to Boston Scientific’s products. If Jackson Carlaw would find it helpful, I am willing to relay to the MHRA the concerns that he has expressed in Parliament. I did that after the committee meeting to which he referred, because there was clearly strong feeling about the MHRA’s role in the process that had been gone through. I am happy to relay those concerns again to the MHRA.

I find the cabinet secretary’s attitude on what is a very serious issue to be complacent. Will the cabinet secretary join me in calling on the Crown Office to investigate the very serious allegations against Boston Scientific of using counterfeit materials, which could be implanted in women in Scotland?

I am sorry that Neil Findlay feels that way about my answer, but I do not regulate the use of medical devices in the United Kingdom; that is the responsibility of the MHRA. All that I can do is make clear the views of Parliament—including the views of Neil Findlay and Jackson Carlaw—to the MHRA. It is up to the Crown Office to decide whether it believes that there are issues relating to the matter for it to look at. I am sure that the Crown Office will respond to Neil Findlay about that. The fact is that it is the MHRA’s role to regulate the use of medical devices in the UK, not the Scottish Government’s role.

NHS Dumfries and Galloway (New District General Hospital)

To ask the Scottish Government what progress is being made with the construction of the new district general hospital for Dumfries and Galloway. (S5O-00219)

Excellent progress is being made. A couple of weeks ago, the topping-out ceremony took place at the new hospital, which signified that the building had reached the highest point in its construction and marked an exciting milestone for all those involved in the project. This is a very exciting time for the new hospital project, as the vision for a fantastic new facility for patients and staff moves one step closer to becoming a reality.

The new hospital project has delivered significant community benefits in terms of new jobs, apprenticeships and training opportunities, and we will continue to maximise those gains over the coming year.

Does the cabinet secretary agree that single-occupancy rooms such as will be in the new hospital are important for patient welfare and for meeting current infection-control standards?

The Scottish Government is committed to providing patients with the best possible standard of patient care: single rooms provide a better and safer environment for our patients. In view of the potential benefits to patient safety and experience, it has been our policy since 2010 that for all new-build hospitals, and other healthcare facilities that provide in-patient accommodation, there should be an assumption that all patients will be accommodated in single rooms, unless there are clinical reasons for multi-bed rooms being available.

East Lothian Community Hospital

To ask the Scottish Government what the estimated completion date is for the new East Lothian community hospital. (S5O-00220)

The highly anticipated facility, which is being developed jointly by NHS Lothian and East Lothian health and social care partnership, will provide a fit-for-purpose facility to deliver high quality healthcare for the county, and it is expected that it will be open to patients in 2019.

As the cabinet secretary will know, services have been relocated from Roodlands hospital as the new hospital has been built. How will disruption to patients from East Lothian be kept to a minimum as the new build takes place?

We would expect such relocations to happen, and we would expect any disruption to be kept to a minimum. Inevitably with projects of such scale there will be some disruption, but it is important that there is continuity of patient care and that disruption to local residents is kept to a minimum.

If Rachael Hamilton would like, I would be very happy to ensure that she is provided with further details of how that will be done in practical terms.

Universities (Study of Medicine and General Practice)

To ask the Scottish Government what discussions it is having with universities to encourage the study of medicine and general practice. (S5O-00221)

We continue to work with Scotland’s five medical schools to ensure that we have a sustainable workforce for NHS Scotland. That includes working closely with universities to deliver our medical education package, which will increase supply and widen access. Through the package, we are investing £23 million in increasing medical undergraduate places by 50 from 2016-17, and in establishing Scotland’s first graduate medical entry programme and a pre-medical entry programme.

Recently I met my constituent Daniel, who is distressed because he was not accepted to study medicine due to grades that he received through personal circumstances that he faced during the academic year. How are young people being supported in their ambition to study medicine and general practice?

I understand that we have the details of the case that Richard Lyle referred to. Officials will reply to him directly.

On the wider point, the Scottish Government and Scottish Further and Higher Education Funding Council are taking specific actions to widen access to studying medicine to people from the widest range of backgrounds. The funding council also supports the reach Scotland project, the purpose of which is to increase the proportion of pupils from the 40 per cent most deprived postcodes and from under-represented schools into higher education. The focus of reach Scotland is high-demand subjects, including medicine.

The funding council has also developed a series of outcomes with all universities, against which progress on widening access can be measured. The 50 extra undergraduate places that I mentioned will be focused on widening-access criteria.

That concludes topical questions.

On a point of order, Presiding Officer.

I apologise for not giving advance notice of this point of order. As the member with question 12 in today’s health questions, I ask whether the Presiding Officer will reflect on the number of questions that were selected and the number of supplementaries that were taken. Given that we had 40 minutes for questions today and 20 members were asked to submit questions which, like mine, were on today’s important constituency cases—for example, people in Elgin who have significant concerns about eye care at Dr Gray’s hospital—should you perhaps be selecting fewer questions and ensuring that we get through all of those, or taking fewer supplementaries to ensure that all the important issues are raised and debated in the chamber?

I thank Mr Ross for that. I am not sure that it is a point of order, but I assure him that the matters are under active consideration. For example, we are considering whether to reduce the number of questions selected. I am conscious that the member who has question 20, for example, will be sitting in the chamber without there being any realistic chance of our getting to that question. We are looking at the possibility of reducing the number of questions being submitted.

On supplementary questions, I am anxious to take members who want to ask those. A number of members pressed their buttons today—including a number of Mr Ross’s colleagues, whose supplementaries I was not able to take. Sometimes I am unable to do so due to the length of replies from the minister, but that happens sometimes because the question requires a lengthy answer.

These are difficult matters, but they are under consideration; I hope that Douglas Ross will accept that.