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Chamber and committees

Meeting date: Tuesday, December 7, 2021

Meeting of the Parliament (Hybrid) 07 December 2021

Agenda: Time for Reflection, Business Motion, Topical Question Time, Covid-19, Maternity Services (Moray), Just Transition, Advanced Research and Invention Agency Bill, Business Motion, Decision Time, Gender-based Violence


Topical Question Time

The next item of business is topical question time. To get in as many members as possible, I would prefer short and succinct questions and responses.

Serious Organised Crime and Terrorism

To ask the Scottish Government what resilience measures are in place to tackle serious organised crime and terrorism, in light of reports that the assistant chief constable in charge has been suspended. (S6T-00339)

That is an operational matter for Police Scotland. The chief constable has confirmed that Assistant Chief Constable Tim Mairs will move from his current role on an interim basis to take responsibility for the organised crime, counterterrorism and intelligence portfolio. The member will appreciate that it would not be appropriate for me to comment further while an investigation is under way.

I appreciate that an investigation is under way. However, the seniority of the individual and the importance of his remit cause the most concern. The assistant chief constable who has been suspended leads the charge in tackling serious organised crime, terrorism and cybercrime in Scotland. We know that cybercrime increased 95 per cent last year, web-based grooming offences have increased by 80 per cent over five years and the police are currently investigating nearly 2,500 serious organised gang members in Scotland. Is the cabinet secretary confident that we are making progress in tackling such crimes? What steps has he taken in the past few days to ensure that the recent events will in no way impact on Police Scotland’s ability to protect the public?

As I said, there is not much that I can say on the investigation. The member says that it is important because of the level of seniority that the person involved has in the organisation, but it would be just as important if an individual at any level in Police Scotland was involved in such a case.

It is the chief constable’s responsibility to deploy his force as he sees fit. I have had discussions in the past few days with the police and the Scottish Police Authority, and I am confident that the police and the chief constable will ensure that, in relation to organised crime and cybercrime, the coverage that is provided, and effort that is made, will be the same as it was before the case came to fruition. That will be effected by the changes that the chief constable has put in place.

I am reassured that a conversation has taken place about the resilience of the police’s ability to handle such serious crime in Scotland, but let us not forget that it is over a year since Dame Elish Angiolini’s final report into police misconduct and complaints handling was published. The Government snuck out a progress report on the final day before summer recess—I raised that at the time—but we have heard nothing since. It remains an astonishing fact that an officer can resign while suspended during an investigation with no further action taken or recourse available. Why is that still the case?

Jamie Greene makes an important point. He knows that one of the recommendations in Dame Elish Angiolini’s report relates to that. He will also know that there were more than 100 such recommendations, many of which have been progressed. I reassure him that a meeting took place last week at which the latest tranche of recommendations that have been progressed was summarised. We will shortly make public the progress that has been made on the range of recommendations.

The situation to which the member refers would require primary legislation to change. We will have to introduce that and, perhaps, another provision on advisory and barred lists, under which somebody who is convicted of an offence in one police force cannot join another police force without that force being told about it.

Those are two important recommendations, but they will require primary legislation and, if we implement them, that will require to be fitted into the legislative programme. The justice portfolio currently has around 22 bills scheduled for this parliamentary session alone before any bills that Jamie Greene and other members might propose. It is a congested programme, but we intend to implement those recommendations. Serious progress is being made on the range of recommendations that Elish Angiolini made.

I thank the cabinet secretary for that information. He will be aware there has been an 18-fold increase in seizures of so-called street Valium in the space of a year, while seizures of psychoactive substances have nearly doubled. I would like further assurance that the cabinet secretary will be mindful of the need for that successful work to continue and not be compromised in any way.

I give Pauline McNeill that reassurance, which is based on the 17,000 police officers that we have in place and the work that is being done through some new initiatives. She mentioned psychoactive drugs. She will be aware of some of the measures that are being taken in relation to the presence of those drugs in prisons. The member will also be aware of recent changes made by the Lord Advocate in relation to how drug offences are prosecuted and dealt with by the police. There is a real focus on the issue.

The discovery of an increased amount of drugs should not necessarily be seen as indicating increased prevalence. We cannot properly determine exactly what that is due to, but it may well be down to the fact that the police are acting very effectively to locate and seize the drugs.

What is the Scottish Government doing to strengthen the process for the handling of complaints and misconduct allegations against police officers?

I think that I partly answered that question in response to Jamie Greene’s supplementary question. Following the review by Dame Elish Angiolini, which has already been mentioned, and which concerned issues with complaints handling, investigations and misconduct, a number of recommendations have already been implemented. Others will require legislation, and we will consult further on those proposals to strengthen the framework for complaints and misconduct allegations against police officers. We will do that next year, including in relation to the conduct framework for senior officers.

There is currently an established process for the handling of police complaints, investigations of serious incidents and misconduct, and I welcome the significant progress that has been made by Police Scotland, the SPA, the Police Investigations and Review Commissioner and the Crown Office and Procurator Fiscal Service, among others, to drive improvements in systems and processes in advance of the legislative changes that I mentioned earlier.

NHS Lothian (Delayed Discharge)

To ask the Scottish Government what support it is providing to NHS Lothian, and other national health service boards, given the consequences and impact of delayed discharges. (S6T-00344)

I thank the member for that important question. The health and care system is under extreme pressure due to the pandemic, and all health boards are experiencing significant issues, including workforce challenges and high levels of delayed discharge. To help alleviate some of that pressure, we announced a substantial new package of more £300 million in hospital and community care to support the NHS and social care systems over the winter, with a substantial proportion of that funding going directly into social care to help with delayed discharge.

Last month, I announced further funding of £10 million to support health boards in maintaining resilience throughout the winter by putting in place a range of measures, including appropriate levels of staffing in the right place at the right time.

I have been meeting the chief executive of NHS Lothian, alongside the chief executive of the City of Edinburgh Council and Judith Proctor and the team at the Edinburgh health and social care partnership, on a weekly basis over the past month to discuss this very issue.

I thank the cabinet secretary for that answer, and I will be measured in my next question. Along with others in the chamber, I was at a briefing on Friday that painted an alarming picture. There has clearly been a spike in delayed discharge, particularly in Edinburgh, leading to a logjam right the way through in-patient care and into accident and emergency.

In the cabinet secretary’s meetings, was the issue identified? My understanding is that the issue is not necessarily just one of money. Is the issue one of social care provision, or are there other blockages to discharge? Is that happening elsewhere in the country?

If Daniel Johnson wants further briefing than this topical question will necessarily allow, I am happy to speak to him in detail offline, with my officials.

In response to Daniel Johnson’s questions, I note that there are some Edinburgh-specific issues, and I meet representatives of the relevant organisations in Edinburgh every single week, as I am really concerned about the level of delayed discharge there—it is the highest in the country. There are also unique circumstances in Edinburgh. There is a severe lack of in-house provision, as Daniel Johnson probably knows, not just in care homes but in care at home, which plays a vital part in keeping people out of hospital, be that via the back door or by preventing people from coming through the front door.

Workforce is clearly a challenge in Edinburgh, too, given the competing workforce pressures in hospitality and so on. Daniel Johnson is absolutely right, however: as I have said to the City of Edinburgh Council, the health and social care partnership and NHS Lothian, finance should not be an issue. In fact, I agreed additional funding, recognising that, for interim care placements, for example, the cost may well be higher in Edinburgh than in other parts of the country. I am convinced and content that funding is not the issue, as Daniel Johnson articulates, but there are a significant number of other issues that we are trying to work through in Edinburgh.

Given the limited time that I have at topical questions, I am happy to write to the member or, if he wants a meeting, I am more than happy to discuss these matters in greater detail.

I would indeed welcome more detail and a meeting. Of particular concern is in-patient care, especially in trauma. One example is orthopaedics, where delays in treatment can obviously have consequences for bone growth and so on. Are there concerns in particular areas of in-patient care, and would the cabinet secretary be able to elaborate on what action is being taken to remove those issues?

There may be concerns across the board, but the member is right to focus on the areas that he has focused on. It is important to note that although—understandably—we often spend a lot of time in the chamber focusing on unscheduled emergency care, we know that a backlog has been building for elective care, which has been exacerbated by the pandemic’s significant impact.

We are using all the national resources possible—for example, we are asking how the Golden Jubilee national hospital can help with orthopaedic surgery in Lothian, the west coast or any other part of the country—and maximising resources as much as we can to help with the elective backlog. We know that, if people wait longer for such surgery, that builds up problems for us in the future. I am more than happy to go into more detail at a meeting with Daniel Johnson.

The cabinet secretary has announced money to address delayed discharges, and he agreed in a previous answer that money is not necessarily the problem. When does he expect to help more long-suffering patients to receive the care that they need and deserve by reducing the level of hospital delayed discharges?

The number is reducing—last week’s figure was below 1,500, although it is still far too high and I want it to reduce even more. I am happy to provide Sandesh Gulhane with the latest figures.

We are beginning to see small reductions, but I need them to be far bigger. I am meeting the six health boards that have the most delayed discharges, and we are working through solutions and making progress, as I said. I hope that the progress will continue. As I said in response to Daniel Johnson and as I have made clear to health boards, funding and finances should not be a barrier to reducing delayed discharges.

I, too, attended the briefing on Friday with NHS Lothian, and then I went to one with NHS Borders. Further to the answers to Daniel Johnson, the problem is not just in Edinburgh. As of today, of the 300 beds in Borders general hospital, seven are occupied by Covid patients, but 51 are occupied by those whose discharge is delayed. I appreciate the various causes of that but, if we are losing 17 per cent of bed capacity when all the predictable challenges of winter lie ahead, we have an immediate problem.

I am listening carefully to the cabinet secretary’s answers. Given that delayed discharge is a problem in the Borders, too, is he meeting Ralph Roberts of NHS Borders?

Yes, as members can imagine, I discuss the issue with every health board. Christine Grahame is right that every health board contends with the problem. There is also very good practice, which I am ensuring is shared across every health board.

As always, Christine Grahame gets to the crux of the issue. If we invest not just in care home placements, which are hugely important, but in care at home and ensuring that people have the appropriate packages at home, we hope that we will prevent them from coming through the hospital front door.

I assure Christine Grahame that I meet the health board chief executives and chairs every week. Ralph Roberts is on those calls and we discuss such matters in great detail.

I am grateful for the answers that we have heard. Following the meeting on Friday, will the cabinet secretary say where the staff will come from who are needed to alleviate the problem across Scotland?

Recruitment is under way and is going well. Job adverts have been placed, interviews are commencing and a number of people have been recruited. In answer to Daniel Johnson, I said that Edinburgh has an acute problem because of pressures from the retail sector and hospitality and so on. A significant proportion of the £300 million of funding that I announced is for additional recruitment of band 2s to band 4s. That work is well under way. If the member wishes to write to me for more specific detail on recruitment, I will be happy to provide the numbers.

Given the cabinet secretary’s comments about capacity in the system, I ask how many people are waiting for a hospital appointment.

Forgive me—I do not have to hand the exact number who are waiting for a hospital appointment, but I am happy to see whether we have the figures and, if so, we will provide them to Stephen Kerr. We are investing heavily to free up as much capacity as we can. Getting back into the community people whose discharge has been delayed will help us to free up space in hospitals and see more people, which is important.

Our investment in primary care is really important to that. We do not want everybody to have to go to hospital to be seen. We are investing across the system so that they can be seen in the community—in primary care. I am more than happy to see whether we can provide the exact figures that Mr Kerr looks for.