Website survey

We want your feedback on the Scottish Parliament website. Take our 6 question survey now

Skip to main content

Language: English / Gàidhlig


Chamber and committees

Meeting date: Wednesday, May 9, 2018

Meeting of the Parliament 09 May 2018

Agenda: Eliminating Hepatitis C, Portfolio Question Time, NHS Tayside (Mental Health Services), National Health Service (Waiting Times), Point of Order, Business Motion, Decision Time, Roads


Portfolio Question Time

Health and Sport

The next item of business is portfolio question time. I say again that, in order to get in as many people as possible, I want short and succinct questions, and answers to match. I am in a good mood at the moment.

Mental Health Services (Involvement of Young People)

To ask the Scottish Government how it ensures that the voices of young people are heard during the development of mental health services. (S5O-02057)

I remind members that I am the parliamentary liaison officer to the Cabinet Secretary for Health and Sport.

When we published our mental health strategy in March 2017, a consistent theme was engagement and co-production with young people. I valued the opportunity to hear young people’s views first hand through the work that we carried out in conjunction with the Scottish Youth Parliament, Young Scot, Children in Scotland and many others. Those views were crucial to informing the final strategy.

We continue to put young people’s voices at the heart of the strategy, and we have several strands of on-going work that directly involve young people. They include: the youth commission on mental health services, which is run by Young Scot; a review of personal and social education in schools, which is strategy action 1; an audit of rejected referrals to child and adolescent mental health services, which is being run by the Scottish Association for Mental Health and is strategy action 18; and work on transitions between CAMHS and adult services, which is being run by the Scottish Youth Parliament and is strategy action 21. All that work is really valuable, particularly given that 2018 is the year of young people.

We will continue to ensure that young people’s voices are heard and acted on, particularly as mental health is consistently mentioned as one of the top priorities—if not the top priority—for young people.

A couple of weeks ago, I held a round-table meeting with the cross-party group on children and young people, in which a range of stakeholders contributed on the subject of mental health and young people. There was a particular focus on the transition period from CAMHS to adult services for young people between the ages of 16 and 18, which the minister mentioned. How is the Government ensuring that young people have a say in the services that are available for that particular group?

I thank Fulton MacGregor for his interest in the issue. It is good to hear that there is a focus on transitions between CAMHS and adult services. That is one of the central themes that emerged during the Scottish Youth Parliament’s speak your mind campaign on mental health, which has been crucial to informing our strategy.

As I mentioned in my first answer, the Scottish Youth Parliament is taking forward work on transitions. We want to focus on how anticipatory care plans can best be used to support young people who transition between CAMHS and adult services, between different child and adolescent mental health services or, indeed, out of CAMHS altogether. The Scottish Youth Parliament’s work will ensure that the final anticipatory care plan has been designed by young people for young people.

The Scottish Youth Parliament held a discussion day event on 24 March, which I attended. I look forward to the final product being finalised and rolled out in the coming months.

In Dumfries and Galloway, we have seen a 10 per cent rise in the number of temporary staff who work in child and adolescent mental health services. Does the minister agree that that represents a huge challenge for the running of child-centred services? What action is the Scottish Government taking to address the issue?

The key is early intervention and prevention. We see increasing numbers coming forward for CAMHS, but we want to ensure that people are properly referred and that, if CAMHS specialist intervention is not required, intervention at tiers 1 and 2 is available.

“Scotland’s Digital Health and Care Strategy”

To ask the Scottish Government how the digital health and care strategy will help to deliver person-centred care. (S5O-02058)

“Scotland’s Digital Health and Care Strategy”, which was published last month, highlights the opportunities that technology offers to empower citizens to better manage their health and wellbeing, to support independent living and provide access to services through digital means and to support a shift in the balance of care. The external expert panel highlighted that Scotland is an international leader in technology-enabled care and our strategy sets out an ambition to widen and extend such services.

How does the strategy contribute to the on-going work on the integration of health and social care in our communities? Does the cabinet secretary agree that the use of a mix of technology, as well as traditional methods, is key to delivering sustainable care now and in the future?

The strategy recognises the benefits of a focused approach to delivery. The eight national health boards’ new collaborative approach to offering improvement and transformational change by working alongside the Convention of Scottish Local Authorities, the local government digital office, the Scottish Social Services Council and the Care Inspectorate, will be key to delivering on those ambitions. This is not about technology necessarily being the solution; wider service transformation will bring together expertise and knowledge, with technology being integral to helping such change to happen.

The cabinet secretary will cover some of this later, but what consideration has been given to using technology in crisis mental health situations, so that people can have rapid access to a councillor or a psychologist in order to avoid a really tragic circumstance?

Of course there are already important services for those suffering crisis, such as breathing space. NHS 24 has been involved in providing services that people can use online, which have been well evaluated. There is probably more that we can do in that space, particularly for people living in remote and rural communities, which I am certainly keen to explore.

Air Pollution (Health Impact)

To ask the Scottish Government what work it is doing to assess and reduce the health impact of air pollution. (S5O-02059)

The Scottish Government takes the issue of air pollution very seriously and is committed to the protection of public health from the effects of poor air quality. Compared with the rest of the United Kingdom and other parts of Europe, Scotland enjoys a high level of air quality, but we cannot be complacent about that.

Our “Cleaner Air for Scotland” strategy sets out an ambitious programme of action to promote air quality and Scotland is the first country in Europe to pass legislation based on World Health Organization guidelines for fine particulate matter.

We are also providing practical and financial support to financial authorities in tackling local air pollution hot spots. Plans are under way to have Scotland’s first low-emission zone in place in Glasgow by the end of 2018.

The situation, particularly in Glasgow, is not as rosy as has been suggested. I think that the minister said that Scotland has great air quality. There are areas of Scotland that have consistently, over many years, failed to meet basic air quality standards. As someone who lives in one of those pollution hot spots, I agree with the opposition councillors who have called for the low-emission zone to be implemented more rapidly than the council proposes. That is the council’s decision, but what support will the Scottish Government give Glasgow City Council to assess the difference in health impact that would be achieved by more rapid implementation of the LEZ, for which the opposition parties in the council are calling?

We are working with local authorities on low-emission zones. I do not think that it is overstating things to say that, compared with the rest of the UK and other parts of Europe, Scotland enjoys high levels of air quality. However, I never suggested for a minute that we are not working hard to make sure that we do more where we can. We are absolutely not being complacent. Some £10.8 million in funding has been allocated this financial year to support the implementation of local low-emission zones, with a particular focus on set-up costs and bus retrofit, for example. We will continue to work with our local authority partners to make the improvements that we need to make.

Around 1.5 million people in Scotland smoke, and cigarette smoke contains more than 4,500 compounds. Those include acetaldehyde, a carcinogen, acetone, which damages the liver and kidneys, and ammonia, a cause of asthma and high blood pressure. Does the minister agree that if we are serious about breathing clean air we must continue to do everything possible to persuade people to quit smoking?

Absolutely. We must continue to do everything possible to persuade people to stop smoking. Our efforts in Scotland on smoking rates have been bold and progress to date has been good. We are also among the first in the world to set a target of being tobacco free by 2034. Quitting is the best thing that smokers can do to improve their health, and we would encourage any smoker to try quitting in their own way and to make use of the free stop-smoking support that is available to them. I point the member to the quit your way campaign that we have taken forward to ensure that people understand the many different ways in which they can get support to help them to quit the habit.

Minimum Unit Pricing of Alcohol (Impact on Health)

To ask the Scottish Government what impact it expects minimum unit pricing of alcohol will have on health. (S5O-02060)

Last week saw the introduction of a minimum price of 50p per unit of alcohol. The University of Sheffield modelling estimates that, in the first year, that will result in 58 fewer alcohol-related deaths and nearly 1,300 fewer alcohol-related hospital emissions, and that, over a five-year period, we could expect 392 fewer alcohol-related deaths and 8,254 fewer alcohol-related hospital admissions. The monitoring and evaluation plan for minimum unit pricing, which is being led by NHS Health Scotland, includes examining the impact on alcohol-related harms.

Recent figures show that, in 2016 in North Lanarkshire, there were 122 alcohol-related deaths, which cost the national health service in North Lanarkshire an estimated £116 million, so I am pleased to hear the cabinet secretary say that minimum unit pricing should go some way towards reducing costs. Does she agree that the minimum unit pricing model that Scotland has introduced is one to which other countries will be paying close attention, with a view to rolling out the model elsewhere?

The Welsh Assembly introduced legislation for minimum unit pricing of alcohol in October last year. The Government of Ireland’s Public Health (Alcohol) Bill includes a provision for minimum unit pricing, and passed the second stage in the lower house in March this year. On Tuesday, the Parliamentary Under Secretary of State for Public Health and Primary Care, Steve Brine MP, confirmed that the United Kingdom Government is commissioning Public Health England to review the evidence for minimum unit pricing in England. I also understand that the Northern Territory in Australia is currently considering a minimum floor price for alcohol. It is a landmark Scottish policy, which other countries around the world are watching with interest.

The cabinet secretary will be well aware that the Parliament has already agreed to legislative provision for a social responsibility levy and that it is up to Government to further its implementation. Will she look again at that levy? It could help to fund third sector groups at local level to try and fight the issues caused by drink-related problems.

The additional revenue that was predicted by the University of Sheffield is very much an estimate. Through the evaluation, we will see where any additional revenues fall, which is important, as we have explored at the Health and Sport Committee. The social responsibility levy was always considered to be a local mechanism that could be used to address local circumstances. However, as I told the committee, we will keep those things under review as the policy goes forward, and that is something that I am happy to keep members informed about.

Fife Health and Social Care Partnership (Suspension of Out-of-hours Services in Dunfermline, St Andrews and Glenrothes)

To ask the Scottish Government what discussions it has had with Fife health and social care partnership since its decision to suspend overnight out-of-hours services in Dunfermline, St Andrews and Glenrothes. (S5O-02061)

The decision to move to contingency measures for the provision of the out-of-hours service in Fife was taken for reasons of patient safety. Officials are in regular contact with Fife health and social care partnership regarding those measures and the on-going situation.

Following the closure of the out-of-hours services, the director of health and social care highlighted growing difficulties in securing clinical cover by both general practitioners and nurses, as a result of national shortages. In Fife, those are well-known difficulties, with many practices struggling to get GPs during the day, never mind at night. Does the cabinet secretary accept the Government’s responsibility in creating that situation? Given those concerns, is she confident that the services in Dunfermline, Glenrothes and St Andrews will reopen in two months’ time, when they are up for review?

As Claire Baker knows, and as I said in my initial answer, the changes to out-of-hours primary care services are a short-term measure that was adopted in the interests of patient safety. NHS Fife is reviewing its longer-term arrangements for out-of-hours care and has undertaken an options appraisal exercise. A public consultation will commence in June, prior to any permanent decisions being made, and we will continue to liaise with NHS Fife throughout the review process.

In Fife, there are significant issues with GP recruitment, which Claire Baker has spoken about, and GP retention. We believe that the new GP contract, along with the £110 million investment in primary care that there has been in this year alone will help to make general practice more attractive and to build on local innovation that has taken place over the past few years. For example, we think that the recruitment and retention fund will be of assistance to local areas that are seeking to recruit. I should also say that the workforce plan that was published recently has a commitment to recruiting an additional 800 GPs over the next 10 years.

Does the cabinet secretary share my concern that no equality impact assessment was carried out prior to the temporary closure of Glenrothes hospital’s out-of-hours service, especially given that such an assessment was a key recommendation of the Ritchie review and that one in three children in Glenrothes lives in poverty?

I understand that an equality impact assessment was not completed due to the emergency nature of the contingency arrangements, which were put in place as a result of clear clinical advice. Although a formal assessment was not carried out, I have been advised by the Fife health and social care partnership that the impact on various communities and groups was part of the decision-making process in relation to the contingency. Such an assessment has been completed in relation to the longer-term plans for the service, and that will continue to be updated.

Access to Healthcare (Funding for Travel Expenses)

To ask the Scottish Government what funding packages are in place to meet the expenses of people who have to travel considerable distances to access healthcare, including outside their own national health service board area. (S5O-02062)

A range of options is available to patients who require financial assistance with travel costs. They include the Scotland-wide patient travelling expenses scheme, for those on qualifying benefits, and the Highlands and Islands travel scheme, which provides assistance to all those who live in remote areas. In addition, all health boards have discretion to reimburse patient travelling expenses where they are viewed as an extension of treatment costs and are deemed to be clinically necessary.

The cabinet secretary will be aware that some people in Caithness, Sutherland and Ross have had to travel for miles to access specialist care at Raigmore hospital in Inverness, with some having to take days off work, often for minor appointments. Can she tell me how the introduction of the NHS near me videoconferencing service will change that, and whether we will see it rolled out to other remote and rural areas?

NHS near me uses the nationally available attend-anywhere video consultation service that is funded by the Scottish Government’s technology-enabled care programme. It provides a secure video consultation environment for any service delivery organisation and can be accessed anywhere, by a member of the public using a web browser or app on their laptop, tablet or smartphone.

In Highland, near me’s initial focus has been on supporting the Caithness area while developing the service, but it is now working closely with the Scottish centre for telehealth and telecare to roll it out to further areas in the region. Uptake of the service continues to increase and can, of course, prevent people from having to travel unnecessarily.

Given that we are now 18 months after a major service redesign at Caithness hospital, does the cabinet secretary believe that the 200-odd mothers and their families who travel to the maternity unit at Raigmore should be provided with suitable accommodation at a hospital that, sadly, is still below what has been agreed as being suitable?

Edward Mountain will be well aware of the reasons for the change of status of Caithness maternity unit, which was made by NHS Highland on the ground of safety, and informed by the review that it commissioned after the death of a child in September 2015.

Making sure that accommodation at Raigmore is suitable is an issue that has been raised with NHS Highland on a number of occasions, and its importance has been impressed on the board. I understand that it has taken action to make improvements on the Raigmore site, and I will continue to press it on that.

New General Practitioner Contract (Consultation with People in Remote and Rural Areas)

To ask the Scottish Government what action it is taking to consult people in remote and rural areas on the impact of the new GP contract. (S5O-02063)

The Scottish Government commissioned the Health and Social Care Alliance Scotland to engage with patients across Scotland, including those in rural areas, on the new contract. The alliance will soon publish a report on that engagement, which will provide valuable feedback to local health and social care partnerships, which are developing their primary care improvement plans. Those plans will set out how the new GP contract will be implemented locally to best meet the needs of patients.

A contract that is based on the number of appointments does not take account of travelling time for rural GPs, who make more home visits due to the lack of public transport in rural areas, meaning that frail elderly people cannot come to the surgery. The contract shows no recognition whatsoever of the difference in rural practice. Similarly, the Scottish index of multiple deprivation, which is used, does not show rural deprivation, meaning that rural GPs miss out again.

The Scottish Government has not heard rural GPs, far less their patients—

Ask a question, please.

How will the Scottish Government rectify the situation and ensure that everyone has access to a GP?

The Scottish Government, in collaboration with the Scottish general practitioners committee of the British Medical Association, is establishing the rural short-life working group, which will work with rural stakeholders to assist in the implementation of the new GP contract. I understand that the first meeting of the group will take place later this month.

Following on from that response, can the cabinet secretary advise Parliament on the timeframe for that short-life working group? Will she also ensure that the group includes island representatives to reflect the specific issues that arise in island communities?

As I said in my previous answer, the group will meet later this month. A lot of effort has been put into looking at the group’s membership and, as I understand it, there is island representation on it. I am happy to write to the member with further details of who those people are.

Drug and Alcohol Services (Quality of Service)

To ask the Scottish Government how it ensures that quality is embedded and evidenced in drug and alcohol services. (S5O-02065)

In 2014, we developed the quality principles that define the standards that people can expect when using a treatment service. The principles put the person at the centre and build a recovery plan around their strengths.

In 2015, the Government commissioned the Care Inspectorate to support alcohol and drug partnerships to evaluate service quality against those principles. We were assured that quality is embedded in our services and that they work for recovery, but there is always room to do more and local improvement plans are in place to evidence that.

Is the minister aware of the high-quality cafe solace in my constituency? A huge part of its success comes from a whole-population approach being taken to tackling the challenges that our community faces, including food poverty and providing people who are in recovery a way to build skills and to give back locally. Will the minister join me this summer on a visit to cafe solace to meet peer mentors to see first-hand its high quality and Convention of Scottish Local Authorities gold award winning work?

I am happy to meet Ruth Maguire in her constituency and to visit the cafe so that I can learn more about, and see first-hand, its excellent work. I understand that, last year, cafe solace also won a COSLA excellence award.

I have been fortunate to visit a number of recovery communities across Scotland—there are more than 120—and to have had the opportunity to speak to many people for whom those communities act as the foundation of their recovery from drug and alcohol use. Those community initiatives are incredibly important, so I would welcome the opportunity to see the good work that is happening in the member’s constituency.

Global Drug Survey’s report “GDS2018 Key Findings Report” today shows the extent of drug use in Scotland, with users taking more cocaine in a single session than people anywhere else in the world, and drugs being delivered quicker than a pizza. I am coming across more and more people whose mental and physical health are seriously affected by cocaine use. If we are looking at having evidence-led policy, is not that evidence, and the level of drug deaths in Scotland, evidence enough that our policy is failing?

We have made a number of advancements through our strategy. A low number of young people are taking drugs and, overall, the number of people taking drugs is declining.

Neil Findlay is shaking his head. I absolutely recognise his point about the issue of cocaine that has been raised in the press today. I also absolutely accept that we see drug deaths every year. That is why I decided to refresh our current approach. That will build on our existing strengths but do more to recognise the changing landscape of drug use.

If Neil Findlay wants to bring constructive ideas to me, as opposed to criticising continually from the sidelines, my door is open. The issue is important. I do not want to get hung up on party politics, so I ask him, please, to come to my office to meet me and tell me his ideas, which we will make sure are part and parcel of the new strategy that I am developing.

Mental Health Strategy (Implementation)

To ask the Scottish Government whether it will provide an update on the implementation of its mental health strategy. (S5O-02066)

In the summer, I will present to the Scottish Parliament an annual report on the mental health strategy’s actions. Progress reports for all 40 actions that are in the strategy were uploaded to the Scottish Government’s website in December, when we also uploaded a report that summarised progress on key deliverables. I would be happy to provide Mairi Gougeon with links to those reports.

We held the second biannual forum of stakeholders on 6 December. The forum is intended to track progress on the actions that are in the strategy, and to help to develop new actions in future years that will help us to meet our ambitions. At the meeting in December, I spoke about our achievements over the previous half year, the challenges that lie ahead and the roles of everyone involved, going forward.

I was contacted by a pressure group from Mackie academy in Stonehaven that is concerned about the support that is available for teenagers and children who are struggling with mental health issues. The group particularly mentioned lack of training for general practitioners, who have told some children that they are “going through a phase”, and it asked for mental health training to be included as part of teacher training, for early intervention.

Given that early intervention is vital, will the minister outline how funding for the mental health strategy is being targeted in that regard? Are measures such as having on-site counsellors or community psychiatric nurses in schools being considered?

I completely agree that focusing on prevention and early intervention is fundamental if we are to achieve our mental health strategy’s vision and aspirations. Training has a central role to play, which is why action 2 of the strategy is to

“Roll out improved mental health training for those who support young people in educational settings.”

Since 2014, the Scottish Government has provided £6,000 per annum to Education Scotland for the roll-out to local authorities of Scotland’s mental health first-aid training for children and young people. The aim is to train staff in secondary school communities so that they are more confident about approaching pupils who might be struggling with a mental health problem. The training complements a range of mental health strategies that are in place in local authorities.

To ensure that the mental health strategy, which covers the period from 2017 to 2027, is delivering for people, it would be beneficial to know when each action should be implemented. Why are very few timescales attached to the actions that are set out in the strategy?

As Mary Fee rightly said, the strategy covers a 10-year period. Some actions have already been implemented. The Scottish Government certainly has a timeline for each action, which I use to monitor progress on each action closely. I can provide the member with further details on that, if she wishes.

Antidepressants (Overuse)

To ask the Scottish Government what its position is on concerns regarding the overuse of antidepressants. (S5O-02067)

People who experience mental ill health should expect the same standard of care as people with physical illnesses, and they should receive medication if they need it. The prescription of any medication, including antidepressants, is a clinical decision that is made in discussion with the patient, and there is good evidence that health professionals assess and treat depression appropriately.

In addition, we are committed to improving access to alternatives, such as psychological therapies, that increase choice and best accommodate patient preference. The Scottish Government supports the breathing space and NHS living life services that are provided to people who experience depression. That work is a key element of wider work across Scotland to intervene early and to prevent problems from becoming worse, and it aligns well with our policy of improving prevention and intervening early, which is one area of focus for our new 10-year mental health strategy.

The number of children under 18 being prescribed antidepressants doubled from 2,748 in 2009-10 to 5,572 in 2016. Although that might reflect an increase in the demand for child and adolescent mental health services, it potentially highlights a worrying reliance on pharmacological solutions to mental health problems. Does the Scottish Government agree that 10-minute general practitioner appointments, combined with a lack of appropriate mental health services, is leading to overdependence on pharmacological solutions that is having a devastating impact on countless lives across Scotland?

As I said in my first answer, the prescription of antidepressants is a clinical decision. It is not for Government to intervene in such decisions. However, I also said that it is important to have alternative therapies and quick responses for people, including young people, who have mental health problems. That is why, in the shift to placing more emphasis on primary care, we are ensuring that counsellors are available early, instead of young people having to wait longer on CAMHS. However, I am also ensuring that those services are moving towards meeting their waiting time targets.

Sport (Support for Participation in Renfrewshire South)

To ask the Scottish Government how it supports participation in sport in the Renfrewshire South constituency. (S5O-02068)

The Scottish Government remains committed to encouraging more people to take part in sport and physical activity at all levels. Sportscotland invests directly in East Renfrewshire Council and Renfrewshire Council, which cover the parliamentary constituency of Renfrewshire South, to support a number of programmes and outcomes in school sport, club sport and coaching and volunteering. For example, in 2016-17, there were 412,180 visits to active schools activities across East Renfrewshire and Renfrewshire and there are now 11 community sports hubs up and running.

Barrhead Youth Football Club has recently increased and expanded the number of its girls teams at various age levels, which I know are already hugely popular. Will the minister join me in congratulating Barrhead YFC on its fantastic work and can she outline how the Government supports opportunities for girls and women to participate in football?

Absolutely. I join the member in congratulating Barrhead YFC on its work and I congratulate all those involved in the work that is going on in football the length and breadth of the country. We had the opportunity a couple of weeks ago to celebrate in the Parliament some of that good work and recognise the effort that is being made to ensure that women and girls get the chance to participate in the beautiful game. The Twitter hashtag that is used for that is #OurGirlsOurGame, and anyone who looks at the Twitter world will see exactly how much fantastic work is being done, driven by volunteers and supported by the Scottish Football Association and others, to ensure that girls get the opportunity to play football.

Is the minister working on delivering a physical literacy pathway that goes from pre-school physical activity into school physical education and then on into the third sector and communities, so that we can ensure that opportunities to access sport and physical activity are as easy as they can be?

We are working on a physical activity plan for all ages and stages and ensuring that all efforts and policies for those ages and stages are linked appropriately with the work that we are taking forward. For example, the on-going work on play makes a very good link with the work that we want to take forward to ensure that young people in particular get the co-ordination skills and the fine motor and gross motor skills that they require to enable them to continue to be active or to proceed into participation in sport at all levels. We hope that some might be on a podium, as the member was a few years ago.

NHS Greater Glasgow and Clyde (Meetings)

To ask the Scottish Government when it will next meet NHS Greater Glasgow and Clyde. (S5O-02069)

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

There is a campaign in my constituency to have an out-patient chemotherapy service at Stobhill hospital, as was originally planned when the new hospital opened in 2010. Does the cabinet secretary agree that that service should be available, where appropriate, closer to home in order to avoid patients having to make tiring journeys before and after treatment?

I am familiar with the campaign and I have, over the years, met some of the campaigners. However, I understand that the expert clinical view is that local people are best served by receiving treatment at the specialist Beatson oncology centre in Glasgow. That said, I know that the health board has assured local campaigners that it will keep the service under review and consider what other local provision would be possible and appropriate.

Multiparametric Magnetic Resonance Imaging Scans (Prostate Biopsies)

To ask the Scottish Government what plans it has to ensure that all eligible men receive an mpMRI scan before a prostate biopsy. (S5O-02070)

Multiparametric magnetic resonance imaging scans are currently being trialled to examine their feasibility and safety as a diagnostic tool in men with prostatic disease. The initial results of the study indicate that MRI could be used as a diagnostic tool in the future, and that it might in time decrease the need for traditional prostate biopsies. Our national advisory groups, such as the national cancer clinical services group, will keep such studies in mind when they are developing future cancer services in Scotland.

In December 2016, the cabinet secretary announced the formation of a urology cancer services review, in recognition of the fact that prostate cancer is the most common cancer among men and will be the most common cancer in the country by 2030. That review has not yet reported back. In September 2017, the cabinet secretary also created the ministerial cancer performance delivery group, but it will not report back until the urology service review has reported. When will the urology services review report back and will the scope of the review cover the adoption of mpMRI?

I will write to Mark Griffin with an update on the timeline for the urology services review, as he has asked me to do. It is very important that we get urology right in Scotland, especially given that urology services are experiencing the greatest difficulties in recruiting staff—that is currently one of the challenges that we face in delivering on our cancer targets. I will get back to Mark Griffin with a timeframe for the services review.

As I said in my first answer, a study is under way to ensure that we gain the relevant clinical evidence on mpMRI. We would rely on groups such as the national cancer clinical services group to advise us on whether it should be rolled out. Again, I am happy to keep Mark Griffin updated as further information comes forward.

Out-of-hours Dental Care

To ask the Scottish Government what action it is taking to ensure that all national health service boards provide out-of-hours dental care. (S5O-02071)

The responsibility for ensuring access to out-of-hours emergency care for patients who are registered with a dentist under the NHS rests with their dentist. The Scottish Government has provided additional funding to NHS boards to put in place out-of-hours services, with appointments being triaged by NHS 24 in line with national clinical guidance. The specific arrangements for providing any required out-of-hours care for patients who have been triaged are for the relevant NHS board to make, in conjunction with practitioners who have a responsibility to their patients.

I represent a rural constituency, and many of my constituents understand the need for some travel to reach health appointments. However, a constituent of mine was told two weeks ago that the only available out-of-hours dental care was at a centre that would require him to make a 110-mile round trip. Will the cabinet secretary ensure that out-of-hours dental care can be made available without requiring people to make such a lengthy journey?

I am aware that NHS Grampian is conducting a review of its out-of-hours dental care. No decision has been made at this stage, but the board is currently looking at how to deliver the most effective service provision for patients, and I will ensure that Alexander Burnett is kept informed of the outcome of those discussions.

I call Tavish Scott to ask question 16. Mr Scott, you have managed it this time—you are very patient.

National Health Service (Regionalisation)

You caught me cold there, Presiding Officer.

To ask the Scottish Government, in light of reported comments by the health secretary regarding co-operation between national health service boards that “there will be a regional structure in place”, whether it will provide further details of this policy, and what the implications are for regional NHS boards. (S5O-02072)

We have been clear that there are no plans to reduce the number of territorial health boards. Our focus is on ensuring better joint working between national health service boards and other partners through more effective regional planning of services. As part of that, three regional implementation leads have been selected from the existing cohort of NHS board chief executives. Working collaboratively with NHS boards and their partners, they are leading the overall design and planning of services at a regional level to provide better patient outcomes and more efficient and sustainable services.

I am grateful for that clarification. Is Shetland NHS Board in the north area that the cabinet secretary described? Is there a regional plan? If so, has that been submitted to the Government? When will it be published?

We have received draft plans from the regions. Over the summer, they will be embarking on public engagement to discuss some of the details in those plans. I hope that Tavish Scott will have the opportunity to attend one of those events.

That concludes portfolio questions, and I am still in a good mood.