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Chamber and committees

Meeting of the Parliament

Meeting date: Wednesday, May 10, 2017


Contents


Portfolio Question Time


Health and Sport


General Practice (Nursing Roles)

To ask the Scottish Government what importance it gives to nursing roles in general practice. (S5O-00949)

The Cabinet Secretary for Health and Sport (Shona Robison)

General practice nurses are essential to the future of primary care and general practice services. That is why the Scottish Government has committed to investing £2 million for additional training to enhance their skills, so that they are better equipped to meet the needs of patients with multiple health conditions, making it easier for patients to access the right person at the right time.

Linda Fabiani

I am pleased to hear that the Scottish Government wants nurses to have an enhanced role in general practice. How does the cabinet secretary intend to make sure that health boards and GP practices take that on board and recognise the worth of practice nurses?

Shona Robison

General practice nurses are essential to the future of general practice and, in particular, to the new model of multidisciplinary team working. We are confident that the new model will recognise the role of the general practice nurse. The on-going contract negotiations are key to the delivery of that.

The £2 million that will be invested in additional training will make sure that general practice nurses can contribute even more than they do already—they contribute a lot to general practice settings and primary care more generally—which will free up time for doctors to spend with patients who need their skill set and ensure that the patient sees the right person in the practice.

A short-life working group that has been instigated jointly by the primary care directorate and the chief nursing officer directorate has commenced its work to refresh the role and educational requirements of general practice nurses. I am confident that GP nurses will continue to play an enhanced role and that they will contribute even more than they do already in general practice settings.

Donald Cameron (Highlands and Islands) (Con)

We welcome the additional investment to upskill general practice staff such as practice nurses. However, what is the Government’s response to yesterday’s call from the Royal College of General Practitioners for the £500 million that the First Minister promised general practitioners and health centres last October to be

“clearly outlined for the GP service ”,

rather than primary care in general, so that all those who work in general practice, including practice nurses, benefit from it?

Shona Robison

We have made it clear that £500 million more will go to primary care by 2020-21, of which £250 million will go directly to general practice. That has been discussed with the British Medical Association and the RCGP, with which I have had meetings. The BMA in particular recognised in negotiations on the new contract that meeting the needs of the population cannot all be put on the shoulders of GPs and that we need multidisciplinary teams. In investing that £500 million, we recognise that, as well as general practice nurses, we need community-based paramedics, allied health professionals, pharmacists, mental health workers and others, all of whom will form such multidisciplinary teams. I hope that few, if any, members would disagree with that principle. There will be a big shift of resource to primary care, which I thought would be welcomed across the chamber.

Anas Sarwar (Glasgow) (Lab)

I welcome the new investment that will go into primary care and what the cabinet secretary said about nursing roles in primary care, particularly as we head towards being 830 GPs short in primary care by 2020. Two key elements to making that investment work will be the GP contract and the workforce plan. What role will other healthcare professionals have in the GP contract process and when will the cabinet secretary publish a detailed workforce plan?

Shona Robison

As I said, the workforce plan is on schedule to be published in late spring—so, imminently, in the next few weeks. That has been a big undertaking, with massive amounts of consultation across many sectors and staffing groups.

As Anas Sarwar will be aware, the GP contract is negotiated between the Scottish Government and the BMA. Once that contract has been negotiated, its details will be released. However, it would be inappropriate for us to do that while the negotiations are on-going. Once they are concluded, I will ensure that Parliament is informed of their outcome.


Overweight and Obesity

To ask the Scottish Government what steps it is taking in light of reports that 65 per cent of adults in Scotland are either overweight or obese. (S5O-00950)

The Minister for Public Health and Sport (Aileen Campbell)

We remain committed to addressing Scotland’s excess weight and, in line with the evidence, we are maintaining activity across the whole of society that makes it easier for people to be more active, to eat less and to eat better. For example, we have invested £12 million over five years to 2017 on a range of programmes to support and encourage healthy eating. This year, we are providing councils with a further £53.9 million of revenue funding for free school meals. We have also exceeded our target of delivering 150 community sports hubs across all local authorities by 2016. In addition, sportscotland has announced a further £6 million investment to create a total of 200 hubs by 2020.

John Scott

Will the minister consider the impact of price promotions on obesity, as Cancer Research UK asserts that 40 per cent of all calories are bought on price promotions? Food and drink products that are high in fat, sugar and salt content are seriously damaging the health of the people of Scotland in many different ways. Can she tell us how she might address those concerns, particularly in relation to extremely high calorie intake as a result of price promotions?

Aileen Campbell

Cancer Research UK has pointed to price promotions as an area that we need to take action on, and there will be opportunities to delve deeply into that issue and a range of others as we develop the obesity strategy and the consultation to go with it in the imminent future. We will continue to engage with Cancer Research UK on this issue. Some of the evidence that it is compiling is very helpful in enabling us to understand just how big an issue this is for Scotland to deal with and to understand the challenges that we face. The issue of price promotions with regard to the availability of, the access to and the affordability of foods that are high in fat, sugar and salt is one that we need to examine. Nothing should be off the table as we approach the new strategy, and I look forward to working with the member on the consultation.

Does the minister share my disappointment that the United Kingdom Government did not take the opportunity to introduce further restrictions on junk food advertising in its action plan on childhood obesity?

Aileen Campbell

I absolutely share the member’s disappointment in that regard, and I think that that aligns itself with the disappointment that Cancer Research UK expressed in relation to the points that John Scott raised.

We have long argued that a ban up to the 9 pm watershed would greatly reduce children’s exposure to the marketing of unhealthy foods. That is not just my point of view; the measure is backed up by recommendations from Public Health England and Food Standards Scotland, has the backing of the Welsh and Northern Irish Governments and has a huge amount of support across our third sector. I again reiterate the strong lines of argument that Cancer Research UK has taken on this issue and hope that, beyond the election, there will be a change of heart.

Colin Smyth (South Scotland) (Lab)

The minister will be aware that, as well as two thirds of adults being overweight or obese, almost a third of children in Scotland are, too. Does she recognise that the current prevention of obesity route map is not working? Further, given that the utterly inadequate child obesity strategy that was recently published by the UK Government, which we have just heard about, is also failing, will she give a commitment that the new strategy will accept and recognise that the causes and consequences of obesity are not borne equally among Scotland’s population, that there is a disproportionate impact on those from deprived areas and that, if we want to tackle this particular health inequality, we also need to tackle wealth inequality in Scotland?

Aileen Campbell

I absolutely recognise that there is a disproportionate impact on the most vulnerable communities and that they stand to gain the most if we take collective, bold action to tackle the issues around obesity. That is why we are introducing a new strategy, starting with the consultation that will be launched soon. We will take on board all the issues that have been raised—not just by the member, who has taken a keen interest in the subject and is continually raising those issues, but by members across the chamber and by partners such as third sector organisations—to make sure that we get this right.

We have a challenge here that we need to face. Obesity costs our national health service and the public purse money, but its impact on people’s lives is also costly. Those who are most impacted are, as Colin Smyth articulates, those who are in the most vulnerable communities. We have to bring communities with us because, if we do something about price promotions, that may have an impact on those with the least money to spare. We have to make sure that nothing is off the table in the consultation and work together to make sure that we get the impact that is required, which is a downward trend in obesity levels in our country.


Health Inequalities

To ask the Scottish Government what action it is taking to address health inequalities. (S5O-00951)

The Minister for Public Health and Sport (Aileen Campbell)

Reducing health inequalities is one of the biggest challenges that we face. They are a symptom of wider income inequalities—inequalities that are exacerbated by policies of austerity and welfare reform. We are taking action, focusing on addressing the underlying causes—ending poverty, promoting fair wages, supporting families, and improving our physical and social environments.

Gillian Martin

I thank the minister for that answer. The minister notes that health inequalities are firmly linked to income inequalities. Can the minister give an analysis of the potential knock-on effect on the national health service that a predicted 10 per cent increase in child poverty, as a result of the UK Government’s two-child policy, will have?

Aileen Campbell

I reiterate that the United Kingdom Government’s welfare cuts are unfair and are having a hugely damaging and disproportionate impact on women. By 2021, around 50,000 households in Scotland will be affected by the two-child cap, reducing spending in Scotland by around £120 million.

The Conservatives here often ask us to do more on a number of different issues. Perhaps they also need to ask their UK Government colleagues to stop this gross unfairness. The Institute for Fiscal Studies estimates that a three-child family will lose, on average, £2,500 per year, while families with four children will lose £7,000 per year; 4 million families right across the UK will see entitlements fall.

Reducing support to low-income families will push people further into poverty, which impacts negatively on health and causes pressure on other public services. I think that 4 million families impacted by harsh Tory cuts give us 4 million reasons why we should not be voting Tory in June.

Miles Briggs (Lothian) (Con)

Has the minister studied the new “Surviving or Thriving?” report that was published this week by the Mental Health Foundation? It highlights severe inequalities within mental ill health in Scotland. What specific additional action is the Scottish Government taking to reduce health inequalities among people suffering from mental health challenges and illnesses?

Aileen Campbell

I thank Miles Briggs for raising that issue. He talks about inequalities quite often in the chamber—again, I think that he should also be making those points to his UK Government colleagues, who are the source of some of those inequalities and have the power within themselves to try to reverse some of them.

The member will have been in the chamber when my colleague Maureen Watt set out our new 10-year mental health strategy, which looks at the impact of inequalities and has a range of actions that will help to reduce inequalities and some of the detrimental impacts that they have on mental health.

I reiterate that it takes a bit of brass neck for the Conservatives to continually come here and talk about inequalities when they themselves have been the cause of much of the social inequality in this country.

Neil Findlay (Lothian) (Lab)

Does the minister agree that income inequality is at the heart of health inequality and that one of the key ways of addressing that is through the tax system? Why will the Government not introduce a progressive tax system?

Aileen Campbell

We have taken a number of measures within the powers that we have to make sure that we can reduce inequalities. We are taking a number of measures around the living wage and we have introduced plans around our tax system as well.

We also continually mitigate the worst impacts of welfare reform, so we are implementing a number of measures, within the powers that we have and the budget that we have been given, to ensure that we can create the fairer society that we all seek. It seems a pity that, at times, Neil Findlay ignores those measures and continues to carp from the sidelines.


Sport (Participation)

To ask the Scottish Government what it is doing to encourage participation in sport. (S5O-00952)

The Minister for Public Health and Sport (Aileen Campbell)

The active Scotland outcomes framework sets out our ambitions for a more active Scotland and is underpinned by a commitment to equality. We want to ensure that people of all ages from all communities across Scotland have the opportunity to participate in sport and physical activity. That is reflected in our investment in programmes such as active schools, to provide more sport and physical activity opportunities for young people, and in our investment in facilities, including community sports hubs, of which there are currently 157 across Scotland, and that number will increase to 200 by 2020. I am also delighted that, following a total investment of £12 million, the superb facilities at the United Kingdom’s first ever parasports centre at Inverclyde are now open.

Dean Lockhart

Despite increasing levels of child and adult obesity in Scotland, the budget for sports has been cut significantly over the past two years, even after taking into account the funding mentioned by the minister. Can she therefore explain how cutting the budget for sports, including budgets for grass-roots sports clubs, will help to tackle the increasing health problems associated with obesity and related challenges?

Aileen Campbell

I announced in April an additional £2 million investment in sports governing bodies, which will be redistributed by sportscotland to help offset the reduced revenue from the national lottery. I have also written to the UK Government about the issues that continually represent themselves because of the reduction in national lottery funding, and I look forward to getting the member’s support in asking his colleagues to do what they can to reverse the national lottery challenges that our sporting bodies face.

Since this Government took office, we have seen an increase in investment in our infrastructure. We have some of the best sports infrastructure in the country and we have invested heavily to ensure that young people get opportunities. We have fundamentally restructured the way in which physical education is taught in our schools, and around 98 per cent of our children now reach the two-hour PE—[Interruption.]

Again, I can hear members carping from the sidelines. The Government has made a significant investment to improve the infrastructure of our sporting arenas across the country. We have increased the number of children who are taking part in two hours or more of PE per week in every school. We have just opened a new parasports centre in Inverclyde and we have hosted one of the best ever Commonwealth games in Glasgow. Our commitment to sport is strong, and we want all our young people to have the opportunities that they deserve. However, the barriers to children’s opportunities and life chances are exacerbated by inequalities, and I reiterate that the Conservatives need to look a little closer to home on where inequalities are being manifested.

Question 5 has not been lodged.


Sports and Leisure Facilities (Grangemouth Area)

To ask the Scottish Government what health guidance is given to the operators of sports and leisure facilities that are close to the Grangemouth chemical complex. (S5O-00954)

The Minister for Public Health and Sport (Aileen Campbell)

There are strict arrangements in place to ensure that the Grangemouth chemical complex operates safely and that, if something goes wrong, the health and safety of the public are protected. Those arrangements include a community warning system in the event of an incident at the complex, to enable people living and working in nearby areas to be alerted quickly. The community warning system is tested twice a year. Falkirk Council provides regular local guidance on what people should do when the community warning system is triggered. That advice, which applies to sports and leisure facilities, is to go in, stay in and tune in—that is, to go indoors, close doors and windows, and wait for further instruction.

Alison Harris

During the recent incident at Ineos in Grangemouth, provision was made for pupils at primary and secondary schools to be kept indoors, but users of the outdoor sports pitches continued to use the facilities. In view of the number of people who use them, will the Scottish Government undertake to review the guidance given to the operators of those facilities?

Aileen Campbell

The member raises a good point. On 2 May, there was an incident at Grangemouth, where a limited number of staff were evacuated from the site following a gas leak. The incident centred on the Kinneil gas plant and involved the release of gases there.

The local incident management plan was activated and local cordons and road closures were put in place to ensure public safety. However, the member makes good points. I am happy to continue dialogue with her on the issue and I reassure her that a multi-agency debrief of the incident will be held on Wednesday 17 May, which will examine the events and ensure that any learning points are captured in order to refine and improve the off-site plan and arrangements. The Scottish Government resilience division is leading the debrief process. I will keep the member updated regarding the outcomes from that meeting.


Mental Health Services (NHS Forth Valley)

To ask the Scottish Government what action is being taken to improve mental health services in the NHS Forth Valley area. (S5O-00955)

The Minister for Mental Health (Maureen Watt)

We have published a new 10-year strategy for mental health in Scotland. The new strategy contains 40 actions, including those that commit to funding improved provision of services to treat child and adolescent mental health problems and funding work to improve provision of psychological therapy services and to help meet set treatment targets.

As part of those actions, we have announced a £54 million comprehensive package of support to improve access to child and adolescent mental health services and to psychological therapies. Within that, we have established an improvement team in Healthcare Improvement Scotland to work on improving access to mental health services, and NHS Forth Valley is one of the first boards to work with the improvement team. Working with the board, a new service model has been introduced in Forth Valley and we have seen substantial improvements in CAMHS waits. NHS Forth Valley is to be congratulated on attaining the target, having recorded the lowest rate of performance across Scotland at this time last year.

Bruce Crawford

I recognise the improvements that have been made. However, can the minister tell me what the current waiting times are for child and adolescent mental health services in the Forth Valley area? I have constituents who continue to be concerned about the length of time that it is taking for their children to access such services. What specific action has already been taken, and what more could be done to improve access to CAMHS in the Forth Valley area?

Maureen Watt

The latest published figures, which are for quarter 4 of 2016, show that Forth Valley’s performance against the standard improved across the second half of 2016, with 94.8 per cent of people treated in CAMHS being seen within 18 weeks. That compares with the figure a year ago of 34 per cent of people receiving treatment in CAMHS within the 18 week standard.

In response to Bruce Crawford’s constituents’ concerns, he might wish to know that yesterday I met parents from the CAMHS Forth Valley parent voices group. I welcomed the opportunity to hear their experiences of CAMHS and to discuss the work that we are supporting through investment and the new mental health strategy to improve the standard of care from CAMHS, including the quality and continuity of service.

At board level, the new service model has been introduced in NHS Forth Valley. The new model looks to address delays that are identified in the system as well as undertaking staff recruitment and working on the longer waits. I understand that the board has established a parent forum to increase engagement with local families, and that it will meet for the first time at the end of this month. That is precisely what the Government wishes to see—patient involvement and participation in designing services.

Monica Lennon (Central Scotland) (Lab)

Bruce Crawford has raised an important issue. I met with the founder of the CAMHS Forth Valley parent voices group, Katie Sneddon, and other parents yesterday, after their meeting with the minister. As the newspapers have reported today, they were in tears as they shared their stories. It was heartbreaking to listen to the individual challenges that they have had to face in trying to get the support that they desperately need for their children.

I welcome the fact that some progress has been made, but it is not simply about waiting times. The Scottish Government has committed to looking at rejected referrals, and I look forward to hearing more of the details on that. However, will the minister provide an update on her response to the group’s call for a full audit and review of CAMHS in Forth Valley and say whether she will consider that?

Maureen Watt

As I said, yesterday I met parents and listened to their stories, most of which are historic and pre-2007. As a result of what we have in the new mental health strategy and what has been done so far, we are seeing excellent progress on waiting times in NHS Forth Valley. Rather than having a full-blown audit of what is happening, I would prefer to get on with doing the job and ensuring that what is required is put in place. That is precisely what we are doing in NHS Forth Valley and, with the new mental health strategy, what we are doing across the country.

Dean Lockhart (Mid Scotland and Fife) (Con)

Despite the hard work of its dedicated staff, NHS Forth Valley continues to suffer from a lack of resource, which left more than 300 people waiting more than four months for treatment. When will NHS Forth Valley be in the position to meet Government targets in this area?

Maureen Watt

As I mentioned in my previous answers, NHS Forth Valley is now meeting its waiting time targets. Of course, this Government was the first to introduce waiting time targets.

The Scottish Government allocation for building capacity in NHS Forth Valley was £233,409 in 2016-17, rising to £369,112 in 2017-18. That money is being used to reduce pressure on core CAMHS services, to increase provision of early intervention, education and community services, and to support group work, with a focus on tier 2 and 3 capacity. It is also being used to fund clinical posts in older people’s services, the MSc in applied psychology in primary care, and early psychological intervention practice support: a range of measures to ensure that NHS Forth Valley meets its targets.


Organ and Tissue Donation (Consultation)

To ask the Scottish Government whether it will provide an update on progress with the analysis of responses to its recent consultation on organ and tissue donation and transplantation. (S5O-00956)

The consultation responses are being independently analysed and we expect to receive the analysis very soon. We will carefully consider the analysis before setting out our next steps in the coming months.

Bob Doris

I helped to scrutinise evidence at stage 1 of the bill that contained the previous proposal for an opt-out organ donation system. Our committee recommended additional specialist nurses, consultants and intensive care beds, irrespective of whether any opt-out system was to be introduced. I voted against the bill, not out of principle but because of the weaknesses in it. What consideration has the Scottish Government given to the recommendation that I referred to and how has it addressed any weaknesses in that bill?

Aileen Campbell

Through the programme of work to increase donation rates as part of “A Donation and Transplantation Plan For Scotland 2013-2020”, the Scottish Government has provided funding to appoint seven additional specialist nurses for organ donation and funding for a dedicated regional manager from NHS Blood and Transplant to work full time in Scotland. There are currently 22 full-time equivalent nurses. Appointing more would dilute expertise in approaching families and obtaining authorisation and would not necessarily lead to a rise in donation rates.

A review by the clinical leads for organ donation across Scotland resulted in resources being targeted in specific areas where it was felt that they could make a real difference, such as ethnic minority groups and rural areas. In addition, resources have been moved to where donation potential is greatest.

In 2015, National Services Division published “Commissioning Transplantation to 2020”, which looked at capacity in the NHS and did not highlight intensive care capacity as an issue.

We have a positive story. Although the bill did not pass stage 1, a huge amount of work has gone into ensuring that we can increase rates of donation. We have a good story to tell, and considerable work has been done. I can continue to keep in touch with Bob Doris on the next steps following the consultation analysis.


Public Health (Noise Pollution)

To ask the Scottish Government what action it is taking to address the effects of noise pollution on public health. (S5O-00957)

The Minister for Public Health and Sport (Aileen Campbell)

Through Scotland’s implementation of the European Commission environmental noise directive—directive 2002/49/EC—noise mapping and associated action plans have been put in place to help manage environmental noise. The strategic noise maps are currently being updated by Jacobs, which is an expert in this field, and are due for publication this summer. They will inform the implementation of the next set of action plans, which could include action in areas such as traffic and transport policies, technological innovation and public awareness raising.

Mark Ruskell

The minister will be aware that noise is the second largest environmental cause of ill health after air pollution. A United Kingdom study last year showed that exposure to noise above recommended levels resulted in an additional 1,169 cases of dementia, 788 cases of stroke and 542 cases of heart attack in a single year. Given that evidence, why was Edinburgh airport recently allowed to carry out a consultation into new flight paths, which will expose nearby communities to levels of up to 80 decibels, without completing a full health impact study?

Aileen Campbell

I will look into the issues that the member has raised. He is right to point out the impact that noise can have on people’s health, which is why the directive recognises that noise pollution is one of the main environmental problems in Europe and that a framework for noise management is necessary.

I will continue to keep the member updated on the mapping work, which includes planning exercises for the four agglomerations, including Edinburgh. That work is multidisciplinary and requires input from a range of local authority staff and other key stakeholders. It is proposed that the working groups for each area will be tasked with delivering the content of the action plans and the Scottish Government will take responsibility for finalising and submitting completed plans. I think that the member will be particularly interested in the plan for Edinburgh, which will include the communities around the airport.

It is clear that noise and air pollution are becoming a systemic problem in Scotland. Will the minister back my colleague Maurice Golden’s campaign to increase the number of air quality monitors in Scotland?

Aileen Campbell

Again, I will keep the member updated on how the mapping exercise is progressing and I will certainly take a good look at the work that his colleague is taking forward.

As Mark Ruskell said, environmental noise is an important issue and it has an impact on health. That is why we need to ensure that we have the right procedures, people and resources in place to ensure enforcement, and that we recognise the impact that environmental noise can have on our communities.

Noise is one of the main environmental problems in Europe, which is why the directive is so important and a framework for noise management is necessary. Even though environmental standards are a European Union requirement, the Scottish Government will continue to maintain, protect and enhance them post-Brexit.

Question 10 has not been lodged.


General Practice

To ask the Scottish Government what support it is providing to general practice. (S5O-00959)

The Cabinet Secretary for Health and Sport (Shona Robison)

In October 2016, the First Minister made clear the scale of our ambition in shifting the focus of health investment from acute care to primary and community care with an increase in overall annual funding for primary care of £500 million by 2021.

Although the full £500 million to be invested in primary care should benefit general practice, Scottish Government investment in direct support of general practice will reach an additional £250 million per year by 2021. There will be year-on-year increased investment between now and then, and the investment has already started. In 2016-17, investment in direct support of general practice was £60 million, which will increase to £71 million in 2017-18.

What support will be provided to practice staff in Edinburgh in particular?

Shona Robison

I am aware that the member has an interest in the issues surrounding Inverleith medical practice in his constituency. The retention of the practice staff team in the national health service was one of the key considerations for NHS Lothian—the member has spoken to me about that on a number of occasions. All the staff have found positions in several other general practitioner practices in the NHS—we actively promoted that.

More widely, the Edinburgh health and social care partnership is using the Scottish Governments primary care transformation fund to develop a programme of support for practices and staff facing challenges.

Brian Whittle (South Scotland) (Con)

The cabinet secretary will be aware that GPs in the practice that runs surgeries in Fenwick, Crosshouse and Kilmaurs have recently had to resign from the practice. The area will potentially lose five GPs, with a further six potentially being lost through imminent retirement. On top of that, as of two weeks ago, there were already 15 vacant places in Ayrshire and Arran. What comfort can the cabinet secretary give those GPs who have had to resign from their practices or who are in danger of doing so?

Shona Robison

As I have said in the chamber on a number of occasions, short and medium-term support is available through health boards to help address some of the recruitment and retention challenges in the here and now. The solution that will help to transform the position of general practice and primary care in Scotland is based around the new contract and the new model for primary care, which will benefit GPs in Ayrshire and Arran and elsewhere in Scotland.

Brian Whittle and Donald Cameron, who raised issues about GPs earlier, are less keen to talk about and quote the Royal College of General Practitioners’ concerns, which it expressed today, that if the 226 GPs from other European Union countries who are working in Scotland have to leave following Brexit, the consequences for patient safety could be grave. We do not hear the Tories quoting the RCGP on that; I wonder why.


Public Health (Cycling)

To ask the Scottish Government what action it is taking to improve public health through cycling. (S5O-00960)

The Minister for Public Health and Sport (Aileen Campbell)

We know that cycling has physical and mental health benefits and plays a big part in health improvement. Over the period 2014 to 2017, sportscotland has invested almost £2.6 million in Scottish Cycling, the governing body for the sport in Scotland. In addition, through Transport Scotland, we have increased investment in active travel by more than 83 per cent compared with investment in 2013-14, and have pledged to match record levels of investment during the current parliamentary session. All cycling organisations are working together to consider what more can be done, at the national and local levels, to get people active through cycling.

I thank the minister for that answer. Does the Scottish Government agree with the eight calls set out in pedal on Parliament’s manifesto? If not, which ones does it not agree with?

Aileen Campbell

We will continue to work with all our partners on what we can do to improve the accessibility and safety of cycling at the local and national levels. We have invested heavily in making sure that cycling is more accessible. We have invested through legacy programmes. The one that Gordon Lindhurst, as a Lothians MSP, might be interested in is the recently opened Skelf bike park in Edinburgh, which got grant funding through the legacy 2014 project, allowing people who might not ordinarily have had access to cycling to use the cycle route there free of charge for many years to come.

Along with our partners, we have invested a total of approximately £138 million in cycling facilities since 2007 and we have increased the number of cycle paths and walking lanes. We will continue to listen to all calls on what more we can do to increase cycling participation levels at the local and national levels. We will also work with pedal on Parliament to identify areas on which we can work together to make improvements for Scotland.

What impact does the Scottish Government envisage that the decision to leave the European Union will have on funding for the future of active travel hubs across Scotland?

Aileen Campbell

We have pledged to match record levels of investment in active travel during this parliamentary session. Transport Scotland, as lead partner, has secured investment of up to £8 million from the European regional development fund 2014 to 2020 programme to support the development of low-carbon travel and transport hubs until December next year.

In June, Transport Scotland will publish details of projects that have been successful under the initial low-carbon travel and transport challenge fund round. All ERDF contracts entered into before the United Kingdom leaves the EU will be guaranteed, even when the payments continue beyond the EU exit point. However, there is no clarity on replacement funding arrangements for those schemes once the UK has left the EU. The Scottish Government will negotiate with the UK Government to ensure that future financial support for the range of initiatives that are currently supported by EU funds is allocated fairly and equitably across the UK post-Brexit.

The member is right to recognise that, in all areas of life, the mess that the UK Government has got us into with Brexit and its lack of clarity and engagement will impact on many issues in local communities, including cycling. We will continue to negotiate, and we will make the case to ensure that Scotland gets a fair deal in the negotiations.


Minor Injuries Units

To ask the Scottish Government what its policy is on the provision of minor injuries units in communities. (S5O-00961)

The Cabinet Secretary for Health and Sport (Shona Robison)

The planning and provision of local services is the responsibility of national health service boards. Planning should take account of local needs, to ensure that demands are met and patient care is delivered in an optimal way.

Pauline McNeill

The west Glasgow minor injuries unit treats adults and children over five. On 13 December, NHS Greater Glasgow and Clyde announced that the service would temporarily move to the Queen Elizabeth university hospital.

I am sure that the cabinet secretary agrees that minor injuries units are an important service that prevents patients from turning up at accident and emergency services and thereby reduces pressure on A and E.

People who live in the west of Glasgow would like an assurance that their service will return, given that the move was a temporary measure. It is important that minor injuries units are local services. Does the cabinet secretary think that the people of the west of Glasgow should have their minor injuries unit returned to them, as promised?

Shona Robison

I agree with Pauline McNeill that minor injuries units are an important service that, as she said, can reduce pressure on A and E departments and provide ease of access for patients.

As I am sure that Pauline McNeill is aware, the Yorkhill unit was always an interim step, as part of the migration of services in Glasgow in recent years. It is right that the board should take the time properly to consider where the new west Glasgow service should be located. Pauline McNeill will understand some of the challenges with the Yorkhill site, which I think were partly the reason for low attendance—the site was not easy to access.

I hope that Pauline McNeill will welcome that there has been an assurance—not least from the chair of the board to me, directly—that there will be a west Glasgow minor injuries unit. It is right that the board look at other locations, one of which is the Gartnavel site—I am sure that the member understands that there are advantages to that site in terms of co-location with other services. I encourage her to engage with the board directly. There is no question whether there should be a west Glasgow minor injuries unit—there will be one; the question is where that is best located.