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Chamber and committees

Meeting date: Thursday, November 10, 2016

Meeting of the Parliament 10 November 2016

Agenda: General Question Time, First Minister’s Question Time, Accessible Hospital Transport, Scottish Parliamentary Corporate Body Question Time, Climate Change Action, Science, Technology, Engineering and Mathematics Education and Training Strategy, Decision Time


General Question Time

Study of Medicine

To ask the Scottish Government what action it is taking to encourage school pupils to study medicine at university. (S5O-00322)

Our education system aims to provide young people with experiences and with careers information, advice and guidance to raise awareness of opportunities and support informed choices. In addition, targeted schools programmes have been developed to encourage and support young people into careers in health and medicine in particular.

I declare an interest, as I have a number of family members who are studying medicine. I am sure that we all agree that the training that they get at university is very good, but figures that the Universities and Colleges Admissions Service recently published showed a decline in the number of Scottish students applying for medicine courses by the October deadline for applications to such courses. Most worryingly, the figure has dropped by 11 per cent since 2013. Given the general practitioner crisis in all parts of Scotland, particularly Edinburgh and the Lothians, it is surely concerning that there will be fewer Scottish medical graduates in the future.

The setting of medical student places is based on the workforce planning needs of NHS Scotland. Although the Scottish Government sets the annual intake into medicine, the selection and recruitment of the individual students who are admitted to study medicine is a matter for individual universities. As a result, the exact number of Scotland-domiciled students varies slightly from year to year.

The evidence suggests that Scotland-domiciled students are more likely to stay and work in NHS Scotland. For that reason, we are taking measures to increase their numbers. We have increased the number of undergraduate medical school places by 50 from this year, with those places focusing on the widening access criteria. The Scottish graduate entry medical programme—ScotGEM—will add another 40 places from 2018 and will have a focus on general practice and rurality.

Royal Alexandra Hospital and Inverclyde Royal Hospital

To ask the Scottish Government what recent discussions it has had with NHS Greater Glasgow and Clyde regarding plans to close the children’s ward at the Royal Alexandra hospital and the birthing unit at Inverclyde royal hospital. (S5O-00323)

Ministers and Government officials regularly discuss matters of local importance with health boards. As I confirmed in my statement to the Parliament on 2 November, NHS Greater Glasgow and Clyde decided at its October board meeting to designate the paediatric proposals as major. As such, they are now subject to formal public consultation and I encourage all local stakeholders to take part. Any final service change proposals will be subject to my approval.

The proposals that affect births at the Inverclyde royal hospital and the Vale of Leven hospital are currently subject to public engagement, which is due to end in early December. The Scottish health council continues to monitor that activity and will, ultimately, offer a view on whether the proposals are major. I will consider that alongside the board’s views and make a final decision on designation. That will inform the board’s consideration of next steps at its meeting on 20 December.

Thousands of people in Renfrewshire and Inverclyde have signed petitions against the closure of the RAH children’s ward and the IRH birthing unit, but the Cabinet Secretary for Health and Sport ignores local people by refusing to offer any reassurance that she will protect the children’s ward or call in the decision on the birthing unit. Shona Robison needs to stop hiding in Edinburgh and start listening in Renfrewshire and Inverclyde. I have asked her before and ask her again on behalf of the many concerned families whether she will visit Renfrewshire and Inverclyde to listen to the public’s views on the future of their local national health service services.

Neil Bibby asked that I should make the final determination on the RAH paediatric service change proposals and I have said that I will do that. Because I have said that, he has now moved on to asking me the same about the Inverclyde royal hospital and I will say the same to him as I said in my initial answer: those are not formal proposals that have been designated as major or otherwise, so the process should be allowed to continue as it was for the RAH.

If we get to a position in which the proposals for the IRH go ahead formally and are designated major—I might decide that they should be designated major in the light of local interests—they will come to me. Perhaps, in the end, all the proposals will come to me, and I hope that Neil Bibby will appreciate and understand that. I have told him what the process is on a number of occasions. Ultimately, those decisions might well be my decisions, and I will make them based on the very clear criterion that the proposals must be in the interests of local patients.

Does the cabinet secretary find it strange, as I do, that the Labour Party in Scotland, which is always talking about local decision making, wants the decision on the IRH and the Vale of Leven hospital to be made at national level rather than at NHS Greater Glasgow and Clyde level? As the cabinet secretary will be aware, there are seven Labour councillors on the board of NHS Greater Glasgow and Clyde; they are the only political representatives on the board.

The actions of the Labour Party are often strange, which is probably why it is sitting in third place in the Scottish Parliament.

As I have said repeatedly in the chamber, there is a well-established process, which we will continue to follow. I am not going to prejudge proposals that are currently the subject of public engagement and consultation, and which might not even emerge as formal proposals and might well change. That is the right way to proceed. Members well understand the process, and that is the process that we will follow.

How will the Scottish Government ensure that all proposed service changes contribute to the Scottish Government’s commitment to shift the balance of care away from acute hospitals and towards primary care?

As the member will be aware, the First Minister made a very important announcement about the funding of primary care—she said that there will be a £500 million investment in primary care over the course of the parliamentary session. That will accelerate a shift in the balance of care from the acute sector to primary care.

I ask members to appreciate that things cannot stay the same. That does not mean that every service change proposal that is put forward is the right one. Each proposal must be tested firmly in the light of what is best for patients. Any member who stands against any change in acute services anywhere will get in the way of that important shift in the balance of care. I hope that no member would do that.

The cabinet secretary will, of course, be aware that only seven members of the board of NHS Greater Glasgow and Clyde are Labour councillors; the other 20 or so are appointed by her. Therefore, Stuart McMillan’s argument was nonsense.

The cabinet secretary has been invited to come to my area to discuss proposals to close the Vale of Leven maternity unit, but she has refused to do so. Given that she has not given any guarantee that she will take the final decision, if it is the case that it is not a major service change, will she visit to explain the decision to my local community?

Yet again, Jackie Baillie is getting ahead of herself. For the record, I have been a regular visitor to the Vale of Leven hospital, which would not be open if it had been left to the previous Administration. It was the Scottish National Party Administration that saved the Vale of Leven hospital. Jackie Baillie does not like to talk about that very often.

I have made clear what the process is. Jackie Baillie and other Labour members continue to try to cut across that process, which is well established. The proposals might not end up being formal proposals or they might change. It is right and proper that any proposal that comes to me is the final proposal that the board has formally put forward.

As I said to Neil Bibby, proposals will often be designated major in the light of local interests, but we have not yet reached that position. Should that decision come to me, I will, of course, deal with it in the same way that I would deal with any decision: I will look at the impact on local patients in the area.

Nordic Baltic Strategy

To ask the Scottish Government what progress it is making with its Nordic Baltic strategy. (S5O-00324)

I refer to my entry in the register of members’ interests, as I am a member of the Norwegian Scottish Association.

Exchanging knowledge and experience with our Nordic and Baltic partners is of great benefit to Scotland, as those countries are recognised as world leaders in many areas of prime importance to the Scottish Government. There is much to be gained in learning from the positive examples that they set.

The Government’s commitment was formalised in 2014 with the publication of the Nordic Baltic policy statement. Since then the Scottish ministers have had a number of engagements with Government representatives of the Nordic and Baltic countries to promote diplomatic, business and cultural ties. I have just returned from a visit to Tallinn in Estonia and, a few weeks ago, the First Minister visited Reykjavik, where she met Icelandic Government representatives, as well as the foreign minister of Finland, on the margins of the Arctic Circle Assembly.

On a practical level, there have been a number of policy exchanges between Scotland and the Nordic and Baltic countries, the most notable being the development of our policy to provide expectant parents with a baby box containing vital items to help them to look after their babies in the earliest days. The policy is based on the tried and tested Finnish model and we have worked closely with Finnish colleagues on its development.

Such policy exchanges have been encouraged and supported by the work of the Nordic horizons group, which the Scottish Government has funded over the past five years and continues to support. The most recent Nordic policy event on 29 October examined the different relationships that the Nordic countries have with the European Union, providing valuable lessons for Scotland as we explore possible options for our own relationship with the EU.

I thank the minister for his detailed reply. It is good to know that such progress has been made. Does the minister agree that, given the turmoil that Brexit is creating, the Scottish Government should be taking every step to further develop and expand our economic, cultural and social links to our cousins in the Nordic region and Baltic states?

I will be briefer in this reply. Yes, we should be encouraging all those bilateral relationships.

Fife Council (Meetings)

To ask the Scottish Government when it last met Fife Council. (S5O-00325)

Ministers and officials regularly meet the leaders and chief executives of all Scottish local authorities, including Fife Council, to discuss a wide range of issues, as part of our commitment to working in partnership with local government to improve outcomes for the people of Scotland.

I was contacted recently by constituents who work as adult services social workers for Fife Council. The company that Fife Council contracts the work out to—Real Life Options—wrote to all its employees nationally last month. The company claims that, despite a number of requests to local authorities, it has not yet received confirmation that any additional funding will be provided to support implementation of the new Scottish living wage. Does the minister think that it is acceptable for Fife Council to get around paying the Scottish living wage to its employees through contracted employers such as Real Life Options?

The Scottish Government is absolutely committed to seeing all adult services care workers being paid the living wage from 1 October 2016. We have provided significant investment to meet that commitment. We provided an extra £250 million this year to support integration of health and social care, out of which the Fife health and social care partnership was allocated £16.83 million. Of that spend, £8.42 million was available to support additional spend on expanding social care to support the objectives of integration, while the other £8.42 million was provided to help to meet the range of costs that are faced by local authorities in delivery of effective high-quality health and social care, and to enable payment of the living wage to care workers who support adults in the independent and third sectors. That commitment allows councils to commission adult social care on the basis that care workers are paid the real living wage, which gives up to 40,000 people—mainly women—who are doing some of the most valuable work in Scotland a very well deserved pay rise.

We have been working closely with health and social care partnerships and providers to make delivery of the commitment successful. Where that has not happened—as is the case with Fife Council, it seems—pay will be backdated to 1 October. That should be done within a reasonable timeframe.

I spoke to the leader of Fife Council this morning. He told me that despite repeated requests to meet the Deputy First Minister and Cabinet Secretary for Education and Skills, the council is finding it difficult even to get a response. Will the minister use his good offices to urge Mr Swinney to respond to Fife Council and to ensure that the council can get a meeting to discuss education issues?

All I can say is that I met the leader of Fife Council recently in Kelty, but that matter was not raised with me. I met the deputy leader of Fife Council only yesterday in Kirkcaldy at the Scottish towns partnership meeting: again, the matter was not raised with me. There are multiple opportunities for the leaders of Fife Council to engage with ministers, so it seems to me to be strange that when I met them they did not raise with me the matter to which Mr Rowley has referred.

Scottish Fire and Rescue Service (Funding)

To ask the Scottish Government what action it is taking to address the reported £42.7 million funding gap in the Scottish Fire and Rescue Service. (S5O-00326)

The challenge of bringing together eight legacy fire services represented one of the biggest public sector reforms in a generation. Audit Scotland confirmed that the fire service reform process had been a success. The Scottish Fire and Rescue Service revenue budget for 2016-17 was protected in cash terms, and that protection supports the range of excellent work that the Scottish Fire and Rescue Service continues to undertake to protect our communities. Audit Scotland also confirmed that the reform process had no adverse effect on the public, and reported savings to the public purse to date put the service on track to exceed expected savings of £328 million by 2027-28.

We were told that the move to a single fire and rescue service would protect front-line outcomes, but we have seen erosion of those outcomes year on year. Surely, it will be the public who will pay the price for that enforced centralisation.

The figure to which the member referred in his first question was, of course, a prediction by Audit Scotland. It was based on some knowns—that is, current known costs—but it was also based on some unknowns: that is, predicted but not actual future costs and Office for Budget Responsibility forecasts of United Kingdom public spending. As a next step, we will need to see what the Chancellor of the Exchequer’s autumn statement holds for Scotland. However, if Alexander Stewart could get behind the Scottish Fire and Rescue Service, he would be calling on his Westminster colleagues to give back to our firemen and firewomen their VAT, which amounts to £10 million per annum. The member should do the maths.

Age Discrimination

To ask the Scottish Government what action it takes to tackle any age discrimination against 17 and 18-year-olds. (S5O-00327)

Overarching responsibility for legislation on equal opportunities is reserved to the United Kingdom Government. The Equality Act 2010 provides the legal framework to protect individuals aged 18 and over in the UK from discrimination because of age by those who provide services or exercise public functions. Those provisions do not apply to children and young people aged 17 or younger. Within our devolved powers, the Scottish Government works with other public authorities to eliminate all forms of unlawful discrimination, to advance equality of opportunity and to foster good relations.

The cabinet secretary will be aware that the national minimum wage for people under 18 is £4 an hour, and £3.40 an hour for apprentices. However, young people who are at school might have no earnings at all. Does the cabinet secretary agree that it is not fair that 16 and 17-year-olds pay adult fares on public transport from their 16th birthday? Would he consider supporting my campaign to extend child fares to all those under the age of 18? Would he also consider the possibility of putting something into a future ScotRail contract to provide 16 and 17-year-olds with the flexibility of independence, which would be an important step for them?

Pauline McNeill has raised valid issues for consideration. Obviously, there are different provisions in Scotland in relation to support for young people; for example, the availability of education maintenance allowance, which is an important contribution for young people in the age group to which she referred.

However, I am sure that the Minister for Transport and the Islands will have heard the point about the ScotRail contract and classification of fares. Of course, Pauline McNeill will be familiar with the legitimate issues regarding the different thresholds at which different age considerations apply, but ministers will certainly reflect on the issues that she has raised.

NHS Borders (Meetings)

To ask the Scottish Government when ministers last met representatives of NHS Borders and what issues were discussed. (S5O-00328)

Scottish ministers and officials meet NHS Borders regularly to discuss matters of interest to the people of the Borders.

The cabinet secretary will be aware of the recent Audit Scotland report “NHS in Scotland 2016” and Audit Scotland’s worrying conclusion that NHS Borders is the board that is least likely to balance its books this year, with 55 per cent of planned savings being classified as “high risk”. She will also be aware that Audit Scotland noted in the same report that NHS Borders has had the largest increase in spend on internal bank nurses and midwives and is spending twice as much on external agency staff as it spent in the previous year. What is the Scottish Government doing specifically to support NHS Borders and its staff through those challenges?

In 2016-17, the NHS Borders resource budget has increased by 5.3 per cent to £193.9 million. The NHS Borders uplift includes £5.3 million for investment in social care, as part of the integration of health and social care. I point out that NHS Borders funding for 2016-17 is more than £4 million above its NHS Scotland resource allocation committee target share. However, we understand the pressures that the growing demand for services brings.

The agency staff issue that John Lamont has raised is a key element of the national programme of work that is under way to reduce agency spend. Part of that is about helping boards to recruit to substantive posts where that makes sense, and to look at other options for reducing spend. I will be happy to write to the member with more details of what NHS Borders is doing to reduce agency spend, as part of that programme.

Before we move to the next item of business, members will want to join me in welcoming to the gallery Mr Asad Qaiser MP, Speaker of the Provincial Assembly of Khyber Pakhtunkhwa in Pakistan. [Applause.]