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Chamber and committees

Meeting date: Thursday, September 13, 2018

Meeting of the Parliament 13 September 2018

Agenda: General Question Time, First Minister’s Question Time, Nae Pasaran!, Food and Drink, Decision Time


General Question Time

Legal Aid

First, I draw the chamber’s attention to my entry in the register of members’ interests as a practising advocate.

To ask the Scottish Government what its response is to the conclusions of the independent review “Rethinking Legal Aid”. (S5O-02349)

Since taking up post in June, I have met key stakeholders including the Scottish Legal Aid Board and the Faculty of Advocates—and I am due to meet the Law Society of Scotland this afternoon—to discuss relevant issues ahead of the publication of the Scottish Government’s response to the review.

The Scottish Government has not made any cuts to the scope of legal aid, and the review recommended that the current scope remain. As set out in our programme for government, the Scottish Government’s response to the report of the independent review of legal aid will be published in the autumn.

Will the Government’s plans for legal aid take account of what is being described as an extremely serious situation, with not enough new entrants to the criminal legal aid sector to sustain the network of criminal firms providing access to justice in Scotland? Does the minister agree with plans that are being drawn up for first-year trainees to appear in court on behalf of clients?

The issue with regard to first-year trainees is not a matter for the Scottish Government. It reflects an agreement between the Lord President and the Law Society of Scotland. Our analysis of the current situation is that, although crime and the number of criminal court actions are reducing, the number of criminal legal aid providers is still high compared with the work available.

Crime has been reducing over several years, and since 2013, the number of criminal case reports to the Crown Office has reduced by 39 per cent. However, in the same period the number of criminal legal aid providers has reduced by less than 16 per cent. As the “Rethinking Legal Aid” report has identified, there is an oversupply of providers in some areas, although we also accept that there is an undersupply in others.

The legal aid review report suggests that the current wide scope of civil actions for which legal aid is available in Scotland should remain. Is the minister supportive of that suggestion?

Unlike our counterparts in England and Wales, the Scottish Government has kept legal aid provisions that help with family, medical, housing and welfare benefit problems. It is important that legal aid continues to offer support for such issues, as they have a devastating effect on people, and often those who are disadvantaged and vulnerable. It is an important aspect of our legal aid system in Scotland, and there are no plans to change that position.

The same areas are not covered in England, where legal aid has been intentionally and severely cut and its scope reduced. It is yet another area where this Scottish National Party Government acts to protect the vulnerable and the Conservatives do not.

First, I welcome the minister to her new post.

I note the minister’s comments about the fall in the number of court actions. However, as the report notes, demand, too, is falling. Does she acknowledge the points made in the report about simplification and improvement of access to and awareness of legal aid, given that 70 per cent of Scots are eligible for it?

Obviously the legal aid system is entirely demand led. The review made 67 recommendations, and my officials are looking at them. We are engaging with all stakeholders on a number of issues, including the one that the member has raised. It will be included in the Government’s response, which I will publish in the autumn.

Deaths Overseas

To ask the Scottish Government what support it provides when a family member dies overseas. (S5O-02350)

Consular assistance, including the notification of a death abroad and subsequent advice to bereaved families, is a reserved matter for the United Kingdom Government. The Scottish Government would ordinarily refer individuals to the Foreign and Commonwealth Office, which works with Police Scotland in such cases.

As for repatriation, it, too, is a reserved policy area, and consular assistance is provided by the FCO as set out in the public guide “Support for British nationals abroad”. The Scottish Government is unable to offer any repatriation services above and beyond that.

Following repatriation, several organisations in Scotland can provide bereavement support for individuals in addition to the work of community support and police groups. One such organisation is Victim Support Scotland, which has a partnership in place with the FCO for the provision of support to families.

When a loved one dies overseas, it can often give rise to significant distress, uncertainty and financial costs. I draw the cabinet secretary’s attention to the fact that there is a financial cost to having that death registered back home in Scotland or, indeed, anywhere else in the United Kingdom. The total cost is £200.

Does the cabinet secretary agree that, given that it is free to register deaths that occur here in Scotland, it is only right that it should also be free to register the death of loved ones when they pass away overseas? Will the Scottish Government work with me to secure the scrapping of such charges to put fairness and affordability into the system in such distressing circumstances?

The member raises a very interesting point. When someone dies abroad, the death is normally registered in the country in which they died, but if the next of kin chooses to register the death in Scotland or elsewhere in the UK, the next of kin or the executor can make an application to the FCO in London for a consular death certificate, which will be in English.

As Mr Doris pointed out, applying for a consular death certificate is optional. The cost is currently £150 for registration and £50 for a copy of the certificate, but I would be happy to instruct my officials to look at the issue to see whether we can work with the FCO to see what can be done.

Pest Control (Railways)

3. Richard Lyle (Uddingston and Bellshill) (SNP)

To ask the Scottish Government what discussions it has had with Network Rail to ensure that it responds to residents’ complaints regarding rodents on the track at Carfin, Motherwell. (S5O-02351)

I am aware that Network Rail and North Lanarkshire Council environmental health department have already met on the matter and have agreed that the railway may not in fact be the source of the issue. It therefore remains a matter for the council to progress.

I recognise that Network Rail does not come under the responsibility of the Scottish ministers.

Does the cabinet secretary agree that this case is another example of the worrying trend of UK Government departments and agencies ignoring Scotland’s elected representatives? What action can we take to ensure that Network Rail and others respond to requests to attend meetings and communicate with MPs, MSPs and the community in Scotland to resolve issues that we believe that they have caused. In refusing to attend a recent residents meeting in Newarthill, which I attended and at which more than 100 people were present, Network Rail has left many unanswered questions, and it now faces a barrage of distrust within the local community.

We in the Scottish Government work closely with Network Rail in Scotland on matters that affect rail users and those who live and work alongside our railway network.

The member is correct to say that Network Rail is a UK Government body. I would expect it to fully engage with local communities, local authorities and local elected members on matters of concern, and I would expect it to respond to the issues that Mr Lyle has raised on behalf of his constituents in a constructive way that helps to resolve the concerns of local residents.

NHS Greater Glasgow and Clyde (Meetings)

To ask the Scottish Government when it last met NHS Greater Glasgow and Clyde, and what issues were discussed. (S5O-02352)

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 and to our health service.

I expect that there is plenty to discuss. Accident and emergency waiting times, cancer detection rates, cancer waiting times, dementia support, the treatment time guarantee, the 18-week referral to treatment time, the 12-week period for a first out-patient appointment, staff sickness and child mental health waiting times are nine national standards that have failed under the Scottish Government. Performance on some is even going backwards.

We know that hard-working NHS Greater Glasgow and Clyde staff are doing their best under difficult circumstances; indeed, they often outperform colleagues in other parts of the country. I ask the new health secretary when patients in my community will get the levels of health and care that were promised to them by this Government?

It is interesting that Mr Bibby likes to recite a long list. I have an equally long list that I could recite, including general practitioner numbers being up by 5 per cent, the workforce being up overall by 9.5 per cent and my absolute intention—[Interruption.] If Mr Bibby would care to pause for a moment and let me finish, that might be helpful. I intend to bring to Parliament a plan to significantly reduce the current waiting times.

However, the fact of the matter is that none of those are assisted when, as I said yesterday, Opposition colleagues deliberately conflate matters. I will give an example from 27 June—the headline “Bombshell board papers reveal huge cuts to NHS in Glasgow and the west”. Labour conflated board financial papers and a high-level strategy paper for the health board in order to get a headline. That behaviour is deeply unhelpful to the people who work in our health service, but much more important is that it does an injustice to the constituents whom Mr Bibby claims he wants to represent.

Does the cabinet secretary agree that it is incumbent on all politicians to put into the public domain full and accurate information that is not designed to paint an inaccurate picture, which is something that all Labour politicians seem to do readily when it comes to the future of Inverclyde royal hospital. It appears that they shut their eyes and ears when the chairman of NHS Greater Glasgow and Clyde reiterated the health board’s long-term commitment to the hospital.

I agree; I indicated earlier that that is absolutely my view. We undoubtedly face challenges in the health service. Opposition members have a right and a responsibility to challenge this Government, but I ask everyone here to raise their game effectively and to have a more mature discussion. It is disappointing when a board chair has to use his time and energy to issue media statements addressing public concerns that have been raised entirely by false speculation by Opposition members when, time and again, the board and its chair have made it clear that the future—in this instance, of Inverclyde royal hospital—is secure. It is not just colleagues from the Labour Party who are guilty; colleagues from the Conservative Party are also guilty in this matter. Members in this Parliament need to grow up and to deal with health in the manner in which it deserves to be dealt.

The cabinet secretary will be aware that Greater Glasgow and Clyde NHS is reviewing and redesigning breast cancer services. A freedom of information request from me revealed that it had consulted only one person about its preferred option, which is to centralise services. The health board said that

“The Scottish Government has indicated satisfaction with the level of engagement.”

In the interest of the accuracy that I wish to share with the cabinet secretary, will she tell the chamber whether that is true?

NHS Greater Glasgow and Clyde has a high-level approach entitled “Going Forward Together” that Ms Baillie and I have discussed on many occasions, in writing and in person. That approach includes the work that we have undertaken, and that has been approved, on the best start approach to maternity services. It is not about having one service only in an area such as Greater Glasgow and Clyde. It is, through clinician and other advice that has been widely welcomed by the Royal College of Midwives and others, about providing the right support in maternity services and breast screening across all our health service in Scotland. There will be consultation on the detail; at the moment, the matter is at a relatively high level.

I point out that it is the Scottish Health Council that provides a recommendation and view to me, as cabinet secretary, on whether a board has properly undertaken wide-ranging consultation. In this instance, we are not yet at that stage. I fully expect us to get there. I have a very strong personal view about what “adequate consultation” is; I will ensure that, across our health boards, adequate consultation of the public and others is fully undertaken.

Medical Isotopes (Security of Supply)

To ask the Scottish Government whether it will provide an update on its assessment of the anticipated security of supply of medical isotopes after the United Kingdom leaves the European Union. (S5O-02353)

I am grateful to Mr Stewart for raising this important issue again. I understand that a meeting was offered in May to discuss the matter further. That did not take place, but I am happy to make the offer again.

In a written answer in August, I said that

“It is imperative that the UK Government continues to secure a sustainable ... supply of time critical ... medical radioisotopes”,

which, as members will know, by their very nature decay over a short time frame. That supply has to be right for Scotland. I added that

“We are in discussions with the UK Government about the issue and the UK’s future relationship with the Euratom.”—[Written Answers, 8 August 2018; S5O-02353.]

Unfortunately, the UK Government has not yet been able to provide any certainty about future arrangements with the European Atomic Energy Community on customs, or about many other aspects of future arrangements with European institutions.

I completely understand that this uncertainty is a source of anxiety for medical practitioners and patients across Scotland. We will continue to attempt to maintain contact with the UK Government and to stress the importance of the issue.

The cabinet secretary is well aware that the UK Government is withdrawing from Euratom, which regulates the supply of radioisotopes that are used in treatment of cancer. The UK has no nuclear research reactors and relies on importation of medical radioisotopes such as iodine 131 from Europe.

I am happy to meet the cabinet secretary to discuss the issue in more detail. The future treatment of our cancer patients relies on safe importation of radioisotopes. I will get in touch with the cabinet secretary later today.

I am grateful to Mr Stewart for that and look forward to that discussion.

Of course, it is not just radioisotopes that are of concern. As I believe Michael Russell made clear in his statement earlier this week, the suppliers of more than 8,000 medicines, not counting devices, have been asked by the UK Government to begin stockpiling six weeks’ worth of medicines.

As we know, it is right and proper that the Scottish Government takes appropriate steps to look at how we might manage Brexit, especially a hard Brexit, so we have engaged with our health boards in order to do that. It is also right and proper that I say clearly that there is a limit to how much we can mitigate the situation. Not only is there a question mark over radioisotopes—some of our medicines cannot be stockpiled.

We should not, as I believe the UK Government is attempting to do, give a false sense of preparedness for a situation that cannot be prepared for in the manner that it suggests. We must take what steps we can, but we must be honest and responsible with the people whom we represent in saying that there is a serious limit to how much the dangers and catastrophe of Brexit will be mitigated.

Perinatal Mental Health

To ask the Scottish Government what action it is taking to improve the provision of perinatal mental health support. (S5O-02354)

I thank James Dornan for his question.

Good perinatal mental health care is vitally important in improving outcomes for mothers and their young children. That is why we are funding a national managed clinical network on perinatal mental health. The MCN brings together specialists on perinatal mental health, nursing, maternity and infant mental health. The network’s long-term aim is to ensure that all women, their infants and families have equity of access to the perinatal mental health services that they need across all of Scotland.

Additionally, as was announced last week in the programme for government, we are providing a package of measures to do more to support positive mental health and to prevent mental ill health, which includes a quarter of a billion pounds of additional investment, starting this year and progressively increasing over the subsequent four years. The funding includes £50 million for perinatal mental health services to develop a strong network of care and support for the one in five new mothers—around 11,000 a year—who experience mental health problems during and after pregnancy.

I thank the minister for that full answer to what I believe is the first question that she has answered in the chamber in her new role.

As the minister will be aware, almost 20 per cent of women experience mental ill health during their pregnancy, so I am grateful that the Government is taking decisive action to improve provision of perinatal mental health support in Scotland. The Government’s programme for Scotland for 2018-19 states:

“We will also substantially expand the range of perinatal support available to women.”

Can the minister advise on how many women she expects to benefit from those new support measures?

As James Dornan mentioned, we set out in our programme for government a package of commitments to expand the help that is available to new mothers who may experience a mental health issue around the time of pregnancy. We will provide three tiers of support across Scotland, in line with the needs of individuals. For those 11,000 women a year who would benefit from help such as counselling, we will support the third sector to provide that. For the 5,500 women who are in need of more specialist help, we will ensure rapid access to psychological assessment and treatment. For the 2,250 women with the most severe illness, we will develop more specialist services and consider the need for a small number of additional in-patient beds or enhanced community provision.

In April, the Scottish Government was widely criticised after data from the Maternal Mental Health Alliance showed that, in 50 per cent of health board areas across Scotland, women had no access to specialist perinatal mental health services. Can the minister assure me that the measures that were set out in the programme for government will enable such access so that women do not face a postcode lottery when it comes to perinatal health support?

The managed clinical network is carrying out a mapping and gapping exercise in support of its shorter-term aims to provide a comprehensive overview of current service provision, and the additional funding that was announced last week will help to ensure that women are able to access the services that they need, when they need them.