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Chamber and committees

Meeting date: Thursday, January 16, 2020

Meeting of the Parliament 16 January 2020

Agenda: General Question Time, First Minister’s Question Time, Sustainable Development Goals, Portfolio Question Time, Disclosure (Scotland) Bill: Stage 1, Disclosure (Scotland) Bill: Financial Resolution, Direct Payments to Farmers (Legislative Continuity) Bill, Decision Time, Point of Order


General Question Time

Alcohol and Drug Services (Evaluation)

To ask the Scottish Government how it evaluates the delivery of alcohol and drug services. (S5O-04009)

“Rights, Respect and Recovery: Scotland’s strategy to improve health by preventing and reducing alcohol and drug use, harm and related deaths”, which was published in November 2018, sets out our national strategy for tackling alcohol and drug harm. That includes an eight-point plan for treatment and recovery, which will improve access to effective services, and interventions to support individuals to achieve their recovery.

In October last year, in partnership with the Convention of Scottish Local Authorities, we published an action plan to deliver the strategy, and local areas are required to have their own strategies in place by April 2020. NHS Health Scotland has been commissioned to draw up a monitoring and evaluation framework for the strategy, which will sit alongside the existing evaluation of the alcohol framework.

I have raised previously the slightly opaque nature of the way in which funding is allocated between clinical and recovery programmes. How will the Scottish Government ensure accountability and transparency around funding and delivery of outcomes so that successful community-based recovery initiatives such as the recovery cafes that are running in Ayrshire, which provide not only practical support but hope and purpose, can be scaled up for the benefit of my constituents?

Recovery cafes play a key role in supporting people’s recovery from problem alcohol and drug use. They are led by people in recovery for others in recovery and demonstrate the impact that people with lived experience can have on supporting others in their recovery. The Scottish Recovery Consortium has played a key role in the development of the cafes across Scotland; I am very much a supporter of them.

As I said in my initial answer, NHS Health Scotland is leading the evaluation of our “Rights, Respect and Recovery” strategy through the evaluation framework. That will be published in February, and it will be used to monitor and evaluate progress against commitments and outcomes from the strategy on an on-going basis. That will sit alongside the existing framework for alcohol harm prevention, but it is important that it goes further than looking simply at medical support for people in recovery and that it looks at wider wraparound support, which very much includes recovery cafes and other such initiatives, some of which do fantastic work and perhaps do not quite get the recognition that they deserve.

What plans does the Government have to introduce a social responsibility levy on alcohol retailers? Legislation on that has been passed by the Parliament, but the measure has not been introduced, although it would provide millions more for alcohol and drug services.

The member has raised that point previously, and he will be aware that I support our having that power. The power is intended to recoup any additional profit from the alcohol industry as a result of minimum unit pricing, but we must accept that it will take some time before we understand whether that additional profit exists. The member has made that point before and I am sure that he will make it again. I do not disagree with him, but we need to ensure that we take actions based on evidence, and we do not quite have the evidence to support taking that action just yet.

What assessment have ministers made of the impact of the loss of drug and alcohol rehabilitation beds? In 2007, 352 beds were available across Scotland, but today there are just 70.

Across Scotland, drug and alcohol partnerships are shaping their services according to local circumstances. Particularly in Glasgow, there has been a major reshaping of recovery services in order to focus on those who need that particular acute support, and there is a shift towards more community recovery. That said, my officials and I are looking across Scotland to map the rehabilitation support that is available so that we can see where there are gaps and then consider how to move forward on that.

Foundation Apprenticeships

To ask the Scottish Government whether it will provide an update on the delivery of foundation apprenticeships. (S5O-04010)

Foundation apprenticeships started with the early pathfinders in 2014-15. Over the first three cohorts and the pathfinder phase, there have been 3,454 FA starts.

Skills Development Scotland will publish its next annual progress report on foundation apprenticeships by March 2020, which will include details of the current cohort.

We await the figures that, as the minister mentioned, will be published in March, but it is clear from the last cohort that was measured that there has been huge variability in uptake across Scotland. In some areas, more than 5 per cent of secondary 4 pupils took part, but in others, including my Highlands and Islands region, the numbers were negligible—0.7 per cent in Moray, 2.5 per cent in Orkney and fewer than five starts in Shetland.

Can the minister tell me whether that is a question of places being available or of insufficient demand in those areas, and will he commit to improving those figures to ensure that foundation apprenticeships are not only available but signposted to young people across the whole of Scotland, and that young people are actively encouraged to take them up?

On the member’s latter point, I certainly agree that we should be ensuring that everyone signposts the opportunity of a foundation apprenticeship to young people. However, I am afraid that, on his overall question, he seems to be somewhat misinformed. We have seen a 345 per cent increase in the number of starts from the first cohort to the third cohort and we have met our commitment to provide 5,000 opportunities by 2019.

If we look at the local authority areas that comprise the Highlands and Islands region, we see that the number of FA starts is broadly in proportion to the population—actually, it is slightly higher per capita. In Scotland, we have seen growth in the number of foundation apprenticeship starts, modern apprenticeship starts and graduate apprenticeship starts.

In Tory England, however, since the introduction of the apprenticeship levy—which was introduced by the Tories without consultation of the Scottish Government—figures for the first three quarters of the 2018-19 academic year, compared to the numbers for the first three quarters of the academic year prior to the introduction of the apprenticeship levy, show a decrease of 29.3 per cent in the number of apprenticeship starts. In the same intervening period across the range of apprenticeship starts in Scotland, we have seen an increase of 11.7 per cent.

Michelle Ballantyne, who is sitting next to Mr Halcro Johnston, had a question on apprenticeships last week. She was rather fortunate that her question was not reached. Mr Halcro Johnston has been less fortunate because his question has been reached. We have placed that on the record and I say to the Tories that apprenticeships are not the most fertile line of inquiry for them as a party.

Mesh-injured Women’s Fund

To ask the Scottish Government whether it will establish a mesh-injured women’s fund. (S5O-04011)

Both the First Minister and I appreciate the impact that mesh complications have had on those affected and their families, not least in light of the meetings that the First Minister and I held with mesh-injured women in November. We want to ensure that all available care and treatment options are open.

With the needs of affected women uppermost in our minds, we will consider the range of services and support that are available. As part of this year’s budget process, I am currently exploring the different forms of support that could be offered beyond the provision of direct care services. It is important that that work recognises the impact that this issue has had on the lives of the women affected, and that is what I will seek to reflect.

Mesh-injured women have lost their jobs, relationships, income and homes, and they have to pay for incontinence products, clothing, bedding and other items to try to manage the horrendous consequences of mesh implantation. Will the cabinet secretary actively speak to the Cabinet Secretary for Finance, Economy and Fair Work to set up a fund to help those women who are being financially penalised through no fault of their own? Will she ask the First Minister to respond to the letter that I sent following the meeting in Glasgow in November to which the cabinet secretary referred, as I have not received a reply?

I am sure that Mr Findlay listened carefully to what I said. What I said implied—actually, it did not imply it; I said it—that as part of the budget process I was looking at all the services and support that are appropriate and should be there to support the women who he referred to, which includes the women whom the First Minister and I met.

It would be irresponsible for me to begin to commit new funds while I am in the middle of a budget process with the Cabinet Secretary for Finance, Economy and Fair Work. When the budget finally comes, it will be a decision for the Parliament. I hope that if we are able to introduce those things that Mr Findlay—rightly—cares about, he will find himself able to support that budget.

On the First Minister’s response to Neil Findlay’s letter, the First Minister is, rightly, waiting to see what I intend to bring forward so that her reply can be as full as possible. I have now said where we are in that process and I hope that he is content with that—indeed, I hope that he welcomes it.

Accident and Emergency Departments (Waiting Times)

To ask the Scottish Government what its response is to reports that a record number of people are waiting over 12 hours in accident and emergency departments. (S5O-04012)

In November, attendances at our emergency departments were more than 11 per cent higher than they were four years ago, and that includes an almost 5 per cent increase in the latest year. Against that significant increase in demand, our national health service emergency department staff continue to deliver the highest performance in all nations in the UK—as they have done for four and a half years now. Nonetheless, the level of 12-hour delays has increased in our key sites.

To support an immediate reduction in the levels of delays, I have continued work on a whole-system response and have intensified the focus on that, with additional financial support to look at what more we need to do to ensure sustainability and robustness in our out-of-hours provision. I have commissioned further work to allow us to understand better why we have that high level of increased attendance, and have continued to work with my partners in local government to ensure that we minimise delayed discharge and improve the flow through the hospital in order to free up beds for patients who appropriately attend A and E and who need to be admitted to hospital for further treatment.

The Scottish National Party’s target of 95 per cent of patients being dealt with within four hours has not been met in the past two and a half years. With all the other issues facing the SNP-run NHS in Scotland, can the cabinet secretary guarantee when we will see continuous sustained improvement over time?

I have to admire Mr Lindhurst’s bravery. I will tell him what will happen with the Scottish Government’s target: we will keep it, unlike his Government south of the border. Not only will we keep the target, we will continue to work to meet it. I remind Mr Lindhurst that our NHS accident and emergency staff in Scotland continue to be the best performing across the United Kingdom, and have been for four and a half years.

I will tell Mr Lindhurst what else the SNP Government will do: we will listen to the Royal College of Emergency Medicine. I wish that his Secretary of State for Health and Social Care would also listen. He might also care to reply to any of the letters that I have sent him over the past 18 months. The Royal College of Emergency Medicine tells us that our target matters and should be kept. We will continue to work towards that target, we will continue to be the best-performing NHS in the UK, and we will continue to have a single-system NHS, unlike Mr Lindhurst’s colleagues south of the border, who continue to break up their NHS. Unlike his colleagues south of the border, who intend to abandon their target, we will keep our target.

By the way, the reason why I mentioned Mr Lindhurst’s colleagues is that he and the other Conservative members want to run our health service in Scotland. God help us if that day ever comes.

US Military Action in Iran (United Kingdom Involvement)

To ask the Scottish Government, in light of the potential impact on Scotland-based armed forces personnel and their families, what its response is to any United Kingdom involvement with US military action against Iran. (S5O-04013)

The Scottish Government would be concerned about any further escalation resulting in military action. We continue to urge all parties to refrain from further violence and to work to de-escalate tensions. Further conflict in the middle east is in no-one’s interests. We recognise the value of the joint comprehensive plan of action and the impact that that agreement has had on peace and stability in the region.

We support the continued commitment of the UK, France and Germany to that agreement, as seen in their E3 statement on January 12. It is right that the E3 are raising their concern at the US decision to re-impose sanctions on Iran, and are urging Iran to refrain from further military action and to return to its commitments under the agreement.

The Scottish Government believes that the joint comprehensive plan of action is the best avenue that we have to prevent nuclear proliferation and to de-escalate tensions peacefully. We understand that the European powers have now triggered the formal dispute mechanism over Iran’s breaches of key parts of the 2015 agreement.

The cabinet secretary will be aware of the irresponsible comments by the Prime Minister earlier this week. He said that he believes that the Iran deal—which the cabinet secretary has referred to—should be abandoned and replaced with “a Trump deal”. Does the cabinet secretary agree that, instead of playing the role of Trump’s lapdog, the UK Government should be advocating the benefits of the current deal, and working with all sides to gain their recommitment to a deal that makes the type of conflict that we all fear less likely?

The Scottish Government is concerned that the UK Government is sending mixed messages. The Prime Minister made his comments on the same day that the UK, as part of the E3, activated the formal dispute mechanism of the current agreement, and stated publicly the “over-arching objective of preserving” the agreement.

If that leads to reactivation of all elements of the agreement, that offers the best prospect of preventing nuclear proliferation by Iran. We support the comments of the EU High Representative of the Union for Foreign Affairs and Security Policy, who recognised the agreement as a significant achievement of multilateral diplomacy, and reiterated the importance of preserving that agreement in the light of heightened tensions.

Royal Hospital for Children and Young People

To ask the Scottish Government what progress has been made on resolving the issues preventing the opening of the Royal hospital for children and young people in Edinburgh. (S5O-04014)

We remain on track to deliver my previously announced timescales of spring for the move of the department of clinical neuroscience, and autumn for the move to the new Royal hospital for children and young people.

All actions relating to medical gases and drainage are now complete, and good progress is being made with ventilation, electrical issues, fire safety and water. The senior programme director continues to ensure that the facility will be fit for occupation, and is overseeing the NHS Lothian action plan. The oversight board, which is chaired by the chief nursing officer, continues to oversee the work to ensure that the hospital is safe and is delivered as planned.

The cabinet secretary has been very keen to suggest that the Scottish Government has no responsibility for the debacle, but the facts remain that the capital finance was provided by the Scottish Government and that it was responsible for the due diligence checks on that spend.

Can the cabinet secretary confirm that, because the building contract was signed off when the hospital was handed over, the original contractors and others that have been approached are not willing to take on the work because they would become liable both for the building and the warranties, and that, as a result, the cost of sorting out that mess is now soaring?

I am not entirely sure where Ms Ballantyne has been in all the discussions that we have had about the issue, or whether she has been doing her homework as a member of the Health and Sport Committee in order to understand how we have undertaken infrastructure projects in Scotland, and why we are now changing that.

The contract is, appropriately and in legal terms, between NHS Lothian and the contractors. Work is under way to ensure that the site will be safe and fit for purpose when the moves that I have outlined take place in the spring and autumn. The discussions are between the contractors and NHS Lothian.

The oversight board is concerned with ensuring that the work is done on time. As I have said, we are on track to deliver that work. I remind Ms Ballantyne and others that I halted the move to the hospital because it was not safe for patients or staff. That was the right decision. The move of the DCN will be in the spring, and the Royal hospital for children and young people move will be in the autumn. At that point, the Government and I, as health secretary, will be assured, as we should be, that it is safe for patients and staff.