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Chamber and committees

Meeting date: Thursday, May 16, 2019

Meeting of the Parliament 16 May 2019

Agenda: General Question Time, First Minister’s Question Time, Community Pharmacy Scotland, Portfolio Question Time, Brexit (Impact on Food and Drink), Decision Time


First Minister’s Question Time

Numeracy Attainment

Marking national numeracy day yesterday, the Deputy First Minister declared that all of us need to have a good grasp of numeracy. I agree. Can the First Minister tell us how much numeracy attainment has improved or declined in our schools since she took office?

I pay tribute to national numeracy initiatives. I think that the Deputy First Minister managed to spell numeracy correctly when he promoted it this week; the United Kingdom skills minister managed to refer to “national numberacy week”.

That aside, we see improving attainment across our schools. For example, we see an increasing intake in STEM subjects—science, technology, engineering and mathematics—generally. I am more than happy to provide the specific numbers on maths for Ruth Davidson later, but I do not have them to hand right now. Across the range of subjects in our schools, we are seeing attainment rising, and we are, of course, also seeing the attainment gap closing. We want to continue that progress in the months ahead.

I thank the First Minister for that answer, but she will not be able to send me the specific numbers later, because she cannot give specific numbers. That is because the Deputy First Minister cancelled the only national survey on numeracy standards that we had, which previously allowed us to see how things were going. That means that, as this Parliament’s Education and Skills Committee declared,

“no meaningful conclusions on upward or downward trends can be reached, at a time of reform within Scottish education.”

The Deputy First Minister told us this week that it is important to have a good grasp of numeracy standards, yet, under this SNP Government, we have no grasp of how those standards are faring. Does that strike the First Minister as acceptable?

If that were true, it would not be acceptable, but it is not true. Under the achievement of curriculum for excellence levels data, which replaced the Scottish survey of literacy and numeracy, we provide more data at all levels of the system than we have ever provided before—crucially, to underpin improvement.

The problem with the Scottish survey of literacy and numeracy was that it did not provide data at school or local authority level. Ruth Davidson does not have to take my word for that. In its review of education in Scotland in 2015, this is what the Organisation for Economic Co-operation and Development said about that sample approach:

“The light sampling of literacy and numeracy at the national level has not provided sufficient evidence for ... use in ... evaluative activities or for national agencies to identify ... areas of strength.”

That survey was not providing the information that we needed, which is why we have replaced it with the achievement of CFE levels data, which provides that information not just at a national level but at school and local authority levels. I would have thought that that is exactly the kind of progress and improvement that Ruth Davidson might welcome.

The OECD said to improve SSLN; it did not say to cancel it.

It is clear from the First Minister’s answers that she has not actually read what the Education and Skills Committee had to say. The problem is that the new assessments, which we support at primary 4, primary 7 and secondary 3, are not comparable—[Interruption.] SNP members should listen. They are not comparable, they cannot show a trend, there is no baseline and they will take time to bed in. In the meantime, we have no idea whether standards in literacy and numeracy are rising or falling.

The committee was explicit about the fact that there is a five-year gap in our knowledge because of the actions of this SNP Government, and it is worried that we are losing the data that we need for Parliament and wider society to hold

“the Government to account for its performance on education”.

I share the committee’s concerns. Does the First Minister not share them, too?

We always pay attention to what committees of this Parliament say, and we will continue to do that.

I will pick up on something that Ruth Davidson said about assessments in primary schools. She said, very carefully, that the Tories support them at P4 and P7—of course, omitting to say that, in their manifesto for the 2016 election, they supported them at P1 as well. That is just another example of Ruth Davidson’s now legendary flip-flopping on every conceivable issue. There are no policies in the Tories, and there is not an iota of principle under Ruth Davidson either.

CFE levels data, of course, provides a trend. The information is published at school and local authority level each and every year, allowing people to look at the trend data, at improvements when they are being made and at whether there are any issues that require to be addressed. That is important progress. Ruth Davidson says that the OECD said that it wanted improvement, and we have provided that improvement to deal with the deficiencies in the survey of literacy and numeracy. There is now more data about pupil performance in our schools than ever before.

Later this year, we will also get the latest iteration of the programme for international student assessment—PISA—study. There is more information about schools’ performance than ever before, all of which—crucially—shows that we are making progress in raising attainment and closing the attainment gap, which is maybe what Ruth Davidson is a bit disappointed about.

What the First Minister does not get is that the mum of a seven-year-old now will not know whether this country is getting any better at teaching maths until her child is a teenager. [Interruption.] It is true. The reason for that is that the old national survey—[Interruption.] Members might want to listen to this. The old national survey showed that standards were declining, for which this SNP Government got the blame, and then it cancelled the survey. That is what happened, and it has left parents without any idea as to whether standards are going up or down.

Here are the figures that we do know about Scottish schools and numeracy. We have lost more than 400 maths teachers since the SNP took office, the number of vacancies has gone up in the past two years and, the last time that we measured numeracy in our schools, we found that Scottish education had gone backwards under this Government.

I think that parents deserve to know what is happening in our schools. Why has the First Minister left them in the dark?

I, too, think that parents deserve to know what is happening in their children’s schools, which is why we now publish the data at school level. Maybe Ruth Davidson should look into this just a little bit more closely. The reality is that, under the survey of literacy and numeracy, a parent had no idea what was happening in their child’s school, because that survey did not produce any data at school level. A parent therefore had no idea whether their child’s school was doing well or badly. The difference in the data that we publish now is that it provides data not just at national and local authority level, but at individual school level. Parents now have much more of an idea of how their child’s school is doing than they have ever had before.

Is it going up or down?

Ruth Davidson asks whether it is going up or down. Attainment in our schools is improving and the attainment gap is closing. Those are the facts, which Ruth Davidson does not like.

There are more teachers in our schools now than there have been at any time since 2010. There are more primary school teachers in our schools now than there have been at any time since I was at primary school. That is the reality of the progress in our education system. It is no wonder that Ruth Davidson is so furious about it.

Mental Health Services

This week is mental health awareness week. As a society, we are increasingly open about, and understanding of, mental health. However, we must also recognise that we need to do much more to get our mental health services right, especially at the point of crisis.

A year ago, the Government announced that an independent inquiry would look at end-to-end mental health services in Angus, Dundee and Perth and Kinross. When the then Cabinet Secretary for Health and Sport announced the inquiry, she said:

“It is my aspiration that the independent inquiry will be seen as a force for good ... The inquiry needs to be seen as a positive thing.”—[Official Report, 9 May 2018; c 58.]

Does the First Minister think that that aspiration is being met?

The independent inquiry has not reported yet. It is an independent inquiry by definition, so the Scottish Government is not in control of the timing of the publication of the report. When the report is published, we will look at it closely—as will, I am sure, Parliament as a whole—implement any recommendations from it, and encourage national health service boards to do likewise.

Richard Leonard is right to raise the issue of mental health. This is, of course, mental health awareness week, and it is important that we continue to tackle the stigma of mental health and invest more in preventative mental health services, as the Government is doing. It is also important that we continue to ensure that we are investing in specialist care for when people need it.

One of the issues—this is just an example, but I will cite it, as Richard Leonard has raised the issue with me previously—is rejected referrals in child and adolescent mental health services. Because of the action that we are taking, rejected referrals are now on a downward trajectory. That is progress, but there is more progress to make, and we are determined to make it.

I hear what the First Minister is saying, but I ask her to listen to these words, which I heard just this morning:

“Nothing seems to have happened. We’re not kept involved. It’s definitely not transparent.”

That is the view of Gillian Murray, whose uncle David’s suicide in October 2016 was one of the tragedies that led to the inquiry.

It is clear that, for the families involved, the cabinet secretary’s founding aspirations are not being met. Will the First Minister reflect on that? Will she tell us what she will do to restore the confidence of families that have lost loved ones because of failures in the system of mental health support in Tayside?

Of course we want to learn lessons from experiences of the kind that Richard Leonard has narrated. My sympathies are with any family that has had such experiences.

I say to Richard Leonard—I hope that he takes this point seriously—that we established an independent inquiry into mental health services across Tayside as a result of some of the cases that he brought to the chamber. That independent inquiry has not reported yet, but I hope that it will report soon. When it does, I am sure that it will be fully scrutinised by members across the chamber. The Scottish Government and the health service more generally will ensure that we reflect carefully on that report and learn any lessons that it says require to be learned.

It would be wrong to pre-empt the outcome of the inquiry, particularly as—as I understand it—it is due to report imminently. I look forward to the publication of the report and, as I have said, I give an assurance that the Scottish Government will take forward any recommendations that it makes.

The terms of reference that were set for the inquiry state that it must

“Consider the perspective and give voice to families, patients, carers and others who have experience of suicide or involvement with mental health services within Tayside.”

That means the voices of people such as Mandy McLaren, the mother of Dale Thomson, who tragically completed suicide in January 2015. This morning, Mandy asked me to ask the First Minister directly whether she will ensure that the families receive an advance copy of the interim report, which is due in the next few weeks. Will the First Minister listen to the voices of those families, and will she do what she can do to help to restore their confidence in the inquiry?

I know that Richard Leonard is aware that the inquiry is being led by David Strang, and that it is an independent inquiry. If the Government interfered in the conduct of the inquiry, I am sure that Richard Leonard would raise that in the chamber.

As I understand it, although David Strang is taking forward the inquiry independently, he has met family members. That would have been expected of him. It would be my full expectation in any inquiry of this nature that an advance copy of the report would go to those directly affected. I will pass that specific point back to David Strang.

I stress again that it is an independent inquiry, and it is right that the Government allows it to be conducted entirely independently of Government. As I said, although I am not in control of the timing, I expect the report to be published imminently. At that point, it will be for all MSPs and the Scottish Government to look carefully at it.

Vale of Leven Hospital (Out-of-hours Service)

The First Minister might be aware that the provision of out-of-hours services in NHS Greater Glasgow and Clyde continues to be a significant problem. Last year, the out-of-hours service at the Vale of Leven hospital was closed 88 times. In the first four months of this year, it has been closed 44 times, and it was closed this weekend. Hundreds of patients had to make the long journey to the Royal Alexandra hospital in Paisley for what should be the most basic local provision. Will the First Minister ensure that out-of-hours services are improved and retained at the Vale of Leven hospital?

Since I was Cabinet Secretary for Health, Wellbeing and Cities Strategy, it has always been our intention to ensure that as many services as possible—out-of-hours and others—are retained at the Vale of Leven hospital. The Cabinet Secretary for Health and Sport has advised me that she is due to visit the Vale of Leven hospital next month, and I am sure that she will have those discussions with staff there.

I expect Greater Glasgow and Clyde health board, as I expect all health boards, to take every measure possible to ensure safe and sustainable out-of-hours services. I know that there have been some issues recently at the Vale of Leven, but I expect the board to work hard to rectify them so that the services are there, locally, for the people who need them.

Mohammad Zahir Zazai (Visa)

The First Minister will be aware of the issue regarding Sabir Zazai, chief executive of the Scottish Refugee Council. The University of Glasgow, which is in my constituency, is awarding Sabir an honorary doctorate, yet the Home Office is refusing his father a visa to enter the United Kingdom to attend the ceremony. That is absolutely disgraceful. Can the Scottish Government take any steps to apply pressure on the UK Government to ensure that Sabir’s father can enter the country and attend this significant ceremony?

Those who know Sabir Zazai are aware that, over 20 years in the UK, he has made a significant contribution in supporting refugees in communities. I thank him for the contribution that he makes to this country, and I am delighted that the University of Glasgow has chosen to recognise that. All of us understand that it is entirely natural that he wants to share that outstanding achievement with his father. It is hard for any of us to comprehend the disappointment that he must feel that his father’s visa application has been refused. That is shameful and inexplicable. I call on the UK Government to reflect carefully on its decision. The Cabinet Secretary for Communities and Local Government has written to the UK Minister of State for Immigration to ask her to look into the case. Today, I reiterate that request very strongly indeed.

Highlands and Islands Airports Ltd

Given the fact that Highlands and Islands Airports Ltd air traffic controllers propose to take strike action on Thursday of next week, can the First Minister update Parliament on the Scottish Government’s contingency plans to minimise disruption to businesses, families and patients in the Highlands and Islands?

It is disappointing that the industrial action is taking place. I appeal both to the employer and to the employees to continue to discuss how it can be resolved in order that there is no disruption to the travelling public. Of course, it is for HIAL to ensure that it has contingency plans in place, and it is working to do that. I am sure that HIAL will be glad to engage directly with any interested member of the Scottish Parliament.

Child Poverty Levels

This week, data from the University of Loughborough was published that revealed that child poverty levels in Glasgow are running at 37 per cent. In the First Minister’s Glasgow Southside constituency, levels are at 46 per cent, the highest of any constituency in Scotland. At a time when we celebrate the 20th anniversary of the founding of the Scottish Parliament, the fact that children are growing up in poverty in Nicola Sturgeon’s constituency is a damning criticism of this Government.

All over Glasgow, children are growing up hungry and in overcrowded houses. The time for soft words and platitudes is over. What will the First Minister do with the powers at her disposal to give those kids some hope and lift them out of poverty?

As I have said previously, child poverty in Scotland is too high, but child poverty is lower in Scotland than it is in any other part of the United Kingdom. However, it is still too high. That is why we are taking action to mitigate the impact of welfare cuts; providing more support to low-income families through, for example, the best start grant; tackling the root causes of poverty; and investing record sums in affordable housing across the country. It is also why we will bring forward plans for an income supplement.

James Kelly is right to raise the issue, but I note that he wants to characterise it as all somehow being the fault of the Scottish National Party Government. Interestingly, the End Child Poverty report that was published yesterday found that Wales was the only part of the UK where there has been an overall increase in the percentage of children in poverty in the past year, and the Welsh Government said that that was entirely down to UK Government welfare cuts and, in particular, universal credit.

Why is it that James Kelly’s colleagues in Wales can see what the root causes of poverty in this country are, but the Scottish Labour Party cannot? It would fit the Scottish Labour Party better if it supported the work that this Government is doing and joined us in asking for all welfare policies to be devolved to the Scottish Parliament.

Climate Challenge Fund (Cut)

More than a decade ago, the first budget concession that the Greens ever won from the Scottish National Party was the climate challenge fund. Since then, it has funded more than 1,000 communities across Scotland, helping them to waste less, switch to greener transport, grow food locally and much more.

We have been hearing of communities losing their grants and, this morning, The Ferret reports the true scale of what is happening: total funding is at its lowest-ever level; funding for new projects has been slashed in half; and scores of projects that were recommended for grants have been turned down, including South Seeds in the First Minister’s constituency, where three members of staff have been made redundant and tens of thousands of households and residents will not get the services that they need.

Now that the First Minister has declared a climate emergency, why is the Government sacking our first responders?

The climate challenge fund is the only fund of its kind in the United Kingdom—that is important. There are always a large number of applications for the fund; I know how competitive it is from the example of South Seeds in my constituency. Twenty-two new projects were funded this year, but it is important to point out that that is in addition to the 65 projects that were funded last year, which now have a second year of funding. The total spend this year will be £8 million, and the total spend across 2019-21 will be more than £9 million. Of course, the climate challenge fund is part of the overall sustainable action fund, which has seen an increase in funding this year.

That said, as I have stated in the chamber in recent weeks, all our policies require to be reviewed in the light of the report of the Committee on Climate Change, which has led us to increase our emissions reduction targets. That will include looking at the role of the climate challenge fund in supporting communities to play their full part in tackling climate change.

The Government has started a review of the fund but has pulled the rug from under people before that review has finished. The budget that was presented to Parliament included funds for the climate challenge scheme; we would certainly not have approved it if it had set out the cut in question.

Last year, the fund helped 65 new projects across Scotland, whereas this year the figure is just 22. Forty-three projects that were recommended for approval by the independent grants panel have been turned down. Those are not just numbers—we are talking about people who are committed to taking climate action and being leaders in their communities. Projects are being abandoned and jobs are being lost. When the Greens criticise the Government for handing cash to the fossil fuel industry or the arms trade, the response is, “Jobs, jobs, jobs.” Well, these jobs matter too.

This is a serious mistake. Will the First Minister step in and replace the lost funding for communities that have been affected by the cut?

These are important issues. I reiterate a point that I think was lost a moment ago: the 65 projects that were funded last year also have funding this year. There are 22 new projects over and above that and this year’s total funding is £8 million.

Yes, we have to look at all these things in light of recent developments on climate change. I give an undertaking to the chamber today that we will look carefully not only at the climate challenge fund or the wider sustainable action fund in which it sits, which has had a budget increase this year, but at all those things, so that we can be satisfied that we are living up to our responsibilities.

Mental Health Services (Waiting Times)

This week, a general practitioner told me that he had stopped referring patients to mental health services because the waiting times are so long and there is no prospect of people ever getting treated. The First Minister promised patients that they would get mental health treatment when they need it. They feel let down. Are they wrong to do so?

Any patient who waits longer for treatment than we want them to wait or than the targets say they should wait is entitled to feel very aggrieved. I apologise to any patient in those circumstances.

On waiting times generally, as Jeane Freeman has set out to the chamber, we are investing £850 million to meet waiting times targets. We are investing significantly in mental health services to improve not just specialist services but preventative and community services, and child and adolescent mental health services are particularly important, with the average waiting time now falling and rejected referrals down.

There is work still to do, but we are investing in and pursuing policies that are about getting in place the right treatment for people when they need it.

If warm words could treat people faster, the First Minister would not have thousands of people waiting for mental health services. One in five people are waiting more than 18 weeks; some are waiting as long as two years; and some never get any help.

The First Minister says that she takes the issue seriously, but her Government’s mental health strategy was 15 months late, its suicide prevention strategy was 20 months late and it is 700 staff short of its own recruitment plan. GPs, accident and emergency departments and police officers have to pick up the pieces, because patients have nowhere else to go. In mental health awareness week, I ask again—years after I first asked her—why are people still waiting so long?

If warm words were all that people were being offered, Willie Rennie might have a point, but budgets for mental health are increasing. The budget for mental health is now more than £1 billion and we are committed to investing in increased staffing not just in mental health and our health service more generally, but in other settings across the country.

Willie Rennie mentioned the mental health and the suicide prevention strategies. I think that it was at his request that we took time to do further consultation on those strategies, to make sure that we were taking the views of all stakeholders properly into account.

We are determined to continue our work to ensure that people get access to specialist services when they need them but that fewer people need to be referred to specialist services, because we have the community and preventative services in place. That is what we are focused on, and we will continue to work on the progress that we are making.


The Prime Minister’s Brexit deal has been dead now for some months and the United Kingdom Government is wasting the Brexit extension, with no meaningful talks having taken place. Any backroom deal struck with the Labour Party would leave Scotland outside the single market, which would cost £2,300 a person, yet the Prime Minister has the audacity to proclaim that MPs have a duty to support her. Does the First Minister think that Scottish National Party MPs have a duty to vote to make Scotland poorer?

I do not think that any MPs should be voting to make Scotland or the UK poorer. SNP MPs will vote against the withdrawal agreement bill, because it would take Scotland out of the European Union and the single market against our will.

The fact is that the Prime Minister is introducing the withdrawal agreement bill only to buy herself more time. It is about preserving her own party—although I am not sure that those attempts will be successful—and not about acting in the best interests of the country. The Tories’ actions and behaviour on Brexit are utterly shameful. In an electoral sense, they will probably get what they deserve in Scotland next week, at the European elections. People will quite rightly be expressing the degree of anger that they have at this whole Westminster Brexit fiasco.

College Lecturers (Pay Dispute)

Scotland’s college lecturers are on strike again today. Indeed, they are demonstrating outside Parliament as we speak. All they want is a fair cost-of-living pay increase in line with public pay policy, something that they have been denied for three years now. Their employers remain intransigent and determined to conflate this claim with the quite separate introduction of national pay scales. Will the First Minister intervene now and get the colleges to agree a fair settlement? If not, will she come out with me after First Minister’s questions and explain why not to the lecturers’ faces?

It always amazes me the number of times that Labour members—proud trade unionists—get up in this chamber and ask me to intervene in national bargaining between employers and trade unions. I want to see the dispute resolved. It is deeply disappointing that talks have not managed to build on the positive progress that has been made over the past few weeks, and I appeal to both sides to get round and stay round the table in order to resolve the issue.

The Scottish Government is, of course, funding in full the additional costs of harmonising pay terms and conditions, which is around £100 million over three years, and we are also investing heavily in Scotland’s colleges. I say to the employers as well as the trade unions—but let me focus on the employers here—that we all want to see this resolved, and I hope that it is resolved sooner rather than later. However, it is the responsibility of those involved in national bargaining to reach that resolution.

Brexit (Travel Companies)

Brexit still has not happened, but the damage is already being done. Today, there are doubts whether Thomas Cook, a travel company with 180 years of history, can continue as a going concern. Does that not demonstrate the impact of Brexit on ordinary families—in this case, families who are looking forward to their well-earned holidays—and why it is so important for Scotland to say no to Brexit next Thursday?

Brexit is having an impact on individuals and businesses the length and breadth of the country. In fact, on a visit to Glasgow university yesterday, I heard about its impact on European Union nationals who are working or studying there. I think that the impact that it is having is disgraceful.

I think that the vast majority of people want to see an end to Brexit and this Westminster chaos and they can exercise that view next Thursday by—and it will not surprise anyone to hear me say this—voting for the Scottish National Party to say quite clearly that Scotland wants to stay in Europe and wants an end to Brexit.

First Minister, I would rather that you did not say that. I hope that you will not directly encourage people to vote and will not campaign in this chamber—and that extends to every member in the chamber. No blatant electioneering, please.

Mental Health Awareness Week

To ask the First Minister how the Scottish Government is marking mental health awareness week. (S5F-03339)

The theme of this year’s awareness week is body image, which is an important factor in mental wellbeing. The mental health minister launched the week at Glasgow Central station, where she and the Mental Health Foundation spoke to members of the public to raise awareness of the issue. She also visited Girlguiding Scotland to hear at first hand from girl guides how body image affects them.

Ahead of awareness week, we announced a new advisory group that will examine how body image impacts on young people’s mental wellbeing. It will identify steps to improve support for young people and advice for relevant professionals, building on our package of measures to improve young people’s mental health.

Last week, we heard the sad news that Dr Dame Denise Coia has had to step down from the child and adolescent mental health services task force due to ill health. Does the First Minister agree that Denise Coia should be thanked for taking forward this important work, and can she outline how the task force’s work will be taken forward to implementation?

I am very sorry indeed that, due to illness, Dr Dame Denise Coia has had to stand down as chair of the children and young people’s mental health task force. As chair, Dr Coia has shown exemplary dedication in helping to improve the mental health of children and young people. I thank her and send her my very best wishes, and I am sure that I do so on behalf of the chamber.

We established the task force jointly with the Convention of Scottish Local Authorities in June 2018 to provide a blueprint for delivering a new approach. Dr Coia’s work has brought the task force to an advanced stage, and the next step is to work towards implementation. As it happens, the task force will meet today to shape how it will take this important work forward.

I stress my support for mental health awareness week. It is absolutely right that mental health is now near the top of the political agenda. However, although we hear good talk from the Scottish National Party, the reality for those who need support is far different.

The SNP pledged to hire an extra 800 mental health workers but the latest statistics show that only 106 have been hired in the past two years. Can the First Minister outline what specific action her Government will take to ensure that the target is met by the end of 2021-22 rather than being missed spectacularly?

We are on track to deliver on that target. It is, as Annie Wells has acknowledged, a multiyear target. In addition, we have commitments to increase the number of school counsellors; £60 million has been invested to support an additional 350 counsellors in education. The first tranche of counsellors will be in place from the start of the 2019-20 school year. That commitment is on track to be delivered by the start of the 2020-21 school year.

We have also committed to putting an additional 250 school nurses in place by 2022 and the first tranche of 50 additional school nurses will be recruited in the current academic year. Across all these areas, there is a real focus—as I commented earlier—on not just ensuring that specialist services are there when people need them, but investing in the preventative services that we hope will stop people needing those specialist services in the first place.

The First Minister will be well aware that people with diabetes are twice as likely to experience depression. Three quarters of people living with diabetes who wanted specialist mental health support could not get it. What is the Scottish Government doing to improve support for people living with diabetes, through emotional, psychological and mental health care?

As David Stewart is aware, because I know that he takes a close interest in this issue, the Scottish Government is carrying out a range of work to help those who have diabetes. I will ask the mental health minister to write to the member on how we support people with diabetes specifically in relation to mental health challenges because, as he rightly says, that is a significant aspect of what diabetes patients deal with. I will ask the mental health minister to provide that information as soon as possible.

Specialist Heart Failure Nurse Services

To ask the First Minister what the Scottish Government’s response is to the Scottish Heart Failure Nurse Forum’s warning of a “potential crisis in care delivery”. (S5F-03331)

We are committed to improving prevention, treatment and care for patients with heart disease and we are taking a range of actions to achieve that through the heart disease improvement plan. The decrease in mortality rates and in the number of new cases of coronary heart disease over the past decade show that we are having success with that strategy.

I welcome the Scottish Heart Failure Nurse Forum’s report, which makes six recommendations for improvements. We will consider those recommendations carefully with national health service boards.

Since 2015, we have invested over £2.4 million a year to support NHS boards to provide enhanced access to specialist nursing services, including cardiac nurses, and I expect NHS boards to ensure that people with heart failure have access to a range of health professionals so that there is appropriate management of their condition.

I thank the First Minister for that answer, but the report notes that there has been little investment in specialist heart failure services over the past six years and there are now fewer heart failure nurses than there were 10 years ago. Nearly 46,000 people across Scotland are living with the devastating impacts of heart failure, so can the First Minister confirm today how much the Scottish Government will commit to investing in the delivery of heart failure nurse teams?

Given the progress that is being made in NHS England and NHS Wales on contributing to the national cardiac audit, supporting data-led redesign of service and provision, will the Scottish Government commit to addressing the lack of national data support to help design better services for patients?

As I said in my original answer, since 2015, we have invested over £2.4 million in enhanced access to specialist nursing services. That includes cardiac nurses. I will ask the Cabinet Secretary for Health and Sport to write to Miles Briggs with the projected spend over the next few years. Of course, that sits within a picture of an overall rise in the number of nurses in Scotland. We will continue to invest and indeed to work with different organisations that have expertise to make sure that we are providing the right support and services for patients.

It is important to note that, although there is still a lot of work to do and the recommendations that are made in the Scottish Heart Failure Nurse Forum’s report will be looked at carefully, between 2008 and 2017, the mortality rate for coronary heart disease for all ages decreased by 36 per cent and for the under-75s, the rate decreased by 33 per cent. Things are going in the right direction, which suggests that we are having success with the actions that we are taking; we will continue to make sure that we take those actions.

Recently, cardiologist Professor Colin Berry came to Parliament to present his research on women’s heart health to the cross-party group on women’s health. His research found that women are less likely than men to be properly diagnosed with a heart attack and twice as likely to die in hospital. Is the First Minister aware that a valuable test that diagnoses small vessel heart disease—a condition that particularly affects women—is not routinely available? What is the Government doing to improve women’s heart health more generally?

We are aware of that issue. The Chief Medical Officer is looking at the issue that Monica Lennon raises. She is a real champion for improvements in women’s health. Often, the symptoms of heart attacks in women are different from those that are experienced by men. Many health professionals will be more aware of those symptoms that are traditionally experienced by men.

“Invisible Women: Exposing Data Bias in a World Designed for Men”, a recently published book that I would recommend to everybody in the chamber, looks at some of the issues that systemise discrimination against women in our society. Those are important issues, and I assure Monica Lennon that they are being looked at actively by the Scottish Government.

That concludes First Minister’s question time. We will have a short suspension to allow the gallery to clear and members and ministers to change seats before the next item of business.

12:41 Meeting suspended.  

12:43 On resuming—