Website survey

We want your feedback on the Scottish Parliament website. Take our 6 question survey now

Skip to main content

Language: English / Gàidhlig


Chamber and committees

Meeting date: Wednesday, September 18, 2019

Meeting of the Parliament 18 September 2019

Agenda: Portfolio Question Time, National Health Service Construction Projects, Criminal Sentencing, Business Motion, Parliamentary Bureau Motions, Decision Time, Children’s Hospice Association Scotland


Portfolio Question Time

Education and Skills

The first item of business is portfolio questions, starting with questions on education and skills. I remind members that questions 6 and 8 have been grouped together. Question 1 was not lodged.

Science, Technology, Engineering and Mathematics Teaching (Dumfries and Galloway)

To ask the Scottish Government how it is supporting the teaching of STEM subjects in Dumfries and Galloway. (S5O-03534)

The Scottish Government’s STEM education and training strategy sets out a range of actions to support practitioners teaching STEM subjects in Scotland’s primary and secondary schools, in early learning and community learning and development settings, and in our colleges and universities.

In Dumfries and Galloway specifically, support for professional learning is provided by a designated Education Scotland STEM education officer who has now been appointed. Practitioners will also benefit from resources with a focus on cluster working to support professional learning in STEM, including numeracy, mathematics and science, through work supported by the enhancing professional learning in STEM grants.

All that will build on the great work started as part of the raising aspirations in science education—RAISE—programme. That is being further enhanced through the creation of a digital and physical hub and spoke network to facilitate digital learning in rural locations.

Dumfries and Galloway College is working towards plans to build STEM extensions at the Stranraer and Dumfries campuses to allow for research and courses on maintenance and construction of renewable technologies. Will the minister join me in welcoming that work, which is supported by the south of Scotland economic partnership, and will he perhaps commit to visiting Dumfries and Galloway College to meet the students and staff in the near future?

I warmly welcome the development to which Emma Harper referred, which, as she said, is being supported by the Scottish Government as part of our £6.6 million investment in the south of Scotland economic partnership skills and learning network. Through the creation of that hub, the project seeks to address the immediate skills gaps that have been identified in the region in key sectors. I would be delighted to visit Dumfries and Galloway with Emma Harper to view for myself the good work that is taking place there to support STEM.

Student Support (Higher Education)

To ask the Scottish Government how it supports students in higher education. (S5O-03535)

The Scottish Government’s commitment to free tuition ensures that full-time Scotland-domiciled students studying for their first undergraduate degree at publicly funded higher education institutions in our country do not have to pay fees. That means that they do not incur additional debt of up to £27,000. We also provide a minimum income guarantee of £7,750 per year for students from the most disadvantaged backgrounds through a combination of bursaries and loans. In 2018-19, we increased the care-experienced bursary to £8,100 per year.

Further to that, following recommendations made by the student support review, we will, during the 2019-20 academic year, provide comprehensive online information on further and higher education student finance, among other things. We have also increased the student loan repayment threshold to £25,000 per year from 2021, ensuring that students are supported not only during their studies but after they graduate. We are working on a range of other measures as well, but that gives a flavour.

On 20 March, Parliament voted to implement the recommendations of the independent review of student support—crucially, a minimum student income. Students throughout Scotland have had enough of delay on the matter, so I ask the minister when we can expect the plans for implementation to be introduced and when every student in Scotland will benefit from a minimum income guarantee.

I remember that debate well. As James Kelly will recall, the Scottish Government supported the principle of a minimum income guarantee for students. As I indicated in my previous answer, we have already started to implement many of the recommendations of the independent review of student support, including the £8,100 care-experienced bursary. Given the overall cost of implementing all the measures in the student review, it will take some time and expense to do that. We will work our way through as we can, as budgets become available and as we calculate the cost of each individual measure.

Scotland gives a very good package of support to our students in this country compared with the packages of support that are available in the rest of the United Kingdom, not just in respect of free education, but in respect of bursaries for independent students who have independent means and do not have family support, and for students from poorer family backgrounds. Our support compares very favourably on a range of measures with what is being delivered elsewhere in the UK.

Young Carers

To ask the Scottish Government what action it is taking to ensure that schools and teachers understand and accommodate the needs of young carers. (S5O-03536)

All children and young people deserve the same opportunity to succeed and reach their full potential, and the Scottish Government is committed to ensuring that all pupils, including young carers, receive the support that they need, when they need it.

Under the Education (Additional Support for Learning) (Scotland) Act 2004, education authorities have duties to identify, provide for and review the additional support needs of all their pupils, including young carers, and all schools have plans in place to do that. In some areas, schools have been commissioned to prepare young carer statements. The Scottish Government supports that approach. Those statements are personalised plans that cover a range of information about a young person’s caring role, including their own individual needs and personal outcomes.

When I speak to young carers and those who advocate for them, a common theme is how patchy the support structure is for them across the education system. Some have excellent school experiences, whereas others have not so excellent school experiences; it depends on individual teachers and their experiences in dealing with young carers. Given that every teacher is likely to work with young carers multiple times in their career, does the cabinet secretary agree that the education of our educators should include specific instruction on the issues that young carers may experience?

Mr Whittle makes a fair point. It is important that all our educators are equipped to deal with young people as they present themselves and the circumstances with which they are wrestling. Mr Whittle is also correct to say that there are examples of outstanding practice in our country and examples in which practice will not be as strong as that.

During the summer, I spent some time at the Scottish young carers festival near Dunfermline, at which I spoke to a group of young people who, even in that small grouping in the same local authority area, were able to recount a position that Mr Whittle has recounted. Some young people had very specific and focused support in place; for others, that was less the case.

I agree with Mr Whittle that, as part of continuing professional development of our teaching profession so that it understands the health and wellbeing aspects of our curriculum, teachers should be equipped with that knowledge to provide the support that young carers require in our society.

I recently spoke with Renfrewshire Carers Centre, which told me about young carers who feel isolated in school and struggle with bullying and teachers who do not understand that they cannot complete their homework or arrive on time because of their caring responsibilities. To change that, it is facilitating peer support groups in school and conducting awareness-raising training for teachers. What can the Scottish Government do to help to support organisations such as Renfrewshire Carers Centre to provide those vital services?

I welcome the information that Mary Fee has shared with us, which illustrates the practical and tangible support that can be put in place for young carers.

Mary Fee recounted circumstances in which there are perhaps difficulties and challenges in the interaction of young people with the school, whether that relates to homework not being presented or young people not being able to get to school on time. Schools should focus on the experiences of individual young people. If we are to sign up to the getting it right for every child agenda, we should be engaging and understanding the needs of every single child. That is the founding ethos of our education system and the curriculum for excellence.

Obviously, those are significant policy approaches that the Government supports. I am grateful to Mary Fee for putting on the record the specific ways in which support is being offered in Renfrewshire, and I am happy to support that.

“Scotland’s People Annual Report 2018”

To ask the Scottish Government what its response is to the satisfaction level of local schools in the “Scotland’s People Annual Report 2018”. (S5O-03537)

Satisfaction levels among those who use our local schools was recorded at 86 per cent in “Scotland’s People Annual Report 2018”. That is testament to the excellent work undertaken by all staff in our schools along with the active participation of pupils and parents. I take the opportunity to commend them on their efforts.

The report shows that, after 12 years of Scottish National Party government, satisfactions levels with services are at their lowest since 2007. Back in 2011, 85 per cent of people were happy with schools; now, the figure sits at 71 per cent. Does the cabinet secretary disagree with those individuals, or will he listen, take action and sort out the school issues?

It is important that we look at what the survey tells us about those who are using our local schools. The rate of satisfaction, among parents and carers of school-aged children, in the quality of school education and local schools is at 86 per cent.

Obviously, we must continue to strive for continuous improvement in our education system. There is a relentless focus in the Government’s education policy on improving our education system and our schools. We should listen carefully to the opinion of service users, because they have lived experience of using our schools. They have demonstrated significant levels of support for, and satisfaction with, the quality of local schools.

Parents, carers and others are concerned about the narrowing of the curriculum in the senior phase of secondary school. On that basis, the agreement to undertake a review of the senior phase, which the cabinet secretary announced earlier this week, is welcome. Will he take this opportunity to tell us more about who will undertake the review and its timescale?

As Mr Gray recounts, I agreed to the Education and Skills Committee’s recommendation that we undertake a review of the senior phase. We will do so, and the review will be independent of Government.

I have not yet come to any conclusions about the names of individuals who will be involved in the review. I am mindful of the fact that the review of broad general education involved input from the Organisation for Economic Co-operation and Development. For consistency’s sake, it might be advantageous to rely on some of its input. I will consider those issues swiftly, and I will update Parliament on the details of appointments and the timescale within which I expect the review to be undertaken.

Questions 6 and 8 have been grouped together.

Substandard Schools

To ask the Scottish Government what its response is to reports that one in 10 pupils are taught in substandard schools. (S5O-03538)

The number of poor or bad schools has decreased from 993 in 2007 to 288 in 2019. It is the statutory duty of local authorities to maintain the school estate across Scotland, but the £1.8 billion schools for the future programme and the £1 billion learning estate investment programme are means by which the Government is demonstrating its commitment to improving Scotland’s school estate.

The Scottish Government’s guidance advises caution when comparing 2019 figures with figures from previous years, because the measurements have changed. Last week, the Scottish National Party compared 2019 figures with figures from previous years, and the Deputy First Minister just did so again. The Deputy First Minister is a serious politician—or, at least, he used to be—and he has a choice. He can either spin stats or acknowledge that the SNP is failing thousands of pupils across Scotland. Is the cabinet secretary interested in accuracy, or is he interested only in papering over the cracks—in this case, literally?

I am, of course, interested in the facts. I am also interested in improving the physical condition of Scotland’s schools and the quality of education. That is what I focus on every day of the week.

Mr Tomkins gives me the opportunity to place on the record further detail in relation to the school estate survey, which it is important for me to do. Mr Tomkins’s reference to the statistical bulletin relates to the effects on individual schools that might have changed their classification as a consequence of the change to the guidance that was applied in 2017. I am advised by statisticians that that affects a small number of schools. The statistical publication, which is a publication not from me but from the chief statistician—I do not control the data; it is controlled by the chief statistician—presents and demonstrates year-on-year comparisons since 2007.

Of course, since 2007, the percentage of pupils who are educated in poor or bad conditions has declined from 36.6 per cent to 10.3 per cent. I accept that one in 10 pupils being educated in poor or bad conditions is unacceptable, but that is a colossal improvement in the situation. That improvement in the school estate around the country as a consequence of the investment by the Government and our local authority partners is visible to the naked eye.

New and Refurbished Schools

To ask the Scottish Government how many schools have been built and refurbished, and at what cost, in East Ayrshire and across Scotland since 2007. (S5O-03540)

Between 2007-08 and 2018-19, 928 schools were built or refurbished in Scotland, of which 21 were in East Ayrshire. Since 2007, the Government and local authorities have collectively invested about £4 billion in improving the school estate. Through the schools for the future programme, the Government and East Ayrshire Council have invested £143 million in six school projects.

It is great to hear that the Scottish National Party Government has completed all that important work in the school estate across Scotland. Will the cabinet secretary outline when all the schools in the East Ayrshire Council area will be upgraded and brought up to a satisfactory condition?

According to the latest school estates statistics, East Ayrshire Council has two schools in condition C—that is, in poor condition. Improvement works are expected to be complete at Netherthird primary school by the end of March 2021 and at St Sophia primary school by the end of June 2021, after which all schools in East Ayrshire will be in the good or satisfactory categories.

Willie Coffey mentioned the scale of the achievement in building all those schools. That undertaking happened during a period of austerity. Had it not been for the Conservative Government’s cuts and had capital budgets remained at the same level as they had been in 2010-11 when it came to office, we would have had in Scotland an additional £7.7 billion in real terms at 2018-19 prices to spend on capital investment, which could have been spent on school investment.

Childcare (Funded Places)

To ask the Scottish Government what action it is taking to ensure that funded childcare places are flexible enough to meet parents’ needs. (S5O-03539)

Quality is at the heart of the expansion, because high-quality early learning and childcare have the potential to transform children’s lives. As well as ensuring a high-quality experience for our children, we are working to enable flexibility for families. To support that, and in preparation for August 2020, local authorities are working with providers to develop their plans for delivering the expanded hours. In line with their statutory duty to consult parents and carers on the provision of early learning and childcare as set out in the Children and Young People (Scotland) Act 2014, local authorities are also working with families to inform how they make ELC available in their area in order to put in place a flexible and high-quality local offer.

The requirement that all settings that want to provide funded places have to offer the full 1,140 hours has meant that small settings that have, to date, been contracted to deliver 600 hours but cannot or do not want to deliver the full 1,140 hours are being removed as a choice for parents. Will the Government consider revising that requirement, to allow parents to choose blended care or fewer hours in small high-quality settings?

That is a very good question. Blended provision is already a cornerstone of many local authorities’ provision. As part of the phasing, local authorities are consulting their communities on exactly what is required. I refer to my earlier response, in which I mentioned the statutory duty on local authorities to consult local families closely, which means that local authorities are aware of what is required in their areas. Blended provision is part of the provision in areas where parents are requesting it.

Will the minister provide an update on the Scottish Government’s recent work on the issue of deferment for children with birthdays from mid-August to December, as highlighted by the members’ business debate on the issue on 1 May this year and the give them time campaign?

I put on record my thanks to Fulton MacGregor for his work on the issue. I know that many of the founder members of the give them time campaign group are his constituents and that he has worked well alongside them to raise their issues.

This morning, I updated the Education and Skills Committee on the work that the Scottish Government and partners are undertaking on funded early learning and childcare and deferral of school start. We are in the process of updating the early learning and childcare statutory guidance to reflect legislative changes since 2014. As part of those updates, we have committed to strengthening the guidance on providing an additional year of funded ELC in a deferred year. We will hold a public consultation on the refreshed statutory guidance prior to its publication.

We have worked with Convention of Scottish Local Authorities members and the give them time campaign on parental communication issues. I put on record my thanks to the campaign for its support for that work. I have updated the Scottish Government web pages to provide more clarity for parents on the right to defer children’s entry into primary 1. We have also investigated the available data on deferral and uptake of early learning and childcare. We will publish new analysis using information from the pupil census.

Health and Sport

I remind members that questions 2 and 8 on health and sport have been grouped.

Women’s Health Group (Pre-eclampsia)

To ask the Scottish Government when a women’s health group will be convened and whether it will prioritise the treatment of pre-eclampsia. (S5O-03541)

Work on developing the women’s health group will commence shortly. The group will consider a range of issues, with a clear focus on tackling health inequalities for women. I have already given a commitment that the group will prioritise the testing for and treatment of pre-eclampsia in its work plan. The member has worked hard to raise awareness of pre-eclampsia, so he will know that it is a pregnancy-specific condition that affects one in 10 pregnancies in the United Kingdom, which is 80,000 woman a year, and that it can affect the mother and the unborn child.

I thank the cabinet secretary for that positive answer. She will be aware that pre-eclampsia is the cause of many stillbirths each year and that placental growth factor-based tests provide a reliable indication of whether a baby is at risk. My own son died a decade ago because two midwives and a consultant, among other professionals, did not diagnose pre-eclampsia in my wife, so I know what many families have gone through. When will such tests be available in routine clinical practice?

As Mr Gibson knows, I have had recent discussions on the matter with my colleague Mr FitzPatrick. We are waiting for additional clinical evidence but, with the chief medical officer, who is of course a consultant obstetrician, we will continue to actively consider how and when we can introduce additional measures for the diagnosis and subsequent treatment of pre-eclampsia. I will ensure that the member is informed of that as soon as I have the information.

Scottish Labour campaigned for a women’s health strategy, so we welcome those developments. I think that I asked this last week, but I ask again: what funding is being made available to support that work?

A range of funding is in place for a number of condition-specific issues that, in clinical terms, affect only women. We are also interested in the wider health issues where research into diagnosis and treatment shows that women are treated differently without an apparent clinical justification. As Ms Lennon knows, that is an issue in relation to heart disease. Dealing with that is about those who diagnose and treat and about changing treatment patterns and patient pathways, and so it does not necessarily require significant additional funds.

As the women’s health group develops a women’s health plan and prioritises its work, we will allocate what we consider to be the relevant funding to the different strands of that work. I will ensure that members of this Parliament are updated, when the group is established, on who its membership is, how it is taking forward its work plan and priorities and what the timeframe is for all that work, along with what additional resourcing is going in its direction.

Questions 2 and 8 have been grouped, so supplementary questions will come after the second question.

Monklands Hospital Replacement

To ask the Scottish Government what progress NHS Lanarkshire has made with plans for a new-build Monklands hospital, following the recommendations made by the independent review. (S5O-03542)

NHS Lanarkshire accepted the recommendations of the independent review into the Monklands replacement/refurbishment project. The board also accepted the additional requirements that I made of it, which include working closely with the local planning authority to ensure that it can support and contribute to a more constructive, inclusive and open site-option review, with meaningful public engagement.

NHS Lanarkshire has established an oversight board, as it was required to do. The oversight board is chaired by Dr Lesley Thomson QC and has the involvement of Sir Harry Burns. North and South Lanarkshire patient/public forum members will provide assurance on the progression of the Monklands replacement project and the oversight board will report directly to the board of NHS Lanarkshire. The newly constituted oversight board will have its first session on 24 September, with a meeting later in October. Timescales on its work will be clarified following the first meeting.

The cabinet secretary will welcome, as I do, NHS Lanarkshire’s commitment to working with others to redevelop the current site

“to provide facilities to improve the health and wellbeing of local people, reducing their health inequalities and providing the opportunity for economic regeneration in the area”,

as the board said in a recent letter to me.

The cabinet secretary might be aware that households in my constituency have received a letter from Labour politicians that uses language about Monklands hospital closing. For the avoidance of doubt, will she confirm the Government’s support for a new Monklands hospital, complete with the accident and emergency department that Labour was so determined to close in the past?

That information is disappointing, because as members know, and as I say again for the record, both the First Minister and I have said on a number of occasions that there is an absolute commitment on the part of this Government to see a replacement built for Monklands hospital, which will include an accident and emergency service.

On the recommendations of the independent review, I have made clear to NHS Lanarkshire that it needs to look again at potential site options. I am pleased that the board is taking forward that work, engaging meaningfully with local planners and planning to engage with local residents.

I repeat again, for the avoidance of doubt, that there is an absolute commitment on the part of this Government to see a replacement for Monklands hospital built that includes accident and emergency.

Monklands Replacement Oversight Board

To ask the Scottish Government how many appointments have been made to the Monklands replacement oversight board, and what skills, expertise and local knowledge are reflected in these appointments. (S5O-03548)

The new Monklands replacement oversight board reflects a blend of patient and public experience from Lanarkshire and senior representation from the non-executives on the national health service board, including the employee director, supplemented by the expertise of Sir Harry Burns, a recognised international authority on health inequalities, and Dr Mike Higgins, a former member of the independent review team.

The oversight board will also have access to the advice of a stakeholder engagement group, which will be made up of a wider mix of third sector, voluntary and patient group representatives.

I thank the minister for providing slightly more information than I have been able to get out of the health board up to now.

The new board appears to be made up of one new external member, four members of NHS Lanarkshire’s board and, as I understand it, four other people from local partnerships. Is the cabinet secretary confident that the new appointments will be independent, which will be vital if she expects the board to help to restore public trust in a flawed process? Will she ensure that they are from the Monklands area and not the other side of Lanarkshire? Given the Government’s recent record on new-build hospitals, with Scottish Labour pushing her to hold a public inquiry in that regard, will she reconsider her decision and rebuild our hospital where it is, in the heart of our Monklands community?

I do not think that anyone who knows Dr Lesley Thomson QC would consider her to be other than independent. The non-executive members of the board who are on the oversight board are precisely that—non-executive members. As the member will know, they are appointed by and accountable to me. Sir Harry Burns is eminently independent, as are the other members. The North and South Lanarkshire patient/public forum representatives are independent members, too.

I will have very clear oversight to ensure that the review’s recommendations are implemented. That will include extensive genuine public engagement, and that can happen in a number of ways. I understand that NHS Lanarkshire is considering discussions with the NHS alliance, which has a strong record of working with local communities to elicit their views and opinions, in advance of any formal consultation process.

On the current circumstances in NHS Lothian with the sick kids and in the Queen Elizabeth university hospital campus, I repeat that in ensuring that we learn lessons from those, and from previous matters concerning the builds, we will be informed not only by the public inquiry that I have announced—which I am sure that we will debate later—but by the independent review of the Queen Elizabeth. Both will inform the work of the national body, which I believe that members previously supported.

Finally, with respect to the current Monklands hospital site, I made it clear when we touched on the matter before, that in order to build on the current site, one would need to demolish the existing hospital. There is no provision to allow the patients and services in the current Monklands hospital to be taken up in other hospitals, so we would lose a significant element of patient care. I am sure that the member agrees that we would not wish to do that. We cannot build alongside an existing hospital. Aside from the fact that the footprint does not allow it, that would be a very foolish thing to do in terms of patient safety and infection prevention and control.

That was a very detailed answer, cabinet secretary. I would appreciate it if you could be a little bit more succinct.

Although I am supportive of a new-build Monklands, will the cabinet secretary give an assurance that the parking and flooding problems at the Gartcosh crime campus will be taken into account when assessing the suitability of the Gartcosh site?

The questions about parking, flooding and the nature of the land on which any new hospital might be built will be taken account of in all the options that the health board is looking at, and will inform its options appraisal work.

Question 3 has been withdrawn.

Primary Care (Tayside)

To ask the Scottish Government what discussions it has had with NHS Tayside regarding the delivery of primary care services across the area. (S5O-03544)

Senior officials and the chief executive of NHS Scotland are in regular contact with NHS Tayside on a range of primary care issues. I will meet the chief executive of NHS Tayside and the chief officer of the health and social care partnership on 25 September to discuss the future delivery of primary care services in the area.

The cabinet secretary recently met my colleague Liz Smith to talk about the sudden closure of the Bridge of Earn general practice surgery, which has caused much anxiety to local people. She will know that one of the concerns in the local community is about the lack of a clear plan for the future delivery of primary care in the area. Can she give us an undertaking today that raising the matter will be a priority when she meets NHS Tayside, and can she tell us when she will be able to report back to Parliament on the outcome of that meeting?

I met the member’s colleague Ms Smith and had a productive discussion in which I accepted her concerns about communication and engagement with the local community, the lack of clarity over a long-standing commitment to invest £1 million of capital in the Bridge of Earn practice and the apparent lack of a plan from the NHS board or social care partnerships for how services will be developed and delivered in the future. Those issues are part of the discussions that my officials are having with officials at NHS Tayside, which I will continue when I meet the chief executive next week. Following that, as soon as I am clear about the future plan—it is important that there is one—I will make sure that not only Murdo Fraser but Liz Smith and other interested colleagues are advised of that.

The cabinet secretary will be aware that many of the underlying issues surrounding general practitioner retention in Tayside relate to the poor quality of many of the privately owned surgeries and buildings. In the case of Bridge of Earn, the owner has, in effect, acted as a rogue landlord for a number of years, and that has led to the GP crisis in the town.

What progress is being made to bring the primary care estate back into public ownership so that it can meet the needs of 21st-century primary integrated healthcare?

The Government is part of the discussion, and the first phase of the GP contract has made additional investment available to primary care GP practices in order to improve existing practices and remove some of the risk around the ownership or lease of existing practices. We are seeing the development of a mixed model, with salaried GPs—Tayside has made significant moves in that regard—and a continued use of private practice.

I am interested in primary care as the foundation of effective health and social care delivery in our communities, with primary care being the multidisciplinary team providing the care that people need when they need it, with the right specialist expertise. That is the work of our primary care improvement plans, in relation to which we have invested £1.5 million in improvements in Perth and Kinross.

Audit Scotland’s recent report on the planning of the primary care clinical workforce recommended improvements to data collection, the monitoring of the GP contract and the simplification of workforce planning. Does the cabinet secretary accept Audit Scotland’s recommendation, and does she share my view that good workforce planning needs accurate and solid data?

Yes, I accept that. I think that we are on record as accepting Audit Scotland’s recommendations, fundamental to which is the issue of quality workforce planning. The member knows that that is never an exact science, but a good place to start is with quality data, and we are working to ensure that we have that. It is part of the GP contract—if you like, it is the other side of the GP contract—that the data that we receive from our GP practices should be consistent across the country, so that we have greater clarity about what is currently in place and what more needs to be done.

Trans and Non-binary People (Healthcare)

To ask the Scottish Government what action it is taking to improve healthcare for trans and non-binary people. (S5O-03545)

The Scottish Government expects everyone, including trans and non-binary people, to be to be treated fairly and equally and with respect when they seek healthcare. That was set out in the charter of patient rights and responsibilities that was published under the Patient Rights (Scotland) Act 2011. An updated charter was published in June.

The charter states that everyone

“will be treated fairly and equally and will not be discriminated against.”

It says that

“access to health services will never be affected or refused because of unlawful discrimination based on ... age, disability, sex or sexuality, gender reassignment, marriage or civil partnership, pregnancy or maternity, race (including colour, nationality, ethnic or national background), or religion or belief.”

The charter also sets out people’s right to be treated with consideration, dignity and respect when they access services in the national health service.

The minister will be aware of a BBC report last week about the extremely long wait for treatment that trans people, in particular, face before they can even begin hormone therapy. The minister might also be aware that the First Minister, speaking at an event in Parliament last week, made it clear that she recognises that the situation in Scotland is not what it should be and that significant improvement is needed. I hope that the minister will agree with that and with the view of the Scottish Trans Alliance that having some people wait two years for a first appointment is unacceptable and that huge progress could be achieved with a relatively small increase in the resources that are spent in this area.

I agree with the comments of the First Minister and with what the Scottish Trans Alliance said about those waits being unacceptable. The service is currently managed by the national services division of NHS National Services Scotland. It commissions national managed clinical networks, which aim to foster improved standards and quality in healthcare.

Those NMCNs include the gender identity clinic network for Scotland, which is a network of clinicians and others who have an interest in the treatment and support that is offered to trans people and to people who are distressed or concerned about their experience of their gender, including clarifying issues around access to surgery for trans people. That clinical network works with the Scottish gender reassignment protocol, which it has requested be reviewed in the light of the Scottish public health network publication on the topic and changes to international standards that are due by 2020. We are taking that request forward. I absolutely agree with the points that were made, and I hope that we see progress.

I am afraid that we are out of time, so that concludes portfolio question time. I highlight the fact that we got through all the education questions. However, I apologise to Rona Mackay and Jackie Baillie, who had questions on health and sport, and to the minister, who did not get a chance to respond. I encourage all members and ministers to be succinct in their questions and answers.