Meeting of the Parliament

Meeting date: Tuesday, November 19, 2019

Official Report 944KB pdf

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Topical Question Time

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Budget

To ask the Scottish Government what the implications are for its budget of the general election and the postponement of the United Kingdom budget. (S5T-01892)

The general election on 12 December has forced us to cancel our plans to publish the Scottish budget on that day, and the uncertainty that is caused by the postponed UK budget continues indefinitely. I agree with the Finance and Constitution Committee’s view that the Scottish budget should, optimally, be published after the UK budget. The consequence of that is that the 2020-21 Scottish budget will not be published before Christmas. I am mindful of the importance of parliamentary scrutiny time around the Scottish budget and will continue to work with the committee to agree a new budget date as soon as possible.

Will the cabinet secretary confirm that, without the tax policy announcements of a UK budget and the tax, social security and economic forecasts that the Office for Budget Responsibility produces, the Scottish Government simply cannot know how much money is available to spend in 2020-21? Will he say what representations have been made to the Tory Government about this challenging situation? Does the Tory Government comprehend the scale of the problem? If so, what response has the cabinet secretary had?

Mr Crawford’s analysis is quite right: without the tax policy announcements of a UK budget and the tax, social security and economic forecasts produced by the OBR for a UK budget, which determine the block grant adjustments, the Scottish Government simply cannot know how much money is available to spend next year. Without a new date for the UK budget, we do not know when that certainty will come.

I wrote to the Chief Secretary to the Treasury and to the Chancellor of the Exchequer—the prospective chancellor—earlier this month, to express concern and to stress that the UK budget should proceed as soon as possible after the general election. I also stressed the need for early dialogue and information sharing with the Scottish Government after the election. I have not had a reply to my letters. Therefore, I do not know about UK ministers’ comprehension of the situation. I am sorry to say that I fear that they are not too interested in the effective working of devolution or the public services of Scotland.

Will the cabinet secretary confirm that there remains the issue of interaction between taxes that are set by the UK Government and those that are set by the Scottish Government, which can cause significant difficulties for Scottish tax policy if the UK Government does not set its tax policy first? Does he agree that, for the Scottish budget to take place in an orderly fashion, it is essential that the UK budget takes place as soon as possible after the general election? What will the consequences be for Scottish public services if the UK budget is delayed beyond the very beginning of the calendar year?

The UK budget contains a number of important pieces of information in relation to devolution and devolved and partially devolved taxes, without which it is more difficult for the Scottish Government to set its budget. We do not have the block grant adjustments, based on the most up-to-date forecasts, or the latest UK policy intentions—let us bear in mind that there might be differences between intentions that are announced by prospective UK Governments in the election period and what features in a spending review or a budget.

I agree that it is essential that the UK budget takes place as soon as possible after the general election. I have emphasised that point to the Treasury and I have alerted the Treasury to concerns about other matters. If the UK Government wants devolution to work successfully, it must engage seriously in this and understand our processes.

The consequences of a delay for public services are important, because, for local government and for public bodies, uncertainty continues about the substantive budgets, which people wish to know about. Of course, in dialogue with trade unions and others, many public sector employers need to consider pay remits that will have effect from 1 April. I will continue to engage with the unions, the Convention of Scottish Local Authorities and others on the budget process, but we will need the UK Government to act as quickly as it can post-election.

My officials will continue to work with committee clerks and the Scottish Fiscal Commission, which has engaged on the matter, on contingency options around the budget process and timetable, so that we can productively use the time before the UK general election to have ourselves as well placed as possible to respond to different scenarios. The failure of the UK Government to engage on the matter is very severe for Scotland’s public services.

There is a slight hint of hypocrisy in the Scottish National Party complaining about a delayed budget when the party voted to have an early general election.

According to a recent Fraser of Allander institute report, Scottish income tax revenues are on track to disappoint, relative to those in the rest of the UK. As a result, despite the block grant from Westminster increasing by more than 2 per cent, the overall budget available to the Scottish Government will increase by less than 1 per cent.

Does the cabinet secretary agree with the Fraser of Allander analysis?

The important point for the Scottish Conservative Party to understand is that it is the Tories who have continuously proposed—I am not specifically referring to the general election—tax cuts for the rich in society over the course of continuous budgets, which would lead to cuts in spending for our public services. Our progressive tax policy has raised revenues for us to invest in our public services.

On the cancellation of the UK Government’s budget, the UK Government could have gone earlier if it had so desired, but the Prime Minister’s track record appears to be that he could not get anything through Westminster, never mind his having the chaos of a budget failing as well. The UK Government’s track record is that it has been incompetent and chaotic, and that may well have led to a chaotic budget process as well.

On the general election, the key point is that we are where we are. There is nothing to prevent the UK Government from proceeding as quickly as possible. I understand that its budget was ready and good to go, although I do not know whether that is true. Any incoming UK Government, whoever it may be, should proceed with a budget as quickly as possible so that the Scottish Government can properly consider the matters that are devolved to us and set out our tax and spending proposals, and the Scottish Parliament can properly scrutinise those proposals. The UK Government must not leave it to the last minute, with all the negative consequences that that would have for the people of Scotland. That is why I am encouraging the Treasury, in the circumstances, to take the action that I have set out.

Councils need to set their budgets and their council tax, which is time limited, and the fact that the devolved social security powers are new means that that expenditure could not be part of a roll-on budget. The cabinet secretary talked about planning for various scenarios. When will he share those scenario plans with the Parliament?

I am engaging with the Finance and Constitution Committee to set out a timetable that can be mutually agreed with Parliament, recognising, as the committee does, that we need a bespoke process that will get us through these unprecedented circumstances.

I share the concern that we must have a timely local government settlement. I have engaged with Opposition spokespeople and I appreciate the consensual approach to that, but there are matters that people need to understand. We do not have a simple mechanism that would allow a roll-over from one financial year to the next. The circumstances were not foreseen by the creators of or signatories to the Scotland Act 2016. If we do not pass a rate resolution, we will raise no income tax, which would be catastrophic to the public services of Scotland. We also need to pass a non-domestic rates resolution and the necessary orders, and to agree a financial settlement for local government. There are many significant matters that cannot be wished away by those who think that there is an easy alternative process.

Working within the circumstances, I will present a budget to Parliament as soon as I possibly can, hopefully in agreement with the parliamentary authorities and the Finance and Constitution Committee. I set out in the medium-term financial strategy a range of determinants that could impact on our fiscal plans, and they have come true, given the risks, the volatility and the variables that we are wrestling with.

I will continue to engage with the Opposition spokespeople to try to ensure that we have a process that will get us through this in an effective, consensual and cohesive manner, but whatever we do, I call on all parties in this Parliament, in these unprecedented circumstances, to work together to ensure that there is no risk to the revenues and expenditure for our public services. Whatever we do, we must work together to address the volatility, uncertainty and chaos that have been foisted upon us by the UK Government, and ensure that devolution can deliver even in these exceptional circumstances.

If we are still waiting, part way through January, for a UK budget to be published, what is the last date on which the Scottish Government can make a decision about whether it will need to attempt to introduce a Scottish budget in the absence of a UK one? If we have to debate a Scottish budget without a UK budget being in place, potentially with emergency bill procedures, surely that is one more example not only of the UK Government’s political contempt but of a fundamentally dysfunctional fiscal framework that needs to be fundamentally redesigned.

I agree with Patrick Harvie’s fundamental point, and I have already alerted the Treasury and the Finance and Constitution Committee to it. Even before the cancellation of the UK budget, I was of the view that, given the experience that we now have, the fiscal framework requires to be reviewed urgently, and the situation that we are now in proves why the framework needs to be revisited as a matter of urgency.

As the Finance and Constitution Committee—of which Patrick Harvie is a member—knows, if the UK Government sets the UK budget so late that it presents the difficulties that I outlined in an earlier answer, it is not impossible that the Scottish Government would proceed before the UK Government’s budget is set. However, that would bring considerable and almost unacceptable risks to the process. There would be risks in trying to arrive at the numbers that we would be working with and in trying to second guess the UK Government in relation to the tax proposition and other matters. It would be a risky process.

We will impress upon the UK Government the need for it to set a UK budget and outline its policies as quickly as is responsible. We, of course, will respond to that. That will give us an orderly approach to budget setting in Scotland. I am concerned about the risks of our setting a budget before the UK Government has set its budget, and I know that the Finance and Constitution Committee agrees that there are risks. We will continue to work with Opposition spokespeople on a range of contingencies, should it transpire that the UK Government will continue with this uncertainty not only by not setting a budget but by not even setting a budget date. That is the position about which we are wrestling with the UK Government.

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National Health Service (Staff Shortages) (Cancer Survival Rates)

To ask the Scottish Government what its response is to reports that NHS staff shortages are putting cancer survival rates at risk. (S5T-01888)

I thank the cross-party group on cancer for its helpful report and recommendations, which fairly set out the key challenges that we face and the work that we need to do.

We have invested £1.6 million in radiotherapy training and staffing to date, which has meant that, in the past two years, there have been significant increases in the number of patients accessing modern radiotherapy. The number of consultants with a speciality of clinical radiology working in the health service in Scotland has increased by more than 45 per cent since September 2006. With 290 more training posts in place since 2014, earlier this month I announced that there will be recruitment in 2020 for 70 additional training posts in key specialisms including radiology and oncology. All those staff and many others are working hard to deliver the high quality of care that our patients need, which results in 95 per cent of patients rating their overall experience of cancer care positively.

I thank the cabinet secretary for that update. I add my thanks to the cross-party group, which did an excellent job in producing the report, and I thank the organisations that were involved in the drafting of it. The report was considered, measured and informative for MSPs.

However, the report found that, by June this year, one in five cancer patients were not seen within the six-week target—a threefold increase in just three years. The report was clear in its conclusion that, in relation to diagnostics, workforce issues seem to be the greatest concern impacting outcomes, and that ministers must take urgent and sustained action to address shortfalls in long-term workforce planning.

In addition to the cabinet secretary’s comments in her first answer, what action will she take to ensure that radiology and oncology departments in Scotland are adequately staffed now, not just in the future? Will she commit to a date by which we can expect the Government’s six-week target to be met across all health boards?

On the last question, if Mr Greene cares to refresh his memory, he will see that the date is set out in great detail in the waiting times improvement plan that I published a year ago.

The report has three key recommendations; I will give the member a brief update on those. With regard to developing a national model of workforce planning, I have made the commitment that our integrated national workforce plan will be published before the Christmas recess, in addition to the other workforce plans that we have already published. Unlocking the potential benefits of linked patient data is a critical part of the report with which I could not agree more—it is easier to write than it is to do; those matters are complex—and members will be pleased to know that we have almost reached an agreement on joint data controllers and data sharing. On delivering a step change in the provision of holistic cancer patient services, our joint work with Macmillan Cancer Support services, totalling £18 million, does precisely that through the provision of a holistic wraparound service.

I will make two final points, if I may, Presiding Officer. It is worth noting that our 31-day diagnosis-to-treatment target has been met at 96.5 per cent, which is 1.5 per cent over target, in quarter 2, which was September 2019. Progress continues to be made, as it does on the 62-day target.

I am sure that the member will be delighted to know that the final statistics for medical trainee recruitment in 2019 tell me that, in clinical radiology, ST1 recruitment has a 100 per cent fill rate.

Progress is being made. There is more to do, but as the member will see, we are utterly committed to delivery.

The cabinet secretary is right: there is much more to do, as the statistics show. Behind every statistic is a cancer patient waiting to be diagnosed and treated. That is the reality of the situation.

The problem is that consecutive health secretaries have been warned repeatedly about these challenges over the years. As far back as 2015, the Royal College of Radiologists issued warnings about low uptake in radiology. In 2017, an Audit Scotland reported flagged up similar workforce planning issues, and in 2018, a leading radiologist, Dr Grant Baxter, warned that our services were on “red alert”. He went so far as to say:

“If we do not address this issue now, there simply won’t be a service in the next three, four, five years.”

Why, after years of repeated warnings from health professionals across the sector, has so little progress been made? Will the cabinet secretary respond formally and in writing to the recommendations in the cross-party group’s report?

All I can say is that it is a good job that the Scottish Government listens a lot better than Mr Greene does. I answered all those questions. Why does he think I gave him all that factual information about what we have done since 2014, what we have done recently, and the considerable progress that has been made?

Mr Greene is absolutely right to say that behind every one of those statistics

“is a cancer patient waiting to be diagnosed and treated.”

I am more conscious of that than he is. However, I also know that behind all those statistics are staff who are working hard every single day. We have a 100 per cent fill rate in medical trainees in radiology. These things are important; they count, and progress is being made. [Interruption.] Mr Greene’s muttering at me from a sedentary position does not take us much further.

On Mr Greene’s final point, I know that the cross-party group knows that I will be delighted to respond in full to its report, which I found very helpful, and to return to the group, as I did in June, for another constructive and helpful conversation. I look forward to doing that.

As co-convener of the cross-party group on cancer, I thank all 67 respondents to the inquiry, whether they be charities, researchers, patients, clinicians or academics. I am sure that the cabinet secretary will agree that the report is constructive, and it aims to inform the Government rather than purely to challenge it.

Will the cabinet secretary endorse all 10 of the report’s recommendations, specifically the one on vacancy rates and how they impact on diagnosis? This year, 16,000 patients waited for longer than the six-week waiting time guarantee for their diagnosis, compared to just 4,000 patients three years ago. That is an exponential increase. What urgent action will the Government take to look at recruitment, retention and training, and how we use our technology and upskill existing clinicians?

I am grateful to Anas Sarwar for his question and for his work in the cross-party group. I completely agree that the report is very constructive and fair, and I am happy to put on record that I endorse all its recommendations. I look forward to the discussion that we will have on the report.

We have made capital investment in radiotherapy and other equipment: £33 million from our £100 million cancer strategy is going into radiotherapy and more money is going into scope capacity and surgical robots for prostate and other cancers.

There is the capital issue and the recruitment, training and retention matters, but, as Anas Sarwar rightly says, there is also the question of redesigning the service and the pathway so that we can upskill existing clinicians and others to take on new roles.

We can look at how we streamline some of that work. We are currently looking at how we use the waiting times plan, and the additional significant investment from it, in order to group together our diagnostic capacity in certain areas, so that we can speed up the time between necessary diagnostic tests in order to detect particular cancers. I would be happy to update the CPG on that matter in due course.

One of the issues that was raised in the report is the ageing population and the very real need to expand our national health service workforce to meet the anticipated increase in demand. Given that the only population increase in Scotland comes from inward migration, and given Tory members’ complete lack of acknowledgement—far less concern—of the impact of their support for Brexit, what assurances has the United Kingdom Government given that, in the event of Brexit, Scotland will have the powers to deliver a tailored immigration system to ensure that our NHS can recruit the specialists that it will need long into the future?

That was slightly tangential, but the cabinet secretary can respond briefly.

I am grateful to Keith Brown for that question, and he is right to talk about immigration policy in the context of the recruitment and retention of staff.

Everyone in the chamber has been happy to laud the value of the work that our colleagues from the European Union mainland, as well as from beyond those shores, do for us across the health service. However, if we do not control our immigration policy and if we are dragged out of the European Union against our clearly stated democratic will, that will increase our workforce challenges. There will also be additional challenges for clinical research and advancement in medicines and technology.

The straightforward answer to Keith Brown’s question is that the previous UK Government, which is currently seeking re-election, has made absolutely no recognition of the special situation in Scotland, and its proposition on immigration in particular—aside from being quite shameful and inhumane—would cause significant damage to the Scottish economy and Scottish society as a whole.

I absolutely endorse the calls, which are increasingly being made by people across the parties and across Scotland, that Scotland should have the right to choose its own immigration policy, just as we should have the right to decide much more about our future.

Staff shortages across the NHS are putting at risk the health and lives of patients, especially cancer patients. As I discovered last week through a freedom of information request, staff shortages in NHS Lothian are resulting in it having to pay up to £1,715 a shift to private agencies to cover vacancies.

NHS Lothian predicts a £90 million budget deficit, it is paying £1.4 million a month for a hospital with no patients—and now this. What does the cabinet secretary say to my constituents—cancer patients and others—who are suffering because of the workforce crisis that has been overseen by successive Scottish National Party ministers?

I think that I have already answered much of what Neil Findlay has asked. The additional information that I can give him, credit for which goes to his colleague Anas Sarwar, relates to the work that Anas Sarwar and I were able to do on the safe staffing legislation, which looked at how we handled agency spend inside boards.

The legislation has now received royal assent. When it commences, we will see a significant shift over time in how boards are able to use agency spend, as opposed to investing in the recruitment of full-time employees. That will make a significant difference to the work that is under way and to the overall sustainability of our health service.

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Student Accommodation (Fire Safety)

To ask the Scottish Government what fire safety checks it has undertaken on the building cladding used in private student accommodation, including whether it has been checked for high-pressure laminate cladding. (S5T-01895)

I am relieved that there was no loss of life in the events in Bolton at the weekend, and I acknowledge the work of all those who brought that fire under control.

In Scotland, student accommodation is classed as a “relevant premises” under the Fire (Scotland) Act 2005. That means that landlords, as duty holders, have responsibility for fire safety risk assessments.

In June this year, my officials wrote to a range of bodies, including the Scottish Funding Council, that represent colleges and universities, to raise awareness of the cladding tests that were being commissioned by the United Kingdom Government, and which might prove to be useful as part of such risk assessments.

Any significant fire in a residential building is, of course, a concern for us all. Greater Manchester Fire and Rescue Service has stated that its investigation into the Bolton fire will consider the role that external cladding played in development and spread of the fire. Once that information is available, we will review any findings as part of our on-going work on building and fire safety, and we will take any appropriate action that is necessary.

As the minister said, the fire brigade operated in an exemplary fashion in bringing that fire under control, but it was an incredibly scary fire. Although the fire brigade made it clear that there was no aluminium composite material on the building in question, eyewitnesses who observed the fire said that it was

“crawling up the cladding like it was nothing”.

That exacerbates the fears of everyone who lives in such buildings.

The minister mentioned fire risk safety assessments. Are those assessments available to the residents of buildings that have been assessed?

I cannot give an answer on that specific question at this moment, but I will write to Mr Wightman with a comprehensive response on what happens with assessments.

That would be extremely helpful, because I have spoken to students and student bodies that are extremely concerned as a consequence of the events in Bolton.

The ministerial working group indicated that a database would be created to maintain safety-critical information for existing high-rise residential buildings. In the evidence that he gave to the Local Government and Communities Committee on 5 September 2018, the minister mentioned an “inventory”. Where are we with that inventory? What additional measures can the Scottish Government and its agencies put in place to reassure residents—students, in particular—that although fire is, of course, always a risk, building materials will never exacerbate that risk?

Student bodies have written to the Government recently on that point, and I will co-operate with Ash Denham, who is the Minister for Community Safety, to ensure that they get answers to the questions that they have asked.

We have been completing work on the inventory of high-rise domestic buildings. It is being developed in order to provide a central source of information and an overview of the key aspects of high-rise domestic buildings, including all their fire-safety features. The inventory includes information on cladding types, including high-pressure laminate, which Mr Wightman mentioned.

This Government will continue to review all that. The ministerial working group continues to meet and has discussed many matters. As and when more information and analyses come to us, we will take the necessary steps to ensure that people are safe in buildings in Scotland.

Three members are waiting patiently to ask questions. If members ask very brief questions and receive similarly concise answers, we will get them all in.

Can the minister offer any reassurance to my constituents who live in buildings with aluminium composite material cladding and who are, as well as being very worried, unable to sell them at the moment?

I think that John Mason is talking about folks who have, on their buildings, cladding that is not made of aluminium composite material, but for whom, in the current situation, there are difficulties with regard to mortgage lending.

Last week, I answered a question from Jeremy Balfour on that issue. The Scottish Government is trying to seek solutions, but mortgage lending is reserved to the UK Government. I have written twice to the UK Secretary of State for Housing, Communities and Local Government, Robert Jenrick, to try to get co-operation on the matter. I recognise that there is currently a general election in the offing, but there is still a day job to do.

My officials have also been in discussions with the UK finance industry and are having more meetings this week to try to reach a resolution, so that folks who are currently finding it difficult to buy and sell properties can be helped. I hope that the UK Government will respond to our request for help in finding a solution.

What work has the Scottish Government done to assess whether local authorities have the staff and resources to ensure that enforcement action can be taken when residents have safety concerns, whether they are students or members of the general public?

I am not aware of any difficulties that local authorities have had in responding to requests that the Government has made, among the multitude of requests since the tragedy at Grenfell Tower. I thank all the local authorities very much for their co-operation and for all that they have done in response to the numerous questions that we have asked in order to ensure that people in Scotland are safe. In particular, I thank them for their co-operation in putting together the inventory of high-rise buildings, which will be very helpful. We will, as a result of that, be required to ask fewer questions in the future, although the inventory will need to be updated regularly so that we know what is going on in respect of such buildings across the country.

In the light of Grenfell and the blaze in Bolton, does the minister agree with the Association of British Insurers that there must be a total ban on use of combustible materials on the outside of buildings?

The Scottish Government has had an external independent panel of experts looking at that: we will continue to take that panel’s advice. The key is to do the right testing to ensure not only that the right cladding materials are used, but that the fire stopping that is required in buildings is put in place properly on every single occasion.

We will continue to review everything as we move forward, and to take the expert advice that is provided to us, because our job is to ensure that everyone in Scotland is safe in their buildings.