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Chamber and committees

Meeting date: Wednesday, February 20, 2019

Meeting of the Parliament 20 February 2019

Agenda: Portfolio Question Time, Hutchesons’ Hospital Transfer and Dissolution (Scotland) Bill: Preliminary Stage, Fuel Poverty (Target, Definition and Strategy) (Scotland) Bill: Stage 1, Business Motions, Parliamentary Bureau Motions, Decision Time, St Rollox Railway Works


Portfolio Question Time

National Health Service (Wigs Policy)

To ask the Scottish Government what the NHS policy is on prescribing wigs for patients receiving private healthcare. (S5O-02879)

The prescribing of wigs is dependent on clinical assessment and individual need. The Scottish Government has previously issued guidance on the provision of wigs to all NHS boards to allow them to deliver services that meet the needs of their local populations. We expect independent healthcare providers to administer all necessary treatment for each episode of care.

Being told that one has cancer is a blow to anybody, and to family members. Whether a cancer sufferer is a private or an NHS patient, they do not need officialdom or red tape. That is what one lady got until officials realised who they were dealing with. The policy is quite clear and should be implemented in that way. I thank the officer in the Scottish Parliament information centre who answered my inquiry in a matter of hours.

As I spoke to that patient, her young son drew the picture that I have in my hand, which says, “We want the wig.” That says it all. By the way, the patient got her wig.

Will the cabinet secretary ensure that a policy that is set out to aid all cancer patients is implemented correctly and that patients, whether private or NHS, are treated with respect and get the service that they deserve?

I could not agree more with Richard Lyle. When someone receives a diagnosis of cancer or any other life-threatening disease, the last thing that they need is red tape and bureaucracy. I am happy to confirm that I will ensure that our guidelines are reissued across all our boards and to the private providers with which we are in contact, so that all our patients are treated with the dignity and respect that they deserve.

I have been assisting a constituent who has alopecia, which has prompted me to write to health boards to ask for a breakdown of the number of real-hair wigs that are offered to patients, as well as the number of synthetic wigs. It is proving difficult to get the data. What can the Scottish Government do to help health boards improve the data that they hold, so that patients with alopecia and other conditions can get the quality of wig that they need and deserve?

It is an important issue. My understanding is that NHS patients may receive up to four stock wigs as required per year. With human-hair wigs, new patients with long-term hair loss may be prescribed one wig per year, or two wigs in the first year, which must last 24 months, then one wig per year thereafter. That is my understanding of what happens currently. I am happy to write to and set that out for Monica Lennon, and also to look a bit further at the way in which data is collected by our boards, so that the kind of questions that Ms Lennon asked can be more easily answered. In the meantime, I will write to Ms Lennon.

Question 2 has been withdrawn.

General Practitioners Premises Sustainability Fund

To ask the Scottish Government how the roll-out of the GP premises sustainability fund will help reduce barriers to the recruitment of GPs. (S5O-02881)

The GP premises sustainability fund, which offers a long-term interest-free loan of up to 20 per cent of the value of premises, is a direct response to concerns that were raised by the British Medical Association and GPs. It aims to ease the financial risk that is associated with owning premises and, in turn, to help with GP recruitment and retention. New GPs need to raise funds to buy into practice premises and can be unwilling to take on or anxious about the associated financial risks. That is considered to deter new GPs and has been evidenced as a barrier to recruitment to some degree.

The roll-out of the first £30 million of the GP premises sustainability fund has been approved and allocated. Last week, we announced an additional £20 million for that fund and the reopening of applications, bringing forward the timeframe to 2019 to 2021. So far, all the feedback that we have had from GPs and the BMA has been very positive, in that the fund has responded directly to their concerns and—we hope—will ease the risk of premises ownership and increase recruitment and retention.

The feedback that the cabinet secretary described is very similar to the feedback that I have had. I know that financial risk is critical factor in GP practices in my constituency and I welcome the Scottish Government’s ongoing commitment to the recruitment and retention of GPs.

The cabinet secretary has answered some of the questions, for which I thank her. However, can the Scottish Government say how much funding has been allocated in total to support the GP premises loan scheme and the new GP contract?

We initially allocated more than £140 million to support the premises loan scheme, the new GP contract and wider primary care reform in 2018-19. I have now increased the £30 million that was part of that £140 million to £50 million. That is our current total investment in this aspect of the recruitment and retention of GPs.

I welcome the GP premises sustainability fund and, indeed, called for it two years ago. It is vital that we ensure that Scotland’s GP surgeries are sustainable and that any prohibitive costs that are faced by GPs and their staff are addressed.

The vast majority of GP practices across the country—793 surgeries—are privately run by doctors themselves and not by the local health board. Can the cabinet secretary confirm today that all GP surgeries in Scotland will not be included in the Scottish National Party’s car park tax proposals?

I have to say that that was a wasted opportunity on the part of Mr Briggs. He is the shadow spokesperson for health, and that is the best that he can do. We will debate the issue tomorrow, but he knows as well as I do that we are talking about an additional power for local authorities to use or not as they choose.

The finance secretary has made it clear more than once—as have I—that NHS staff will not be required to pay that tax, should the local authority concerned implement it. That, of course, applies to GP practices that have a contract with us to provide NHS care. How much clearer can we be on that? Next time, Miles Briggs will perhaps ask a question that is relevant to the health portfolio.

I welcome any and all initiatives to improve the sustainability of general practice, particularly in rural areas. However, I read in the national code of practice that health boards will have a new power to withdraw both notional rent and borrowing cost payments from GPs. Will the cabinet secretary outline in more detail where and when the new powers could be used?

I think that Mr Stewart is referring to the lease aspect of the new scheme. As we know, some GP practices own the premises; that is where the loan scheme comes into play. Others do not own but rent their premises. We are offering those GP practices the opportunity for the lease to be taken on by the health board, thereby alleviating some of the risk that the practice might face in relation to a private landlord, as well as offering longer-term security for the lease provision.

I think that that is what Mr Stewart asked me about. That is part of the overall primary care reform programme and is already under way. I am sure that it will be taken up more in 2019-20. If the member wants more details on that, I am happy to provide them.

For the first time since the creation of the National Health Service in 1948, the village of Stoneyburn has no GP service. The premises—although they need improvement—are there, but there is no doctor in the health centre. Does the cabinet secretary agree that that is completely unacceptable, and will she come with me to see the premises and to speak to local people about the fact that they no longer have a GP?

My understanding is that my officials are in contact with West Lothian health and social care partnership, which has, of course, planning and commissioning responsibility in the area. They have advised me of the decision to continue to provide consolidated GP services for all patients who are registered at the Breich Valley medical practice, including patients who live in Stoneyburn, and that the partnership remains committed to retaining the Stoneyburn community health centre, in which patients can access a wider range of community health services, including district nursing and health visitors, and is looking at ways of bolstering services to the Stoneyburn community, with housebound patients continuing to receive exactly the same services that they currently do.

I am happy to look at the matter further and, indeed, to discuss it personally with Mr Findlay to see whether there is more that we can do at this point.

Healthy Valleys (Community-led Health Initiatives)

To ask the Scottish Government what role third sector organisations such as Healthy Valleys in Lanark play in supporting preventative health and other community-led health initiatives. (S5O-02882)

I acknowledge the very important work that community-based organisations such as Healthy Valleys play in addressing the challenges of inequalities in health and the complex issues that lie behind those challenges. Scotland’s strong and dynamic third sector plays a crucial role in the drive for social justice and inclusive economic growth, and it is essential to reform of public services and to the wellbeing of our communities. That is reflected in our continuing financial support for the sector via the core third sector budget and a range of other planned expenditure across portfolios.

The core budget is, of course, very important, but does the minister agree that some sort of guidelines—I do not know whether the Scottish Government already has those—and specific plans are needed to help organisations such as Healthy Valleys to gain a more assured future? Many of them are reliant on unreliable short-term grant funding, which makes it difficult to support specialists and, indeed, quite remote rural areas in working preventatively with continuity.

We absolutely encourage organisations such as Healthy Valleys to work with their funding partners to support them to continue their good work on a more sustainable basis. The Scottish Government continues to look at how we can support that activity. We are currently considering how future funding under the empowering communities fund can be streamlined to support that and improve delivery.

The Cabinet Secretary for Health and Sport and I recently attended the launch of a collaboration between Yipworld and Cycle Station, which are third sector organisations. We would like such collaboration to be promoted. Does the minister agree that the way that the third sector is currently funded makes such collaboration difficult? Is not it about time that we looked at how we can align the third sector and fund it so that there is more such collaboration?

Brian Whittle makes a good point. I have already said that collaboration is really important and that such organisations need to work with their funding partners. There needs to be partnership working.

I think that we all agree that we want to encourage models of social prescribing in the future. That involves looking at how we use the funds that we have. That is why it is important that we are specifically looking at what the funding models are, and at how we can use the empowering communities fund to streamline delivery better. We need to ensure that we are as joined up as possible across all portfolios so that we support the kinds of initiatives that Brian Whittle has mentioned.

NHS Scotland Resource Allocation Committee Funding Formula

To ask the Scottish Government what plans it has to review the NRAC funding formula for NHS boards. (S5O-02883)

There are currently no plans to review the NHS Scotland resource allocation committee funding formula for national health service boards. The formula has been used in NHS Scotland since 2009, following its approval by all NHS boards and the technical advisory group on resource allocation. It is updated annually on the basis of statistical analysis by experts, and it remains the most objective and robust method of allocating health service funding on an equitable basis.

This year, our health boards are getting an average uplift of 3.8 per cent. That is less than the 5.3 per cent uplift for the overall health budget. Health boards deliver the vast majority of NHS work. Thanks to Barnett consequentials and the United Kingdom Government’s spending decisions, an extra £2 billion is coming north for our NHS. How will the cabinet secretary allocate that extra money to guarantee that our health boards get the funding that they deserve?

Mr Kerr is displaying significant misunderstanding of the funding of our health service and the various means by which that funding gets to patients, which is the most important thing. As he will be aware, NHS boards receive an allocation in addition to the funding under the waiting times improvement plan, which provides additional resources. There is £160 million more in the draft budget, although that funding is dependent on Parliament approving the budget tomorrow. That sum includes funding to extend free personal care to under-65s, which I know Miles Briggs was, quite rightly, very keen to promote, so I hope that he will support the budget tomorrow. The £160 million for additional provision will go to our health and social care partnerships and to local authorities.

If members look in the round at the overall level of health spending on patients, and at our commitment, which we honour consistently, to pass all health consequentials on to the health portfolio, they can see that we continue to increase our health spending and that we are on track to achieve our target of shifting the balance of care from acute to community settings.

Does the cabinet secretary agree that there will not be any increase in NHS funding if the budget is not passed tomorrow? Does she also agree that any future review of the NHS Scotland resource allocation committee funding formula must take greater account of poverty and deprivation, given that they are primary indicators of likely health need?

Mr Gibson is completely accurate to say that where we stand with our health service will depend on Parliament’s decision on the draft 2019-20 budget. I remain ever hopeful that all members will understand the vital importance of the additional resource that we are putting into health, and that they will be able to support it.

Mr Gibson is also right to say that poverty and deprivation are key elements in the NRAC formula, which supports access to health care according to need. As I have said, recent reviews by independent experts have ensured that the formula remains fit for purpose. Of course, as with all formulas, it is not an exact or perfect science, so we should always remain open to continued consideration of the formula’s effectiveness.

The Scottish Parliament information centre has produced research that shows that NHS Grampian has received £239 million below the NRAC target allocation over the past 10 years. Does the cabinet secretary accept that it is not the case that the NRAC formula is at fault, but that there has been consistent failure to provide the NRAC allocation every year since 2009?

All boards being moved as close as possible to parity under the NRAC formula requires that some boards lose funding and other boards get increased funding. Mr Rumbles will know that the Government has, in stages, moved to the position in which all boards are within 0.8 per cent of parity with the formula. The figures to which he refers date back to a point at which NHS Grampian’s parity with the NRAC formula was at minus 4.8 per cent. We are making progress towards increasing equity and fairness in application of the formula, and will continue to do so on a staged basis. Every penny relates to a direct service to patients, which means that we need to take that staged and sensible approach.

Clinical Nurse Specialists (Enhanced Role and Benefits)

To ask the Scottish Government how it has enhanced the role of clinical nurse specialists in the NHS and what the benefits have been. (S5O-02884)

The role of clinical nurse specialists in our health service is important, and there has been development across a range of specialisms over a number of years.

We are engaging on a transforming nursing roles programme. The work includes the establishment of a specialist short-life working group, which will look at the clinical nurse specialist role. The group’s aims are to clarify the role, regardless of specialism, to reduce variation or duplication in the roles across the country and to have a clear focus on the total education, training and support requirements for clinical nurse specialists, in order to improve and enhance patient care.

That work has begun. I am told that it is expected to be completed in a year’s time, but I have asked officials whether there is any way in which it can produce interim recommendations or complete its work much earlier than that.

I thank the cabinet secretary for that answer, which I very much welcome. The Royal College of Nursing recommends that all children with epilepsy be seen by a specialist nurse, and that is happening in every health board area in Scotland except Dumfries and Galloway; even the Borders, with its smaller population, has this issue covered. An estimated 150 to 250 children and young people in Dumfries and Galloway live with epilepsy and, although I understand that it is a matter for the board, that is little comfort to the families concerned. Can the Government put any pressure on the Dumfries and Galloway board to change its position and catch up with the excellent position in the rest of Scotland?

I am grateful to Ms McAlpine for her supplementary question, and I share the concern that she obviously has at Dumfries and Galloway appearing to be an outlier in an area that is pretty important, not least for the families whom she has mentioned. I assure the member right now that I will personally look at why the Dumfries and Galloway board has taken this view, what it perceives to be the barriers that lie in its way as opposed to what is happening in other health boards and how we might assist it in overcoming those barriers and meeting the recommendation that she has referred to.

Given recent reports of the extremely high demand for accident and emergency services at Borders general hospital, which culminated in the director of nursing and acute services making a public appeal to urge people to visit A and E only in a serious medical emergency, how does the cabinet secretary see the enhanced role of clinical nurse specialists easing the pressure on NHS Scotland’s strained A and E departments?

A number of enhanced roles can address the additional pressure on our A and E departments. Ms Ballantyne is correct in pointing to the issue of additional demand; indeed, we experienced such demand only last year, which, as members will recall, was made particularly difficult by weather, flu and so on. For a number of weeks, demand across almost all our A and E departments increased in percentage terms to varying degrees.

As well as looking to ensure that all our emergency departments apply the six key actions that have been agreed so that they operate as effectively as possible, we are looking with health boards and health and social care partnerships at two other areas. First, there is the flow through the hospital, which will also include the issue of delayed discharge.

As for the second area, I do not want to say to people, “Don’t go to your A and E department.” Instead, I want the emergency department and those at the front door of the hospital to be able to signpost people appropriately. For example, the Royal infirmary of Edinburgh has recently opened a minor injuries unit beside its emergency department; people who come to the front door are properly signposted to that unit next door, where they will be treated properly and where a range of professional input, not least physiotherapists but advanced nurse practitioners, medics and clinical nurse specialists, can, where relevant and depending on the nature of the demand, play a role. We are looking at making the best possible use of the range of professional disciplines and skills in our health services and at increasing and enhancing them while at the same time ensuring that the patient gets the care and skills that they need at the point that they need them.

How is the implementation of advanced nurse practitioners, which are different from clinical nurse specialists, in primary care settings such as general practices benefiting communities, particularly those in rural areas such as Dumfries and Galloway in my South Scotland region?

Ms Harper is right that advanced nurse practitioners differ from clinical nurse specialists. Advanced nurse practitioners have an important role, which is why we have committed to train 500 of them by 2021. Their role in primary care, in GP practices and in some of the linked community-based services that I touched on in response to Ms Ballantyne and others is to support joined-up anticipatory and preventative care through working with individuals in their local community. In my constituency, I have seen advanced nurse practitioners take on a number of roles in the primary care setting, which has allowed GPs to step forward into the role that the new contract and the British Medical Association wish GPs to be in, which is that of clinical general specialist lead in the local community for the team of healthcare practitioners, including the advanced nurse practitioners.

Rural Clinics

To ask the Scottish Government what it is doing to ensure that its commitment to develop rural clinics aligns with the needs of NHS boards and clinicians. (S5O-02885)

We are committed to ensuring that healthcare services provide high-quality sustainable care for patients across communities, including those in rural areas. Integration authorities are responsible for planning local services in line with national policies and local priorities, and they have a statutory duty to consult partners, stakeholders and professional groups as part of their strategic commissioning process.

The memorandum of understanding that was published alongside the new general practitioner contract is clear that primary care redesign needs to be safe, effective and accessible to all and agreed with local clinical professionals. That should help to ensure that, across the country but particularly in remote and rural areas, the services that are redesigned as part of our overall primary care reform—for which there is additional resource—meet the particular needs of local communities, and that that is done through consultation, which is a statutory responsibility on health and social care partnerships.

The cabinet secretary will be aware that, in many rural communities, access to carers is important and access to transport is relatively limited. In light of that, will the cabinet secretary encourage the integration services to take those factors into account when designing the new way in which rural clinics are operated and offered?

I am happy to give Mr Stevenson that commitment. I know from my experience in my constituency that, in a rural area, it is possible to look at a map and think that it is not that far from A to B when actually it takes a great deal longer than it perhaps would take in a central belt location. I am happy to give the member a commitment that I will ensure that our integration authorities take those factors into account wherever they commission and plan services.

Ambulance Drivers (Safe Working Hours)

To ask the Scottish Government for how many hours on-call ambulance drivers can safely work in addition to their day shift. (S5O-02886)

All working patterns in NHS Scotland meet the limits of the working time regulations, including the average 48-hour working week and the required minimum daily and weekly rest periods. Over the past 12 months, on-call working for ambulance crews has been eliminated in Wick, Thurso and Dufftown and an announcement was made last week to recruit to six new ambulance posts, which will eliminate on-call working in Portree. The Scottish Ambulance Service recognises the staff concerns around fatigue related to on-call working and has agreed in partnership a fatigue policy, which is designed to address those concerns.

Ambulance crews in remote rural areas work their day shift hours and then cover the rest of the 24-hour period on an on-call basis. That can mean that staff work their full day shift and are then called out in the middle of the night. In my region, those call-outs can involve a round trip of more than six hours on top of the day shift already worked. If those staff were employed as professional drivers, that would be illegal and indeed they could be charged with dangerous driving. They can register as fatigued—that is up to them—but if they do so they cannot return home. I ask the cabinet secretary to investigate that practice and ensure that the health and safety of the crews and their patients are safeguarded.

I understand Ms Grant’s point, and I am happy to confirm that I will have further discussions with the Scottish Ambulance Service on that point and will write to her in due course on the outcome of those discussions.

St Brendan’s Hospital

To ask the Scottish Government whether it will provide an update on plans to replace St Brendan’s hospital on Barra. (S5O-02887)

I completely understand the frustration that I am sure Dr Allan feels and the local community certainly feels at what appears to have been a lengthy process.

The health board, the local authority and the Scottish Government remain committed to delivering the St Brendan’s reprovision at the earliest opportunity. The outline business case was approved in April 2018.

Work continues between the health board, the council and the integration joint board, with the support of the Scottish Futures Trust, to determine the best approach for delivery of the hospital project and the Castlebay community hub—integrated or separate solutions—to ensure that public infrastructure best meets the needs of the local population and provides an effective and sustainable health and education resource for the future. We have made clear—and I make clear again today in the Parliament—that, although we are supportive of NHS Western Isles exploring that opportunity, we do not want it to create any delay in the submission of the full business case for the health centre.

I thank the cabinet secretary for her helpful answer. Will she acknowledge that people in Barra have been waiting a very long time for NHS Western Isles to provide a replacement hospital? I will be in Barra on Friday, and I know that my constituents there will want to be reassured that, in whatever form this project is realised, any changes will not delay the submission of a full business case or affect the Government’s commitment to provide a new hospital by 2021.

I am happy to give Dr Allan that absolute assurance. I have asked my officials to provide an update on where we are between the submission of the outline business case about 10 months ago and the full business case that I expect to see very shortly. Should there be hiccups or hitches in that regard, I expect my officials to intervene and to assist the health board in producing the full business case at the earliest opportunity, so that we can make good on our commitment and the assurances that we have given many times—it is time for us to ensure that they are delivered on.

NHS Fife (Out-of-hours Urgent Care)

To ask the Scottish Government whether it will provide an update on out-of-hours urgent care in NHS Fife. (S5O-02888)

Fife health and social care partnership is in the process of carrying out further work with communities and key stakeholders across Fife, following the meeting of the integration joint board on 20 December, when the decision on the future of out-of-hours services was postponed until the community participation requests had been answered. I understand that NHS Fife expects to communicate with the community groups as soon as possible and I have asked to be kept informed.

As the member for the Cowdenbeath constituency, I stress that overnight, out-of-hours urgent care at the Queen Margaret hospital in Dunfermline and in Glenrothes and St Andrews has been suspended for nearly 11 months. Will the cabinet secretary use her good offices to ensure that Fife health and social care partnership resolves matters in the interests of individuals and families in Fife?

As Ms Ewing knows, I was concerned in December that the integration authority might take what I considered to be a precipitate decision; I am grateful that it postponed the decision and has undertaken the further work that I think was required.

I assure the member that I am taking a close interest in the matter. I understand that a progress report on a number of the outstanding issues will be given to the IJB meeting in April and I am assured that some progress has been made, including, for example, the introduction of a new remuneration rate for general practitioners, which has supported an increase in the number of GPs who provide regular sessions.

In addition, continued support for and investment in nurse training and the use of paramedics is improving resilience in the short and longer terms.

I absolutely understand the need for consistency and resilience in the service. My officials will continue to work with Fife health and social care partnership during this period, and I will ensure that I am kept up to date.

What steps is the cabinet secretary taking to ensure that staff shortages do not lead to further centralisation of out-of-hours services in Fife?

It is clear that there are a number of issues that the health and social care partnership needs to address, to ensure that there is as reasonable as possible equity of access to out-of-hours services.

I benefited from discussion with GPs from St Andrews on their propositions for what might be appropriate and possible there. I have all those matters in mind as I look to be updated on how Fife health and social care partnership’s consultation is going and on the final set of propositions that it brings forward. I take Mr Stewart’s point. I do not believe that it is entirely a matter of staff shortages, and I have already outlined some improvements in that regard. It is about understanding what is most suitable for the local communities involved and issues such as transport—we touched on that earlier—and ease of access to out-of-hours facilities. I will be looking for that when I see the final proposals.

The cabinet secretary may be aware that, in December 2018, the highest number of patients of any time over the past four years attended the down-scaled out-of-hours service that is based at the Victoria hospital in Kirkcaldy. Does she agree with me that those numbers illustrate the demand for the service? Does she share my concern that the centralisation disadvantages communities outwith Kirkcaldy? She referred earlier to the issue of rural distances, and I hope that she recognises that Fife comes into the category of areas that are affected by that. Notwithstanding her previous comments, does she commit to supporting NHS Fife to increase the pool of GPs who will work out of hours. I understand that, at the end of last year, an advert for the post of out-of-hours GP in Fife had no applications at all.

I hope that Ms Baker is assured that I understand the issues that she raises. I understand the point about remote and rural areas and, having travelled in Fife, I know that, although it looks like a relatively compact area on a map, travel on the roads in Fife is perhaps less straightforward than travel in other parts of our country—that is precisely my point. Some work has been done to increase the number of GPs who are prepared to work out of hours but also, as I said in response to earlier questions, to look more widely at the professional skills mix that is appropriate for out-of-hours services, not least in our increased and enhanced paramedical facilities as well as advanced nurse practitioners. I will be looking for that in the mix to ensure that, as far as is possible, we have equity of access to out-of-hours services across the kingdom of Fife.

Can the cabinet secretary update the Parliament on the transport appraisal for Glenrothes hospital’s GP out-of-hours service, in order to assure my constituents that access to transportation to the Victoria hospital has been assessed appropriately?

If I had had advance notice of Ms Gilruth’s question, I would have ensured that I had that information. I do not have it, but am happy to forward it to her.

Sports Pitches (Anniesland)

To ask the Scottish Government what action it is taking to support the upgrade of sports pitches in Anniesland to 3G multi-use game areas. (S5O-02889)

The Scottish Government routes plans and applications for the upgrading and maintenance of sporting facilities through sportscotland, which is the national agency for sport. It is not aware of any current proposals for pitch developments in the Anniesland area, but it would be willing to discuss potential applications from clubs and/or community groups that seek support.

I know that the Scottish Government has been proactive in supporting upgrades for sports facilities in primary schools, including within my Anniesland constituency. Will the Government work with Glasgow City Council and other councils across Scotland to make further progress on ensuring that secondary schools also make the upgrade to 3G pitches?

I understand that Glasgow City Council has asked Glasgow Life to lead a review of the existing pitch strategy in Glasgow. The review will focus on the sports that are covered in the existing strategy, which include football, rugby union, rugby league, hockey, cricket, tennis, bowls, shinty and basketball, and will look at the strategic supply of and demand for pitches across the city.

Of course, the focus of Glasgow City Council is on increasing the provision of grass and synthetic pitches across the city, and sportscotland would be happy to discuss that matter further with the council.

Royal Alexandra Hospital (Infection Control Measures)

To ask the Scottish Government whether it will provide an update on infection control measures at the Royal Alexandra hospital and NHS Greater Glasgow and Clyde. (S5O-02890)

I will start my answer by passing on my sincere condolences to the family and friends of the person who died as a result of contracting the Stenotrophomonas maltophilia infection.

When an outbreak or incident is identified by a board, an incident management team is established to assess and manage the situation. Clearly, the specific control measures that are required to prevent further cases and ensure patient safety are tailored to the nature of the bacterium that is identified and how it is spread.

NHS Greater Glasgow and Clyde has worked with Health Protection Scotland to ensure that those additional appropriate infection control measures have been put in place and remain in place in relation to the incidents that have been reported across the board area, including those at the Royal Alexandra hospital.

Yesterday, Health Protection Scotland published a report on a recent inspection at the RAH that found staffing gaps in the domestic cleaning rota and issues with the maintenance of the estate. That is concerning, as it comes after recent infections across the health board area, including the bacterial infection in the RAH that the cabinet secretary mentioned, which contributed to the death of a patient.

Does the cabinet secretary believe that the standards of cleanliness that are highlighted in the report are sufficient? What is the Government doing to ensure that our hospital environments are maintained and that there are no staffing gaps in domestic cleaning rotas?

I am grateful to Mr Bibby for his supplementary question. His analysis of what that report says is absolutely correct, and I take that seriously. I was concerned to read about those gaps in the cleaning rota and in relation to maintenance because, of course, cleaning, domestic services and maintenance are critical elements of infection prevention and control. My officials, including the new director general for health and chief executive of NHS Scotland, are in daily contact with NHS Greater Glasgow and Clyde, picking up on those matters and checking the additional work that is being done to ensure that the concerns are addressed. I receive a daily update to ensure that I am kept up to date with the situation, and I am pursuing some of the issues with the health board directly.

As far as other health boards across the country are concerned, we have sought assurance from them with regard to the data that they have on their staff numbers in terms of domestic and cleaning work and maintenance, and when we identify what we consider to be unacceptable gaps in those numbers and a lack of any immediate plan to fill those gaps, we pursue that with those health boards in order to ensure that all the vacancies are filled, as far as possible.

Pitlochry Minor Injuries Unit (Reopening)

Question 13 is from Murdo Fraser.


Thank you. I had given up on you, Presiding Officer. [Laughter.]

To ask the Scottish Government what action it is taking to ensure the full reopening of the Pitlochry minor injuries unit. (S5O-02891)

I had almost given up on Mr Fraser—[Laughter.] Never, ever.

The Pitlochry minor injuries unit’s current opening hours are Monday to Friday, between 9.00 am and 4.30 pm. Outwith those hours, appropriate out-of-hours services, including a nurse or a general practitioner, can be accessed through NHS 24 by calling 111.

The Perth and Kinross health and social care partnership is continuing to run a recruitment exercise to appoint additional staff with the specialist skills required, in order to support the full opening hours of the Pitlochry minor injuries unit, which, as I understand it, were from 9 am to 9 pm.

The cabinet secretary will know that the minor injuries unit at Pitlochry is now closing at 4.30 pm on weekdays, and has been closed at weekends for some months, which is causing a great deal of frustration to residents in Highland Perthshire, who face a long journey to the nearest alternative facility, which is in Perth.

What specific action can the Scottish Government take to support NHS Tayside to try to find replacement staff to ensure that that important local facility is reopened to the full extent?

We continue to work with NHS Tayside to look at the detail of the problems that it is addressing and to consider whether there are additional measures and steps that it can take to improve its opportunity to recruit the necessary staff and whether it is looking as widely as possible at the appropriate staff mix. We continue to have those discussions.

It is important that members understand that, when we are aware of situations like this one—which has gone on for some time—we get in touch directly with the relevant health board and local health and social care partnership to understand the detail of what they are doing and to suggest ways that have been successful elsewhere that they might consider adopting or additional measures that the Government might assist them with. We continue to work with Perth and Kinross health and social care partnership and NHS Tayside on that, and I would be happy to update Mr Fraser on the detail of what we have been doing.