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Chamber and committees

Meeting date: Wednesday, June 20, 2018

Meeting of the Parliament 20 June 2018

Agenda: Agricultural Support (Post-Brexit Transitional Arrangements), Portfolio Question Time, Freedom of Information (Scottish Government Request Handling and Record Keeping), Access to Medicines, Business Motions, Parliamentary Bureau Motions, Decision Time, Glasgow (Music Tourism)


Portfolio Question Time

NHS Lothian (Musselburgh General Practitioner Services)

To ask the Scottish Government what discussions it has had with NHS Lothian regarding general practitioner services in Musselburgh. (S5O-02239)

NHS 24 is delivering a pilot at the Riverside GP practice in Musselburgh whereby it is triaging patients who have requested same-day GP appointments. Where appropriate, NHS 24 will signpost patients to areas of the primary care system that are better placed to meet their needs, often more swiftly. Indications are that the pilot is working well, with a number of patients signposted to more appropriate support, freeing up GPs to deal with patients with more complex needs. A full evaluation is under way with a report due in the coming weeks, which will be shared with health boards and integration authorities.

Earlier this month, 200 angry Musselburgh residents turned out at a public meeting because they have had real and persistent difficulties in accessing GPs locally. They do not think that the pilot is working that well. Many of the problems are caused by a GP shortage—a point that the practice and the British Medical Association have acknowledged. Can the cabinet secretary explain to my constituents why they have to phone NHS 24 to see their GP and when she expects Scotland’s GP shortage to be resolved?

The pilot that NHS 24 is running is a system that has worked well elsewhere and that has had strong evaluation, so I urge Kezia Dugdale to wait for the formal evaluation of the pilot. I am happy for her to be furnished with the evaluation if she would be interested in that.

With regard to the way forward for general practice, she will be aware of the new contract that has been put in place with substantial resources to back it up. In this financial year, we will invest £100 million to support the new contract, and we also have the ambition to increase the number of GPs by at least 800 over the next 10 years. In addition, the multidisciplinary team will make sure that we can reduce the workload of GPs.

As Kezia Dugdale has outlined, Musselburgh residents are complaining of long waits—often of half an hour—just to get through on the phone and then waits of around three weeks before they are seen by a GP. Does the cabinet secretary think that that is acceptable?

No, I do not think that that is acceptable. However, it is important that we try new ways of working. The NHS 24 system has worked well in other areas and has been well received by patients. If there are issues with the way in which the pilot is working in Musselburgh, that will need to be picked up by the evaluation.

More generally, Miles Briggs will know that the work around the expansion of the primary care team, the new GP contract and the increase in the number of GPs over the next 10 years are all about reducing the workload of GPs so that they can spend more time with patients when they need to. That requires a multidisciplinary team, which it will take a bit of time to put in place.

Attention Deficit Hyperactivity Disorder Diagnosis (Adults)

To ask the Scottish Government what the average waiting time has been in the past year for adults seeking diagnosis for attention deficit hyperactivity disorder and how many rejected referrals for diagnosis there have been. (S5O-02240)

The data on waiting times for psychological therapies is collected by Information Services Division Scotland. The data is gathered in an aggregate form from NHS boards and does not allow waiting times and rejected referrals for adults with an ADHD diagnosis to be analysed separately.

It is dreadful that we do not capture that data, because it is critical in enabling people to be directed to the right specialists. It is a bit like not knowing whether people are being referred to oncology or to orthopaedics for physical health conditions. Anecdotal evidence—

No—I want your question, please.

What will the Government do to catch that information so that people can be directed more effectively in mental health services?

As I said in my previous answer, that information is not collected at the moment but we are looking into the matter and are in discussion with ISD Scotland on how we can move it forward.

Ageing Population (Oral Health)

To ask the Scottish Government what action it is taking to meet the oral health needs of an ageing population. (S5O-02241)

In January, we published Scotland’s “Oral Health Improvement Plan”, which includes actions to ensure that older people receive appropriate oral health care. One of our priorities is to introduce a new domiciliary care service. For adults, including older patients, the plan also introduces an oral health risk assessment, which will ensure that dentists can offer tailored advice to older people on how to look after their oral health and minimise any risk of dental disease, including oral cancer.

What discussions has the Scottish Government had with the United Kingdom Government on including dentists in the proposed visa cap scheme, particularly given the large number of European Union nationals who operate as dentists in the north-east of Scotland, whose future in the service might be at threat?

The member is right to point to the number of EU nationals who are working as dentists in the north-east of Scotland—that is also the case in Dumfries and Galloway—as a result of previous successful recruitment campaigns. I would be very concerned to lose any of them from Scotland.

An announcement last week confirmed that, from 6 July, doctors and nurses are to be excluded from the cap on skilled worker visas under tier 2 of the immigration rules. Although that is welcome, we need to see the detail of the policy, which may increase capacity for other applications from outside the health professions. Obviously, dentists are not directly covered, so we want to take the matter up with the UK Government, and we will seek further detail on that in the coming weeks.

I refer to my entry in the register of members’ interests, which shows that I am a former practising dentist and that my wife is still a practising dentist.

The health secretary will be aware that the British Dental Association has raised concerns about the risk, which the new oral health action plan poses, that more patients will turn to private plans such as Denplan. What assessment has been made of the number of patients who are turning to Denplan? Will the cabinet secretary agree to meet me and a delegation from the BDA as well as practising dentists to discuss the issue further?

I have discussed the issue with the BDA and with dentists when I have had opportunities to engage with them. They have raised positive issues about the new plan as well as some of the concerns that Anas Sarwar has raised. He will understand that the issue is about making an appropriate risk assessment and that the whole idea is to ensure that dentists can spend more time with those who have the poorest oral health. That means that the appropriateness of the plan is dependent on the person’s oral health. I would hope that we can all agree on that.

On the implementation of the plan, it is important that the chief dental officer and others continue to engage with the BDA and others—as I will do—to reassure them on the issues that they have raised.

NHS Fife Primary Care Emergency Services (St Andrews)

To ask the Scottish Government what discussions it has had with NHS Fife regarding the withdrawal of primary care emergency services from St Andrews, and what action it will take to ensure that the town is considered an option for future service provision. (S5O-02242)

My officials have been in regular contact with Fife health and social care partnership during the contingency period for the primary care out-of-hours service in Fife. The provision of a safe and sustainable out-of-hours service is the responsibility of NHS Fife in collaboration with the health and social care partnership. I understand that the partnership will shortly consult on the future of the out-of-hours service across Fife. The review, including an options appraisal, has been in development for some time in response to the recommendations from Sir Lewis Ritchie’s report on out-of-hours services in Scotland, which was published at the end of 2015.

Does the health secretary understand the level of anger and frustration that exists in the whole of North East Fife? St Andrews community hospital is not even an option in the consultation that she just talked about for primary care emergency services, even though local general practitioners have offered to support a local solution in North East Fife. Will the health secretary intervene to ensure that that is considered as an option, so that the whole of Fife can get the service that it deserves?

As I said, my officials are in regular contact with the partnership. I understand that the partnership is continuing its discussions with GP colleagues in North East Fife on the future of the out-of-hours service and their potential contribution. I have asked to be kept informed of those discussions as they progress.

Does the cabinet secretary agree with Professor Sally Mapstone, who is the principal of the University of St Andrews, and her senior officers? At the recent public meeting to which Mr Rennie has just referred, they argued that the large percentage share of students in the town creates a unique demography that, in itself, is reason to treat St Andrews as a special case when it comes to the provision of medical services.

In implementing the proposals, the partnership will have to look at the provision in the whole area, including St Andrews. I would expect it to take into account the demographics of the population, including the student population to which Liz Smith has referred. All of that should be looked at, and I will make the point that Liz Smith has raised to officials to pass on to the partnership.

NHS Dumfries and Galloway (Vacancies)

To ask the Scottish Government what action it is taking to fill vacancies at NHS Dumfries and Galloway. (S5O-02243)

NHS Scotland boards are required to have the correct staff in place to meet the needs of the service and ensure high-quality patient care. The Scottish Government works closely with boards to support their efforts in staff recruitment. The Scottish Government remains fully committed to a sustainable NHS and its workforce, who continue to deliver consistently high-quality healthcare services to the people of Scotland, including those in NHS Dumfries and Galloway.

NHS Dumfries and Galloway is currently exploring a number of options to meet its continuing recruitment challenges, particularly in relation to medical staffing. The board has reported that it has recently made a number of offers of appointment and that further targeted recruitment activity is planned.

Does the cabinet secretary realise that, in NHS Dumfries and Galloway, the vacancy rate for pharmacists is 28.4 per cent and the vacancy rate for consultants is 22.1 per cent? The bill for locums is an eye-watering £12.6 million per year because it cannot fill vacancies. Newton Stewart and Moffat hospitals have just had to cut their numbers of beds by a third because there is a shortage of nurses. The health board has reported that it—

No—I need a question now, please, Mr Smyth.

I ask the cabinet secretary whether she is aware of all those matters.

Thank you. I call the cabinet secretary.

Is she aware or—

No—thank you. Cabinet secretary.

Yes, of course. That is why, in my initial answer, I referred to the recruitment campaign that we support NHS Dumfries and Galloway in undertaking. I hope that the board will be part of our international campaign, which I announced just this week, to help to fill key specialties that are very difficult to fill here.

What action is the Scottish Government taking to grow our NHS workforce across Scotland?

Under this Government, the workforce has increased by more than 10 per cent, to historically high levels. In the past year alone, it has risen by almost 500, to nearly 140,000. The fact that we have more posts sometimes impacts on the vacancy level, which we are determined to address.

In 2015, we saw a GP recruitment and retention programme recruit, at a cost of £2.5 million, only 18 doctors, none of whom was in Dumfries and Galloway. Only this month, there has been an announcement of yet another similar scheme. This health secretary has been trying such schemes since 2015, and they seem to be failing. Does she not agree that fresh ideas for recruitment in rural areas are needed urgently?

Well, if Mr Carson has any such ideas, they would be gladly received. However, the ones that we have had have been based on evidence about how to conduct the recruitment of GPs, which has been very difficult everywhere and not just in Scotland. Such incentives are proven to attract GPs, and we want to do more of that. As I have said, the international recruitment campaign that we have launched this week will look at the key specialties, of which I am sure that general practice will be one.

Health and Social Care Hub (Glasgow East End)

To ask the Scottish Government what its position is on whether Parkhead should be the location for a new health and social care hub for the east end of Glasgow. (S5O-02244)

The decision on the location of the new health and social care hub is a matter for local determination by the Glasgow health and social care partnership in consultation with local stakeholders. I expect the initial agreement to be submitted to the NHS capital investment group for discussion at its next meeting in August. Before any final decision is made, I expect the partnership to carry out a site options appraisal, which will be an open and transparent process as required by the Scottish capital investment manual.

I accept that the decision will, and should, be made locally. However, will she at least accept that transport—especially public transport—links to Parkhead are much better than those to other sites such as Lightburn, so that Parkhead is by far the best option?

Full marks to John Mason for trying. As I have said, I expect the health and social care partnership to engage fully with the local community before coming to a conclusion. All the issues that John Mason has raised, including transport links, deprivation and, of course, an analysis of the best site, will be taken into account. Once a shortlist of options has been agreed to, further engagement will take place.

NHS Ayrshire and Arran (Gender Pay Gap)

To ask the Scottish Government what action NHS Ayrshire and Arran is taking to tackle its gender pay gap. (S5O-02245)

NHS Ayrshire and Arran’s latest published gender pay gap information shows a male-to-female pay gap of 2.84 per cent for NHS agenda for change staff overall and 4.63 per cent within the consultant cohort. Each health board has published its own gender pay gap data, which is not collated centrally across NHS Scotland. However, the figures for NHS Ayrshire and Arran compare favourably with the full-time gender pay gap in Scotland, which was 6.6 per cent last year, compared with a United Kingdom-wide gap of 9.1 per cent.

In Ayrshire, the reality at University hospital Crosshouse is an average pay gap of £35,000 between male and female consultants, with men earning a staggering 61 per cent more than their female counterparts. Will the cabinet secretary introduce any proposals or strategies to address the huge variations in the gender pay gap in our NHS?

The Scottish Government has taken clear steps to promote NHS Scotland as a modern, inclusive and diverse employer and is supportive of all measures to promote women in strategic leadership roles and deliver a more equal workforce, including tackling the gender pay gap.

NHS staff receive NHS pay rates and receive the rate for the job. Although the rate is the same for male and female workers, evidence of a gender pay gap is sometimes quoted as average earnings, but that, of course, does not take into account hours worked and any allowances accrued.

The gender pay gap at that grade reflects the fact that, historically, there were few female consultants in NHS Scotland due to childcare commitments and career breaks. The situation is slowly changing, and more specialties report that between 30 and 60 per cent of females are in post in the middle trainee grade. When those doctors finish their training, the percentage of female doctors and consultants will increase across NHS Scotland, which will help to close the gender pay gap.

General Practitioner Appointments

To ask the Scottish Government what action it is taking to ensure that general practitioner appointments are being made available in a timely manner. (S5O-02246)

The new GP contract, which is backed by investment of £110 million in 2018-19, will ensure that GPs can spend more time with patients when they really need to see them, as well as developing wider multidisciplinary teams to support GPs and to improve patient care. We are also working to increase the number of GPs by at least 800 over 10 years to ensure a sustainable service that meets increasing demand.

The lack of GP appointments is a constant issue across my region. A woman from Blantyre recently told me that it would take more than three weeks for her to be allocated an appointment. I have raised the issue in writing with the cabinet secretary and I am still waiting for a reply 10 weeks down the line. When will she reply to the issue that I raised on behalf of my constituent? What specific—

Thank you. I call the cabinet secretary.

What specific action—

I call the cabinet secretary. Please, Mr Kelly.

—is being taken to address the GP crisis?

As I have outlined, the level of investment that we are making, the new GP contract, the primary care plan and our ambition to increase the number of GPs by at least 800 over the next 10 years show our plans to expand primary care.

I will chase up the reply to James Kelly’s letter and make sure that he gets that as quickly as possible.

Distress Brief Intervention Pilot

To ask the Scottish Government how it is progressing the distress brief intervention pilot. (S5O-02247)

The distress brief intervention pilot went live in June 2017, initially in Lanarkshire only, with the other pilot areas in Aberdeen, the Scottish Borders and Inverness going live in October 2017. The pilot is being hosted and led for the Scottish Government by North and South Lanarkshire health and social care partnerships. It is progressing well.

I ask the minister to recognise what a sensible scheme this is, with local public agencies in Lanarkshire being responsible for intervening early if people are seriously distressed, and to recognise how worth while it is to train all staff in public agencies on such early intervention.

I thank Linda Fabiani for her interest in the pilot that is under way in her area, and I thank her for hosting the parliamentary reception for members of the international initiative for mental health leadership, who had a worldwide week of collaboration in Scotland to learn about the DBI, which they were very impressed with and hope to replicate in their countries.

Mesh Implants Review

To ask the Scottish Government whether it can provide an update on the inquiry by Professor Alison Britton into the review of mesh implants, and when it expects the findings to be published. (S5O-02248)

I understand that Professor Britton’s review is progressing, but as it is being carried out independently of the Scottish Government, the precise detail, including the publication date of the final report, is a matter for Professor Britton and her team.

Will the cabinet secretary join me in paying tribute to Michele McDougall, a brave soul who recently died of cancer and was tragically unable to receive chemotherapy because of the debilitating consequences of faulty mesh devices that were implanted in her groin and abdomen years earlier? In view of the national and, indeed, international attention on and importance of Professor Britton’s review, will the cabinet secretary agree to hold a full parliamentary debate on the report in the autumn, when it is published, and on the wider developing issues that are now associated with the use of mesh?

I join Jackson Carlaw in paying tribute to Michele McDougall. When Professor Britton produces her report, I will be happy to bring that back to Parliament in whatever form is appropriate. As I said, I do not know the timescale for the publication of the report, but we must allow Professor Britton to continue her work and to conclude it in due course.

I was at Michele’s very moving and quite inspiring funeral. The resolve of the mesh women who attended is greater than ever. I remind Parliament that 101 members of Parliament called for there to be no whitewash of mesh reports. We will be watching very carefully, and I hope that the debate on the report happens very early, in Government time, in the new term.

As I said, it will be down to Professor Britton to determine when her report is published. Of course, it will be her report but, as I said to Jackson Carlaw, I will be happy to make sure that Parliament is given the time and the opportunity to discuss it.

Respiratory Improvement Task Force

To ask the Scottish Government whether it will provide an update on the work of the respiratory improvement task force. (S5O-02249)

I remind Parliament that I am the convener of the cross-party group on lung health.

Officials are working closely with the recently appointed chair of the respiratory task and finish group and key partners to finalise the group’s constitution and to set out the objectives, including the workstreams that are required to develop a plan for respiratory care for Scotland.

This week is pulmonary rehabilitation week, and PR is one of the most powerful and cost-effective interventions for people who live with chronic obstructive pulmonary disease and other lung diseases, as it allows people to self-manage and stay out of hospital. What action will the Government take to ensure that every person who would benefit from pulmonary rehab gets access to a programme?

The Scottish Government recognises that pulmonary rehabilitation is an important element of respiratory disease care. There is a well-established evidence base for its benefit in helping to support self-management and reduce exacerbation and hospital admissions. It is the subject of a key recommendation in the national clinical guidelines, which we expect boards to follow.

Access to pulmonary rehabilitation will form an important part of our quality improvement plan for Scotland, and I am pleased to advise that the Scottish Government is funding participation in the national asthma and COPD audit programme, which will collect data on the provision of pulmonary rehabilitation across Scotland. That will be a valuable tool in improving the care of and outcomes for people in Scotland who live with COPD.

Suicide Prevention

To ask the Scottish Government what priority it gives to suicide prevention. (S5O-02250)

Mental health and suicide prevention are an absolute priority for the Scottish Government. Over the past several years, we have worked with a wide range of partners to tackle suicide, and the suicide rate has fallen by 17 per cent over the past decade. Before recess, we will publish the new suicide prevention action plan, which will be designed to continue that long-term downward trend.

Emma Harper—oh, I am sorry; Brian Whittle.

Try again.

I beg your pardon—I am all guddled up. I should have called Clare Adamson. I apologise.

The minister will be aware of the particular circumstances in my constituency, where a number of young men have taken their lives leaving their family and friends and the wider community devastated. My staff are undergoing safeTALK training and I undertook an applied suicide intervention skills training—ASIST—course last year. What opportunities are there for young people to access those training services across our communities in Scotland?

Every life matters and every death by suicide is a tragedy. Everyone has a role to play in suicide prevention. NHS Health Scotland provides a range of training on suicide prevention. We are committed to continuing support for the mental health first aid and suicide prevention training. The new suicide prevention action plan will be published before recess, as I said, and an extra £3 million over the next three years will support innovative work on suicide prevention.

Strangely enough, I call Mr Whittle.

Is the minister aware of Kris Boyd’s charity, which was formed after the tragic death of his brother, and its approach, which is to encourage those suffering to come forward and discuss their issues, and to break down the stigma associated with mental ill health? Does she recognise the importance of peer-to-peer work in the prevention of suicide?

I am aware of the Kris Boyd Charity. There are a wide range of interventions, and peer support is absolutely crucial. Under the suicide prevention action plan, I am very keen for peer support to give families and relatives who have been bereaved by suicide the support that they need.

FreeStyle Libre Glucose Monitoring System

To ask the Scottish Government which national health service boards offer the FreeStyle Libre glucose monitoring system. (S5O-02251)

Currently, seven NHS boards in Scotland have included FreeStyle Libre sensors in their local formulary. They are NHS Borders, NHS Forth Valley, NHS Lothian, NHS Dumfries and Galloway, NHS Greater Glasgow and Clyde, NHS Lanarkshire and NHS Ayrshire and Arran.

If FreeStyle Libre is good enough for patients in Edinburgh, why is it not good enough for patients in Inverness?

David Stewart knows that it is up to NHS boards to determine what is available, based on the best clinical evidence. There is still a bit of work to be done around the clinical evidence on FreeStyle Libre. Once that is established, local NHS boards will be able to work out how best to support patients with type 1 diabetes. I will keep him updated, as we expect the Scottish health technologies group to publish its advice statement, which will enable health boards to take an informed decision.

Can the minister outline when the Scottish health technologies group will report on the long-term clinical evidence on FreeStyle Libre, as I understand that some boards, including Fife, are waiting to make local decisions based on those findings?

Jenny Gilruth is absolutely right, and that is why I said what I said to David Stewart about the evidence that is required for NHS boards to make their own decisions on the matter. We expect the Scottish health technologies group to publish its advice statement in July 2018.

In Vitro Fertilisation (National Health Service Policy)

To ask the Scottish Government what the national health service policy is on access to in vitro fertilisation treatment by couples. (S5O-02252)

Couples must meet certain eligibility criteria before being referred by either primary or secondary care providers for NHS IVF treatment. The eligibility criteria for and the provision of NHS IVF treatment have changed on a number of occasions over the past few years, following recommendations from the national infertility group, always with a view to improving the service for the majority of patients and improving outcomes for babies born following IVF treatment. I am pleased that Scotland has the most generous provision of NHS IVF treatment in the United Kingdom.

My constituents, who have been unsuccessful twice with treatment, were told that they could have a third attempt, but NHS Greater Glasgow and Clyde maintains that they are not entitled to that. Will the minister meet me and my constituents to discuss what can only be described as an outrageous situation for them?

If Mr Lyle’s constituents were referred from primary or secondary care for NHS IVF treatment after 1 April 2017, they should have been considered for a third cycle of treatment. If they were referred before 1 April 2017, they are unfortunately not eligible to be considered for a third cycle. I am disappointed to hear that Mr Lyle’s constituents were given conflicting advice about whether they were eligible for further treatment, especially when it relates to something as emotional as the longing to start a family. I will ask the health board to investigate this serious issue and meet Mr Lyle and his constituents. As always, I am, of course, happy to meet Mr Lyle to hear his concerns about the case directly.

Health Services (Deprived Areas)

To ask the Scottish Government what its position is on the provision of health services in deprived areas. (S5O-02253)

The Scottish Government is committed to ensuring that there is adequate provision of health and social care services across all areas of Scotland. It is worth noting that the new general practitioner contract is designed to support areas with higher levels of deprivation. Decisions on the level of provision required are a matter for local determination.

The east end of Glasgow contains an extremely high proportion of Scotland’s most deprived communities, so it is good news that Lightburn hospital was saved and that health services in the area are to be enhanced. I will be conducting my own survey of constituents over the summer to ascertain local views on the scope and shape of local services—

Get to the question, please, Mr McKee.

Does the cabinet secretary agree with me that full public consultation is essential to ensure that the east end gets the services that it deserves in the best locations, including the Lightburn site if appropriate?

As I said earlier to John Mason, it is important that there is full consultation and full analysis and that there is a full site options appraisal, which is an open and transparent process, as required by the Scottish capital investment manual. That is what should happen in the east end of Glasgow.

NHS Lanarkshire (Meetings)

To ask the Scottish Government when it last met NHS Lanarkshire. (S5O-02254)

Ministers and Scottish Government officials regularly meet representatives from all the health boards, including NHS Lanarkshire, to discuss matters of importance to local people.

Recently, at a meeting with NHS Lanarkshire, I raised the issue of the withdrawal of phlebotomy services from general practitioner practices in Stonehouse. NHS Lanarkshire had no knowledge of that but ensured that the nurses got access to accommodation to continue this much-needed service in Stonehouse hospital.

Will the cabinet secretary discuss with NHS Lanarkshire at a future meeting the need to improve communication with GP practices, especially when there are significant changes to the services that are available at the practices?

As part of the development of primary care improvement plans, which needs to happen in every area to implement the new GP contract, integration authorities should liaise with their local GP community on changes to services. My officials are engaging with NHS Lanarkshire in the process and I will be happy to write to Christina McKelvie on the matter in the near future.

HM Prison Edinburgh (Prisoner Health and Wellbeing)

To ask the Scottish Government how the national health service supports the health and wellbeing of prisoners in HM Prison Edinburgh. (S5O-02255)

NHS Lothian is responsible for the delivery of healthcare in HMP Edinburgh. The health centre in HMP Edinburgh has primary care, mental health and addictions trained nurses who provide for the health needs of the patients in the prison environment. There is also access to visiting specialists, including in psychiatry, psychology and dentistry, and patients have access to a full range of secondary services.

Saughton prison, in my constituency, has had a substantial increase in the number of prisoners self-harming—there have been 74 cases in the past year. What action is being taken specifically to address self-harming in prisons?

I thank the member for raising that important issue. Of course, the Scottish Government always takes the mental and emotional wellbeing of people in prison incredibly seriously. That is why action 15 of the mental health strategy, which is being taken forward by Maureen Watt, commits the Government to increase access to the mental health workforce through the introduction of 800 additional staff in key settings, including in prisons.

The Scottish Prison Service is committed to ensuring that those in its care who are experiencing distress and who are at risk of self-harm have access to the support that they need, including from NHS Lothian and other partners. The SPS ensures that staff are fully equipped to promote a supportive environment, so that people in prison can ask for help, and all prison establishment staff are trained in suicide prevention. The SPS also supports Scottish mental health first aid training.

I am happy to meet the member if he would like to discuss the issue further, so that we can ensure that we are doing all that we can to support the vulnerable people in prison in the constituency that he represents.

Teenage Cancer Trust (Talks)

To ask the Scottish Government what its position is on the value of talks by the Teenage Cancer Trust to make young people aware of the signs and symptoms of cancer, and how it ensures that local authorities encourage schools to hold such talks. (S5O-02256)

The Scottish Government supports the Teenage Cancer Trust’s work in delivering vital awareness and education sessions in secondary schools.

I am encouraged that 80 per cent of schools in Scotland have already received an awareness session from the charity in this academic year alone. I am even more heartened to see that that figure is 100 per cent in my constituency of Dundee. I have written to all members of the Scottish Parliament asking them to engage with their relevant local authorities, to encourage schools in their catchment areas to welcome this cancer education programme.

Does the minister agree that promoting the talks in our schools should be a priority in helping to improve survival rates of young people in Scotland with cancer?

I agree with the member that educating our young people about the possible signs and symptoms of cancer at an early age is of vital importance for not only their own wellbeing but their role as influencers of older adults in the family circle. It is timely, in the year of young people, that we acknowledge that we need to equip our young people with the skills and information that they need in order to know about the benefits of good health and when they might need to seek medical advice.

NHS Borders (Delayed Discharges)

To ask the Scottish Government what action it is taking to reduce delayed discharge at NHS Borders. (S5O-02257)

Scottish Government officials are meeting senior officers from the partnership today and will continue to work closely with them to reduce the level of delays. A range of improvement measures have already been put in place, which has led to a reduction of more than 30 per cent in bed days lost between November 2017 and April 2018.

Information Services Division statistics have revealed that NHS Borders lost, on average, 1,000 bed days a month over the past two years, which is just not good enough. What will the Scottish Government do to help rural health boards like NHS Borders ensure that when a patient is fit to leave, they can?

In the April census, 10 partnerships recorded standard delays over three days in single figures, but the worst four partnerships accounted for 43 per cent of the total delays, so it is important that we focus particularly on those partnerships.

The Borders partnership has introduced a range of measures aimed at reducing delays, including an £850,000 investment in a step-down intermediate care facility and the development of a hospital-to-home reablement service. That service was piloted initially in two localities, which led to a 40 per cent decrease in long-term care requirements. The partnership plans to roll out the service across the area, with increased allied health professions input, which I think will make a real impact on reducing bed days lost.

Chronic Obstructive Pulmonary Disease (Stranraer)

To ask the Scottish Government what action it will take to tackle the reported high levels of chronic obstructive pulmonary disease in the Stranraer area and whether that will include the installation of new air-monitoring equipment. (S5O-02258)

We know that Scotland has high rates of COPD, which is why we are working with our clinical experts and key partners, such as the British Lung Foundation and Chest, Heart & Stroke Scotland, to develop a respiratory health plan for Scotland. The plan will include the key priorities of prevention, diagnosis, treatment and research in relation to respiratory conditions, including COPD, and it will build on the work of the “COPD Best Practice Guide”, which was published in November last year.

It is my understanding that under the Environment Act 1995 local authorities have a duty to designate areas where air quality objectives are not being met as air quality management areas. Currently, no air quality management areas are identified in Dumfries and Galloway. That will be kept under review, to ensure that we make the most efficient use of limited resources, such as our network of high-precision and real-time air quality monitors, by focusing our attention on areas of concern.

As the minister might be aware, Stranraer has not only the highest levels of COPD in Scotland but the highest levels in the world. An Interreg project called the BREATH—Border and regions airways training hub—project is currently investigating the reasons behind that high incidence. Can the Scottish Government outline how it might help the BREATH project to establish a centre of excellence in Stranraer?

I recognise the interest that the member takes in the issue and I am aware of the BREATH project. Scotland participates in the Interreg VA cross-border programme 2014-2020 with Northern Ireland and the border region of Ireland, and the eligible areas for Scotland are regions in the Western Isles and the west of Scotland. We will maintain a real interest in the BREATH project as it progresses, to ensure that we get the best evidence on how much more we can do to help to support people in areas with a high incidence of COPD. We want to ensure that we recognise the learning that can be got from projects such as the BREATH project, to enable us to tackle COPD across the country.