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Chamber and committees

Meeting date: Wednesday, June 21, 2017

Meeting of the Parliament 21 June 2017

Agenda: Motor Neurone Disease Global Awareness Day, Business Motion, Portfolio Question Time, Freedom of Information Requests, Agriculture, Business Motion, Parliamentary Bureau Motions, Prohibited Procedures on Protected Animals (Exemptions) (Scotland) Amendment Regulations 2017 [Draft], Point of Order, Decision Time, Stroke Care


Portfolio Question Time

Health and Sport

Question 1 has not been lodged.

Dentists (Rural and Island Communities)

To ask the Scottish Government what action it is taking to address the reported shortage of dentists in rural and island communities. (S5O-01136)

There has been a substantial increase under this Government in the numbers of high street dentists providing national health service dental care in Scotland. We recognise the potential challenges facing very remote and island communities, and that is why we have put recruitment and retention allowances for high street dentists in place. The areas where those allowances are available are reviewed annually to ensure that the needs of our island and rural communities are reflected.

I thank the minister for that answer, but that has had little impact. She will be aware that a dental practice has closed in the Uists and that there are proposals to close another one there. The lack of dentists in Lewis means that 6,000 people are without a dentist, and there is a similar situation in Shetland, where people are being asked to fly to the mainland to access private dental treatment.

Nothing that the minister has specified has changed that. It is not enough, and she knows that poor dental health impacts on an individual’s overall health. What is she going to do to ensure that my constituents can access dental services close to home?

In relation to Lewis, officials have been working closely with the health board over the past few months. We expect a new high street dental practice to open in Stornoway within the coming months. As soon as an opening date has been confirmed, we will be sure to let interested members know about it.

As for Shetland, capacity is being built. This is the first time that a high street dental practice is offering NHS dental services. The opening of that in Shetland will enable the board to free up the PDS—the public dental service—to ensure that those islands that are further away from the Mainland of Shetland have access to dentists.

I should point out that the Government’s record is strong when it comes to dentists. More than 91 per cent of people in Scotland are registered with an NHS dentist, compared with only 52 per cent in September 2007. What we inherited in 2007 has been drastically overcome, and we will continue to build on that record to ensure that people across the country, regardless of whether they live in rural or island communities, get the access that they deserve.

I wish to question the minister further. It is not just about dental health. In Caithness, there are plans for NHS Highland to pool services between three medical surgeries, which is totally unacceptable. Does the minister have a view on that, or is that acceptable, too?

That is slightly tangential, but the minister may briefly respond.

We will endeavour to ensure that we engage with the member about the issues. The Government is ensuring that there is adequate local provision for people who require medical help and support, as well as ensuring that we have the clinically driven evidence that is required for the appropriate siting of specialist services, delivered in a safe way for patients. We have a strong record in ensuring that medical support is provided in localities that are suited to people.

On the issue that Edward Mountain raises, we will continue to work with him to ensure that that provision can be enhanced.

I have a relevant supplementary question, Presiding Officer.

I remember a situation in Aberdeen and Aberdeenshire years ago, when there were queues round the block to register with NHS dentists, such was the demand of patients relative to the shortage of NHS dentists. How has the number of dentists being trained and employed to deliver NHS services changed over the past decade?

The minister will note that it is for the chair to decide what is and is not relevant.

Okay. Thank you, Presiding Officer. However, Gillian Martin is right and correct to point out that there has been significant change over the past 10 years, and part of that success has been down to the opening in 2008 of the Aberdeen dental school, which is near the area that the member represents and has helped to increase the supply of dentists in the north of Scotland by 31 per cent over the same period.

Again, over the past 10 years, the number of dentists, both independent and employed, providing NHS general dental services has increased by almost 30 per cent, and we now have nearly 3,350 dentists in Scotland providing NHS general dental services. We continue to train dentists to ensure that the dental workforce of the future reflects our population’s needs, with 178 students expected to graduate this year, compared with 133 in 2008.

Registered Nurses from the European Union (EU Referendum)

To ask the Scottish Government how many nurses from the rest of the European Union have registered to work in Scotland since the EU referendum was held, in light of a recent report suggesting that there has been a 96 per cent decline in the United Kingdom as a whole. (S5O-01137)

It is important to note that, despite the huge drop that the member has referred to in registrations across the UK as a whole, the Nursing and Midwifery Council has actually recorded an increase over the year to May 2017 of approximately 7.4 per cent in the number of EU-trained nurses registered to an address in Scotland.

The cabinet secretary might be aware that, as the nursing establishment has expanded following the application of workforce planning tools, the boards have a number of vacancies to fill. Does she therefore agree that losing the option of freely recruiting nurses from elsewhere in the EU will result in great strains on the national health service and might impact on patient services across the region and particularly in my Midlothian North and Musselburgh constituency?

I very much agree with the member. The Health Foundation figures that the member has referred to show a 96 per cent drop in the number of nurses from the EU registering to practise in the UK as a whole since July last year, and it is extremely concerning that only 46 EU nurses registered in April. The point is that, without EU nurses, it will be even harder for the NHS and social care providers to find the staff that they need to provide our services. That is another negative consequence of a hard Brexit, which is, of course, something that we need to avoid.

I remind the cabinet secretary that nurse shortages existed for a long time before the EU referendum. In fact, when she was health secretary, the First Minister cut nurse training places by a fifth. Does the cabinet secretary therefore accept that the current nurse shortages in Scotland are a result of that decision?

What Dean Lockhart has not acknowledged is the fact that we have more qualified nurses and midwives than we had previously; indeed, under this Government, the number has increased by more than 2,700 whole-time equivalents. Of course, there is more to be done, which is why, this year, we have seen the fifth successive rise in student nursing and midwifery intakes to bring us closer to delivering our commitment to creating 1,000 extra nursing and midwifery training places over the course of the Parliament. I would have thought that Dean Lockhart would welcome that.

Recruitment of Nurses and Midwives (NHS Scotland)

To ask the Scottish Government what steps it is taking to support NHS Scotland’s recruitment of nurses and midwives. (S5O-01138)

Workforce planning is the responsibility of national health service boards, which have fully delegated powers to recruit and plan their workforce in the way that best serves the needs of their population. The Scottish Government works closely with NHS boards in their recruitment efforts and a great deal is already being done to deliver sustainable solutions to workforce challenges.

Since 2007, the number of qualified nurses and midwives in NHS Scotland has increased by 6.7 per cent, or more than 2,700 whole-time equivalent qualified staff. We have also recommended a fifth successive increase in nursing and midwifery student intakes in 2017-18. Finally, a national health and social care workforce plan is being developed to strengthen workforce planning practice, including within the nursing workforce.

The Royal College of Nursing wrote to me this morning. It said:

“Nursing morale is low, and teams are struggling to recruit and retain the staff they need”.

The latest figures show that the nursing and midwifery vacancy rate stands at 4.5 per cent, which is the highest rate ever reported. With unfilled posts at that level, how will patients receive the care that they need?

We work very closely with the RCN. I meet it regularly and, of course, I listen to any concerns that it raises.

On nursing vacancies, in some specialties in particular, the creation of more posts has an impact on the number of vacancies, but it is important that vacancies are filled. There is work with boards to ensure that, as we drive down agency costs and the reliance on agency recruitment, part of the solution is the filling of substantive posts. The work with boards to ensure that vacancies are filled is on-going.

There are challenges in particular specialties such as paediatrics and district nursing that are partly linked to the creation of new posts. There is, of course, a major expansion of health visitor posts, which will take time to fill, but great efforts are being made to do that.

Under the cabinet secretary, we have seen a workforce crisis, with more than 2,500 nursing and midwifery vacancies. When will the cabinet secretary publish the workforce plan? Will she do so before the summer recess? When will she clamp down on the £175 million of agency spend? When will she scrap the NHS pay cap? Should we accept that the cabinet secretary who helped to create the problem cannot be the one who can fix it and that, instead, we should wait for the expected reshuffle and ask the next health secretary the questions?

Such a charmer.

The workplace plan will be published before the recess.

The Government has less agency spend than the agency spend that we inherited from when Labour was in power. As I said in my previous answer, we have a lot of work under way to drive that spend down, but it is still less than what we inherited.

On the pay cap, I hope that we can address pay issues with the staff side. As I said previously and as the First Minister has said, it is important that we take that issue forward. We very much recognise that inflation and costs are rising. Discussions with the staff side are under way in order to find a way forward that we can jointly agree on.

Anas Sarwar might want to reflect on other parts of these islands. Nurses’ pay under the Scottish Government is higher than that in any other parts of these islands. In particular, the lowest-paid staff in the NHS in Scotland are paid over £1,000 more than those in other parts of these islands.

We have done a lot of work, and we will continue to do that work in partnership with the staff side.

NHS Greater Glasgow and Clyde (Chief Executive)

5. Stuart McMillan (Greenock and Inverclyde) (SNP)

To ask the Scottish Government whether the health secretary has met the new chief executive of NHS Greater Glasgow and Clyde and, if so, what was discussed. (S5O-01139)

The Cabinet Secretary for Health and Sport (Shona Robison)

I have met the new chief executive of NHS Greater Glasgow and Clyde, Jane Grant, and we discussed matters of importance to local people.

Does the cabinet secretary agree that the appointment of the new chief executive of NHS Greater Glasgow and Clyde gives the board the opportunity to significantly improve its communications with elected representatives and the wider public, not least on matters to do with local service changes?

Yes. I expect all health boards, including NHS Greater Glasgow and Clyde, to meaningfully communicate and engage with all local stakeholders in line with national guidelines and standards, especially when local service changes are proposed. I know that the new chief executive of NHS Greater Glasgow and Clyde is taking the opportunity to review a number of arrangements at the board and that she is fully committed to working effectively with local representatives and local people in the best interests of patients.

The people of West Scotland are concerned about the suggested moving of general practitioner out-of-hours services from the Vale of Leven hospital to the Royal Alexandra hospital in Paisley. Locally, that is viewed as going against the spirit and substance of the vision for the Vale. The public are concerned about the time and distance that would be placed between them and a primary care source. Will the minister confirm whether the move of GP out-of-hours services from the Vale will go ahead?

The issue of out-of-hours services is challenging, because NHS Greater Glasgow and Clyde has found it difficult to recruit GPs for those services. Despite that challenge, the board has to continue to provide a safe service and it is looking at the best way to do that. I expect the board to ensure that people in the locality of the Vale of Leven hospital continue to get a good and safe out-of-hours service.

Our wider work on out-of-hours services, which is led by Sir Lewis Ritchie, is to set up urgent care hubs that are multidisciplinary in nature to ensure that we do not rely solely on GPs to provide out-of-hours care. That is a sustainable solution, but it will take some time to roll that out across Scotland. I will be very happy to keep the member informed about the progress of that work.

The cabinet secretary will be aware that NHS Greater Glasgow and Clyde has decided to proceed with its plans to close Lightburn hospital, and that the final decision will be passed to her. When does she expect to formally receive the proposals and what will the process be for their consideration? For example, would she be interested in meeting users of the current facilities?

I expect to receive the board’s formal submission shortly. As in all such cases, I will carefully consider all the available information and representations before coming to a final decision, which will include meeting local service users and stakeholders to hear their views.

The member will be aware of the history of Lightburn hospital. I have said—as the First Minister did, previously—that I would not consider approving proposals that do not address the concerns that were expressed in 2011, when the issue was last considered. The issues that were raised then have to be addressed effectively.

With regard to how long it will take to make a decision, I will take as long as is required to fully look at all the issues and to meet local people, as the member would expect me to.

As the cabinet secretary said, the fate of Lightburn hospital in the future remains in her hands. In her deliberations, will she consider the fact that many current users of the hospital will not be able to travel to the proposed new sites in Stobhill and Parkhead, as there is no bus service? I am sure that she is aware of the very low car ownership of people in the east end of Glasgow. Will the cabinet secretary take that factor into account in her deliberations as, if people cannot access the service by public transport, they cannot access the service at all?

Shona Robison

I will look at accessibility and transport issues, because they are important. I assure Pauline McNeill that I will consider those issues as part of my deliberations.

NHS Greater Glasgow and Clyde (Meetings)

To ask the Scottish Government when it last met NHS Greater Glasgow and Clyde and what issues were discussed. (S5O-01140)

Shona Robison

Ministers and Scottish Government officials regularly meet all health boards, including NHS Greater Glasgow and Clyde, to discuss matters of importance to local people.

I last met the health secretary at a protest in Paisley against the closure of the Royal Alexandra hospital children’s ward, which the Scottish Government had said was safe. She cannot ignore the fact that thousands of families and national health service staff in Renfrewshire are totally opposed to the closure. The health secretary said that she would listen. Local Scottish National Party politicians might be silent, but the message from families and staff is loud and clear: the RAH should not be downgraded and the children’s ward should be saved right now. Will she and the Scottish Government prove that they are finally listening to families and staff, and stop the closure of the RAH children’s ward without any further delay?

As Neil Bibby will be aware, after I had the pleasure of meeting him on 19 May I had a very important meeting with local parents, who are the most important people in all of this. At that meeting, which they felt was constructive and a good format for their views to be heard, I gave an undertaking to hold a series of further local meetings with local people. That is the right process to go through. I would have thought that Neil Bibby would appreciate my taking the time to meet as many local parents as possible. It would be very odd if he thought otherwise. I will continue with that process. I have another visit planned for the beginning of July, when I will visit the hospital and meet more local parents as part of the clear service change process that is laid out for ministers to follow.

Obesity and Type 2 Diabetes

7. David Stewart (Highlands and Islands) (Lab)

To ask the Scottish Government what initiatives it is supporting to tackle obesity and type 2 diabetes. (S5O-01141)

In line with the evidence, we have invested in a range of programmes to tackle obesity by making it easier for people to be more active, to eat less and to eat better. Those programmes include football fans in training, the healthcare retail standard, the eat better feel better campaign and a £50 million investment in active schools between 2015 and 2019.

In tackling type 2 diabetes, our newly formed expert group is leading on the development and implementation of a diabetes prevention framework, which will complement our wider health strategy, to identify high-risk population and support early diagnosis, treatment, education and lifestyle management.

Five per cent of the population of Scotland has diabetes, and there has been a 25 per cent increase in diagnoses since 2008. Diabetes costs the national health service around £1 billion a year in direct costs. The nine processes of care for diabetes are a key tool in preventing avoidable complications such as kidney failure, heart attack, stroke, sight loss and amputation. Will the minister introduce robust reporting and monitoring processes to assess how well every health board is delivering those services to people with diabetes?

I appreciate the interest that Dave Stewart takes in the issue. The annual Scottish diabetes survey aims to be published within 12 months of the end of each calendar year, so information is already being gathered for the 2016 survey. In addition, the expert group is looking at a range of areas in which we can enhance our knowledge of diabetes.

The obesity strategy consultation will be important for the preventative work that we need to undertake to help people to avoid getting diabetes in the first place. Tomorrow, I will speak at a podiatrists conference on some of the work that they are doing to enhance their knowledge of how to treat people with diabetes and how to help them to cope with the impact of the disease.

Maree Todd (Highlands and Islands) (SNP)

What is the Scottish Government doing to support the development of more innovative approaches to improving the treatment of conditions such as diabetes?

Examples of current innovative approaches include my diabetes, my way, the current small business research initiative innovation process to develop personalised care and education for people who have type 1 diabetes and the work of the Scottish diabetes research network, which supports the set up and delivery of clinical and epidemiological research across Scotland.

Innovation is one of the priorities of the Scottish diabetes improvement plan, and we will continue to provide the support that the diabetes community needs to develop and adapt innovative approaches to ensure that people get the help and support that they require.

Adult Psychological Therapies (Waiting Times)

To ask the Scottish Government what action it is taking to reduce waiting times for adults referred for psychological therapies. (S5O-01142)

We have put in place a £54 million comprehensive package of support to improve access to mental health services for adults and children, which will provide funding for additional staff, for workforce development and for in-depth improvement support to local services. In this first year, £4.3 million has been awarded to boards across Scotland to build capacity within mental health services. Further funding has been awarded through NHS Education for Scotland to provide each board with an individual tailored offer of funding and workforce development.

As part of a comprehensive package of support for boards, £4.6 million was announced for Healthcare Improvement Scotland to establish a mental health access improvement support team, which is working in partnership with boards to improve access to mental health services.

I am glad that the hard work of staff in NHS Forth Valley has resulted in improvement in child and adolescent mental health services in recent months. However, waiting times continue to be a problem for adults who are referred for psychological therapies in NHS Forth Valley. According to the most recent figures from the Information Services Division, only 40 per cent of adult patients who were waiting for psychological treatment were seen within the Scottish Government’s target timeframe of 18 weeks, which left nearly 500 people waiting too long for support. Does the minister agree that NHS Forth Valley needs more support to address those concerns?

I am glad that Dean Lockhart has acknowledged the great improvements in waiting times for access to CAMHS in NHS Forth Valley—the rate has gone up from 57.1 per cent in 2015 to 99.7 per cent in 2017. That shows the value of the improvement team’s work with the board. The member should be aware that the initial focus was on CAMHS; the team and boards will share the lessons that they have learned in CAMHS in order to improve delivery of psychological services to adults.

As a result of the higher profile of mental health, the number of people who come forward for psychological therapies in Forth Valley has almost doubled. That is why it is important that we increase the number of lower-intensity interventions for people who want psychological therapies.

The minister will know that there tends to be a sharp drop-off in referrals for psychological therapies among adults over 65. As part of the £54 million package of support that she mentioned, what work is the Government doing to reduce that inequality and ensure that adults throughout Scotland have the same access to psychological therapies, regardless of their age?

Monica Lennon is right to say that people should have access to services regardless of their age. I am well aware of the work that is going on in that regard through the age in mind initiative. The mental health strategy emphasises the approach “Ask once, get help fast”, which applies as much to people over 65 as it does to anyone else.

Question 9 has not been lodged.

Hospital Waiting Times (West Scotland)

To ask the Scottish Government what action it is taking to reduce hospital waiting times in the West Scotland parliamentary region. (S5O-01144)

I announced on 30 May that £50 million was being made available to NHS Scotland to help to improve performance and reduce waiting times for patients. The funds are being distributed across all territorial boards, including those in the West Scotland parliamentary region. West Scotland boards will receive up to £23 million in total from the additional funding.

In the previous quarter, NHS Ayrshire and Arran had the worst waiting times of any health board in Scotland, with only 73.6 per cent of cases meeting the 18-week referral-to-treatment guarantee. In March, that meant that more than 2,000 people waited too long.

Will the cabinet secretary say why NHS Ayrshire and Arran’s performance is at the bottom of the spectrum? What support might she offer the board to help it to improve? More important, when will she set out a timeline for when Scotland’s health boards will meet the Government’s waiting times targets?

I recognise the particular challenges with waiting times performance in NHS Ayrshire and Arran. The board has been allocated £3.7 million to improve its waiting times performance. Part of the challenge is to do with recruitment and retention of key specialist staff, which has been a long-standing issue in Ayrshire and Arran. The board is being supported to look at solutions to the problem in order to enable it to overcome some of the challenges.

All boards are drawing up their plans on waiting times improvement and recovery performance; those are due to come to the Scottish Government very soon. I will be happy to keep Jamie Greene informed of the detail of plans for NHS Ayrshire and Arran, if he so wishes.

In the previous quarter, 95.6 per cent of patients who were waiting for chronic pain services in Ayrshire and Arran waited more than 18 weeks. To put that in perspective, I say that in the quarter ending in March this year, of the 295 patients who were referred for chronic pain, only 13 were seen within the target 18-week period. Does the cabinet secretary agree that that is completely unacceptable? What specific action is the Government taking to ensure that those who are suffering from chronic pain in Ayrshire and Arran are given the treatment that they need within the Government’s target time?

A lot of work is going on. The Scottish Government gathers figures for chronic pain services and the waiting times for them. That is unusual; such figures are not gathered in other places. However, it is very important that we use that information to make the improvements that are needed. Aileen Campbell, the Minister for Public Health and Sport, has established an expert group that is considering how to make the improvements. Support will be given to NHS Ayrshire and Arran and elsewhere in order to make improvements.

I agree with Colin Smyth that NHS Ayrshire and Arran’s performance in the matter is not acceptable; it is not as we want it to be. We know that chronic pain has a severe impact on the quality of life of people who suffer from it, so it is very important that that work be taken forward. I am sure that Aileen Campbell will be happy to keep the member updated on progress.

Waiting Times (NHS Greater Glasgow and Clyde)

11. Anas Sarwar (Glasgow) (Lab)

To ask the Scottish Government how many patients in NHS Greater Glasgow and Clyde were not treated within the legally guaranteed treatment waiting time in 2016. (S5O-01145)

In the year 2016, more than 85,100 patients in NHS Greater Glasgow and Clyde were seen within the legal treatment time guarantee, and around 3,000 patients waited longer than 12 weeks.

I recognise that some patients are waiting too long for treatment, which is why I have made £50 million available to NHS Scotland, with up to £11.2 million being made available to NHS Greater Glasgow and Clyde. That additional funding will build up its capacity to ensure that all patients are treated in a timely fashion.

Despite the actions of the cabinet secretary, treatment waiting time guarantee failures are actually going up and not down. As she has said, the independent statistics show that more than 3,000 patients waited longer than the Government’s own legally guaranteed treatment target. To put that sharp increase in context, from March 2016 to December 2016, there was a 5,600 per cent increase in the number of patients who waited more than 12 weeks.

How can the cabinet secretary justify that rise? Does she recognise the impact that it is having on patient care and the extra stress that it is putting on our staff? Does she not recognise that this is just one more example of her complete mismanagement of our national health service?

The reason why I announced the £50 million is that I recognise that waiting time performance needs to improve and the impact on patient care.

The £11.2 million that I mentioned in my first answer will be deployed to deliver the plan for improving its waiting time performance that NHS Greater Glasgow and Clyde has been working on. That money has not had an impact as yet, because the plan is being drawn up and the money has only recently been announced. The waiting time performance improvement that we expect to see over the next few months will be of benefit in Greater Glasgow and Clyde, and of course elsewhere in Scotland, as the money begins to have an impact.

The cabinet secretary has answered the initial part of my question, which was about what investment is being made in the NHS to improve waiting times. Can the cabinet secretary outline what additional support is provided to health boards to reduce waiting times?

Officials work closely with boards to improve waiting time performance. That is why officials are working with NHS Greater Glasgow and Clyde to agree a plan for increasing activity to support the reduction of waiting times, with a particular focus on those patients who have the longest waits.

In addition, a big programme of reform is under way to modernise the out-patient journey in order to ensure that performance related to out-patients improves. A range of changes are laid out in the modern out-patient programme. That work is important in making sure that those who come through the system get to the right health professional as quickly as possible in order to have their needs assessed.

Question 12 has not been lodged.

Cervical Screening Awareness

13. David Torrance (Kirkcaldy) (SNP)

To ask the Scottish Government how it promotes cervical screening awareness. (S5O-01147)

The Scottish cervical programme is supported by a range of national and local resources, including a suite of public communication materials that are also available in a number of languages; a new advertising campaign, which was launched in February this year and was developed in partnership with Jo’s Cervical Cancer Trust to raise awareness of cervical screening among women aged 25 to 35; various local initiatives, including cervical screening awareness workshops; drop-in clinics for women from disadvantaged backgrounds; dedicated staff working with women with learning difficulties; and workshops run for staff by national health service boards to promote cervical screening.

The Scottish Government is also working closely with Cancer Research UK and colleagues in NHS boards to develop a facilitators programme to support and promote cervical screening in general practices and pilot projects to target uptake among those who are less likely to participate in screening. We are also investing up to £5 million of funding from the cancer strategy in screening programmes to reduce inequalities in access to screening in Scotland.

The majority of cervical cancers are caused by a persistent human papillomavirus infection, which causes changes to the cervical cells. Will the minister provide an update on progress on HPV primary screening in Scotland?

The United Kingdom national screening committee recommended the introduction of HPV primary screening in January last year. Following that recommendation, a full and detailed business case has been developed for implementation of the recommendation in Scotland and was considered by the Scottish screening committee at the start of this year.

The SSC recommended to ministers that HPV primary testing should be introduced in the Scottish cervical screening programme over the course of the next two years. We are now working with NHS National Services Scotland and NHS boards across Scotland to implement that change.

NHS Forth Valley (Meetings)

To ask the Scottish Government when it last met NHS Forth Valley and what issues were discussed. (S5O-01148)

The Cabinet Secretary for Health and Sport (Shona Robison)

Scottish ministers and officials meet NHS Forth Valley regularly to discuss matters of interest to local people.

Clearly, the cabinet secretary and members in the chamber are aware that NHS Forth Valley has met waiting time targets for those needing specialist child and adolescent mental health support. There has been a marked improvement over the past year, following support from Healthcare Improvement Scotland. I note the cabinet secretary’s response to question 8 earlier. Can she advise the chamber what action the board is taking to improve the performance of its adult mental health service?

As the member said, within Forth Valley there has been a focus on child and adolescent mental health services and NHS Forth Valley is to be congratulated on its progress and hard work to reach this point. I will be looking to see that the team and board share the lessons on best practice in improving access to and the delivery of psychological therapies as things move forward.

As well as the improvement support, the £54 million package of support to improve access to mental health services includes funding for additional staff, workforce development and capacity planning within local services, which will support improvements in adult mental health services. We remain determined that we will hit our 90 per cent target. and we will continue to work with boards to ensure that that happens right across Scotland, including in Forth Valley.

Hospital Food (Quality)

15. Brian Whittle (South Scotland) (Con)

To ask the Scottish Government how it ensures that the highest-quality food is served in hospitals. (S5O-01149)

Patients have a right to expect high-quality and nutritious food that meets their specific needs and aids recovery. The Scottish Government has a strong set of nutritional standards in place for hospital food and, in March 2016, consulted on refreshed and expanded guidelines in “Scotland’s National Food and Drink Policy—Becoming a Good Food Nation”, which advocates greater use of fresh, seasonal, local and sustainable produce.

Given recent revelations about public food procurement and given that our hospital food comes through the central Excel contract, does not the minister recognise—as her colleague in education does—that an inquiry into the nutritional value of hospital food is appropriate? [Interruption.]

I hope that you could hear that, minister.

I apologise, Presiding Officer. I did not hear all of the question, but I think that it was about procurement. Our contracts endeavour to encourage more local sourcing through an increased focus on fresh, local and seasonal produce. An increasing proportion of food has been sourced from Scotland, and recently the Scottish Government convened a cross-industry meeting to examine increasing Scottish sourcing through public sector contracts, at which we agreed to look at how we can build much more capacity for local producers, streamline the contracts process to make it more accessible for local producers and increase regional buying.

We take the issue very seriously. Scotland was the first country in the United Kingdom to develop a document specifying catering guidelines and nutritional standards for food in hospitals, so we will certainly look to see where improvements can be made. We have already made improvements across our hospitals, but there is no denying that good-quality food is part of the healing process, and we will endeavour to make improvements where we can.