Meeting of the Parliament

Meeting date: Thursday, November 21, 2019

Official Report 973KB pdf

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Portfolio Question Time

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Health and Sport

We move on to portfolio question time. In order to fit in as many members as possible, I ask for succinct questions and answers, please. Question 1 is from Maurice Corry.

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Flu Vaccine (Supply)

To ask the Scottish Government, in light of reports of shortages, what action it is taking to ensure that there will be ample supply of the flu vaccine over the winter to meet demand. (S5O-03789)

I hope that the Presiding Officer will accept that this answer will be slightly longer than the rest, given the public interest.

I am aware that there have been process issues within Movianto UK—the supplier that has been contracted to store and distribute the flu vaccine—that have resulted in some national health service boards experiencing a delay to their delivery of adjuvanted trivalent influenza vaccine, or aTIV, which is one of the flu vaccines for over-65s. We are assured that there is ample supply of flu vaccine within the system, that the majority of delays have been resolved and that the remaining delays will be resolved by the end of this week. We are also aware that for all areas of the United Kingdom there will be a delay for a proportion of the children’s flu vaccine Fluenz Tetra.

We are working closely with Public Health England, who purchase the children’s flu vaccine on behalf of all areas of the UK, to understand the impact of those delays. In the meantime, we are working with Health Protection Scotland, NHS boards and other relevant partners on plans to ensure that all eligible children get their flu vaccine as soon as possible. I reassure parents and families that we are doing everything possible to minimise any disruption caused by the delay and we anticipate that the full allocation of Fluenz Tetra for Scotland will be received over the course of the season. The delay is completely outwith our control, but we would continue to urge eligible people to be vaccinated, as we know that that is the best protection against the flu.

We are now one month into a flu vaccination programme that is experiencing disruption to the provision of vaccinations for primary school-aged children. A number of health boards including NHS Greater Glasgow and Clyde, which is based in the region that I represent, have reported delays due to supply issues. Last year there were supply issues with vaccines for the over-65s, and this year there are issues with vaccines for primary school children. What reassurances can the minister give the chamber that those issues will not become an annual occurrence?

I think that I answered the member’s question, specifically about the child flu vaccine. It is a UK-wide problem. The vaccine is purchased by Public Health England for the whole of the UK and, as I said, we expect the vaccine to be distributed across the UK during the course of the flu season.

The most recent uptake figures show that only 2.5 per cent of pre-school children have received a flu vaccine compared to 18.6 per cent at the same point last year. What assessment has the Government made of the possible impact that that could have over winter and what advice is the Government giving to parents who have not yet had their child vaccinated?

We are absolutely determined to do everything that we can to make sure that the flu vaccine is available for children across Scotland. I encourage everyone who is entitled to the flu vaccine, whether a child or an adult, to please go and get vaccinated, because it is the best protection against the flu.

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National Health Service (Ageing Workforce)

To ask the Scottish Government what steps it is taking given the warnings from NHS Grampian about its ageing workforce. (S5O-03790)

In NHS Grampian, there have been increases in whole-time equivalent staff numbers of people who are aged 50 and over, but those are partially offset by increases in the younger age bands, from 20 to 29. Of the three key care providing staff groups that are featured, only nursing and midwifery has a profile of notable increases in older age bands. We are increasing the number of training places for medics, nurses and midwives in the north-east. The 2019-20 intake of nursing students at the Robert Gordon University and the University of the Highlands and Islands was increased by 9.7 per cent. All of that means that we will be progressively growing more of our talent in the north-east. Recent media coverage has highlighted the positive working partnership between NHS Grampian and developing the young workforce Moray, including an event that took place on 8 November to encourage young people to consider a career in NHS Grampian.

Before I call Mr Chapman again, I point out that quite a few people have pressed their buttons. I remind members who have pressed their buttons that their supplementary question should be about NHS Grampian.

Given that Dr Gray’s hospital has already experienced downgrades in women’s and children’s services due to a shortage of doctors, what assurances can the cabinet secretary give to patients that that will not happen to other services at hospitals in NHS Grampian?

The issue at Dr Gray’s hospital is slightly more complex than Mr Chapman has said. I am very happy to write to him in detail about that, bearing in mind the Presiding Officer’s wish for short answers.

Work has been undertaken at Dr Gray’s in phase 1 of the plan to return services to their full capacity. Phase 2, which I have signed off, is also on track, but there has been an additional complication in relation to guidance on anaesthetics, which means that the board is undertaking more work at Dr Gray’s.

I noticed that NHS Grampian has undertaken a very important initiative with colleagues in the housing sector and in other public services. Housing provision is being looked at in order to encourage the workforce to stay in NHS Grampian, particularly around the Moray and Elgin areas, and to attract new members of the workforce who might, for limited periods of their career, want to experience the significant services that Dr Gray’s offers. That is a good thing, and it is much better to get young talent to come to NHS Grampian in that way. If housing is part of the barrier, all credit to NHS Grampian, the local authority and others for taking forward that initiative.

We debated our NHS workforce on Tuesday, and I understand that Mr Briggs will raise the issue in a later question. Does the cabinet secretary agree that Conservative plans to cut immigration and end freedom of movement could send Scotland’s working-age population into decline, which might cause staffing shortages in NHS Grampian and other boards in the future?

That question was loosely related to the topic. I ask for a very quick answer, please, cabinet secretary.

I will be very brief, Presiding Officer.

I agree with Emma Harper. It is important for our NHS, as well as for the rest of our public services in Scotland, that we have full control over immigration powers, so that we can tailor policies and practices to meet Scotland’s needs.

The cabinet secretary will be well aware that allied health professionals are a key group in NHS Grampian and beyond, but the Scottish Government has no direct involvement in their training. Will the Scottish Government re-examine that area in relation to workforce planning?

We have a creative group of MSPs in the chamber, Presiding Officer.

I absolutely agree that allied health professionals are key, particularly but not exclusively to primary care. They also have a big role to play in secondary care and in social care. We have had discussions with the representative bodies, and I am sure that David Stewart knows that we have recently appointed, at Government level, a professional lead for allied health professionals, who is working in the chief nursing officer’s directorate. That is an important step forward for us and an important indication that we want to look at what we can do to ensure that we train and upskill all our allied health professionals, including those who are currently in post.

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Breastfeeding

To ask the Scottish Government what it is doing to encourage and support new mothers to breastfeed. (S5O-03791)

Since 2011, we have provided more than £18.1 million directly to national health service boards for the implementation of the maternal and infant nutrition framework, of which breastfeeding support is a key component. More recently, we have provided an additional £3.7 million to NHS boards, the third sector and other partners for breastfeeding projects.

This year, we launched the breastfeeding friendly Scotland national campaign to positively influence attitudes to breastfeeding. Scotland was the first country in the United Kingdom to achieve 100 per cent accreditation in maternity and community services by UNICEF UK’s baby friendly initiative.

I thank the minister for outlining the Government’s desire to encourage as many new mums to breastfeed as possible. However, I want to flag up some issues in the north-east, where the number of mothers who breastfeed compared with the number of those who use formula is not ideal. I raise the issue particularly because a constituent who wished to breastfeed her baby, but whose milk was not coming in quickly, told me at a recent advice surgery that she felt pressured into using formula in a maternity ward in Aberdeen, despite her desire to persevere with breastfeeding. There are demands on maternity nurses’ time, and breastfeeding support can be resource intensive. Will the minister agree to look into the breastfeeding rates in the area and to investigate the reasons behind them, so that they can be addressed?

It is important that mothers do not feel pressured in any way; they should feel supported. Breastfeeding rates across Scotland are rising steadily. The latest statistics show that, in the NHS Grampian area, a higher percentage of babies—45.7 per cent—are being exclusively breastfed at the first health visitor visit than the Scottish average of 37.4 per cent. As I mentioned, we are also getting close to the point of having 100 per cent accreditation by the UNICEF UK baby friendly initiative. However, we need to continue to do everything that we can to ensure that mothers feel supported throughout the period that they are breastfeeding.

Will the Scottish Government give an update on training existing national health service staff to perform procedures for tongue-tie in order to improve the capacity of services to breastfeeding mothers?

We expect health boards to ensure that their staff are appropriately trained and developed for their roles, as per the staff governance standard. That standard complements the training expectation that is set out in individual, professional and regulatory regimes.

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Cancer Care (Diagnostic Workforce)

To ask the Scottish Government what its response is to the cross-party group on cancer recent report on the priorities for the future of cancer care, which highlighted concerns regarding gaps in the diagnostic workforce. (S5O-03792)

As I did earlier this week, I put on record my thanks to the cross-party group on cancer for its helpful report and recommendations, which set out the key challenges that we face and the work that we need to do.

As part of the waiting times improvement plan, more than £8.2 million has been made available to date for cancer diagnostics for the financial year 2019-20. That funding supports radiology and endoscopy services, enabling health boards to create additional capacity through the provision of additional sessions, increased reporting and workforce expansion. That will ensure that those who are on the urgent suspected cancer pathway receive key tests to rule cancer in or out as quickly as possible.

Last year, more than 32,000 Scots were diagnosed with cancer. Projections show that, by 2035, the number of people who are diagnosed with cancer is expected to increase to more than 40,000. Will the Scottish Government take the necessary steps to adapt and trial a model of long-term national planning for our national health service, in anticipation of projected patient need for the diagnostic workforce?

I am happy to say that that is part of our integrated workforce plan—members will be able to judge that when the plan is published before the Christmas recess. Work is under way to consider longer-term projections of 10 to 15 years to try to understand not only expected demand, but how the successful integration of health and social care impacts that and produces additional demand in the community-based setting. All of that is factored into a question that will be answered later, which relates to a redesign of the cancer treatment pathway to ensure that we can bring more of that closer to home than is currently the case, by taking advantage of new technologies.

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Cancer Treatment (NHS Greater Glasgow and Clyde)

To ask the Scottish Government what its response is to the NHS Greater Glasgow and Clyde initiative, moving forward together, which includes a review of how certain types of cancer treatment will be administered. (S5O-03793)

NHS Greater Glasgow and Clyde’s plans for cancer services are being taken forward as part of a regional approach for the west of Scotland, which involves a tiered approach to care, from specialist cancer provision at the Beatson to local outreach centres such as that proposed at the new Stobhill hospital. That reflects significant changes in service requirements and delivery, coupled with the introduction of new diagnostic and treatment technologies that have been developed over recent years.

My constituent from Lenzie, Tom Herbert, has been campaigning for treatment for certain types of cancer to be brought closer to home, specifically in Stobhill hospital, for more than a decade, following the passing of his wife. Does the cabinet secretary agree that the plan will mean that patients can avoid a tiring journey to receive treatment and that Greater Glasgow and Clyde NHS Board should be congratulated on that forward-thinking initiative?

I agree. Mr Herbert, who has campaigned assiduously on this important issue over several years and has made strong representations to several health secretaries, should be congratulated on and thanked for the work that he has done on that. I hope that he feels that his hard work has been responded to effectively.

That is not only happening at Stobhill—I am very pleased to say that the Vale of Leven hospital will also be part of the network. It is just the kind of service development that we have always whole-heartedly supported: patients can be treated safely, effectively and timeously in their local community, closer to their homes—as they should be—so as to avoid some of the additional stress relating to journey times and travel.

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Post-Brexit Trade Agreements (Drugs)

To ask the Scottish Government, in light of the potential impact on NHS Scotland, what its response is to concerns that the United Kingdom might reach trade agreements following Brexit that could lead to an increase in the price of drugs. (S5O-03794)

It should be deeply concerning to every member in the chamber, as it is to us in Government, that a future trade deal by the UK Government with either the USA or anyone else could increase drug prices in Scotland. Research by Dr Andrew Hill of the University of Liverpool has observed that, if we had to pay for medicines at the same per capita rate as the USA, medicines prices could more than double.

Given the damage that could be done by the dilution of arrangements to manage medicines costs in the national health service by future trade deals, it is very disappointing that Labour and Conservatives members voted yesterday against the protection of the NHS through an NHS protection bill. The next Westminster Parliament needs to pass the protection bill as a matter of urgency—unfortunately, the powers to do so still reside with it—and all parties need to support the bill and stop working across their unionist ideologies in order to prevent it.

We know that Brexit is by far the biggest threat to our NHS and that the Tory-Trump trade deal risks opening it up to unprecedented levels of private involvement. Does the cabinet secretary agree that, if parties are really genuine in their commitment to keep the NHS out of trade deals, no party should be unable to back an NHS protection bill that is put forward in the UK Parliament, which would give the parties in this Parliament a second bite at the cherry?

I absolutely agree with Gil Paterson. NHS protection legislation is self-evidently the right thing to do, and it is genuinely beyond my understanding that those who constantly thank our NHS staff and tell us that they will protect the NHS are not willing to offer their support for something so straightforward, which would protect our NHS from trade deals that could undoubtedly damage that national service.

This Government and this party, which I am proud to belong to, will always support our NHS, and we will do everything that we can to protect it. We will continue to press hard for that legislative protection, and I really hope that other members in the chamber will reconsider their positions and join us.

Question 7 has been withdrawn.

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Neurological Conditions (National Action Plan)

To ask the Scottish Government when it will publish the national action plan on neurological conditions, which was first announced on 14 September 2017. (S5O-03796)

Over the past two years, we have engaged extensively with the neurological community to identify its needs, wishes and priorities. That has enabled us to develop commitments that aim to ensure that everyone in Scotland with a neurological condition can access the care and support that they need to live well on their own terms. By the end of this year, we will publish a five-year framework for action, setting out those ambitious commitments for the future of neurological care and support in Scotland.

Is the minister confident that, as a result of the plan, people with neurological conditions such as multiple sclerosis and motor neurone disease, especially those who are under the age of 65, will no longer be placed in older people’s care homes or spend long periods of time in hospital unnecessarily? Will they instead have proper specialist care in their own home, or in a specialist residential centre if they can no longer live at home?

The plan will look at a range of ways in which we can support people with all forms of neurological conditions. I look forward to publishing the plan before the end of this year, to show how we can take forward the actions and priorities by working across a range of policy areas, such as mental health, dementia and strokes.