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Chamber and committees

Meeting date: Wednesday, October 24, 2018

Meeting of the Parliament 24 October 2018

Agenda: Portfolio Question Time, University Hospital Monklands, Ending Austerity, Poverty and Inequality, Business Motions, Parliamentary Bureau Motions, Decision Time, Deaths Abroad (Support for Families)


Portfolio Question Time

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-02459)

Ministers and Scottish Government officials regularly meet representatives of all health boards, including NHS Greater Glasgow and Clyde.

The Cabinet Secretary for Health and Sport will be aware that Greater Glasgow and Clyde NHS Board is considering changes to breast cancer services. At the weekend, the Greenock Telegraph reported on a freedom of information request by Martin McCluskey, which showed that not a single patient from Inverclyde was consulted on the proposal to close the breast cancer services at the Inverclyde royal hospital. Can the cabinet secretary reassure local campaigners and confirm that breast cancer services at Inverclyde royal hospital will remain open and that the proposals will be shelved for good?

As I understand it, at this point, no specific service proposals are included in what Greater Glasgow and Clyde NHS Board is doing in its review of acute and critical care under the banner of moving forward together. As Mr Bibby knows, should the health board want to make significant changes to service provision, in any part of its remit or its geography, those would require significant public consultation and I am keen to ensure a genuine engagement. Those proposals would then come to me, as cabinet secretary, for me to reach a view on whether I concur with them.

I hope that that is sufficient reassurance for the member, at this point, about the process that we will go through. My understanding is that, as yet, there are no specific proposals. Proposals would need to be subject to due public consultation.

I will take two supplementary questions; I ask members to be quite quick with them.

Does the cabinet secretary agree that the right to raise genuine concerns about health boards is pivotal in holding the Government and health boards to account? Does she also agree that acting responsibly is crucial in this area, and that the Labour Party continually fails in that regard, with its constant negativity and talking down of the national health service and services at Inverclyde royal hospital?

I agree that it is important—I have said so in this chamber—that we discuss our national health service and its challenges and that if Opposition members have criticisms of this Government they absolutely should raise them.

However, we need to do that within the overall context and recognise that our health service is performing well, notwithstanding significant challenges that we must meet. We need not to take single bits of information out of context and then make assertions and claims on the back of them. In saying that, I am not casting aspersions on anyone in this chamber; I think that it is an important lesson for us all to learn and an important approach for us all to sign up to.

The most recent statistics reveal that, in the last quarter, less than 80 per cent of cancer patients in NHS Greater Glasgow and Clyde received their first treatment within the 62-day Scottish Government target. I appreciate that the cabinet secretary talked about waiting times yesterday. What action will be taken in the months immediately ahead to reassure cancer patients that they will not wait longer than the treatment time guarantee?

Before I answer Ms Wells’s question, it is important to give the context and say that the 31-day target is being met across our health boards.

However, Ms Wells is absolutely right to raise the very poor performance with respect to the 62-day target. The plan that I published yesterday covers our intention to work towards meeting that target, particularly with respect to diagnostics. As I set out, specific action plans that will come in from this month, magnetic resonance imaging, and other scanning technologies at the Golden Jubilee national hospital will increase the diagnostic capacity that is available to NHS Greater Glasgow and Clyde.

In addition, as we work from today towards driving that waiting times improvement plan, we will be looking at each board and asking specific questions about what they are going to do and how they will make best use of the additional funds that I announced.

Winter Weather Health Effects

To ask the Scottish Government what action the health secretary is taking to support those most vulnerable to the effects of winter weather. (S5O-02460)

The Scottish Government has invested an extra £10 million to support boards and their partners to develop their winter plans. The winter plans should ensure that adequate staffing cover is in place across acute, primary and social care settings, and that patients are discharged as soon as they are ready on week days, weekends and public holidays. With their partners, boards will put in place steps to avoid unnecessary admissions and to ensure that elective procedures are protected as far as possible so that they continue throughout the winter period. Those plans, once they are approved, will be published shortly.

I launched this year’s flu vaccination programme on 1 October, targeting more than 2 million Scots, and I have recently seen for myself some of the work that our front-line health staff are doing to encourage their peers to be vaccinated.

Recently released figures show that last winter saw the highest recorded increase in winter deaths in Scotland in 18 years. It is only October, but across Scotland we have already heard of a shortage of flu vaccines in many pharmacies. In my region, many older people in Orkney and Shetland are already struggling to keep their homes warm because of high rates of fuel poverty. In Moray, my colleague Douglas Ross MP raised the case of an expectant mother who was forced to endure a 60-mile trip to Aberdeen to deliver her child, due to the downgrading of the maternity unit at Dr Gray’s hospital in Elgin.

Given that we know the extensive pressures that are already faced by the national health service across the Highlands and Islands, is the cabinet secretary confident that, as winter approaches, all NHS boards in Scotland are ready to meet the challenges of winter weather?

As I mentioned, those winter plans are there precisely in order to provide me with that degree of reassurance and to let me question where I do not think that boards have planned sufficiently, based on the lessons learned from last winter, which was one of the most severe on record. I said that those plans, once approved, will be published shortly, and they are coming to me so that I can look at them.

The deaths that Mr Halcro Johnston referred to arose as a result of the severe weather—from flu, respiratory infections and other causes—and the plans are designed to ensure that we are as prepared as possible for the worst winter.

On the supply of flu vaccinations, we order a number of delivery drops of flu vaccines, based on data on the take-up the year before. In this year, the first delivery drop has not been adequate to the demand, but that does not mean that we are wrong about the demand; it just means that more people have come forward early. We have not had all the supplies, but the supplies are coming through as anticipated and we will have sufficient vaccinations.

There were a number of points to Mr Halcro Johnston’s question, so I have two final points to make. Members will be aware that I have asked for a detailed plan on how we can begin to move back towards the reinstatement of all services at Dr Gray’s hospital. The first plan that I received was insufficient, in my view, in terms of its timeline and content, and I hope that in the course of the next 10 days or so I will be able to approve the additional work that I think is necessary in the short to medium term so that we can move back to full services at Dr Gray’s.

My final answer is on the question of fuel poverty. Other portfolios carry that responsibility and a great deal of work is being done across this Government, but I cannot sit down without making the point that, if the UK Government paid proper attention to what is required in terms of benefits and support to our most vulnerable citizens, we would see a great deal less in the way of poverty as a whole, fuel poverty included.

The cabinet secretary will be aware that longer, harsher winters are just one of the reasons why Orkney has the highest levels of fuel poverty anywhere in the country—together with the health impacts that come as a result of that. Can she therefore redouble her efforts to press upon her colleague the Minister for Local Government, Housing and Planning to ensure that the forthcoming legislation on fuel poverty makes specific reference to the rural minimum income standard for the criteria for assessing fuel poverty and directing support to where it needs to go?

As Mr McArthur knows, that was a subject in which I took a great deal of interest when I was in a previous role, along with my colleague Mr Stewart. I understand the issues that Mr McArthur is raising. Under my health portfolio, we have ensured that Mr Stewart is aware of those matters, particularly as they concern our more remote and rural communities, and I am confident that he is giving them all due and proper consideration.

I wish to take supplementaries, but questions and answers have already been fairly long. Unless members are willing to cut them down, we will not get through nearly so many questions.

Question 3 was not lodged.

Rehabilitation Right (Chest, Heart and Stroke Patients)

To ask the Scottish Government what plans it has to introduce a right to rehabilitation for patients with chest, heart and stroke conditions. (S5O-02462)

Early assessment and the provision of rehabilitation by multidisciplinary working in the first few days following an acute stroke achieves the best outcomes for the person, and that is therefore a priority within the Scottish stroke improvement plan, with each national health service board reporting on progress as well as sharing good practice.

We recognise that pulmonary rehabilitation is an important element of respiratory care, and it is a key recommendation in our national clinical guidelines, which boards are expected to follow. Access to pulmonary rehabilitation will form an important part of our respiratory care action plan for Scotland.

With respect, I asked whether people would have an automatic right to rehabilitation, rather than just access to it. I remind the health secretary that there are 9,000 people across the Lothians who would benefit from pulmonary rehab, but there is only capacity for 1,100 people to get it. Without a right to rehab, how can my constituents expect to see that gap close?

I do of course understand that. In our recent meeting with Chest Heart & Stroke Scotland, we began discussions on its one in five campaign. We will continue those discussions, and we will see how we can move towards the end result that Chest Heart & Stroke Scotland and, I believe, Ms Dugdale are looking for.

At this point, however, the right thing for me to do is to continue those discussions so that we can ensure that, if we make a commitment, it is one that we can meet.

General Practitioner Access (Homeless People)

To ask the Scottish Government how it ensures that people who are homeless are not disadvantaged from accessing a general practitioner. (S5O-02463)

The Scottish Government published a guide for healthcare providers of general medical services on 20 September this year. The guidance clarifies that inability by a patient to provide identification or proof of address is not considered reasonable grounds to refuse or delay registering a patient. The guidance clarifies that practices can use agreed addresses such a homeless centre, a practice’s own address or “no fixed abode” to register a patient, and that street homelessness can be considered as residence in a practice area.

I have a constituent who is currently homeless and is, with her two children, temporarily staying with a friend. When her youngest child needed an appointment with a GP, it was refused, with homelessness cited as a reason. My office’s intervention secured an appointment.

Members will note that I have not named the practice publicly, which is because I would rather promote improved practice than shame the practice in this case. The vast majority of general practices fulfil their obligations, but how can the Scottish Government—yet again—remind general practices of their responsibilities? Are there any actions that could be taken regarding general practices that behave in such ways?

We not only published the guidance but asked boards to ensure that it was circulated to all general practices, and we asked boards to follow that up. In addition, primary care performance improvement plans are coming forward, and I would look to ensure that general practices within primary care areas understand what the guidance is and abide by it.

If any member is aware of a situation such as that described by Mr Doris, I ask them to bring it to our attention as quickly as possible, so that we can address it as quickly as possible. I intend to raise the matter through our work with the health and social care partnerships and the Convention of Scottish Local Authorities to ensure not only that general practices know what the guidance is but that teams working with people who are homeless—as street teams or in whatever other fashion—are aware of it, too, and can advocate on behalf of those individuals’ rights.

Given the links between transmittable diseases, such as tuberculosis, and homelessness, how will the Scottish Government ensure that homeless people, including destitute and homeless asylum seekers, can reach out to health services, and thus prevent the spread of transmittable diseases?

I am grateful to Ms Fee for that very important question. I draw her attention—not as a complete answer, but as part of one—to a practice here in the city of Edinburgh that I visited early in my time as cabinet secretary. In that practice, there are street homeless workers, housing workers, general practitioners, addiction workers and other support staff, all working as a single team. I am pleased to say that they will shortly move to new and more bespoke premises. That is an example of what we should see in other areas where there are significant numbers of homeless people. It is one that I am raising and trying to ensure is adopted elsewhere as part of the other work that I am talking about, which is about raising the pace and spreading good practice where we expect to see it.

Question 6 has been withdrawn.

Respiratory Improvement Taskforce

I refer members to my entry in the register of interests and declare that I am the convener of the cross-party group on lung health. To ask the Scottish Government whether it will provide an update on the work of the respiratory improvement task force. (S5O-02465)

As I am sure that Ms Harper knows, in Scotland respiratory managed clinical networks exist in most health boards, working to improve respiratory health and quality of life for patients. The national advisory group is the overarching group and it began the work of the task force to which Ms Harper refers. It is currently at the final stage—if you like—which it describes as the task and finish group. That will set up a respiratory action plan for Scotland.

I agree that a great deal of work has already been undertaken by the national advisory group, and I understand that the group, which is now led by Dr Tom Fardon, has a key aim to publish an improvement plan. Will the cabinet secretary provide an update as to when a draft or final plan will be presented on that important work?

My understanding is that we expect the plan to be published in mid-to-late 2019.

Breastfeeding Services (Funding)

To ask the Scottish Government how the extra funding that it announced in July 2018 to support breastfeeding services has been distributed. (S5O-02466)

The Scottish Government has provided additional funding to health boards, third sector organisations and other partners to meet the cost of local quality improvement projects and initiatives aimed at improving the breastfeeding experience for women across Scotland.

I recently met mums here in Lothian who told me about training for a peer support group network. Specifically, they asked me to raise the issue that the £2 million that the minister mentioned has not provided funding to help support that. Is the minister willing to investigate the establishment of a breastfeeding peer support fund for national health service boards across Scotland, to develop that vital network and the delivery of training and resources for peer support across Scotland?

Peer support is a very important aspect, and it is one of the areas that I expect our funding to support. As well as directly funding boards, other organisations that we have funded include the Breastfeeding Network, the National Childbirth Trust, the Yale becoming breastfeeding friendly initiative, and Edinburgh Napier University for its work on the UNICEF baby friendly initiative. I will come back to Miles Briggs on the specific point as to whether peer support is being supported in Lothian. My officials have a meeting with NHS Lothian soon to discuss the review of breastfeeding services across Lothian and I will come back to Miles Briggs after that meeting.

Changes to the referral system mean that breastfeeding clinics in NHS Lothian that originally served up to 60 women a week are now serving only 12. Indeed, information that they have provided shows that attendance at specialist breastfeeding clinics has dropped by more than 50 per cent in the past year. Does the minister agree with the changes that have been made by NHS Lothian and, if not, what will he do about it?

As I said to Mr Briggs, my officials will be meeting NHS Lothian soon to discuss the changes to ensure that they are meeting the needs of the small number of women who experience problems that impact on their breastfeeding journey. I am happy to update Daniel Johnson along with Mr Briggs.

Changing Places Toilet Facilities

To ask the Scottish Government what support it is providing to ensure that there are more changing places toilet facilities throughout Scotland. (S5O-02467)

We are committed to increasing the number and locations of changing places toilets in Scotland. There are currently 178 such facilities across Scotland and one portable changing places toilet—a pamiloo.

I welcome the progress that has been made so far as a result of the campaign by the Profound and Multiple Impairment Service—PAMIS—and others, who I know greatly appreciate the support that they have received from a number of ministers and cabinet secretaries in the Scottish Government.

The announcement from Kevin Stewart prior to the summer recess, in which he confirmed that he intends to introduce changing places toilets in Scottish building regulations for certain types of new buildings, was good news for the campaigners. Although that move is very welcome indeed, will the minister advise whether the Government will encourage Scotland’s national health service boards and other public bodies to retrofit changing places toilets in their premises the length and breadth of the country?

The Scottish Government continues to work closely with PAMIS, which the member mentioned. PAMIS is an organisation that campaigns to ensure that, in Scotland, people with profound and multiple learning disabilities and their families have access to changing places toilets where they need them in the community.

We are confident that the proposed requirement for changing places toilets in certain types of new, large buildings, through the review of the Scottish building regulations that the member mentioned, will significantly increase the availability of changing places toilets in buildings. However, I commit to continue to work with PAMIS and others to make sure that we have those changing places toilets where they are needed.

There are two supplementary questions.

I welcome the commitment to support an increase in changing places toilet facilities. However, the question has been asked at a time when public toilets are vanishing from our communities. Can the minister advise us what work has been undertaken to assess the public health impact of those toilet closures?

I know that some members across the chamber have concerns about decisions that local authorities have made to close public toilets. I would encourage any local authority to consider carefully the implications when they change any service. I know that the issue has been of particular concern to members from the Highlands and Islands area. I do not think that the member would expect me to stand here and tell local authorities what to do, but I hope that they will take account of the needs of their residents when making any service changes.

It was great to see the opening of the changing places toilet at Aberdeen airport in my constituency as part of the terminal’s redevelopment.

Further to the point made by Angus MacDonald on retrofitting, although it is welcome that a requirement will be introduced for new buildings, can the minister perhaps undertake discuss with his colleagues what requirements could be introduced where refurbishment and redevelopment are taking place? That work is obviously not categorised as new build; nonetheless, that might open up opportunities for changing places toilets to be installed.

The member makes a good point. Clearly, it is much easier to make such changes by design in new buildings, and retrofitting can pose challenges. However, the member makes a good point in relation to refurbishment, which I will follow up.

Primary Care Emergency Service (St Andrews)

To ask the Scottish Government whether it will provide an update on the proposed closure of the primary care emergency service facility in St Andrews. (S5O-02468)

Fife health and social care partnership undertook a review of its out-of-hours service in line with the recommendations in Sir Lewis Ritchie’s national review of out-of-hours services and an options appraisal exercise between August and October 2017. There has been a consultation, which has concluded, and the results of that consultation, which is on wider primary care and other services across Fife, will be considered by the Fife integration joint board at its meeting on 20 December.

However, as I am sure Mr Rennie will know, general practitioners in north-east Fife have offered to keep the local service running overnight. I understand that, in the next few weeks, the partnership will continue to work closely with them on those services to look at how they can develop proposals in the light of the consultation feedback and the GPs’ proposition.

The health secretary will know from her visit to St Andrews in recent weeks that there is a lot of anger in the town and across east Fife, with more than 6,000 people signing a petition and packed public meetings opposing the proposed closure. The area has a rural and remote student and elderly population and local GPs are prepared to step up and provide a service, as the health secretary said. I am keen to understand what she will do if the Fife health and social care partnership proceeds with the closure. Will she step in and change its mind?

I understand the anger and concerns that are being expressed. I also understand—from my constituency, apart from anything else—how all too often it is easy to look at a map and think that, with regard to transport, it is relatively straightforward to move across an area without taking account of the fact that the area is remote, rural and less easy to move across in practice than Google maps or another device may make it seem. I completely appreciate the concerns.

I would not want to wait until final proposals are brought forward, and I am actively pursuing being kept up-to-date with the thinking of the health and care partnership in Fife about how it will move forward, not only on the wider consultation but on matters that directly affect patients’ access to the care that they need. I hope to be able to update Mr Rennie and colleagues who have an interest in the matter from a constituency perspective over the next few weeks.

Does the cabinet secretary believe that the retention of out-of-hours services in St Andrews, particularly at the weekend, would be more likely if the health and social care partnership adopted a more multidisciplinary approach that is less reliant on GPs?

There are two parts to the difficulty that we have with out-of-hours services. First, the 2004 GP contract said specifically that GPs did not have to work out of hours. Secondly, the national pensions cap makes the situation more difficult, and we have struggled to find GPs who want to work out of hours.

It is important that Sir Lewis Ritchie’s recommendations and the new GP contract, which has been agreed with the British Medical Association, make it clear that out-of-hours services should be GP led. That said, other parts of the new GP contract absolutely recognise the importance of multidisciplinary teams and place the GP as the local clinical leader—the medical general specialist in an area—who will work with the multidisciplinary teams to provide not only out-of-hours services but services for the rest of the time, too. Mr Ruskell makes an important point. It is important for us to understand, at least in part, why we have some of those difficulties with out-of-hours services at the moment and to recognise that we are moving to a situation in which GPs will work under a new contract that will specifically say that out-of-hours services should be GP led. That does not preclude others, of course.

Invictus Games

To ask the Scottish Government what role the Minister for Public Health, Sport and Wellbeing is having with its plans to bring the Invictus games to Scotland, and what discussions he has had with the culture secretary on that. (S5O-02469)

The Cabinet Secretary for Culture, Tourism and External Affairs and the Minister for Parliamentary Business and Veterans have confirmed the Scottish Government’s interest in considering whether Scotland should host the Invictus games in the future. That can happen only through the appropriate formal bidding process and would be informed by a feasibility study to determine the viability of hosting. We will learn from the current games in Sydney to assist our considerations. The Scottish Government commends and congratulates the athletes who are currently competing in this year’s Invictus games. I thank Mr Corry for the opportunity to put those congratulations on the record.

Holding the Invictus games in Scotland would demonstrate how highly our armed forces disabled veterans are respected here. Will the minister do all that he can to have the Scottish Government bid for the fourth Invictus games to be held here in Scotland?

The member makes a strong point about the value of sport for our veterans. I was privileged to spend some time at the national centre for sport in Largs to see its para facilities. It is the first fully inclusive national sports centre, and it is second to none in the United Kingdom. When I was there, I met and discussed support with some serving armed services personnel who were being supported by Help for Heroes and who were using sport to help with their rehabilitation. The power of sport is really important.

We have fantastic facilities that are a strong argument for Scotland being a location for the games. However, there has to be a proper bid process. It is important that we use this year’s Sydney games to help us to understand the size, scale and delivery of a future games here in Scotland, as a prelude to a possible future feasibility study. Along with the cabinet secretary and the veterans minister, I will give my support to Scotland making that initial feasibility study.

Mental Health Services (LGBT+ People)

To ask the Scottish Government what action it is taking to improve access to mental health services for lesbian, gay, bisexual and transgender plus people. (S5O-02470)

We are engaging with LGBT+ groups to support the implementation of our mental health strategy and the suicide prevention action plan “Every Life Matters”, and in the work of the children and young people’s mental health task force. Up to 2019-20, we are investing £54 million to help health boards to improve access to mental health services. Our programme for government also sets out a £250 million package of measures to support positive mental health and prevent ill health. The funding aims to ensure that high-quality mental health services are accessible to everyone.

The achievements of Kirkcaldy high school’s LGBT+ group were recognised at the recent Convention of Scottish Local Authorities excellence awards. How important does the minister consider such groups to be as we continue to challenge prejudice and inequality and improve the confidence and mental health of LGBT young people?

I congratulate Kirkcaldy high school on its work and ask the member to pass on my congratulations to the school. Such work is vital to ensure that young people are confident in talking about issues that affect them. At each meeting of the children and young people’s mental health task force, Dame Denise Coia will share the chair with a member of the youth commission to ensure that the voices of children and young people are kept at the centre of that work. Young people are bringing an LGBTI voice to the youth commission and, as part of its research, the youth commission plans to meet LGBT Youth Scotland.

Flu Vaccination Target (Frontline Staff)

To ask the Scottish Government what action it is taking to reach the 60 per cent target of front-line staff immunised with the flu vaccine. (S5O-02471)

The chief medical officer wrote to the national health service in August to reiterate the importance of the flu vaccine to staff, especially for those who are directly involved in patient care, and we have instructed boards that every effort should be made to offer the vaccine in a way that is accessible to all staff regardless of location and working pattern. In addition, there are national resources, including a toolkit that staff can use to plan their local flu campaign. This year, that includes an edit of our television advert and an interactive app that has previously been used successfully in other parts of the United Kingdom and that is designed to drive uptake among healthcare workers.

Recent figures show that 45 per cent of NHS Scotland staff who are eligible to receive the vaccine have received it. In NHS England, the figure is 68 per cent. In England, staff who refuse the vaccine are moved from critical areas if they work with vulnerable patients, which seems eminently sensible. Will the cabinet secretary confirm whether NHS Scotland is aware of that and say when it will introduce a similar scheme, before it is too late?

We are aware of the situation in England; indeed, the app that I referred to has been successful there in driving uptake.

An important feature of how our NHS works in Scotland is that we have a clear partnership approach with our staff, our staff-side unions and other staff representatives to ensure that we work together collaboratively across a range of matters. I would be very reluctant to start issuing diktats about moving or not moving staff without continuing discussion in the partnership forums at the national and individual board levels to find ways by which we can continue to improve uptake.

Uptake has gone up in the past two years. As Mr Kerr said, our target for this year is 60 per cent. I have seen staff take a number of innovative approaches to encourage their peers to be vaccinated, not least in the Royal Alexandra hospital, which I visited recently to launch the flu vaccine campaign.

NHS Greater Glasgow and Clyde Treatment Time Guarantee (Hip Operations)

To ask the Scottish Government what proportion of hip operations have been carried out within the 12-week treatment time guarantee in NHS Greater Glasgow and Clyde in 2018. (S5O-02472)

Waiting time information is collected at specialty level, not by procedure. That said, in the year to 30 June 2018, 48 per cent of orthopaedic in-patient and day-case procedures were carried out within 12 weeks. I am sure that Mr Kelly agrees that that level of performance is unacceptably low. The health board has begun work to address that by improving theatre utilisation, making full use of capacity at the Golden Jubilee national hospital and having additional activity in evenings and at weekends. The plan that I published yesterday will provide more investment to the board and other boards to increase capacity and improve performance.

The 48 per cent performance level is unacceptably low, as witnessed by my constituent Mr Paul O’Brien, who has had to wait almost 18 months to receive an orthopaedic appointment. Following numerous scans, he was placed on the waiting list in February and, as recently as September, he was advised that there is still no appointment available for him. As a result, he is off work and suffering constant pain.

The national health service board has confirmed to me that it is unable to meet its 12-week waiting time guarantee for orthopaedic appointments because it does not have the capacity to do so. Why should anyone trust what Ms Freeman and the Government say about the NHS when people such as Mr O’Brien wait for years for a hip operation?

I absolutely agree with Mr Kelly that the situation that his constituent has faced is unacceptable, and I am very sorry for it. The plan that I published yesterday is about increasing capacity, precisely to address the issues that have been identified and the issues that the health board has raised with Mr Kelly. That said, it is clear that NHS Greater Glasgow and Clyde’s capacity was not fully utilised. There are two parts to work on this, one of which is to ensure that individual boards fully utilise their capacity. The example that I gave yesterday from Forth Valley relates to that. The other part involves the significant additional investment that was announced yesterday alongside a clear phased plan to introduce additional capacity and produce a sustainable service to deal with waiting time matters.

NHS Greater Glasgow and Clyde Waiting Times (Orthopaedics and Ophthalmology)

To ask the Scottish Government what steps it is taking to reduce orthopaedic and ophthalmology waiting times in NHS Greater Glasgow and Clyde. (S5O-02473)

NHS Greater Glasgow and Clyde has redesigned a number of orthopaedic pathways to increase capacity—for example, hip and knee post-operative pathways and foot and ankle community services. That increases capacity in other orthopaedic service areas.

The plan that I announced yesterday will provide additional capacity to Greater Glasgow and Clyde NHS Board, including through the additional use that it, and other boards, will be able to make of the Golden Jubilee national hospital; the additional computed tomography scanner that will come in early next year; the throughput of cataract operations; additional ophthalmology staff; and moving on to phase 2 of the Golden Jubilee national hospital’s expansion. All of that—in addition to checking that the capacity that already exists is being fully utilised and looking at evening and weekend working, which I mentioned in my previous answer—is designed to increase capacity and improve performance.

As I know the cabinet secretary is aware, the Golden Jubilee national hospital—Scotland’s NHS national waiting times centre—is within the Greater Glasgow and Clyde NHS Board area, on the doorstep of my constituency, yet despite thousands of patients waiting in pain for increasing times of nine months to a year, the board sends a tiny proportion of cases to the Golden Jubilee hospital. Does the cabinet secretary agree that the most important consideration must be the patients? Will she tell NHS Greater Glasgow and Clyde to make better use of the Golden Jubilee hospital, so that people do not need to suffer any longer?

I am grateful to Ms Baillie for her supplementary question on an issue that she and I have discussed many times, even prior to my appearing in this Parliament. I agree that patients are the most important consideration. I also agree that the Golden Jubilee hospital, our national waiting times centre, is not always utilised by colleague boards as well as it should be, and that is something that the Scottish Government is taking an active interest in. However, it is a national waiting times centre and it is there to provide additional capacity for all our health boards and, indeed, some of our island communities. It is because of the success of the Golden Jubilee’s work and its success in patient experience and patient outcomes that the Golden Jubilee is the very model that will underpin the new elective centre programme—delivery of elective centres—that I announced yesterday.

That concludes portfolio question time. I ask members to note that, despite going over time, we still only got to question 15, so I ask them to consider for the future the length of time that supplementary questions and answers take.