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Chamber and committees

Meeting date: Wednesday, January 25, 2017

Meeting of the Parliament 25 January 2017

Agenda: Portfolio Question Time, Supreme Court Judgment (Article 50), Draft Budget 2017-18, Business Motion, Parliamentary Bureau Motion, Decision Time, Celebrating Burns and the Scots Language


Portfolio Question Time

Alzheimer’s Disease (Link with Air Pollution)

To ask the Scottish Government what its response is to research suggesting that there is a possible link between Alzheimer’s disease and air pollution. (S5O-00579)

The Scottish Government is aware of the recently published research that suggested a possible link between air pollution and Alzheimer’s disease. The Scottish Government receives advice on such issues from public health experts, including Health Protection Scotland and Public Health England, who keep the evidence on public health risks under constant review. The approach ensures that policy interventions are based on all the available, relevant evidence.

The study, which was led by Public Health Ontario and published in The Lancet recently, found that, among people who lived within 50m of a major road, one in 10 cases of dementia could—I stress “could”—be attributed to traffic exposure. In light of that new and concerning research, can the minister reassure members that she will work across portfolios to limit air pollution from traffic?

I understand that risks from noise might also be associated, particularly in relation to people who live and work close to heavy traffic.

I am aware of the Ontario study, which was widely publicised—it is just one piece of research. As the member knows—she has her environmental hat on—we are committed to improving air quality across the country. There have been significant reductions in pollutant emissions over the decades, through tighter industrial regulation, improved fuel quality, cleaner vehicles and an increased focus on sustainable transport. We know that there are hotspots, in relation to which local authorities have a key role in ensuring that air quality is up to standard.

I was not aware of the noise aspect but I am happy to look into the matter. If I find anything, I will let the member know.

Does the Scottish Government have details of the estimated costs to the national health service and wider society as a result of air pollution? If the information is not available, will the Scottish Government commit to a study in the area?

All local authorities have plans on air quality management. The Government provides £2 million in funding annually to local authorities, to assist them in ensuring that air quality is up to standard. I assure the member that the Government works across portfolios to ensure that the risks are minimised.

I declare an interest, as a councillor on Stirling Council.

Is the minister concerned, as I am, that increasing numbers of councils are making decisions on developments that will worsen air quality, often despite recommendations from directors of public health to reject the developments? In Perth, the Scone development of 700 houses was objected to by the head of public health at NHS Tayside but has been approved, although it will make air quality around Bridgend, in Perth, substantially worse. What will the minister do to ensure that we join up health and planning?

I think that the member’s question is more for the planning minister, who has announced a review of planning, into which it would be wise of the member to feed his concerns. There is a debate on planning tomorrow.

According to recent figures on dementia post-diagnostic support, only 17 per cent of people who live in the most deprived areas are referred for support, compared with 24 per cent of people in the more affluent areas. I am sure that the minister agrees that both figures are shockingly low. What action is the Government taking to ensure that everyone who has a diagnosis of dementia receives the care that they require?

I was glad to see the figures published yesterday that give us a true picture of those who are in need of dementia care. Scotland is the first country in the United Kingdom to have one-year post-diagnosis support. The dementia strategy is being reviewed and members can look forward to a new strategy shortly that will take those figures into account.

Health Inequalities (Pregnancy and Postnatal Period)

To ask the Scottish Government what action it is taking to reduce health inequalities during pregnancy and in the postnatal period. (S5O-00580)

Action from the Scottish Government and the national health service boards has meant that women are now accessing maternity care earlier in their pregnancies, with more than 80 per cent having their antenatal booking appointment by 12 weeks gestation; that is across all Scottish index of multiple deprivation quintiles. Last week we published a review of all maternity and neonatal services, developed around what women and families tell us that they want, which made a number of recommendations focusing on inequalities. In spring, we will roll out free vitamins to all pregnant women—no other country in the United Kingdom has committed to doing that—and from the summer every child born in Scotland will receive a baby box with essential items to help level the playing field for every family.

We have invested more than £11.2 million from 2011 to help boards to promote breastfeeding and to support women to breastfeed for as long as they wish. Scotland is the first country in the UK to have 100 per cent of our maternity units accredited by the United Nations children’s fund baby-friendly initiative. We are providing funding for an additional 500 health visitors and have introduced a new enhanced universal service with key child health reviews, in addition to offering the family nurse partnership programme to all eligible teenage mothers by the end of 2018. Those measures are examples of our ambition to give children the very best start in life, regardless of income.

Reducing health inequalities is obviously one of the biggest challenges that we face. Creating a culture in which healthy behaviours become the norm should start in the very earliest years. What is the Scottish Government doing to ensure that health outcomes for children are improved and inequalities are reduced?

Reducing inequalities, including those around health, is a key part of the Government’s aims. With our partners, we support a wide range of activities to address that; I have mentioned the family nurse partnership, the universal pathway for health visiting, increased numbers of health visitors, support for breastfeeding, free vitamins for pregnant women—those are just a few. We also address wider issues that impact health, including child poverty and our aspirations for raising attainment. I agree that the early years are crucial, as is early intervention and prevention, and we continue to strive to achieve our aim of getting it right for every child. The roll-out of early learning and childcare will also play a part in the ambitions that we have for our children.

One of the best possible ways to achieve better outcomes for babies who are born premature or sick is to ensure that parents are able to spend time with their baby for long, uninterrupted periods and take the lead in the delivery of their care. The “Bliss Scotland baby report 2017” has quite shocking findings that only three out of 12 units have dedicated accommodation for parents of critically ill babies. I know that the cabinet secretary attended the reception last night; after she left the reception, we heard from Coady, whose baby was delivered at 29 weeks. In her local hospital, there was only one room for parents to stay overnight. What specific action will the Government take to prevent the trauma of separation between mother and baby and to reduce the pressure on neonatal units?

I thank Monica Lennon for her supplementary question. As I mentioned in my response to Ash Denham, we have published a review of all maternity and neonatal services, which has been developed around what women and families have told us that they want. Some of the things that the member has pointed out will have been part of that engagement progress. The review sets out a comprehensive package of things that we can do to improve the services that we have across the country.

It is important to remember that we will be building on a position of strength and on the great work that is happening across our NHS. There are a number of recommendations about what we should do on neonatal services and we are working hard now to implement those recommendations to bring even greater improvements to services.

I welcome the Government’s positive response to the Scottish Greens’ calls for a roll-out of the healthier, wealthier children scheme, which is effective in terms of addressing the health inequalities that we are discussing. Can the Government give Parliament some information regarding the implementation of and the timescale for that roll-out?

I will commit to updating Alison Johnstone and will write to her with some of the details that she seeks. However, I again point out the work on the early years collaborative, which I have had cause to mention in many discussions and debates in the Parliament. It is not just about the work that is being done in Glasgow; it involves the work that is being done across the country with local authorities and others to ensure that income maximisation is part of the holistic support that is offered to children and families in those crucial early years.

Rural General Hospitals (Recruitment of Physicians and Surgeons)

To ask the Scottish Government what steps it is taking to recruit physicians and surgeons for rural general hospitals. (S5O-00581)

NHS Scotland boards are required to have the correct staff in place to meet the needs of the service and to ensure high-quality patient care. The Scottish Government works closely with boards to support their efforts in staff recruitment.

A range of actions are already being taken to support boards to recruit in remote and rural areas. Those actions concern potential recruitment from abroad and the encouragement of people who previously trained or worked in NHS Scotland to return and work in the health service. We will continue to look at how we can build on that.

The cabinet secretary will be aware that, as I have been told by NHS Highland on many occasions, the nature of rural general hospitals means that general surgeons are required. That goes against the trend in recent years for surgeons to specialise in a particular field. What can be done to encourage trainee surgeons not to specialise and to gain a broader range of experience and training?

Gail Ross makes an important point. The longer-term solution lies in implementing the recommendations in the report of the shape of training review in order to achieve a better balance between general and specialist medical skills. Proposals that have been worked on with the surgical colleges are well advanced for a revised training curriculum that will equip trainees with the competencies that are required to deliver elective and emergency general surgery in a district general hospital setting. Trainees who complete the programme successfully will become consultant general surgeons.

As changes impact across the United Kingdom, health ministers from across the nations will soon be invited to approve the implementation of those proposals. They will help to enable our district and rural general hospitals to recruit and retain the staff that they need in order to deliver services.

The cabinet secretary will no doubt have heard the interview with Dr Peter Bennie of the British Medical Association in which he spoke quite candidly about being fed up with the Government mantra that there are more doctors than ever before, when the actual question should be whether there are enough doctors, enough nurses and enough staff.

Given the challenges that exist in all areas, but particularly in rural areas, what impact does the cabinet secretary believe that the offering of 9:1 contracts to consultants rather than 8:2 contracts is having in terms of attracting consultants to come to Scotland?

We work closely with the BMA—indeed, we will have a meeting with the BMA next week. One of the issues that we will discuss concerns the balance of the consultant contract, which varies within boards and across boards. I will continue to discuss with the BMA how we take that issue forward.

On the point about how we can ensure that we continue to secure enough doctors to deliver the quality service that we have in Scotland, I can say that not only have we taken action to expand the number of undergraduate medical places and to improve access to those medical places so that we can have a more diverse medical workforce, but we will be opening Scotland’s first new graduate medical school in due course, which will help to ensure an even greater supply of doctors for the service.

Does the cabinet secretary agree that the huge cuts in NHS Highland’s budget, which were highlighted on the front page of today’s Press and Journal, will lead to the health board continuing its centralisation of services to Raigmore hospital, which will lead to the absolute detriment and destruction of our rural hospitals?

In contrast to that, the national health service revenue budget will increase by £500 million above inflation over this parliamentary session. Of course, in 2017-18, funding for our core NHS budgets will increase by more than £320 million, which is more than the Barnett consequentials for health of £304 million. We are investing £128 million in service delivery in territorial boards over the next year, and NHS Highland will benefit from that investment. It will get an uplift of 1.5 per cent and, importantly, a share of the £50 million NHS Scotland resource allocation committee funding.

I assure Edward Mountain that more investment is going into our NHS but, as always, efficiency savings will be required to deliver some of the changes that are required. All that money is invested back into front-line services.

Further to Gail Ross’s point about specific general practitioners and consultants for rural general hospitals, will the cabinet secretary go back to the idea—which, in fairness, was posed in the past—of considering how key staff could be retained for such hospitals post-graduation, given the significant investment with which Parliament and Government support them through their training?

A number of recruitment and retention measures are available to boards to recruit and retain staff, particularly staff in key specialties, who are more difficult to recruit. We are keen to work with boards to consider what more can be done. The training changes will make an important change to the role of staff. Having a general surgeon will be very important for our district and rural general hospitals, but so will the concept of doctors working across a network of hospitals so that they may spend part of their time working in a teaching hospital and part of it working in a rural general or district general hospital. That makes a post far more attractive.

Tavish Scott will also be aware of the range of activity that we are undertaking to address some of the gaps in general practice, particularly in rural areas.

Is the cabinet secretary aware of the situation in the Belford hospital in Fort William, which has lost three rural general surgeons through a series of unfortunate events that has left the hospital struggling for general surgeons? Will she work with NHS Highland to ensure that replacements are available?

Yes, I am aware of those challenges. Our health and social care delivery plan, which was published in December, recognises that we need services that have the capacity, focus and workforce to continue to address the pressures of a changing society and an ageing population. Those key priorities are set out in the delivery plan.

A key driver for that will be our national health and social care workforce plan, which will be published in the spring of this year. NHS Highland is already considering ways to make better use of the available workforce and to work across traditional site boundaries—I referred to that in my response to Tavish Scott.

All those measures will be important in bringing stability and helping some of our rural general hospitals to recruit and retain staff.

NHS Fife (Funding)

To ask the Scottish Government what the funding uplift will be for NHS Fife in 2017-18. (S5O-00582)

NHS Fife will receive a baseline uplift of 1.5 per cent, which will take resource funding for 2017-18 to £616.2 million. That follows the Scottish Government’s draft budget for 2017-18, as set out in Parliament on 15 December 2016. The draft budget does not include the board’s share of £50 million of additional NHS Scotland resource allocation committee funding, which will be confirmed as part of the 2017-18 budget bill, subject to parliamentary approval.

What proportion of NHS Fife’s budget will be used to support the integration of health and social care in 2017-18?

Health boards are setting their budgets for 2017-18, and NHS Fife has yet to finalise its figures for next year. However, we estimate that its recurrent budget in 2017-18 will be £616 million, as I said in my initial answer. The Scottish Government requirement is that the allocation to integration authorities from health boards must be at least equal to their 2016-17 recurrent budget allocation. For NHS Fife, that figure was £338 million, so we estimate that around 55 per cent of NHS Fife’s 2017-18 budget will be delegated to the Fife health and social care partnership to support the integration of health and social care.

Badminton (Participation of Young People)

To ask the Scottish Government what action it is taking to encourage young people’s participation in badminton. (S5O-00583)

Since the success of Scottish badminton players at the Glasgow 2014 Commonwealth games, we have seen a steady increase in people playing the sport. For instance, since the games, the active schools programme has seen an increase of more than 2 per cent in participant sessions, with a total of over 292,000 sessions in 2015-16.

Sportscotland, which is the national agency for sport, is investing up to £2.9 million in Badminton Scotland for the 2015 to 2019 investment cycle, which is a 2.7 per cent increase from the 2011 to 2015 funding cycle. In addition, through VisitScotland’s events directorate, the Scottish Government is supporting the badminton world championships, which will be staged at Glasgow’s Emirates arena in August this year. Badminton Scotland plans to get 30,000 more schoolchildren playing the game through its big hit festivals as part of the legacy programme that is built around the championships.

I thank the minister for that detail. Does she have any thoughts on the recent announcement that badminton is to be one of the five sports to lose all UK Sport funding for the 2020 Olympics in Tokyo? As the minister will know, Hamilton sports council has supported many young people to take up and become champions in sport, not least our own very successful badminton star, Kirsty Gilmour, who recently raised concerns about the UK funding cut. What support does sportscotland give to our current sports stars and possible sports stars of the future to ensure that we do not lose that talent?

I thank Christina McKelvie for raising the issue and giving us the chance to again congratulate Kirsty Gilmour on all her achievements in her career. Sportscotland has developed a world-class sporting system at all levels that connects sport in schools and education, in clubs and in the community with performance sport. For instance, sportscotland is investing £50 million over the period 2015 to 2019 in its active schools programme, which provides opportunities for children to try sports and begin on the path towards becoming sport stars of the future. I will continue to engage with Christina McKelvie on any issues that she would like to raise on badminton, particularly given her local interest in Kirsty Gilmour’s career.

I find it rather hypocritical for Christina McKelvie to raise the issue when her Government proposes to slash the sports budget by £4 million, which sportscotland has indicated to the Health and Sport Committee will have significant repercussions for the number of sports that it can support and the value of that support. How does the Scottish Government propose to mitigate the effect of its own slashing cuts?

I do not doubt Brian Whittle’s commitment to sport. I do not think that any member across the chamber can compete with his first-hand knowledge and experience of sport, no matter how much they enjoy and experience sport. However, I think that added to his gold medal should be a brass neck, given the devastating blows that his party has dealt to our poorest communities through welfare reforms and austerity. My party and this Government have to soften those blows. Alongside that, we remain absolutely committed to sport and activity and to building on the legacy of our 2014 games, empowering our communities and maximising the significant investment that we have made in improving facilities the length and breadth of the country.

Health Advice (Accessibility to People with Hearing Loss and Deafness)

To ask the Scottish Government what steps it takes to ensure that the health advice it produces is accessible to people with hearing loss and deafness. (S5O-00584)

The patient charter clearly sets out what patients can expect when they use NHS Scotland services and receive care. That includes the right to be given the information that they need in a format or language that they can understand. Under the Equality Act 2010, NHS Scotland is required to provide translation and interpreting services and written material whenever that is possible and reasonable. All NHS boards have a published accessibility policy and arrangements in place to support such needs. People who are deaf or hard of hearing can access Scotland’s national health and information service, NHS inform, by using the contactSCOTLAND-BSL service, by textphone or by web chat, which is available on the NHS inform website.

Does the minister agree that taking steps such as subtitling Government videos is important to ensure that people with deafness benefit fully from health advice?

I fully agree with Emma Harper and I assure her that the Scottish Government is committed to providing health information in formats that are accessible to people with hearing loss and deafness. All Scottish Government campaign websites are tested for accessibility as standard, and subtitles are added to videos that are posted on YouTube.

In addition, all reasonable efforts are made to ensure that top level and main contact pages on the Scottish Government website comply with World Wide Web Consortium standards that cover a range of disabilities, including auditory disabilities. NHS 24 is working with partners to ensure that videos that are displayed on the new NHS inform website have language options, including British Sign Language and subtitles, as seen on the Care Information Scotland website.

The British Deaf Association Scotland 2016 health review said that people with hearing loss found that communication was easiest in local primary care services that they were familiar with and was more difficult in secondary care settings. What plans do ministers have to improve healthcare for deaf people, specifically in secondary care settings?

As I said in my previous answer, people with impairments should be able to have access. It is a case of ensuring that, before a patient goes to receive secondary care, the letter that is sent to ask for an appointment for them makes it clear that the person has hearing loss or another impairment. Such issues are being worked on as a result of the BSL legislation that the Parliament passed.

General Practitioner Practices (Resourcing)

To ask the Scottish Government what its position is on GP practices in the most deprived areas receiving more resources per patient than those in less deprived areas. (S5O-00585)

Tackling health inequalities is one of our primary care outcomes, as recently published in a joint memorandum with the British Medical Association. Adjusting the Scottish allocation formula, which weights general practice funding by various factors that affect workload—not least deprivation—is one way that could deliver that outcome.

We also need to look beyond the general practitioner contract to other interventions and ways of supporting general practice in areas of high deprivation. That is why the Government has committed to increasing the number of link workers who support general practice.

The BMA is in a difficult situation, because it supports GPs in rich areas and in poor areas. I wonder whether we should put more emphasis on deep-end practices in poorer areas, because they deal with much greater health needs and multimorbidity. GPs in such practices need to spend a lot more time with individual patients.

John Mason makes a fair point, but I am confident that we can get agreement with the BMA to ensure that there is solid recognition of deprivation in the allocation of resources to the practices that operate in our most deprived communities. Deprivation is one factor that increases demand on GP resources, so the Scottish allocation formula is weighted to help practices in deprived areas.

We are investing in projects such as the deep-end pioneer scheme to support GPs who work in very deprived areas. That is in addition to our investment in primary care more generally. An additional £500 million will be invested over the parliamentary session, which means that there will be a big shift in national health service front-line spending to our community and primary healthcare services.

The Scottish allocation formula has been reviewed and is under review, and we are commissioning a further review of GP pay and expenses. Alongside the renegotiation of the GP contract, that will help to address some of John Mason’s concerns.

I emphasise to the cabinet secretary the concern that the current formula for GPs in deprived areas has the unintended consequence that they have less time to meet, talk and work with needy patients. Doctors have said to me that, although link workers might be part of the process, they are concerned that the current funding approach means that, while GPs can give people drugs, they have less time to spend with people. In fact, such patients do not need tablets; they need somebody who properly understands their condition. Will the cabinet secretary make a commitment to look again at how that is taken forward? It is a genuinely bizarre situation when the doctors who are under most pressure are less well funded.

Johann Lamont has raised the issue a number of times in the chamber. I reassure her that, as part of our negotiations with the BMA, the Scottish allocation formula has been reviewed. We are commissioning a further review of GP pay and expenses because we need to understand more of the detail in order to look at the contractual agreements.

In addition, there is more general work that is geared towards addressing workload issues, which will help GPs who work in deprived communities, as well as GPs overall. As that will mean that GPs will be able to spend more time with patients who have complex issues, there will be a benefit for those who work in deprived communities, given that many of their patients have complex multimorbidity issues on which more time needs to be spent.

I recently met a link worker who is attached to a GP practice in East Ayrshire. They made clear the importance of ensuring that GPs are able, through link workers, to connect patients to local services, whether those are mental health or other services. I am convinced that the link worker role will make a tremendous difference in helping to ensure that patients get to the right place.

The cabinet secretary mentioned the financial commitments to primary care, but a lack of clarity remains about where that resource will be targeted. The chair of the Royal College of General Practitioners Scotland, Dr Miles Mack, said that it presents an

“opportunity to ... lessen the effects of the inverse care law, under which those most in need of healthcare have least access to it.”

Will the cabinet secretary today give details of where those sums of money will be targeted?

I reiterate that, in the next financial year, we will invest £72 million in improvements to primary care and GP services, against the backdrop of our commitment to invest an additional £500 million over the current session of Parliament. That is a huge shift in investment, which I hope that Donald Cameron welcomes.

As for where that money will be spent, we have set out our priorities, which include reducing workload, improving recruitment and retention, and building multidisciplinary teams that can work together to see and help patients, with a GP as the clinical expert who supports each team. That model has support from the BMA and, I believe, from the RCGP.

I am happy to continue to provide detail as we take the issues forward. Our work represents a big transformation in the way in which primary care is delivered, but it will very much benefit patients.

Sport (Participation)

To ask the Scottish Government what action it is taking to encourage more participation in sporting activities. (S5O-00586)

The Scottish Government is committed to increasing rates of physical activity, and participation in sport is a key element of that. The active Scotland outcomes framework sets out our ambitions for a more active Scotland and is underpinned by a commitment to equality and the need to ensure that, regardless of gender, age, sexuality or income, there are opportunities and support to encourage people to be active.

I welcome the work that is being done. In 2017, we are three years on from the Glasgow 2014 Commonwealth games from which we sought to create a legacy. What action has the Scottish Government been taking, and what action will it continue to take, to deliver community sport hubs across Scotland to continue to build on that legacy?

I am delighted to say that, through investment by sportscotland, there are already 157 community sport hubs up and running across Scotland, and that number will increase to 200 by 2020 to provide more and better opportunities for people of all ages and abilities to get active. Sportscotland is currently focusing on seven community sport hubs across five local authorities in the 5 per cent most deprived areas, providing additional support to help to enhance the local offer, develop existing and new opportunities, grow membership and explore barriers to school and club participation.

Ninewells Hospital (Electrical Wiring)

To ask the Scottish Government whether it will provide the £90 million required to bring the electrical wiring at Ninewells hospital up to safe and modern standards. (S5O-00587)

NHS Tayside is currently developing a long-term investment plan for Ninewells hospital, which includes work to ensure the resilience of the electrical infrastructure of the site. The board is in the process of developing the business case for the project, which will be submitted to the NHS capital investment group for consideration in the coming weeks. A decision on the funding will be made once the business case has been reviewed.

While the plan is being developed, there is continual maintenance across the Ninewells site, and there is on-going investment in the site’s infrastructure to ensure that NHS Tayside can continue to deliver a high-quality, sustainable and safe service for its patients.

The cabinet secretary will know as well as I do that NHS Tayside is running a projected deficit this year of £18 million and has millions of pounds of debt to the Government with no obvious way to repay it. In light of that and of Audit Scotland’s warnings about NHS Tayside’s finances, will she pledge to fully fund the £90 million bill, so that we can ensure that the electrical wiring at Ninewells hospital is safe for patients?

On the issue of the NHS Tayside deficit, which has been subject to a lot of public scrutiny, not least from the committee that Jenny Marra convenes, the Scottish Government will continue to work with NHS Tayside in helping it to deliver a sustainable plan to recover its financial position.

If Jenny Marra had listened to my initial answer, she would have heard clearly that a decision on the funding will be made following the review of the business case. That is how we do things—we get a proper business case from a board, we review it and we then take it forward. It would not be appropriate to make any decision before that review is complete. That is the proper way to make investment decisions.

We recognise the importance of Ninewells having a reliable and safe electrical infrastructure, and Scottish Government officials have been working with NHS Tayside as the board develops its case. I said that that would happen in the next few weeks and I would have thought that Jenny Marra might welcome that.

Ten days ago, NHS Tayside took a decision to close the dedicated mental health unit, the Mulberry unit, at Stracathro hospital, which is the only adult psychiatric admissions ward in Angus, because only 18 whole-time junior doctors are available to NHS Tayside out of a requirement of 31. What is the Government actively doing to recruit more mental health doctors, and when will NHS Tayside have enough resource to reopen the Mulberry unit?

In this case, although the question is valid, it is not a supplementary to a question about electrical wiring at Ninewells. We will take question 10.

NHS Greater Glasgow and Clyde (Meetings)

To ask the Scottish Government when the health secretary will next meet NHS Greater Glasgow and Clyde. (S5O-00588)

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

As the health secretary will know, a campaign group of strong and committed parents has been set up to oppose the closure of ward 15 at the Royal Alexandra hospital in Paisley. We heard last week that a young boy from Paisley, Alex Gray, had to be diverted to Edinburgh because of the lack of beds at the new children’s hospital in Glasgow. Does the health secretary think that the closure of ward 15 should go ahead, given that the new children’s hospital could not take that one child, never mind the estimated 18,000 additional cases that are to be transferred from the RAH to Glasgow? Can the health secretary tell us whether she intends to visit Paisley at any point to listen to the views of local parents?

It is important that we understand what the paediatric intensive care service is. It has operated as a single national service, delivered from two units in Edinburgh and Glasgow, since 2007. It has specialised facilities, with highly skilled clinical teams. It is clearly important that the beds are managed on a Scotland-wide basis and that children will get to the right place when they require a bed. That sometimes means that if there are no beds available in Glasgow, children will go to Edinburgh, or vice versa. They are very specialist beds, and they are managed on a national basis.

It is important not to conflate that issue with the matter of ward 15 at the RAH, which does not have any paediatric intensive care beds. Children could not be treated in those beds if they had that level of need. The two issues are very different.

As Mary Fee knows full well, the closure of ward 15 at the RAH was designated by the board as a major change and the proposal is currently out to formal public consultation until 6 February. I encourage all stakeholders to register their views. It would be inappropriate for me to comment further at this point except to say that the final proposals will be subject to ministerial approval and I will consider carefully all the available information and representations before coming to a final decision.