Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, October 26, 2021

Official Report 1097KB pdf

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Topical Question Time

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NHS Lanarkshire Risk Level

To ask the Scottish Government what its response is to reports of NHS Lanarkshire moving to the highest risk level, black, and cancelling elective care, including some cancer procedures. (S6T-00225)

Our health and care system is under extreme pressure due to the direct and indirect consequences of the pandemic, and NHS Lanarkshire, like all health boards, is experiencing significant pressures, including workforce challenges. We have deployed military assistance to support emergency care and, to minimise delays for patients who are waiting for elective care and cancer treatment, the board is maximising theatre capacity and support from other boards to provide greater access for patients.

We expect, and are planning for, this winter to be the most challenging in the history of the national health service. To help to alleviate those pressures, over and above the £300 million package of winter measures, I announced earlier today an additional £10 million to help patients to avoid a hospital stay whenever possible and to speed up discharges for those who are in hospital, which will, of course, free up capacity for patient care.

I thank the entire NHS Lanarkshire workforce for its exceptional efforts.

Today, Cancer Research UK in Scotland described the situation in NHS Lanarkshire as deeply concerning, and it has warned us that, for people with cancer, every day counts. Can the cabinet secretary confirm how many cancer procedures in Lanarkshire have been cancelled so far and whether he expects more cancer procedures to be cancelled or delayed in the weeks ahead?

I cannot confirm that, because the number is so low that saying it would risk identifying the individuals. I can say that the number of cancer procedures that have been postponed is very small. I have spoken to NHS Lanarkshire, which is working extremely hard in respect of its theatre allocation space to ensure that it can reprioritise those procedures and treatments as quickly as possible.

Monica Lennon and I will undoubtedly have various exchanges on health over the course of the winter, but I am sure that she would agree and understand that decisions on any patient care, but particularly those that relate to cancer, are never taken lightly. I can provide to her, in written form if she wishes, updates on what we are doing to try to recover some of the cancer diagnostics that we know were affected because of the pause in screening in the early days of the pandemic.

I am pleased to hear that other theatres and boards have some capacity to assist NHS Lanarkshire. Is the cabinet secretary aware of any other health board that has had to cancel cancer procedures? Is any other health board in Scotland warning that it, too, could declare a code black or, to give it its correct term, the highest risk level, which is black?

Decisions on what procedures and treatments can take place are taken at individual health board level. I speak to health board chairs and chief executives on a very regular basis, and all boards are at a significant level of escalation. My most recent conversation with chairs was yesterday, and there was no indication that any other chair, chief exec or health board was going to declare the highest level of escalation, as Lanarkshire has done, but that is, of course, kept under review.

In Lanarkshire, the highest level of escalation, the black level of escalation, is kept under daily review, and it will not be in place for a moment longer than it has to be.

I congratulate Monica Lennon on securing the question. There is no doubt that there are serious pressures across all aspects of our health and social care services, which have been exacerbated by the pandemic. I thank NHS Lanarkshire staff for all that they are doing in these difficult times to serve my constituents in Airdrie and Shotts.

Can the cabinet secretary again outline what additional support has been given to NHS Lanarkshire, and in particular to its general practitioner services? As my constituents are reporting to me, some—but most certainly not all—surgeries are referring patients directly to accident and emergency, probably for understandable reasons, but that will be having an impact on the pressures that are faced by the three accident and emergency units and, by extension, the hospitals in Lanarkshire.

In the interests of brevity, it would probably be easier for me to write to Neil Gray in relation to the additional funding that we have given NHS Lanarkshire, which includes Covid and non-Covid funding. In her statement, the First Minister will outline some further funding that will go to health boards. In the interests of brevity, I will write to Neil Gray with the details on that point.

On his second point, which I think is incredibly important, we have given additional funding to general practitioners. In my winter package, I announced an additional £28 million for primary care services, a portion of which will, of course, go to GPs.

I met representatives of the British Medical Association earlier this week. The BMA and I wrote jointly to every GP practice in the country, thanking GPs for their incredible service throughout the course of the pandemic, but saying in black and white that, with the change in guidance, we would expect there to be an increase in face-to-face appointments, which will hopefully help in relation to the pressure that we are seeing at the front door of A and E departments.

Since NHS Lanarkshire entered code black, I have received emails from constituents who have raised serious concerns over the advice that they have received from NHS 24. One constituent who emailed me was advised that no consultant was available, despite her family member having a repetitive cough, high temperature and sickness. The Scottish Government was aware of the critical level that faced NHS Lanarkshire and other health boards, so why did it not address the staffing issues to ensure that those who phone 111 do not have to present at A and E?

If there are any constituent cases that Ms Gallacher wishes to raise with me, she can do that, and I will, of course, contact the health board to see what more can be done for her constituents.

I do not agree with Ms Gallacher’s characterisation. The fact that we requested military assistance is a demonstration of how seriously we took the situation at NHS Lanarkshire, and I thank the armed forces for responding in typically quick fashion to our and NHS Lanarkshire’s request.

Additional resources are going into the NHS 24 workforce, with a new call centre opening up in Dundee, which will be helpful across the entire country.

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Spiking

To ask the Scottish Government what work is being undertaken in response to reports of recent increases in drink spiking and spiking by injection in nightclubs and bars. (S6T-00222)

Anyone who is found to spike a person will be arrested and may be prosecuted. Police Scotland is pursuing every single report of spiking and is in daily contact with my officials so that we can better understand the prevalence of the activity. A gold command has been established and is being led by an assistant chief constable. That command is reaching out to universities and licensed premises.

I wish to make it absolutely clear that one case of spiking is one case too many, and the act of spiking is an absolutely despicable activity. Such harmful behaviours cannot be tolerated in our society.

We are working with our partners to ensure that we have the right balance of targeted and universal interventions, alongside our wider work to tackle misogynistic conduct and to ensure that men take responsibility for their behaviours.

The reports of increases in spiking are troubling. While I know that there is no simple solution to the abhorrent act of spiking, I am determined to work with organisations such as Rape Crisis Scotland, Engender, the Scottish Licensed Trade Association and Police Scotland, as well as with the cabinet secretary, to see what more can be done. Will the cabinet secretary meet me to discuss this concerning issue?

I would be more than happy to meet Evelyn Tweed and key partners to understand what more could be done to address this concerning issue. As I said, spiking is an abhorrent act, and I am committed to working with partners to tackle that unacceptable behaviour.

Will the cabinet secretary join me in doing everything that we can to encourage anyone who has been spiked, or who has witnessed someone being spiked, to contact the police as soon as possible so that they can investigate the instances as quickly as possible, especially since the evidence that they need is time sensitive; and to highlight that people can reach Rape Crisis Scotland for support via its helpline number, which is 08088 010302?

Evelyn Tweed makes an important point about the time-sensitive nature of the evidence that is crucial for the police. It is the case that Police Scotland is taking every report of spiking seriously. I encourage anyone who has been spiked, or who has witnessed someone being spiked, to report it to the police as soon as possible. As Evelyn Tweed said, support is available from Rape Crisis Scotland for anyone who needs it, and there is no harm in repeating its helpline number, which is 08088 010302.

The Scottish Government has a new policy of non-prosecution for drug possession. Will the cabinet secretary back our calls for an exemption to that policy for those who are caught with drugs that are intended for the purpose of spiking?

I think that Russell Findlay misunderstands, because that is not a Scottish Government policy but declared guidance from the Lord Advocate. The issue that Mr Findlay raised is one for the Lord Advocate, although I take on board the suggestion that was made and will give it further consideration. However, as to prosecutions, Mr Findlay should be aware that those decisions are for the Lord Advocate alone.

It is important that we all stand up against spiking. On Wednesday, I will address a protest at the University of St Andrews, and I want to report to the protesters that the Scottish Parliament is taking action on spiking. A successful testing-strip promotion scheme is already in place in Lincolnshire that provides free test strips for all venues. Would the Scottish Government be prepared to roll out a similar scheme in Scotland, as well as fund it?

Willie Rennie makes a constructive suggestion. I undertake to have a look at the initiative that he mentioned. However, I should say that, along with the police and the nightclub industry, other partners are addressing the matter, not least our universities—Willie Rennie mentioned the University of St Andrews—and colleges, given that a number of spiking incidents have happened around student bars. I am more than happy to consider Willie Rennie’s suggestion and any others that come forward, but quite a number of actions are being looked at just now by Police Scotland and the Scottish Government.

Like other members, I am completely horrified by the recent disclosures about cases of spiking in which young women have wilfully and recklessly been targeted. In my constituency, Robert Gordon University has put the safety of students front and centre of its equally safe strategy. What more can be done to support students within and beyond the campus to ensure that they are safe?

The gold command group that has been established and which is led by an assistant chief constable in Police Scotland is reaching out to universities and licensed premises. I hope that that gives some reassurance to Audrey Nicoll. In addition, members of the equally safe in colleges and universities core leadership group, which includes Universities Scotland, NUS Scotland and the Scottish Funding Council, have been asked to share important Police Scotland information on the issue through its networks.

A final point to make is that we cannot let the issue be the responsibility of those who are victims of spiking. We know that spiking is largely done by men and that four fifths of the victims are women. It is a big challenge for society, and one where men must take on responsibility for their actions. Telling victims what they should do to avoid spiking might be well intentioned, but it is our responsibility, along with the police, various institutions and the nightclub industry, to ensure that we do what we can to make premises safe for everyone concerned.