Meeting of the Parliament (Hybrid)

Meeting date: Thursday, January 27, 2022

Official Report 1204KB pdf

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General Question Time

Good morning. I remind members of the Covid-related measures that are in place. Face coverings should be worn when moving around the chamber and across the Holyrood campus.

The first item of business is general question time. In order to get in as many members as possible, I would be grateful for short and succinct questions and responses.

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Travel to Medical Appointments (Support)

I refer members to my entry in the register of interests, which mentions my involvement with the Western Isles Cancer Care Initiative.

To ask the Scottish Government what financial support is offered to patients and authorised escorts who need to travel significant distances for medical appointments. (S6O-00684)

Financial support for travel is available for patients and authorised escorts, in line with eligibility criteria and medical requirements. We continue to work with boards to build on the significant innovation that there has been throughout the pandemic to limit the need for travel where that is possible and clinically appropriate. For example, there has been increased use of digital and technological solutions such as the Near Me service.

Where travel is necessary, boards are expected to support patients to identify and access the available support, take account of individual circumstances and ensure that patient care is always at the centre of those decisions.

The charity Western Isles Cancer Care Initiative recently recorded its fastest approval for financial assistance for a cancer patient, whose patient escort request—for a friend to accompany them—had been refused by the health board. For people who live on the mainland, it must be strange to imagine having to undergo something as worrying as cancer treatment without the support of a loved one, but, in the past few years, that has become an all-too-common scenario in the Western Isles since the handling of patient escort applications changed. Does the cabinet secretary agree that patients should not be disadvantaged with regard to the emotional support that they can draw on just because they live on an island?

I whole-heartedly agree with that point, and I think that Alasdair Allan articulates it very well. People on the mainland would not expect to go through that situation, worry and anxiety on their own, and he makes that point very well. I am sympathetic to his point in relation to not just cancer diagnosis but any diagnosis that could be life altering. Therefore, I will take the issue away and look at it in more detail. Obviously, there would be a financial impact, but he is absolutely right to put patient care and safety at the heart of the matter. I am sympathetic to that and I will keep the member updated.

I have previously written to the cabinet secretary about that matter and have not received a reply. A review of patient travel in the Highlands and Islands was due to take place, but it has been delayed since August last year because of the pandemic. When will the review take place? It is urgently required, because the criteria and reimbursement amounts date back to 1996 and do not account for inflation. Will the cabinet secretary also confirm that the review will be subject to an island impact assessment?

I apologise if Ms Grant has not had a response to correspondence that has been sent recently. I will check that out as soon as we are out of the chamber.

With regard to her wider point, she is right that a review was due to be undertaken, but, unfortunately, the pandemic has meant that it has been delayed. We will look to bring forward the review as soon as possible. I am sure that she understands that our boards and health and social care civil service team are still under immense and intense pressure.

With regard to the latter point that she raised about any review undergoing an island impact assessment, I will ensure that that is the case.

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Physical Activity (Access During Lockdown)

To ask the Scottish Government what action it is taking to mitigate the effect that reduced access to physical activity during lockdown has had on the health of young people. (S6O-00685)

Our approach during the pandemic has been to permit as much sport and physical activity as possible and, in particular, to prioritise under-18 sport, as we recognise its importance to physical and mental health. When schools were closed during the pandemic, active schools staff were deployed flexibly into childcare hubs to deliver sport and physical activity interventions. They also delivered online physical activity sessions for those who were learning from home.

The Scottish Government has committed to doubling the budget for sport and active living over the lifetime of this parliamentary session, which will make access to sport and physical activity more inclusive, reduce barriers to participation, and play an important role in supporting the long-term recovery from the pandemic.

For six to 17-year-olds, the recommended daily exercise requirement is 60 minutes of moderate to vigorous activity. Pre-lockdown, less than one quarter of children in that age group participated in that 60 minutes. Without question—I say this as a coach as well as an MSP—the percentage has seriously declined over the past two years, as access to activity has been significantly curtailed, especially in deprived areas.

That will not be resolved without direct targeted action and intervention from the Scottish Government. What will the Scottish Government do to tackle this ticking health time bomb?

I thank the member for his continued interest in the area. We absolutely recognise the need to prioritise participation across all groups, but also to tackle inequalities. We are working with sportscotland and organisations and individuals across Scotland to break down the financial and other barriers that keep too many people from leading active lives.

We have ideas about how to increase participation by women and girls. We are looking at tackling the exclusion of people with disabilities. We are determined to increase the level of activity right across the board, but we are particularly focused on tackling inequalities in children and young people.

I preface my comment by saying that I am not promoting intergenerational wars, but older people—I declare an interest in that regard—not only have missed exercise but are often still understandably cautious about being out and about in public. They are losing confidence and becoming isolated. Will the minister also give that issue consideration? I am talking about exercise and not sport, to which I am a stranger.

I acknowledge Christine Grahame’s on-going interest in the area. The over-50s are a priority group for sportscotland’s equality outcomes for 2021-25. We hope to achieve a number of changes in that area. We want people in that group to participate in sport, we want them to see and hear people participating in sport, and we want to use their long experience by having them involved in organising sporting communities.

In relation to activities, I highlight Paths for All, which has the most amazing programmes. One is called health walks, which is about exactly what Christine Grahame spoke of: increasing the confidence of people who might have got out of the habit of exercising or have health worries that make them fear exercising, and offering them a social opportunity. I heartily recommend to all my colleagues that they direct folk to have a look at Paths for All. It has fabulous opportunities for every age range to participate in.

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Stirling Council

To ask the Scottish Government when it last met Stirling Council and what was discussed. (S6O-00686)

Ministers and officials have regular meetings with representatives of all Scottish local authorities, including Stirling Council, to discuss a wide range of issues, as part of our commitment to working in partnership with local government to improve outcomes for the people of Scotland.

Community projects, high streets and tourist venues across the Stirling local government area have been severely impacted by the most recent and unnecessary restrictions that were imposed by the Scottish National Party. The vast majority of those organisations are still waiting for assistance that was promised by the Scottish Government. When will it be received, and why is there a delay?

A great deal of assistance has been set out during the pandemic to support the types of organisations that Dean Lockhart has outlined. The Scottish Government has worked with partners to try to ensure that that money and support goes to local projects as quickly as possible. From my engagement with third sector organisations, I know that that support has been warmly welcomed and has enabled them to support people in our communities, particularly the most vulnerable.

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Breast Cancer Oncology (NHS Tayside)

To ask the Scottish Government what its plans are for service continuity for breast cancer oncology services in NHS Tayside, in light of reports of further resignations within the service. (S6O-00687)

On 20 January 2022, NHS Tayside announced that, due to a staffing gap that will arise at the end of January, a mutual aid agreement has been agreed between NHS Tayside and three other health boards. The agreement outlines that some patients living in Tayside and receiving radiotherapy for breast cancer will be required to travel for their treatment to their nearest cancer centre in Edinburgh, Glasgow or Aberdeen. All other radiotherapy services in Dundee cancer centre will carry on locally. Meanwhile, recruitment for any vacant posts within the service is on-going.

I can inform Parliament and the cabinet secretary that, over recent days, two further consultant oncologists have resigned. That will leave NHS Tayside with no breast cancer oncology specialists and serious shortfalls in oncology consultant cover in relation to other tumours.

Putting aside the incompetence of the Government and health quangos that got us here, I implore the cabinet secretary, on behalf of the women of Dundee and Tayside, at long last to treat the situation as the crisis that it is. Will he immediately intervene to guarantee the full recovery of breast cancer services in Dundee?

I will not rise to the political attack. It is important to engage with the issue in a non-partisan way and to put the women and patients who are affected very much at the heart of the situation. Michael Marra asks me to intervene, but I can give an absolute assurance that I and other ministerial colleagues have been deeply involved in the issue. There is no question of NHS Tayside not taking action; it has been taking action.

I will give some examples. Last year, NHS Tayside undertook three rounds of recruitment, with one successful applicant. It has been in regular contact with all United Kingdom agencies—more than 120 in total—in relation to both contracted and non-contracted posts. Medical directors have been in contact with several of the larger cancer centres in England, which report similar challenges.

We will, of course, work closely with NHS Tayside. It is in a deeply regrettable situation. We will do everything that we can to ensure that NHS Tayside’s breast cancer service is staffed in the best possible way. However, the shortage of medical oncologists, particularly for breast cancer, is not unique to NHS Tayside. It is felt acutely there, but the issue is wider than that. I am happy to meet members about the issue. It will take a collective effort by the Government and the health board to ensure that a full service resumes in NHS Tayside.

NHS Tayside’s inability to recruit replacement breast cancer therapists and clinicians is putting a huge strain on individuals, especially when they have early stage breast cancer. The cabinet secretary identified that people are going to cancer centres in Glasgow, Aberdeen and even Forth Valley, all of which also have staffing issues. What additional measures can be put in place to ensure that the disruption to those patients is kept to a minimum?

Alexander Stewart is right in saying that the focus is on trying to ensure that the disruption is kept to a minimum. NHS Tayside has made it clear that, when there is a need for patients to travel and be accommodated, it will seek to make sure that those costs are covered.

We are working intensively with the board to support all further solutions. That includes international recruitment; regional roles that support several centres—involving, for example, NHS Lothian and NHS Tayside; a re-examination of locum capacity, including dealing with international locum agencies; role redesign, including research opportunities with Dundee medical school; and exploring an enhanced marketing campaign for NHS Tayside to attract more oncologists, and breast cancer oncologists in particular.

Although we are rightly and understandably focusing on NHS Tayside, the issue is felt not only by other health boards in Scotland but by other health boards and national health service trusts in England and other parts of the UK. We will do everything that we can to ensure that breast cancer services across Scotland are fully staffed.

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National Care Service

To ask the Scottish Government whether it will provide an update on its plans for a national care service. (S6O-00688)

The consultation on the national care service received more than 1,300 responses. Analysis of the responses is currently under way and we expect to be able to publish a report on the findings as soon as possible. I am sure that members will appreciate that the ability to prepare easily accessible versions, both written and audible, will drive the final timetable.

Given the breadth of the consultation, ministers across Government will want time to reflect on the analysis. As such, there is no plan for a concurrent Government response.

Can the minister confirm whether good food nation plans would be relevant to the formation of the national care service?

We want Scotland to be a good food nation in which people from every walk of life take pride and pleasure in, and benefit from, the food that they produce, buy, cook, serve and eat each day. We will consider how to take account of the good food nation principles in the national care service as we develop our proposals.

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NHS Greater Glasgow and Clyde

To ask the Scottish Government when it last met NHS Greater Glasgow and Clyde. (S6O-00689)

I met the chairs and chief executives of the national health service boards, including those from NHS Greater Glasgow and Clyde, this morning.

A registered blind constituent asked me what lateral flow test help is available for visually impaired people. Are the health board and the Scottish Government aware of the difficulties that people with that disability encounter? What help is available to them?

I am aware of those issues, which many members have raised. Rona Mackay raises an important point.

The national testing programme was primarily delivered by the United Kingdom Health and Security Agency, and we are working with it to continually explore ways to enable more accessible testing. For people with access to a smart phone, the UK Covid-19 testing programme launched the Be My Eyes support service in early 2021 to improve accessibility for at-home polymerase chain reaction—PCR—testing.

In response to calls for the same support for at-home lateral flow tests, an expansion to the existing 119 phone service and the Be My Eyes service was launched today, 27 January, to assist asymptomatic visually impaired people, and anyone else who needs support, to conduct a rapid flow self-test independently. People who have severe sight loss might find it easier to get the test done by a friend or family member, but I understand that not everybody is in that position.

In addition, instructions on the LFT self-tests that are used in the national testing programme are available in large print and easy-read formats and can be accessed through the appropriate manufacturers’ links.

I will ensure that our communication around that issue is on our NHS Inform website and I will work with third sector partners to ensure that information on the new extension to the Be My Eyes service is widely available.

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Endoscopy and Urology Diagnostic Recovery and Renewal Plan

To ask the Scottish Government whether it will provide an update on the implementation of its endoscopy and urology diagnostic recovery and renewal plan. (S6O-00690)

The endoscopy and urology diagnostic recovery and renewal plan was published on 30 November. Actions in the plan are on track, and we have committed to annual updates on progress against commitments in the national health service recovery plan. The first update will be later this year.

The plan contains a commitment to set up several diagnostic urology hubs and one-stop clinics across Scotland to reduce waiting times for cancer and routine diagnosis. One such hub was set up in NHS Highland in June last year. What arrangements have been made to ensure that people in Ayrshire have access to a diagnostic urology hub or a one-stop clinic in NHS Ayrshire and Arran, and when will such a unit open?

Ayrshire and Arran has a urology hub. Cancer service performance is 96.9 per cent for the urology 62-day pathway and 100 per cent for the 31-day pathway.

As we further develop the neurology diagnostic hubs, we hope that their full benefits will be realised and waiting times for cancer patients will reduce. We intend to give annual updates on the matter, and I will be happy to provide information about the support and the actions that we are taking in their local health board areas if members want it.

That concludes general question time. I apologise to Oliver Mundell—we have been unable to reach him in the time that is available.