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Chamber and committees

Meeting date: Thursday, February 28, 2019

Meeting of the Parliament 28 February 2019

Agenda: General Question Time, First Minister’s Question Time, World Hearing Day and Hearing Awareness Week 2019, European Union Exit (Impact of United Kingdom Immigration Policy), Devolved Benefits (Delivery), Point of Order, Census (Amendment) (Scotland) Bill: Stage 1, Standards Commission for Scotland (Appointment of Member), Decision Time


General Question Time

Thrombectomy Services

To ask the Scottish Government what progress is being made with introducing access to thrombectomy services in Scotland. (S5O-02929)

As the member knows, we are working towards the provision of a thrombectomy service in Scotland. To do that safely and sustainably, it has to be properly planned and every aspect has to be thought through and clearly understood.

As promised, the draft framework was provided to the national planning board last month. The national planning board has asked the advisory group to further develop its draft plan and it is anticipated that the board will consider the revised plan at its next meeting in May.

Every week that goes by without a thrombectomy service in Scotland sees stroke specialists denying our patients the best possible treatment. That means that people are missing out on the chance to walk again or to get out of the house, and are even losing their voices.

It is four years since large-scale studies proved the impact that the treatment could have on people’s recovery after stroke. It is two years since the case for thrombectomy was made to National Health Service directors in Scotland. I therefore ask the cabinet secretary whether we will see the service up and running in Scotland in 2019?

I am sure that the member will appreciate that it is not for me—I am not a clinician—to second-guess expert clinical opinion. The work is being led by clinical experts precisely to ensure that the service is introduced in a planned, safe, clinically-effective and, most importantly, sustainable way.

I do not think that members would wish a politician to start imposing deadlines on the expert opinion and best advice of clinicians. I cannot, and would not wish to do that. Our services should always be led by those individuals.

We are clear that evidence shows that thrombectomy is an effective treatment for patients with severe stroke due to large artery blockage, as the member said. We do not dispute that. However, we want to see the service introduced in a planned, safe and sustainable way and we are going about that in exactly the right way by ensuring that its introduction is led by clinical expertise.

I am happy to update the chamber following the discussion with the expert group at the planning board in May and to ensure that members are kept up to date with our progress. I, too, am keen to introduce the service. However, as a politician, I would never presume to second-guess expert opinion.

My constituent, Robert Baldock, was one of just 13 people who were lucky enough to receive a thrombectomy in 2017, which saved his life after a stroke. Despite being left with no speech and other challenges, he has been leading a campaign to bring back thrombectomy, because he wants to ensure that the 600 people who need that operation every year get the best possible chance.

Until the treatment is routinely available in Scotland—as it is in the rest of the United Kingdom and most of Europe—what contingency plans will be put in place to ensure that more people’s lives are not destroyed? For example, people could be transferred to centres south of the border where the operation can be carried out.

I met Mr Gray’s constituent and had the opportunity to learn from his experience and hear about the effective campaign that he is part of. I have also received the campaign signatures.

Let me put a couple of things straight. It is not the case that the treatment is routinely available south of the border—I have the figures in front of me and that is clear. It is, however, the case that Scotland lags behind those figures; I would never, and have never, disputed that. However, it is important that we are factually accurate in these matters and the assertion that the treatment is routinely available south of the border is inaccurate.

The expert group is working with the planning board to look at the plan that needs to be put in place for the introduction of the safe and sustainable service to which we are committed. In the interim, it is looking at what additional mitigation measures can be put in place in a way that provides equitable access to patients across Scotland. That will be part of the discussion at the meeting in May. As I said, I am happy to update members at that point.

New Health Centre (Lochgelly)

To ask the Scottish Government whether it will provide an update on a new health centre for Lochgelly. (S5O-02930)

NHS Fife, the Fife health and social care partnership and the Scottish Government are working in partnership to strengthen the business case for the health centre development in Lochgelly. Under an initiative called local care, a refreshed business case will be submitted to the Scottish Government this summer for review by the NHS capital investment group. I welcome that approach and look forward to receiving the revised initial agreement.

I hear what the cabinet secretary says, but the people of Lochgelly will be somewhat puzzled, because the so-called initial agreement document was submitted 18 months ago. Will the cabinet secretary clarify the process from this point and the timescale that is being worked to?

I understand the frustration that Annabelle Ewing expresses. To reshape and strengthen the business case, NHS Fife and the Fife health and social care partnership have been working closely with the Scottish Government’s primary care team and the Scottish Futures Trust to ensure that the business case is more appropriately focused on a community-based approach that is embedded in primary care. The approach will add somewhat to the timeline, but should mean that we receive a better and more comprehensive proposal.

The revised business case is almost complete and is about to go through the local governance review process before it is submitted to the NHS capital investment group later in the summer. I look forward to receiving it.

Although a new healthcare centre is welcome, with reports of 18 practices having closed lists and major difficulties in employing family doctors, how does the cabinet secretary plan to address the general practitioner crisis that currently grips Fife?

Again, I start by urging a dial back on the hyperbole.

As Alexander Stewart knows, a considerable amount of work is going on involving Sir Lewis Ritchie and the Fife health and social care partnership in discussions with GPs in the north-east of Fife to ensure that we have an equitable distribution of GP services around Fife, taking account of challenges in certain rural parts of that area.

I am sure that Alexander Stewart is also aware of the increase in the number of undergraduate medical places, the introduction of significant additional packages to encourage GP relocation and the Scottish graduate entry medicine course, which delivers postgraduate medical training in Fife, all of which is focused on increasing the number of GPs.

Land Banking (Town Centres)

To ask the Scottish Government what it is doing to tackle the issue of land banking in town centres. (S5O-02931)

The Scottish Government has asked the Scottish Land Commission to evaluate the impacts of land banking practices and to make recommendations to ministers. That is included in the Land Commission’s programme of work for 2018 to 2021.

We want all our towns and town centres to be vibrant and successful, and exploring options to address land banking is one of a number of actions that we are taking to achieve that.

The cabinet secretary will be aware of the recent purchase of buildings in the Midsteeple quarter of Dumfries after they were left to deteriorate. Will she confirm that land banking is an issue that the Land Commission will consider with a view to difficulties in urban areas, in particular?

Yes. The Land Commission has been asked to tackle land banking around Scotland, including reviewing issues in urban areas. Our work on community ownership also covers urban and rural Scotland.

We know that land banking can remove land from productive use for years, and I am determined that Scotland’s land should be used productively and not sit idly, contributing nothing. The Land Commission is looking at various issues—including land banking—that are thwarting our efforts to ensure that everybody in Scotland benefits from land.

Autism Strategy

To ask the Scottish Government how it is working with stakeholders to improve its autism strategy. (S5O-02932)

The Scottish Government is committed to improving the lives of autistic people and their families through our 10-year autism strategy. The strategy directly funds a number of organisations that assist in delivering the outcomes and priorities that we set in the autism strategy. That includes the extensive work of Autism Network Scotland, Inspiring Scotland and NHS Education Scotland, alongside specific projects with other public bodies, such as the Care Inspectorate.

The work of the strategy is increasingly being informed, developed and implemented with the involvement of autistic people’s organisations and autistic individuals. More than £2 million is spent each year to directly support stakeholders in a number of national and local initiatives around Scotland, with each initiative contributing to the implementation of one or more of the outcomes that were identified in the “Scottish Strategy for Autism: outcomes and priorities 2018-2021”.

Has spending on autism gone up or down this year?

The Government is committed to improving mental health and the lives of people with autism and their families. Improving mental health is a key priority, and an additional £250 million will be spent on mental health services over the next five years. We have listened to the voices of autistic people and their organisations, and we have involved them in the work that supports the strategy. We will ensure that there are appropriate autism services and support.

School Estate (Dumfries)

To ask the Scottish Government what its position is on whether the school estate in Dumfries meets an acceptable standard. (S5O-02933)

According to the latest published national school estate statistics, 87 per cent of Dumfries and Galloway Council’s schools are in a good or satisfactory condition. Our aim is for no child to have to learn in a school that is in a poor or bad condition. Through the Scotland’s schools for the future programme, Dumfries and Galloway Council has been awarded significant funding of £24.5 million towards three school projects.

Does the cabinet secretary accept that, after more than 10 years of a Scottish National Party Government, it is pretty appalling that schoolchildren in Dumfries still ask me why their schools have leaking roofs, mouldy walls and windows that will not shut, with no prospect of a new school in sight?

I am concerned about the conditions that Mr Mundell recounts, but I remind him that he is apparently a supporter of localism. Local authorities carry the statutory duty and responsibility to maintain their school estate. The Government has assisted in that respect: when the Government came to office in 2007, the proportion of schools that were in a good or satisfactory condition was 61 per cent; it is now 87 per cent as a consequence of the Government’s investment.

I would be delighted to work with Dumfries and Galloway Council to try to address the issues that have been raised. I had a very constructive meeting with Councillor Elaine Murray—our former colleague in Parliament—and Councillor Rob Davidson to give them advice on how we might help them support the development of their school estate.

Although Mr Mundell has not lifted a finger to vote for any of the provisions that would allocate money to local authorities, he will know that the Government is committed to £1 billion of investment in the school estate. Before Mr Mundell comes to the chamber with the usual whingeing critique of everything, I ask him to think about whether he could make a contribution to the process by voting for the Government’s budget, as opposed to playing fast and loose with Scotland’s public finances.

Can the Scottish Government provide an update on its discussions with Dumfries and Galloway Council officials regarding the reopening of the North West community campus in Dumfries?

I discussed the issue with the leader and the deputy leader of Dumfries and Galloway Council when I met them on 12 February. The council expects that the Langlands special school pupils will return to the campus on 20 March, with nursery and primary pupils returning in the week commencing 25 March and secondary school pupils returning in the week commencing 3 June, once the Scottish Qualifications Authority diet is completed.

Question 6 has been withdrawn.

Orkney and Shetland Internal Ferry Services (Fair Funding)

To ask the Scottish Government whether it supports the principle of fair funding for internal ferry services in Orkney and Shetland. (S5O-02935)

The Scottish Government understands the significant financial challenges that can fall on individual local authorities and remains committed to the principle of fair funding for the provision of ferry services and ferry infrastructure. As part of that commitment, this year’s budget has made available a further £10.5 million in support for internal ferry services, bringing the total support provided for that purpose in the past two years to £21 million.

Ahead of last year’s budget, the Parliament voted unanimously for the Government to deliver on its earlier promise to provide fair funding for Orkney and Shetland’s lifeline internal ferry services. The councils in Orkney and Shetland have made clear what is needed to deliver on those promises and the will of the Parliament. Why is the Government short-changing Orkney and Shetland and why has it walked away from the principle of fair funding for ferries in the northern isles?

Hopefully, Mr McArthur was listening to my answer when I said that we have not walked away and have specifically committed to the principle of fair funding. It was welcome that Mr McArthur supported last year’s budget to provide £10.5 million funding this year. Mr McArthur’s party did not support this year’s budget, which provides a further £10.5 million to support Orkney Islands Council and Shetland Islands Council.

Mr McArthur asks a fair question. This is a serious matter, in which I acknowledge he has a legitimate interest, and I am keen to engage with him on it. We acknowledge the difficulties that local authorities face in providing ferry services and I emphasise that we are committed to working with both councils to try to find a fairer future for the funding of those services. We are in dialogue with both councils about developing business cases that might support the transfer of responsibility for the services to the Scottish Government, if that is what they wish.

I reiterate that Mr McArthur could play a constructive role in supporting that in the coming year if he and his colleagues were to work with the Government on its next budget instead of opposing it on constitutional grounds.

I had a letter from the minister this morning saying that he had not decided how the £10.5 million would be distributed. He also said that Argyll and Bute Council has issues with its interisland ferries and he seemed to suggest that the £10.5 million in this year’s budget would be spread to include Argyll and Bute Council, which would mean that Orkney and Shetland councils would receive considerably less than they did last year. Is that the case, or will additional money be put into the budget for Argyll and Bute Council?

Ms Grant raises a fair point. I met ferry officials this morning to have further discussions about the allocation of the £10.5 million. We hope to report to Orkney Islands Council and Shetland Islands Council in the very near future, in advance of Orkney Islands Council’s meeting next Tuesday to settle its budget, on the detail of the allocation.

We recognise the issue with Argyll and Bute Council and are in discussions with the council about the potential transfer of services to the Scottish Government. We are working with the authority to try to reach a common understanding of the costs that are involved in doing that. I am happy to engage with Rhoda Grant on the discussions that we are having with Argyll and Bute Council in that respect.

Emergency Workers (Mental Ill Health)

To ask the Scottish Government what proportion of emergency workers’ time is lost due to mental ill health. (S5O-02936)

Information on the proportion of time lost to mental ill health is not held centrally. The recording and management of absence is undertaken by emergency services bodies in their capacity as employers. Effective health and wellbeing support is vitally important, which is why our police, fire and ambulance services, along with other NHS Scotland boards, have policies in place so that staff can access support when it is needed.

We know from recent reports that the number of staff days lost due to mental ill health among our hard-working emergency workers is rising, but that is not the only reason why time is lost. On a recent visit to Drylaw Mains police station in my constituency, the chief inspector told me that he was very concerned about the number of hours lost at shift time when officers attending a situation in which mental ill health was a factor were having to stay with a person in hospital for several hours, until they were discharged of that duty.

Will the minister work with Police Scotland to review that situation and the regulations around police attending situations in which mental ill health is a factor?

It is important that we look at all the effects of mental illness and mental ill health across services. My area is one of three in Scotland that are piloting distress brief interventions, in which people who present to emergency services can access next-day support. That is being evaluated but, anecdotally and from the evidence that we have so far, that project is working very well, and the emergency services, including the local police, very much support the way in which it is assisting them in their duties.

Before we turn to First Minister’s question time, I invite members to join me in welcoming to the gallery the Hon Stephen Rodan MLC, President of Tynwald.