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Chamber and committees

Meeting date: Thursday, June 28, 2018

Meeting of the Parliament 28 June 2018

Agenda: General Question Time, First Minister’s Question Time, Ministers and Junior Ministers


General Question Time

NHS Greater Glasgow and Clyde (Out-of-hours Provision)

To ask the Scottish Government what action it is taking to improve out-of-hours provision at NHS Greater Glasgow and Clyde. (S5O-02289)

The Scottish Government is working closely with health boards and integration authorities to ensure that a safe and effective general practitioner-led out-of-hours service is provided across Scotland.

Over the past three years, we have invested £25 million to support the delivery of 25 recommendations from Sir Lewis Ritchie’s report on GP-led out-of-hours and urgent care services. The recommendations are focused on ensuring that a wider, more resilient multidisciplinary team is in place to support our out-of-hours GPs. In 2018-19, NHS Greater Glasgow and Clyde will receive £1.1 million to support local action. That is in addition to investment to train 1,000 additional paramedics over the course of this parliamentary session, who will play a critical part in the expanding multidisciplinary teams.

I thank the minister for his response and I welcome him to his new role in the health team. NHS Greater Glasgow and Clyde has just announced its vision for the future of acute services. Over 30 services are set to change, including out-of-hours services at the Vale of Leven hospital. There is no clear information on the impact on hospital services, nor is there clarity about the consultation process. Some people more cynical than me have suggested that the health board does not want to consult.

Will the minister give me a guarantee that the information on hospital provision will be provided urgently and that significant service changes such as these will be subject to full consultation? I also issue an invitation through him for the new Cabinet Secretary for Health and Sport to accompany me on a visit to the Vale of Leven hospital.

I thank the member for her supplementary question and for her invitation. I see that the cabinet secretary-designate is in the chamber. The member will know my commitment and the cabinet secretary-designate’s commitment to engagement on a whole range of issues. The fact is that the Vale of Leven hospital had many, many years of services being run down by the previous Administration. This Government ended that uncertainty with our vision for the Vale.

On Sunday last week, a shortage of GPs in greater Glasgow meant that there were not enough doctors on duty to staff its out-of-hours centres between 1 am and 6 am. That meant that patients requiring urgent medical care were asked to go to accident and emergency, while some had to wait for primary care emergency centres to open again at 6 am.

Given the challenges of GP recruitment and retention in Scotland, how will the minister refresh failed recruitment drives that are known not to be working?

There was clearly a specific problem, which Ms Wells has related. That was identified in time for alternative strategies to be put in place and I think that that was the right thing to do because there would have been a danger of people being pointed towards services that would not have been suitable. It was correct that the action was taken in advance of that becoming a problem, but clearly we need to look at what lessons can be learned for the future.

Rural Colleges (National Pay Bargaining)

I refer members to my entry in the register of members’ interests as a board member of North Highland College.

To ask the Scottish Government what flexibility there is for rural colleges in the harmonisation of terms and conditions under national bargaining. (S5O-02290)

This Government is committed to national bargaining for Scotland’s colleges and we are funding in full the costs of harmonisation of pay, terms and conditions. In 2018-19, that amounts to additional funding of £31.7 million. In addition, we have increased rural and remoteness funding by £1 million, to a total of £8 million this year.

North Highland College in my constituency takes students on block placement from local employers. Some weeks, the students do full-time hours and other weeks they do none. The college finds it a challenge to align its lecturers’ weekly hours with the students’ needs. How is the Scottish Government working with rural colleges to ensure that they can fulfil their obligations to all their students, lecturers and staff in line with national bargaining terms and conditions?

We welcome and value the approach that North Highland College and all colleges throughout the country take to adapt learning approaches to individual circumstances to reflect the geography, conditions and communities in which they are active. Therefore, I am keen to ensure that, in the dialogue with North Highland College, the Scottish Further and Higher Education Funding Council has a full and clear awareness of the models that the college uses. We are keen to ensure that those can be reflected in the harmonised terms and conditions that will be brought into place as a consequence of national bargaining.

I suppose that the most direct answer to Gail Ross’s question is that the opportunity for dialogue and discussion on all such questions is central to how we resolve North Highland College’s particular needs and circumstances. I encourage the college to engage in those questions to ensure that the issues are properly and fully addressed as part of our efforts to deliver a modern and flexible workforce.

Insulin Pumps (Under-18s)

To ask the Scottish Government what plans it has to increase the funding for and provision of insulin pumps for under-18s. (S5O-02291)

The latest published data shows Scottish national health service boards’ performance for children under 18 years old at 34.4 per cent, which considerably exceeds the ministerial commitment of 25 per cent set in the chief executive letter that was issued in 2012. That commitment was met by 1 April 2015 and was supported by £7.5 million of Scottish Government funding.

We expect NHS boards to provide insulin pumps to all clinically suitable children and young people once structured education and pump training are completed. We will continue to keep the support of that important area of work under review.

I welcome the minister to his new role in the health team. Does he accept that pump therapy cuts hospital admissions, reduces long-term complications and improves quality of life? Does he share my view that we need to do more to support young people with insulin pump therapy and continuous glucose monitoring by ending the postcode lottery and boosting Scottish pump usage to levels that are experienced in Europe and the USA?

I thank the member for his welcome. He makes a lot of good points. I recognise his interest in the field as convener of the cross-party group in the Scottish Parliament on diabetes.

We expect NHS boards to provide that life-changing technology when it is clinically appropriate. The additional funding that the Scottish Government provides is to support NHS boards’ efforts to increase the level of provision of insulin pumps. That funding has been allocated taking account of the need to reduce the gap between the lowest and highest levels of provision. In discussions about the pump services, we need to take account of levels of local investment and comments by local boards. However, I agree that, for many people, pumps and glucose monitoring equipment make a real difference. We need to think about how we can ensure that they are available when clinically appropriate.

Will the minister use his considerable influence to have NHS Borders roll out the FreeStyle Libre system across the area? At the moment, it is only on trial and the people who are on the trials, which are successful, are worried that it will be withdrawn from them.

NHS boards are taking a phased approach and made the decision to prescribe FreeStyle Libre to 50 patients in the first instance to allow staff to deliver the education that is required within the resources that are available to the teams.

I am delighted that Ayrshire and Arran NHS Board uses flash glucose monitoring technology, which means that many people who live with diabetes do not have to do regular finger-prick tests. That technology is easier to use, less painful and improves people’s self-management. It is also cost-effective for people with diabetes who are treated with insulin and test frequently. What plans are there to ensure access throughout Scotland to that life-changing technology?

I recognise Mr Gibson’s interest in this field. The area is one that was raised in the chamber last week, and I refer members to Aileen Campbell’s extensive answer.

Each national health service board must consider the inclusion of a drug or device in its local formulary in the context of its local population and priorities, while managing its budgets and resources effectively. Because there is a limited amount of good clinical trial data to support long-term clinical evidence on the benefits and cost-effectiveness of FreeStyle Libre, some NHS boards have decided to wait for the Scottish health technologies group’s advice statement, which is due in July. I look forward to the SHTG’s advice statement, which I expect to be a valuable source of advice on which NHS boards will base their final decisions on how FreeStyle Libre should be prescribed in the longer term.

Placement Moves (Young People in Care)

To ask the Scottish Government what the average number of care placement moves is for young people. (S5O-02292)

For the 14,897 young people in care on 31 July 2017, the average number of care placements was 2.3. Just under half the young people in care on 31 July 2017 were in their first placement.

Last week’s attainment statistics told us that 48 per cent of care-experienced school leavers who had had just one placement achieved a level 5 qualification or better, but the figure fell to just 19 per cent for those who had been moved three times or more in their childhood.

The evidence is clear. We do not need to wait for the independent care review to report. What urgent action does the minister intend to take to reduce the number of times that care-experienced young people are moved throughout their childhood?

Tackling inequality is at the heart of the Scottish Government’s agenda. As part of that, we are committed to improving all aspects of the lives of looked-after children, so that they can reach their full potential during education and beyond.

As Kezia Dugdale highlighted, the proportion of looked-after school leavers with one or more qualifications at Scottish credit and qualifications framework level 5 or better has continued to increase. Since 2009-10, it has more than doubled, from 15 per cent to 44 per cent.

Multiple placements occur in a myriad of different circumstances. As Kezia Dugdale said, the relationship between the number of placements and adverse outcomes for young people is very well established. Through the permanence and care excellence programme, we are beginning to see a reduction in drift and delay in the system, as more children achieve permanence.

Kezia Dugdale mentioned the independent care review, which is now in its journey phase. I am absolutely sure that it will look at the impact of the journey between placements, and I look forward to welcoming its findings.

Given the announcements that were made yesterday, in which it was acknowledged that looked-after young people are disproportionately more likely to become homeless, what actions is the Government taking to ensure that young care leavers are ready for independent life and to reduce their chances of becoming homeless?

As Michelle Ballantyne knows, we have a number of measures in place to support the implementation of continuing care. Since 2015-16, we have paid £4.2 million annually to local authorities for the implementation of continuing care, and that will rise to £9.3 million by 2019-20. In addition, we are working with local authorities, through staff and the continuing care focus group, to gather information on the use of continuing care and to resolve any issues.

We are working very hard in this area. I am more than happy to meet Michelle Ballantyne, along with my colleague the Minister for Local Government and Housing, who has done a great deal of work on preventing homelessness, to fully apprise her of all the measures that we are taking in our work in this extremely challenging area.

Question 5 has not been lodged.

Highlands and Islands Airports Ltd (Car Parking Charges)

To ask the Scottish Government whether it considers that Highlands and Islands Airports Ltd’s decision not to consult regarding car parking charges at some island airports is consistent with the provisions of the Islands (Scotland) Bill. (S5O-02294)

HIAL has consulted on the implementation of the extension of car parking charges to Stornoway, Kirkwall and Sumburgh airports. HIAL has taken account of the responses to its consultation work and has made changes to its implementation of the charges as a result. That includes making free parking available at Sumburgh airport for the use of inter-island travellers, extending the free drop-off and pick-up period from one hour to two hours and allowing blue badge holders to park free of charge. I am also aware of specific measures that HIAL will be taking to offer free parking to those travelling by air for national health service appointments and those travelling under Loganair’s compassionate travel policy. I particularly welcome those steps.

I welcome the minister to his new position of responsibility for the islands and forgive him for not answering the question. Will he bring an open mind to the issue and accept that there has not been any proper consultation on the matter, nor what the councils and community councils have asked for, which is a full impact assessment? Will he use his considerable abilities to tackle the problem and insist that those two things happen?

I thank Tavish Scott for his kind remarks, and I certainly hear what he is saying about the matter at hand. I am keen to listen to stakeholders in the islands, and I am happy to meet Tavish Scott at any time on any matter to do with the implementation of the Islands (Scotland) Bill, because I am keen to work with him and other island members on that. However, I point out that HIAL has made some important changes, and I hope that Mr Scott welcomes them. I am keen to hear from him if anything further can be done.

I welcome the minister to his new position. The move by HIAL to introduce parking charges was at least financially motivated. Today, we have seen Loganair, the main operator serving the islands, announce significant losses. Both organisations will be looking for certainty about the Government’s future approach to island aviation and road equivalent tariff on ferry fares, which will undoubtedly have an impact on their businesses. With that in mind, can the minister clarify when the pledge to introduce RET on the northern isles routes will be delivered on?

That matter will obviously be high on the agenda for the cabinet secretary-designate, Mr Matheson, and me to discuss. I am happy to meet Mr Halcro Johnston to talk about such matters and their importance to the islands’ economies. Although this is early in my new portfolio, I am aware of how important the RET issue is to the islands’ economies and I am keen to discuss that with all members.

Drug Abuse Deaths (Ayrshire)

To ask the Scottish Government what action it is taking to reduce the death rate from drug abuse in Ayrshire in light of reports that it has more than trebled since 2010. (S5O-02295)

A range of measures have been taken by alcohol and drug partnerships in Ayrshire. A pan-Ayrshire drug death prevention framework was published in May, which followed on from an Ayrshire-wide drug death conference in November 2017. Work to reduce the number of drug deaths is being supported by local drug death prevention groups, as well as by the pan-Ayrshire drug death prevention group.

Nationally, the Scottish Government has invested over £746 million to tackle problem drug and alcohol use since 2008, and we will allocate a further £20 million a year to support the improvement of treatment services. We will also publish a substance use strategy later this summer, which is being developed in recognition of the changing drug landscape in Scotland, not least the complex health needs of people with problematic drug use.

Mr FitzPatrick will have been as disappointed as I was to learn that the crude mortality rates for drug-related deaths by national health service board of residence between 2009 and 2016 show that Ayrshire has the highest rate in Scotland at 23 per 100,000 of the population. I welcome what Mr FitzPatrick has just said, but, given that that increase in the number of drug-related deaths is happening right across Scotland, does the cabinet secretary agree that the current method of dealing with the growing problem has not worked and that it is time for the Scottish Government to take a new approach to addressing a problem that blights Ayrshire and Scotland?

I thank the member for the rapid promotion that he gave me, although I am sure that it was not deliberate.

I recognise the very serious nature of the problem that he has raised and accept that we cannot take the matter lightly, which is why we are looking to develop a new strategy. I will work with any members who have suggestions about how we can take that work forward. I met two members earlier today to discuss the issue, and I am keen to meet Mr Scott if he has some particular ideas. I know that, in his local area of south Ayrshire, we have expert advice from Kenneth Leinster, who is the head of community health and care services. He is one of the experts whom we are working with in developing a strategy to address the changing landscape of drug use. However, if the member—or any other member across the chamber—has any suggestions about how the strategy should be developed, my door is open.