Chamber and committees

ScotGEM students are very specifically entitled to apply for a £4,000 per year ‘return of service’ bursary. This means for every year they take this they are committing to stay and work in NHS Scotland for a corresponding amount of years. Once the first cohort of ScotGEM students graduate in Summer 2022, we intend to evaluate the effectiveness of the ScotGEM bursary in retaining trainee doctors in hard to fill posts within our healthcare service. Further consideration to any extension can be made at that point.

The Scottish Government has no current plans to provide financial support for HVO. However, we already offer a comprehensive support package for domestic heat and energy efficiency measures through our Home Energy Scotland service.

Our Heat in Buildings Strategy, which will be published in due course, outlines four key no and low regrets areas strategic technologies for the transition, including energy efficiency, heat pumps in on and off gas grid areas and low and zero emissions heat networks. It also highlights that here may be a small number of buildings for which bioenergy, including HVO among others, may play a role for home heating if displacing fossil fuels in off-gas-grid areas where electric heating or heat pumps are unsuitable.

We wish to see bioenergy used where it has the greatest value in reducing emissions, however this decision is also dependent on which sectors will make the best use of the bioenergy feedstocks that we can grow sustainably or produce domestically in comparison with those we may need to import. For this reason we have assembled a Scottish Government working group which will develop a strategic framework for bioenergy, taking into consideration the competing demands on land for feedstock production, sustainability, technical capabilities and opportunities of a just transition to net-zero. This will help to inform a more detailed Bioenergy Action Plan by 2023 which will urgently tackle these challenging issues as we begin the next stage of decarbonisation in Scotland.

We have also published a Bioenergy Update paper where we outline how we intend to move forward over the next 18 months to understand the most appropriate and sustainable use of bioenergy resources in Scotland.

As we deliver our Heat in Buildings programme following the publication of the Strategy our delivery programmes and support mechanisms will support the mass move from fossil fuel reliant systems to low and zero emissions heating in tandem with achieving a good standard of energy efficiency across all buildings in line with our strategic priorities.

The options selection work will be concluded by Transport Scotland, Network Rail and ScotRail by summer 2022. In accordance with the Rail Enhancements Capital Investment Strategy each of the options will be appraised to identify which offer the most benefits and also represent value for money.

Network Rail recently confirmed that positive progress is being made on the project with ground investigation works starting in October 2021.

Transport Scotland expect Network Rail to produce the final programme for delivering the project during autumn 2022.

Delivery of any section of the programme can only commence if approved under the relevant statutory procedures and thereafter a timetable for progress can be set in line with available budgets.

Work is ongoing to produce a progressive stroke pathway document by December 2021. This will take account of international evidence, including the World Stroke Organisation’s roadmap to delivering quality stroke care, to define what a progressive stroke pathway should look like in Scotland.

The progressive stroke pathway will, similarly to the roadmap, follow the continuum of care starting at the onset of a stroke event through the acute phase (emergency department and inpatient care), and stroke rehabilitation and long term supported recovery.

Following this, an implementation plan will identify any gaps between current capacity and the progressive stroke pathway vision, and outline clear actions to take.

The core criteria for defining a stroke unit are well described in the academic literature, including in Langhorne et al (2002). Though the size and configuration of stroke units across Scotland may vary depending on local factors, most will be in a defined ward setting and have a specialist stroke multidisciplinary team.

Covid-19 has had an unprecedented impact on the world, NHS Scotland and stroke services. Each service will have responded in the best way that it could, depending on the specific issues affecting them.

The 2021 Scottish Stroke Improvement Programme Report (which includes 9 months of the pandemic) shows slight deterioration in performance against the stroke standards for stroke unit access (77% in 2020 compared to 82% in 2019).

While stroke unit access declined, achievement of standards in other areas, including brain imaging within 12 hours of arrival (86% in 2020 compared 84% in 2019), time to carotid intervention (61%; 59%) and mean thrombolysis door-to-needle (DTN) time (51 minutes in 2020 compared to 53 minutes in 2019), improved.

All of these aspects also have an important impact on recovery from stroke, and therefore it is not possible to isolate the recovery impact based on one standard (such as stroke unit access).

The Scottish Government supports the planting of the right tree in the right place. Forest and woodland strategies, including the Scottish Borders Woodland Strategy , set the regional framework for woodland expansion and are developed by the local authority in partnership with interested stakeholders. These strategies identify preferred areas where forestry can have a positive impact on the environment, landscape, economy and local people, and also identify sensitive areas where forestry may not be a suitable choice.

The Regional Strategic Woodland Creation Project is furthest developed in the South of Scotland. Here it is being developed as an evolution of the Scottish Borders Woodland Strategy . The ambition is to better define where the preferred areas for woodlands are, helping bridge the gap between strategic and site level considerations.

Regional Land Use Partnership (RLUP) pilots are being established this year, with Regional Land Use Frameworks (RLUF) being developed by 2023. The RLUPs will work within the existing context of their region, including identifying and working with key strategies and projects. The South of Scotland is one of the pilot regions. They are now beginning to engage with stakeholders on their regional approach, which will include engagement with forestry stakeholders as well as local communities, land managers and owners, experts and local and national government.

Following closure of the Lowit Unit at the Royal Aberdeen Children’s Hospital in 2014, a programme of CAMHS redesign started in 2015. This included all services for children and young people with mental health issues being redesigned to support children aged 0-18 years.

During this redesign, the majority of staff were co-located in a new purpose redesigned CAMHS building funded by the Scottish Government. The remainder of staff are now based in Moray as part of a Hub and Spoke model of care. This includes Unscheduled Care and Tier 4 staff to support children, young people and their families. All Tier 4 patients are cared for by a Multi-Disciplinary Team, using a Care Programme Approach. The CAMHS service in NHS Grampian is now also part of a North of Scotland regional Tier 4 network with Tayside and Highland and in-patient beds can be accessed within the Young People's Unit, if required.

It is for individual Health Boards to ensure that they provide mental health services in line with the needs of their local population.

NHS Grampian is currently meeting the CAMHS Waiting Times target of patients starting treatment within 18 weeks, with compliance at 90.8% in the last quarter. Waiting times performance since the whole service redesign in NHS Grampian was completed shows the positive impact this has had on access and care.

I refer the member to the answer to question S6W-03027 on 1 October 2021. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

Our initial estimates are that the increase in employer National Insurance contributions will result in the following costs:

(a) NHS - £67 million

(b) Local Government - £31 million

(c) Other parts of public sector - £53 million

Combined these come to an initial cost estimate of £151 million across the public sector in Scotland.