Chamber and committees

The Scottish Government does not centrally collect data on waiting times for accessing end-of-life care services across Scotland. Referral to specialist palliative care services for people living with serious health conditions and/or those who require specialist palliative care when they are dying is based on individualised needs assessments.

As a wide range of specialist and generalist staff in hospitals, care homes, primary care, social care, hospices and the third sector will be involved in providing palliative care to individuals and their families, and could all be considered as delivering palliative care, it would be challenging to gather this data centrally.

It remains the ambition of the Scottish Government to deliver a National Low Vision Service. This would deliver a range of services to people with visual impairment including both the provision of assistive technology and support for the use of technology already openly available (e.g. applications available for download/use on a smartphone/tablet). The Scottish Government is unable to take this forward at the present time due to financial constraints.

There is no definition of, and thus no data collected for, waiting times for community optometry services, whether urban or rural.

However, we are working closely with the three island Health Boards to resolve some local access issues.

The Scottish Government has not received correspondence with regards waiting times in Aberdeenshire.

It is for Integration Joint Boards (IJBs) to govern, plan and resource adult palliative care in their areas, using the delegated budgets under their control, to meet the needs of their local populations.

Evidence gathered to support the development of the draft palliative care strategy shows that, for people living and dying at home, general practitioners (GPs) and district nurses have important and valued roles providing ongoing relationships, care of the whole person and family, broad expertise and coordination of care. These relationships are particularly important in rural and island communities. The actions set out in the draft palliative care strategy seeks to support IJBs ensure equitable access to palliative care in their areas.

The Scottish Government remains fully committed to tackling food insecurity which can contribute to health inequalities. No one in Scotland should have to compromise on food or other essentials.

Food insecurity is driven by insufficient and insecure household income, which is why we continue to call on the UK Government to deliver an Essentials Guarantee to ensure people have enough money to meet their basic needs, which the Joseph Rowntree Foundation estimate could lift 140,000 people in Scotland out of poverty this year.

Scotland is the first nation in the UK to publish a Cash-First Plan, grounded in human rights, that works towards ending the need for food banks in Scotland. Through “Cash-First: Towards Ending the Need for Food Banks in Scotland”, we are taking forward nine actions over three years, 2023-2026, to improve the response to crisis, using a Cash-First approach so that fewer people need to turn to food parcels. The Trussell Trust and the Independent Food Aid Network agree with our approach.

We recognise the pressure on household budgets which is why the 2025-26 draft budget continues to allocate over £3 billion a year to policies which tackle poverty and the cost of living.

The Scottish Government continues to work with NHS Education for Scotland (NES) and the Royal Pharmaceutical Society to develop a joint programme to encourage more people, and not just school leavers, to consider careers in pharmacy. This includes targeting deprived and rural communities.

In our strategy for pharmaceutical care in Scotland ‘Achieving Excellence in Pharmaceutical Care’ (2017) we committed to enhancing access to pharmaceutical care in rural communities. We commissioned NES to work with rural Health Boards to explore mechanisms to attract more pharmacists and pharmacy technicians to work in rural communities; ensuring any associated education and training needs are flexibly met. We also committed to testing a pharmacy longitudinal clerkship.

Following a pilot with Robert Gordon University and NHS Highland, rural longitudinal clerkships were incorporated into experiential learning in 2022-23. The initiative is open to pharmacy students in the final two years of their undergraduate pharmacy course at both Scottish Schools of Pharmacy.

During Foundation Training Year, to attract potential trainee pharmacists some training providers offer multi sector/split programmes within rural locations. These programmes, where trainees spend time in more than one sector of pharmacy, are highly sought after.

In addition, to promote pharmacy technician recruitment in rural areas, a number of senior pharmacy technicians attend school careers fairs and other recruitment initiatives to raise awareness of the role.

Initial diagnosis of visual impairments largely takes place in community optometry practices following patient presentation to the service. We are not aware of access concerns to the service at this time.

There is currently no community provision for audiology in Scotland. Diagnosis is performed within secondary care settings and typically on referral from wider health networks and services. Consideration of audiology capacity – within existing NHS hospital services – is being taken forward in response to the findings of the Independent Review of Audiology. In addressing the Review’s recommendations, audiology has been designated a clinical priority area, with improvement work being progressed through the National Planning and Delivery Board arrangements, led by the Chief Operating Officer – NHS Scotland.

The Scottish Government recognise that people in rural areas can experience particular challenges in relation to their mental health and wellbeing.

Decisions around the provision of mental health services is a local responsibility, planned by Integrated Joint Boards and delivered through a mixture of NHS, local authority and third sector organisations. Mental Health services will vary depending the local population needs and will be guided by clinical decision making.

While we expect service decisions to be taken locally, we have invested £66 million in our Communities Mental Health and Wellbeing Fund for adults since 2021. The Fund has a strong focus on prevention and early intervention and prioritises a range of ‘at risk’ groups including those people disadvantaged by geographical location (particularly remote and rural areas) with over 900 awards being made to community projects supporting people disadvantaged by geographical location (including rural areas) since its inception.

The Scottish Government has committed to improving access to NHS dental services with a £65.2 million(14%) funding increase for primary care dental services in the 2025-26 draft budget, bringing the total funding to over £500 million.

Recent data from Public Health Scotland indicates nearly 4 million courses of dental treatment was delivered from November 2023 to September 2024, showing positive performance nationally after reform.

However, access remains a challenge in certain rural areas despite significant investment. To help address this, the Scottish Government provides the Remote Areas allowance which pays out up to £9,000 to dentists providing NHS dental services in qualifying areas. Additionally, the Recruitment and Retention Allowance is in place for certain areas where there is a particular and protracted issue with the recruitment of dentists. This pays dentists £25,000 over two years, and £12,500 paid over one year for dentists undertaking vocational training.

I am also working with other nations to enhance the NHS dental workforce capacity, including reviewing international recruitment pipelines.

It is for Integration Joint Boards (IJBs) to govern, plan and resource adult palliative care in their areas, using the delegated budgets under their control, to meet the needs of their local populations.

Evidence gathered to support the development of the draft palliative care strategy shows that, for people living and dying at home, general practitioners (GPs) and district nurses have important and valued roles providing ongoing relationships, care of the whole person and family, broad expertise and coordination of care. These relationships are particularly important in remote and rural communities. The actions set out in the draft palliative care strategy seeks to support IJBs ensure equitable access to palliative care in their areas.