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Chamber and committees

Meeting date: Wednesday, May 1, 2019

Meeting of the Parliament 01 May 2019

Agenda: Portfolio Question Time, Subject Choice, Business Motions, Parliamentary Bureau Motion, Decision Time, Nursery Funding (Deferred Entry to Primary School)


Contents


Portfolio Question Time


Education and Skills

The Deputy Presiding Officer (Linda Fabiani)

The first item of business is portfolio questions, and the first section is education and skills. Questions 1 and 8 have been grouped together.


Higher Education Research (Brexit)

1. David Stewart (Highlands and Islands) (Lab)

To ask the Scottish Government what assessment it has made of how research capabilities in higher education have been affected by Brexit. (S5O-03154)

The Minister for Further Education, Higher Education and Science (Richard Lochhead)

Given the strong international connections of Scotland’s world-leading research base, the United Kingdom Government’s chaotic handling of Brexit threatens to disproportionately affect Scotland’s university research.

The total UK and Scottish share of horizon 2020 projects is already falling, according to the latest figures. If there is no deal, that could result in a loss of income for Scottish research organisations totalling an estimated £37 million, depending on the Brexit date.

Around a quarter of full-time research staff at Scottish universities are non-UK European Union citizens. There is already anecdotal evidence that fewer EU citizens are applying for research jobs in Scotland and that some of those who are based here are relocating back to their home countries.

We will continue to monitor closely the relevant data sources.

David Stewart

The minister will be well aware of the crucial role that the EU plays in research and development in higher education, such as through horizon 2020, which he has mentioned, Interreg and the EU structural funds. Does he share my view that EU funding has been key to the development of the University of the Highlands and Islands in my region, with great examples of that being the centre for health science and innovation in life sciences? What discussion has the Scottish Government had with the UK Government about accessing the UK’s shared prosperity fund to fill the huge research funding vacuum post-Brexit?

Richard Lochhead

David Stewart rightly highlights one of the institutions that will be most affected by Brexit in any shape or form. Indeed, it is fair to say that the University of the Highlands and Islands would potentially not exist if it had not been for EU funding. Just this week, another EU grant was awarded to the UHI—it was in the news just a couple of days ago.

I assure David Stewart that we recognise the devastating impact on the UHI of Brexit, should it go ahead. I raise the issue regularly with my UK counterparts. As he suggests, there is a need to ensure that any funding that is lost through leaving the EU is replaced by the UK Government, but we have yet to get that assurance—we have not had any guarantees along those lines. It is important that we get our share of UK research funds if we leave the EU. Of course, the solution is not to leave the EU in the first place.


Higher Education Institutions (Brexit)

8. Jenny Gilruth (Mid Fife and Glenrothes) (SNP)

To ask the Scottish Government what impact Brexit will have on higher education institutions. (S5O-03161)

The Minister for Further Education, Higher Education and Science (Richard Lochhead)

A lessening of access to European research programmes could see Scottish institutions lose, in some cases, up to a quarter of their total research funding, as I have just discussed.

A reduction in the number of European Union citizens coming to work and study at our universities, meanwhile, threatens our research excellence and the ability of institutions to continue providing certain courses. It could also lead to a loss of the multiculturalism that is absolutely vital to our campuses’ success and the experience of our students in Scotland.

The Scottish Government continues to work tirelessly with the sector to protect our institutions from the damage that an unwanted Brexit would entail. We continue to make known to the UK Government the views of Scotland and those of our universities and further and higher education institutions.

Jenny Gilruth

A fifth of the funding for the University of St Andrews comes directly from EU sources. Has the Scottish Government undertaken any analysis of how a reduction in EU funding will impact higher education institutions’ ability to provide a quality education and how that might affect local economies?

Richard Lochhead

St Andrews is, of course, one of Scotland’s leading higher education institutions. One of the reasons why it is doing well is its European collaboration and the research funding that it gets through the European research programmes, which Jenny Gilruth highlights.

As I said in my previous answer, we have looked closely at the potential impact on Scotland. We punch above our weight when it comes to securing horizon 2020 research funding—we are way above the rest of the United Kingdom in that regard—therefore we will be disproportionately damaged if we lose access to those programmes. At the very least, in any of the Brexit scenarios, should they happen, we will need to have full participation in the future horizon 2020 funding programmes. As I have said before, unfortunately for the University of St Andrews and the rest of our institutions, we have not had any such guarantees from the UK Government as yet.

The Deputy Presiding Officer

I ask for shorter questions and answers for the supplementary questions.

Gillian Martin (Aberdeenshire East) (SNP)

Brexit will also affect students from European Union countries who want to study at our universities. The United Kingdom Government has talked about three-year study visas. Given that Scottish undergraduate courses last four years, what is the Scottish Government doing to highlight to the UK Government the fact that a three-year visa system will simply not work in Scotland?

Richard Lochhead

It so happens that, today, I met the chairs of the university courts for a meeting. It is fair to say that the number 1 concern that they expressed to me, among many Brexit-related concerns, was the impact of the UK’s immigration policy and the ludicrous and infuriating fact that the current immigration policy for students has been designed around the English degree, not the Scottish degree, which, as Gillian Martin highlights, takes four years. That is evidence—if anyone still needs it—that Scotland is an afterthought when it comes to UK policy making and its impact on Scottish further and higher education. That is disgraceful. A lot of anger has been caused among our institutions and, of course, our student population. We are making the strongest possible representations to ensure that, should we leave the EU, the subsequent immigration policy will take into account the distinctive nature of Scottish higher education.

Willie Rennie (North East Fife) (LD)

The minister will agree that the best way to make all of this stop is to stop Brexit altogether. However, the most important thing is to maintain relationships between the European and Scottish universities. Has the minister had any discussions with education ministers in European countries about keeping those close relationships so that, when we stop Brexit, they can continue?

Richard Lochhead

Willie Rennie raises an important issue. We have discussed maintaining the relationships between European and Scottish higher education institutions, and we have lent our support to our institutions in that regard. The Scottish Government also has plans to reach out directly to the European institutions. I know that the UK Government claims to have done that, because, when we raised the issue at our meeting with the UK ministers, they said that they were in contact with the European institutions. The issue is high up our agenda and we will pursue it, because we absolutely have to protect those valuable relationships.


Developing the Young Workforce (Fife)

2. Annabelle Ewing (Cowdenbeath) (SNP)

To ask the Scottish Government whether it will provide an update on progress with the operation of the developing the young workforce programme in Fife. (S5O-03155)

The Minister for Business, Fair Work and Skills (Jamie Hepburn)

We have seen good progress on the developing the young workforce programme in Fife. Collaboration between Fife College and local schools is ensuring that career education is central to the curriculum offer, supporting young people to identify their own skills and learn in a range of settings in their senior phase.

In addition, the DYW regional group has connected schools and employers. A significant partnership with St Andrews Links Trust is providing a wide range of programmes, including new opportunities through its pre-employment academy for young people at risk of a negative destination.

Annabelle Ewing

I am pleased to note that good progress is being made in Fife. Given that a key issue for the programme’s architect, Sir Ian Wood, was the involvement of primary school children, can the minister provide an update on whether all primary schools in the Cowdenbeath constituency are now participating, so that pupils can be inspired from a young age by the wide opportunities of the world of work?

Jamie Hepburn

The short answer is yes. Developing the young workforce has had a strong focus on the Cowdenbeath primary cluster. For example, Kelty primary school has created a teaching resource folder to assist with embedding DYW in the curriculum; Benarty primary school meets local employers to co-design programmes, and is involved in engagement between industry and education; and Crossgates primary school runs a skills and enterprise academy programme. Further, in Cowdenbeath on 7 June, six primary schools in Annabelle Ewing’s constituency will take part in the Greenpower Education Trust’s Goblin kit car race event, which involves pupils working with local engineering firms and small and medium-sized enterprises to design and build from scratch a car and race it. I am sure that Annabelle Ewing would be delighted to be there, if she is available.


Scottish Medical Schools (Graduate Employment)

3. Miles Briggs (Lothian) (Con)

To ask the Scottish Government what proportion of graduates from Scottish medical schools go on to work in the national health service in Scotland. (S5O-03156)

The Minister for Further Education, Higher Education and Science (Richard Lochhead)

The Higher Education Statistics Agency’s destinations of leavers from higher education survey shows that, in 2016-17, of those who were working six months after graduation, around 66 per cent of clinical medicine United Kingdom and European Union-domiciled graduates from Scottish higher education institutions worked for an NHS organisation in Scotland.

Miles Briggs

In July 2018, before Mr Lochhead became the minister, he said in The Press and Journal:

“We need radical interventions to effectively handcuff more doctors trained in Scotland at public expense to the Scottish NHS—at least for a set period of time.”

I do not agree with the language that he used, but what progress have Scottish National Party ministers made towards developing a bonding scheme?

Richard Lochhead

I congratulate Miles Briggs’s researcher on digging out those fantastic quotes from the member for the Moray constituency. Although the Scottish Government continues to consider other initiatives to address that issue, we have—as, I am sure, Miles Briggs is aware—taken a number of bold steps over the past couple of years alone. The medical undergraduate intake has increased significantly since 2007. There were 953 places in 2018-19, and up to 1,038 places have been scheduled for 2020-21. There has also been an increase in the intake of Scotland-domiciled students, from 485 in 2015-16 to 515 in 2017-18.

As Miles Briggs will know, we take advice and guidance from a committee of medical professionals on workforce demands and the number of undergraduates and graduates that are required in Scotland. Although we continue to consider taking more, we have already taken a number of bold steps that are set to make a material difference.


Schools (Subject Choice)

4. Finlay Carson (Galloway and West Dumfries) (Con)

To ask the Scottish Government what its position is on expert evidence presented to the Education and Skills Committee regarding a reduction of subject choice in schools. (S5O-03157)

The Deputy First Minister and Cabinet Secretary for Education and Skills (John Swinney)

Curriculum for excellence provides significant flexibility. Schools now have the freedom to design a three-year senior phase that includes a range of courses and qualifications that are tailored to meet the needs of young people who are at school.

Wherever possible, schools should ensure that young people can choose their preferred subjects in the senior phase, working with partners to do so. What matters are the qualifications and awards with which pupils leave school, not only what they study in secondary 4. Last year, a record proportion of pupils went on to positive destinations, including work, training or further study.

Finlay Carson

The cabinet secretary will be aware of the copious amount of evidence that has been presented to the Education and Skills Committee on the teaching of several levels of a course in the same classroom. Evidence suggests that that has substantial repercussions for subject choice and for a teacher’s ability to prepare students, particularly in science subjects.

Can the cabinet secretary say how many schools are being forced to teach multilevel courses in science subjects in Dumfries and Galloway and the Galloway and West Dumfries constituency?

John Swinney

I do not have that information to hand. However, Mr Carson should know that multilevel teaching has been a feature of Scottish education for a long time. Indeed, multilevel teaching was around even when I was at school, which was not yesterday. It is therefore not a new phenomenon.

Every effort is made to meet the needs of young people in their subject choices. As we go through this debate, it is important that we take a whole range of evidence. Mr Carson cited evidence that the Education and Skills Committee has seen on the subject. He may also have seen the comments of another expert, Professor Mark Priestley of the University of Stirling. Yesterday, on the subject to which Mr Carson referred, he said:

“This is not new news. It is at least the third time we have seen a moral panic about curriculum narrowing, each one based on low level, superficial and sometimes flawed analysis of largely publicly available data. There is a need for a more nuanced approach.”

I am interested in that approach and will take it forward in the debate this afternoon, to ensure that we meet the needs of young people in Scotland.

Emma Harper (South Scotland) (SNP)

The number of subjects that pupils sit is a matter solely for individual schools and headteachers to determine, and should not be a matter for local authorities.

Does the cabinet secretary agree that members should ensure that they have their information correct before giving misleading statements to the local press and therefore misleading the public, parents and teachers, and that all evidence should be considered in order to reach an evidence-based conclusion?

John Swinney

I think that there should be accuracy in statements that are made and in the detail that is provided. Although I am not sure what Emma Harper is referring to, I am sure that her points are well validated. It is important that we have an evidenced debate on the subject, because the future of young people depends on the way in which we consider that evidence.


Further and Higher Education (Student Support)

5. Jackie Baillie (Dumbarton) (Lab)

To ask the Scottish Government what support it provides to young people from armed forces families when applying for further and higher education. (S5O-03158)

The Minister for Further Education, Higher Education and Science (Richard Lochhead)

We are committed to supporting all students, including those who are from armed forces families.

Assuming that they meet the normal eligibility rules, members of the armed forces and their families who are ordinarily resident in Scotland can apply to the Student Awards Agency Scotland to fund their higher education tuition fees. That is in addition to potential living costs support through bursaries and loans, which may be available, again in line with well-understood criteria.

In relation to further education, members of the armed forces and their families who are ordinarily resident in Scotland can apply to their college to fund the cost of their tuition.

Jackie Baillie has rightly raised a number of issues that relate to constituency cases in correspondence with me, and we are actively looking into those concerns. I hope to be able to update her more fully in due course.

Jackie Baillie

As the minister knows, my constituent Abigail has lived with her grandfather in Scotland since June 2018. Her parents sold their home in England, as her father is being transferred to Faslane. Scotland will be their new home, but her father is at sea for six months, so they have not yet bought a house locally. Abigail wants to study engineering, but she is being denied funding to go to college because she does not meet exactly the residency criteria. That seems desperately unfair and goes against the spirit of the armed forces covenant.

I am grateful to the minister for his letter an hour ago. Will he outline what further consideration is being given to the matter? It is clear that there is some urgency if Abigail is to go to college this year.

Richard Lochhead

I have asked my officials to look into that case in more detail.

I was keen to reply to Jackie Baillie before today’s question to put her in the picture about what we are thinking. It is clear that there are different arrangements for further education and higher education. The further education issue is that there are no reciprocal arrangements with the other United Kingdom Administrations. Jackie Baillie will understand that we cannot do one thing while the rest of the UK does something different that does not support Scottish students.

I ask Jackie Baillie to rest assured that I am looking at the issue. It is clear that we have to look at the law and the regulations carefully.

The Deputy Presiding Officer

Maurice Corry has a quick supplementary question.

Maurice Corry (West Scotland) (Con)

What measures are in place specifically to help veterans who may need additional learning support? Does the Scottish Government think that more could be done to help veterans to succeed once they have a place in further or higher education?

Richard Lochhead

I assure Maurice Corry that the Minister for Parliamentary Business and Veterans, Graeme Dey, is taking an interest in those issues, and I would be happy to update Maurice Corry on our planned conversations on what extra support could be made available for students from the armed services who have extra needs in further or higher education. I understand that some measures are in place, and I would be happy to write to Maurice Corry about them.


Scottish Qualifications Authority (Industrial Action)

6. Daniel Johnson (Edinburgh Southern) (Lab)

To ask the Scottish Government what its response is to the announcement that SQA staff are to be balloted for industrial action. (S5O-03159)

The Deputy First Minister and Cabinet Secretary for Education and Skills (John Swinney)

That is, of course, an operational matter for the Scottish Qualifications Authority, but I assure Daniel Johnson and Parliament that the Scottish Government is in regular contact with the SQA to monitor the safe delivery of the 2019 exam diet and to ensure that appropriate contingency arrangements are in place. I urge the Scottish Qualifications Authority and the unions concerned to continue their discussions to reach a resolution.

Daniel Johnson

The SQA is due to meet the Advisory, Conciliation and Arbitration Service again next week. What specific action will the cabinet secretary take to ensure that the concerns of staff are taken seriously by the SQA, especially given how long it took it to engage with the trade unions in the first place, and that the workforce’s confidence in the leadership of that organisation is restored?

John Swinney

Some of the trade unions have been in agreement with the restructuring proposals that the Scottish Qualifications Authority has taken forward, so not all the trade unions are involved in the particular action that Mr Johnson has cited.

In general, effective and engaged dialogue to resolve such questions with the workforce is good and constructive practice. The Government’s application of the fair work principles is consistent with that whole approach, and we expect the SQA to operate on that basis. I hope that the discussions that take place under the auspices of ACAS will be constructive ones that lead to a resolution.

On the SQA’s leadership, Daniel Johnson may have noted this morning that an announcement was made on the appointment of Janet Brown’s successor as the SQA’s chief executive. I am delighted to congratulate Fiona Robertson on her appointment to that significant role in Scottish education.


Young Adults (Educational Support)

7. Bob Doris (Glasgow Maryhill and Springburn) (SNP)

To ask the Scottish Government how it is seeking to improve educational support for young adults when transitioning from children’s to adult services. (S5O-03160)

The Deputy First Minister and Cabinet Secretary for Education and Skills (John Swinney)

The most recent statistics indicate that 94.4 per cent of all school leavers had a positive destination—including work, training or further study—within three months of leaving school.

We recognise the importance of preparing our young people for life beyond school, and a range of supports are available in schools across Scotland to help pupils with that. In addition, education authorities have specific duties to prepare pupils who have additional support needs for their post-school transition. That preparation should happen no later than two years before the pupil leaves school.

Bob Doris

My constituent, Jennifer, who is turning 18, has physical and cognitive impairments and has been supported in special education throughout her time at school. Jennifer is considering taking a national qualification in skills for life and work at college, but has only recently been notified that she has an adult social worker, and they will meet shortly for the first time. It is unclear how Glasgow City Council will support Jennifer, including through self-directed support—which can be restrictive in Glasgow—although she has a major decision to make on her educational future.

How can we ensure that local authorities better support families in planning for transitions such as Jennifer’s? She and her mother, Chrystal, feel that Glasgow City Council could have assisted far more and far earlier.

John Swinney

I am concerned about the details that Bob Doris has raised. I reiterate the point that I made in my previous answer: at least two years before a young person will leave school, there should be engagement to begin handling of transition arrangements, which I recognise are significant, in particular for young people with additional support needs who might also have disabilities.

We are working with a range of organisations, including integration authorities and social care providers, to ensure that our approach addresses circumstances such as Bob Doris has raised. I am happy to look at that specific case to see whether the Government can encourage any further interventions to ensure that Jennifer’s needs are best addressed, and so that she can make the effective transition to a post-school environment.


Health and Sport

The Deputy Presiding Officer

I ask that thought be given to offering fairly short questions and answers, especially supplementaries, or we will not get through all the questions.


Fife Health and Social Care Partnership (Budget)

1. Willie Rennie (North East Fife) (LD)

To ask the Scottish Government what impact reductions to the Fife health and social care partnership budget will have on its ability to meet rising demand for social care. (S5O-03162)

The Cabinet Secretary for Health and Sport (Jeane Freeman)

The Fife integration joint board budget has not decreased, but has increased by £14.7 million this year, which takes the budget to a total of £511.7 million.

Fife integration joint board has reduced budgetary pressures by nearly £9 million since it was established in 2016-17. NHS Fife, Fife Council and the IJB need to continue to address the deficit, so together with the Convention of Scottish Local Authorities we are engaging with them to systematically reduce the deficit in a planned way, without reducing capacity.

Willie Rennie

The demand for social care is rising, and there is a £15 million gap in the partnership’s budget. As a result, the Leng resource centre and the St David’s centre in my constituency are to close, charges have increased and complex and respite care packages are to be cut. What is the cabinet secretary going to do to prevent those things from happening?

Jeane Freeman

First, I will use accurate figures. There is not a £15 million gap. In the 2019-20 budget, there is an £8.5 million gap, which is, as I said in my first answer, down from the £15 million deficit budget that the IJB started with, and which was agreed by NHS Fife and Fife Council. Every year since 2016-17, the council and the health board have contributed to reducing the IJB’s annual overspend, which seems to be a prudent way of bringing down a deficit that the IJB did not create, but which existed when the IJB was established. That is the approach that we are taking.

The Government and COSLA are trying to get the three parties—the IJB, NHS Fife and Fife Council—to agree that over a three-year period they will, for example, take a systematic approach to reducing the deficit that will not cost the health board or the council more money than they have annually, which will allow the IJB to operate on a sounder financial footing.

As for the increased demand, we provided, in the health budget that was approved by Parliament, an additional £160 million through local authorities for integration of healthcare and social care, to recognise the additional demands that result from the rising demographic challenge.

Alexander Stewart (Mid Scotland and Fife) (Con)

What discussions have taken place between Fife health and social care partnership and the Scottish Government on the increase in social care service charges and its likely impact?

Jeane Freeman

Social care service charges are a matter for local authorities to determine; it is up to them to decide how they wish to allocate their resources to all their responsibilities. However, there is disparity across the country on the issue. Concerns about that have been raised directly with me and, I am sure, with other members. All that is being factored in to our current review of adult social care, which will include leadership by people who are on the receiving end of social care in order to ensure that we find a better overall position and get a consistent standard across the country in delivery of, and charging for, social care.


Prostate Cancer

2. Liz Smith (Mid Scotland and Fife) (Con)

To ask the Scottish Government which national health service boards offer robotic-assisted prostatectomy as a method of surgery for prostate cancer. (S5O-03163)

The Cabinet Secretary for Health and Sport (Jeane Freeman)

All NHS Scotland boards offer robotic-assisted prostatectomy on a regional basis across the three high-volume centres, which are in Edinburgh, Aberdeen and Glasgow.

Liz Smith

It has been brought to my attention that patients in NHS Tayside can access RAP as a method of surgery for prostate cancer only through an out-of-area referral. What assessment have ministers made of the outcomes for Tayside patients receiving surgery, and what discussions have they had with NHS Tayside on investment in that surgery?

Jeane Freeman

If by “out-of-area referral” Liz Smith is referring to the regional centres that I have mentioned, the situation is exactly as I set out in my first answer. A referral from NHS Tayside would be to Aberdeen, Glasgow or Edinburgh.

Of course, the decision to offer that procedure in that way is clinically led and driven, and is for clinicians to follow up with their patients. From our work that has been looking at the outcomes of different procedures, I can say that no issues have been raised directly with us with regard to that procedure. It is for NHS Tayside to determine, in conjunction with its own clinicians, whether additional provision should be made for patients in the NHS Tayside area. If that is the case, the board will, properly, bring that matter to us. That has not happened, although of course it might happen in the future.


Compensation for Workplace Injuries (NHS Grampian)

3. Peter Chapman (North East Scotland) (Con)

To ask the Scottish Government how much compensation has been paid to NHS Grampian staff in each year since 2016 for incidents or injuries in the workplace. (S5O-03164)

The Cabinet Secretary for Health and Sport (Jeane Freeman)

The total amount of compensation claims made by staff since 2016 is £144,000. That breaks down to £16,500 in the first year; £30,823 in 2017; and £96,771 in 2018.

Peter Chapman

That is a significant sum, and it has risen year on year. The payments were made for a variety of incidents, including exposure to contaminated blood and violence at the hands of the public. The Government has presided over a staffing crisis for the past 12 years, with fewer employees being asked to do more and front-line staff working in demanding and stressful environments. Of course, the real issue here—

The Deputy Presiding Officer

Can you get to your question, please, Mr Chapman?

Peter Chapman

I am doing exactly that. The real issue here is that NHS Grampian has been consistently underfunded by the Government—

The Deputy Presiding Officer

Could you get to your question, please?

Peter Chapman

—and I believe that it is high time that the region was given a fair share of resources. Does the cabinet secretary agree?

Jeane Freeman

I will not agree with factually inaccurate statements. First of all, there is no staffing crisis driven by lower than usual numbers of staff. In fact, staffing numbers across the board have increased in NHS Scotland. The member has heard me say that many times, but I am happy to send him the detail, yet again. Nor is NHS Grampian underfunded—we have been through that before.

I am disappointed that Mr Chapman did not get to the important point of the question, which is about the safety of our staff and the work that we do across our health boards to ensure that staff are protected and as safe as possible and that, where instances of violence, aggression or unsafe practice damage them, we take those seriously, review our policies to see where improvement might be made and make compensation when that is required. There is another way of looking at this, which is to see that the indicators are that we take the issue seriously.

All the work on policies and practice that we undertake to keep staff safe, including the increased work that is under way on mental health and wellbeing, is undertaken directly with the staff organisations and trade unions, which is exactly the right way to do it.

David Stewart (Highlands and Islands) (Lab)

How much compensation was paid to NHS Grampian staff in each year since 2016 specifically for bullying? Can the cabinet secretary provide those figures, perhaps in writing, for all Scottish boards? I am particularly interested in the figures for NHS Highland and NHS Tayside, where staff have persistently and over a long period expressed concerns about bullying.

Jeane Freeman

I do not have those figures available, but I am happy to provide Mr Stewart with as much of that information as we hold centrally as soon as I can.


NHS Fife (Meetings)

4. Claire Baker (Mid Scotland and Fife) (Lab)

To ask the Scottish Government when it last met NHS Fife and what issues were discussed. (S5O-03165)

The Cabinet Secretary for Health and Sport (Jeane Freeman)

Scottish ministers and Government officials regularly meet representatives of all health boards, including NHS Fife. I last met the chair of that health board on 25 March.

Claire Baker

Is the cabinet secretary familiar with the improving the cancer journey service, which was initially piloted in Fife and then rolled out along with Macmillan Cancer Support and which involves partners from housing, health, voluntary and financial support services working together to support people with cancer? Figures from the Scottish cancer patient experience survey that were published yesterday show the need for more signposting for patients towards support and welfare advice and for health partners to have a stake in that, and they revealed that less than one third of people receive a care plan—

The Deputy Presiding Officer

Can you come to your question, please?

Claire Baker

What is the Scottish Government doing to support the sharing of best practice such as the ICJ service in Fife more widely?

Jeane Freeman

I am grateful to Ms Baker for raising that important question. As she knows, the survey was conducted by Macmillan Cancer Support, and the work that we undertake in the area is done jointly with Macmillan services. The survey also indicated that more than 90 per cent—I think that the figure was 95 per cent—of patients are satisfied with the care that they receive. However, significant improvements are required in relation to the information that people receive at the time of diagnosis and the capacity to go back, once people have absorbed the diagnosis, to ask further questions and get further information. With Macmillan Cancer Support, we will analyse the results of the survey and look at the specific areas where we need to make improvement. I hope to be able to update the Parliament on that shortly.

Mark Ruskell (Mid Scotland and Fife) (Green)

The Fife health and social care partnership was due to meet last week to approve a new multidisciplinary model for out-of-hours services in St Andrews, but the meeting was cancelled, leaving communities stuck with the same contingency arrangements that they have had for the past year. Can the cabinet secretary provide an update on the reasons for that delay? For how long will patients in north-east Fife have to travel for nearly an hour to attend out-of-hours appointments in Kirkcaldy?

Jeane Freeman

My understanding is that the Fife health and social care partnership is due to meet at the end of May, when it will receive a number of proposals on the delivery of services throughout Fife, including north-east Fife. As the member will recall, in the latter part of last year I specifically asked the integration joint board not to proceed with the proposals that it had at that stage because there was a significant degree of local concern about those proposals, including concern about the engagement on them. There were also specific requests to the health board from two local organisations.

I am not aware, therefore, of any reason why a more recent meeting has been cancelled. I understand that improvements have been made and that there have been significant discussions in north-east Fife, including with the university, that look to provide some answers to the concerns that local people had raised about the accessibility and delivery of service. There is increased use of paramedics, advanced nurse practitioners and so on. I am happy to ensure that the member has the detail of that but, as I understand it, it will be the end of May when the IJB considers all the proposals.

The Deputy Presiding Officer

There are a further four questions and we will not get through them all. Cabinet secretary, I know that you like to give lots of information, which can be appreciated, but I ask you to truncate your answers somewhat. I know—it is difficult.


National Health Service Budgets (Patient Care)

5. John Scott (Ayr) (Con)

To ask the Scottish Government what steps it is taking to minimise the risks to patient care arising from warnings of budget deficits in NHS Ayrshire and Arran and other NHS board areas. (S5O-03166)

The Cabinet Secretary for Health and Sport (Jeane Freeman)

I am not sure what evidence the member has to suggest that patient care is at risk.

NHS Ayrshire and Arran will receive a further £720 million. Its most recent result for the hospital standardised mortality ratio, published in February, is improved, even on the Scottish results. All of our indicators for patient safety show that NHS Ayrshire and Arran is doing better in some instances than the rest of Scotland, and Scotland is doing very well on those indicators. I am not really clear what the member’s specific concerns are.

John Scott

Lewis Morrison, chair of doctors’ union BMA Scotland, has said that his members say regularly—indeed, it was reported in a major survey by 97 per cent of doctors—that inadequate resources are affecting the quality and safety of care. I have particular concerns about NHS Ayrshire and Arran. What will the Scottish Government do to help doctors to deliver better patient care in Ayrshire and throughout Scotland?

Jeane Freeman

I firmly believe, as does Lewis Morrison from the BMA, that the new general practitioner contract is a significant step forward in helping doctors, in particular GPs, to do the work that they need to do. If Mr Scott would like to bring me his specific concerns, I will look at them.

Kenneth Gibson (Cunninghame North) (SNP)

Can the cabinet secretary advise the chamber what percentage of Scotland’s resource budget is allocated to the NHS and can she confirm whether all Barnett health consequentials are assigned to NHS Scotland? If so, does she agree that any shortfall in NHS funding in Scotland is down to the austerity of Mr Scott’s United Kingdom Tory Government colleagues?

Jeane Freeman

Health expenditure is the largest element of the Scottish Government’s budget, accounting for 43 per cent of total Government expenditure—a rise from 37 per cent in 2010-11. This year, it will exceed £14 billion and our recently published medium-term financial framework sets out a proposal for further funding of £2.7 billion between now and 2023-24.

Mr Gibson is perfectly correct. In real terms, our budget will be cut by 6.8 per cent compared to what it should be, which is entirely down to the approach of the Westminster Government.


HIV Infection Rates (Glasgow)

6. Anas Sarwar (Glasgow) (Lab)

To ask the Scottish Government what its response is to research from Glasgow Caledonian University that suggests a tenfold increase in HIV infection rates among drug users in Glasgow. (S5O-03167)

The Minister for Public Health, Sport and Wellbeing (Joe FitzPatrick)

I thank Anas Sarwar for bringing this important question to the chamber. I know that it will be appreciated by the people who are behind those figures.

I welcome the research from Glasgow Caledonian University and Health Protection Scotland on the causes of the outbreak of HIV identified in 2015 among people who inject drugs in Glasgow. The research was done in collaboration with NHS Greater Glasgow and Clyde and is an example of the kind of joint working that has been vital to tackling the outbreak.

The most recent HIV figures, published yesterday, suggest that the outbreak is coming under control, but there is no room for complacency. Prevention of HIV transmission remains a clear priority for the Scottish Government.

Anas Sarwar

I support the Government’s calls for a safe injecting room in Glasgow to help to tackle the issue. Alongside that, I ask the Scottish Government to commit to a new drugs strategy that reflects the reality in too many of our communities across Scotland. Further, what urgent action will the Government take to tackle homelessness, which is identified as one of the key reasons for the increase in HIV infection rates?

Joe FitzPatrick

Both of Mr Sarwar’s very important points are recognised in the new drugs strategy. We absolutely acknowledge that more must be done to tackle the harms and deaths associated with drug use.

The issue is complex, and that is why our strategy challenges our stakeholders and service providers to adapt to ensure that they provide a high-quality person-centred approach and that they better engage with and meet the needs of those who are most at risk as a result of their drug use.

The member is right to talk about the safe consumption facility. It is an evidence-based proposal that will make a difference and would save lives. I emphasise again that if the UK Government is not prepared to take action that will save lives here in Scotland, it should transfer the powers to this Parliament, where we can make those decisions to save those lives in Glasgow and elsewhere in Scotland.

Miles Briggs (Lothian) (Con)

In September of 2017, NHS Greater Glasgow and Clyde closed the needle exchange within the city centre. That has been widely noted as being part of the increase in infection rates that we have seen. Does the cabinet secretary now think that that was a mistake?

Joe FitzPatrick

I will not take the promotion.

The member makes an interesting point. Obviously, the vision of the service within Glasgow Central station was not supported by Glasgow health and social care partnership, and it was a regrettable decision that those services were removed. Since then, we have been working with the partnership as it looks to address the wider issues, but specifically, I know that the service in Glasgow is now providing and developing outreach work, through which it is taking that service directly to those people who require it. That is proving more adaptable, because it is able to move to wherever it is required.

It was regrettable that that decision was taken. It was not within our control and we did try to reverse it. I know that the previous public health minister had a lot of engagement to try to turn the decision around. However, it is good to see that Glasgow health and social care partnership is working to find alternative provision in the area.

The Deputy Presiding Officer

That concludes portfolio question time. I apologise to Colin Smyth and Mark McDonald for not reaching their questions.

I also want to make an observation. In this particular portfolio, ministerial responses took a long time, although, in fairness, some of the questions asked for a lot of information and might better have been lodged as written questions. Members might consider that in future, so that we can make sure that everyone gets a fair shout at health portfolio questions.

We will move on to the next item of business when the main players are settled.