Meeting of the Parliament

Meeting date: Thursday, October 3, 2019

Official Report 1140KB pdf

---

General Question Time

---

Children and Young People (Rights and Wellbeing)

To ask the Scottish Government what steps it takes to ensure that its policies and legislation protect and promote the rights and wellbeing of children and young people. (S5O-03625)

Protecting and promoting the rights and wellbeing of our children and young people is fundamental to achieving our national outcome that

“We grow up loved, safe and respected so that we realise our full potential.”

In 2015, we introduced the child rights and wellbeing impact assessment approach to support all Scottish ministers in meeting their duties in relation to the United Nations Convention on the Rights of the Child, which are set out in the Children and Young People (Scotland) Act 2014. That helps us to assess whether proposed policies, measures and legislation will protect and promote the rights and wellbeing of children.

The recent programme for government clearly demonstrates the priority that we continue to place on supporting our children and young people to thrive in these uncertain times. Importantly, it reaffirms our commitment to incorporating the UN Convention on the Rights of the Child into domestic law and to bringing forward legislation within the current parliamentary session.

We have also made clear our continuing commitment to getting it right for every child, which remains at the heart of our approach to promoting the wellbeing of Scotland’s children and young people.

On 20 June this year, in a statement to Parliament, the Scottish Government committed to replacing schools guidance on transgender young people with Scottish Government guidance that will be inclusive of all children, and will not risk excluding girls from female-only spaces.

Does the minister agree that the use of a child rights and wellbeing impact assessment in policy and guidance formation is the best way to ensure that all children enjoy their rights, as set out in the UNCRC? Furthermore, does she agree that any organisation that works with children and young people, or that advises people who work with children and young people, should be held to those best-practice standards, which protect and promote the rights and wellbeing of all children?

In June this year, the Scottish Government confirmed that we will bring forward updated guidance to support transgender young people in our schools. Work is under way for that to be available by the end of the year. That will include completion of an equality impact assessment and a CRWIA.

Since its introduction in 2015, the child rights and wellbeing impact assessment has been a really valuable tool in ensuring that we protect and promote the rights and wellbeing of children and young people. It allows us to identify potential negative impacts of proposed policy and legislation, and to take action to mitigate them. An example of that relates to the stop and search code of practice: the CRWIA and responses to the consultation shaped revisions of the draft code and identified the need to include a separate section to deal exclusively with children and young people.

Question 2 has not been lodged.

---

Funded Childcare Expansion (Aberdeenshire)

To ask the Scottish Government whether it will provide an update on progress with personnel recruitment and facilities in Aberdeenshire for the expansion of funded childcare to 1,140 hours. (S5O-03627)

The Scottish Government wants children and families right across Scotland to benefit from extra access to high-quality, nurturing early learning and childcare. We are investing an additional £2 billion to realise our ambition, though a landmark funding deal with the Convention of Scottish Local Authorities.

By 2021-22, Aberdeenshire Council will receive nearly £26 million of additional revenue funding for early learning and childcare, which will support the expansion of the early years workforce. Over the five-year period to 2020-21, Aberdeenshire Council will also benefit from more than £27 million of additional capital funding to build, refurbish and extend nursery facilities.

Yesterday, the Improvement Service published further progress data that shows that, nationally, more than 46,000 two, three and four-year-olds are already benefiting from extra funded early learning and childcare. The data demonstrates that local authorities across Scotland, including Aberdeenshire Council, are working incredibly hard with nurseries, playgroups and childminders locally to prepare for August 2020, and that recruitment and infrastructure development continue to progress well.

I thank the minister for that comprehensive answer. Trained personnel are, of course, only one part of the equation. Can the minister give an update on where we are nationally with improvements to the availability and condition of the estate that is needed to deliver the 1,140 hours? What has been done to assist private partner providers in helping us to meet the challenges in recruitment and facilities?

We are investing £476 million for new, refurbished and extended high-quality ELC settings. Yesterday, I visited Sauchie nursery school in Alloa, where I saw the benefits of that investment at first hand. Clackmannanshire Council has used some of its capital funding to extend Sauchie nursery school with a kitchen and dining facilities. Children now have hot cooked healthy meals provided on site.

We expect that 900 such projects, large and small, will be delivered by the end of the expansion. In July, we set out the support that each local authority offers to private providers. Through our funding deal with the Convention of Scottish Local Authorities, we are delivering significant increases in hourly rates, which from August 2020 will enable payment of the real living wage to all childcare workers who are delivering funded hours.

Many private nurseries can also now benefit from 100 per cent business rates relief, and we have enabled private and third sector providers to post job opportunities for free on the myjobscotland website.

I am pleased to hear the minister’s response to Gillian Martin. However, in a recent survey of the private, voluntary and independent sector, around 80 per cent of respondents stated that they were having great difficulty recruiting and retaining trained staff because local authority nurseries are able to offer a much higher rate of pay. That is largely due to local authorities using a higher revenue funding rate per child for their own services than they allocate to PVI providers. What can the minister offer the PVI sector to assist it with that ongoing staffing crisis?

As I have said since I became the Minister for Children and Young People, private providers will be absolutely crucial to delivery of the expansion. We have put in place a number of opportunities, including training opportunities in college, on the job, in modern apprenticeships and at university. There is a vastly increased number of qualified people in the sector.

Through the agreement with COSLA, we have also ensured that a sustainable rate is being paid to private providers so that they can pay the living wage and compete with local authority providers in the future.

---

Cold Spell Heating Assistance (Implementation)

To ask the Scottish Government when it will take decisions on the implementation of cold spell heating assistance. (S5O-03628)

We are putting in place robust plans to deliver cold spell heating assistance from winter 2021. Our priority in taking on full responsibility for all the devolved benefits is a safe and secure transition so that people continue to receive support at the right time and in the right amount.

Over the course of the next year, we will seek the views of people who have benefited from cold weather payments in the past, as part of our commitment to designing our new social security system with the people who are likely to use it. In addition, we will seek a wide range of expert opinion and look to design processes that better reflect the needs and experiences of the people of Scotland.

I was pleased when the cabinet secretary previously said that she would review how eligibility for payments is triggered, including looking at the number and location of weather stations. That was very welcome for towns such as East Kilbride. Its weather is currently judged by the weather station in Bishopton, which is at sea level and is therefore often much warmer than East Kilbride. When will we have confirmation that the weather stations have been reviewed, in order that my constituency will no longer be disadvantaged?

I am well aware of the calls for more localised forecasts and additional weather stations, most particularly from Linda Fabiani, who has been determined to take the case forward for a number of years now. As I said in my original answer, we will, over the course of the next year, seek the views of people who have benefited from the cold weather payments in order to ensure that we can develop our policy around cold spell heating assistance. We want the most appropriate, most active and most cost-effective ways of ensuring that the weather forecasting and monitoring that we have targets support and assistance to those who are in greatest need. That will, of course, include a review of eligibility for payments and how they are triggered, with the number and location of weather stations being very much part of that process.

---

Infrastructure Failures (Impact on Surgical Waiting Lists)

To ask the Scottish Government what impact infrastructure failures at the Queen Elizabeth university hospital and Royal hospital for children and young people have had on patients who are on surgical waiting lists. (S5O-03629)

No patients who are on surgical waiting lists at the Queen Elizabeth university hospital or the Royal hospital for children and young people have been impacted by the infrastructure issues at those two hospitals. NHS Lothian has confirmed that infrastructure issues at the Royal hospital for children and young people have had no impact on patients on surgical waiting lists. A number of theatre lists were cancelled before and after the original planned move date as part of the agreed migration plan. However, the infrastructure issues have had no impact.

That is an interesting answer. After 15 months on the neurosurgical waiting list and 11 months on the short-notice list because of persisting severe pain, my constituent had still had no operation and felt that he had no choice but to pay to have it undertaken privately. His surgeon’s explanation related to a lack of a trained theatre nurse, the response to emergency work and infrastructure issues, including sewage ingress, and delays of more than 18 months to get access to new theatres at the Queen Elizabeth university hospital. My constituent, who is watching this meeting, is angry and out of pocket and he feels let down. What can the cabinet secretary say to ease his anger? Does she know how many other patients have sought private treatment because of the waits that they have faced?

If Ms Ballantyne had cared to write to me before now, I would have been able to give her a more detailed answer on the particular case that she has raised. However, in the absence of that, it seems to me from what she has said that she is referring to the neurosurgical theatres, which were the responsibility of the University of Glasgow to plan and build. We have discussed previously in the chamber and elsewhere the inadequacy of the original plan-and-build process in meeting the standards that the national health service requires. Following an important and helpful intervention from the principal of Glasgow university, the work has now been undertaken to standard and I believe that NHS Greater Glasgow and Clyde is about to take possession of those theatres, at which point they will be able to be used for patients.

---

Non-prescribed Benzodiazepines

To ask the Scottish Government whether it will provide an update on the action that it is taking to address the use of non-prescribed benzodiazepines, such as etizolam, in Glasgow. (S5O-03630)

That is an issue not just in Glasgow but in communities across Scotland, and it is one of the matters that the drug deaths task force will consider as part of its work. Earlier this year, the Glasgow health and social care partnership put in place a number of measures on so-called street Valium, including specific outreach activity and the provision of harm reduction information. The partnership also implemented a treatment protocol for the management of dependence that is associated with the use of street Valium for those most at risk.

Nationally, Police Scotland, national health service boards and funded agencies have sought to increase awareness of the dangers of taking prescription-type drugs, including so-called street Valium, through national warning bulletins, messages on social media and local information campaigns.

Street Valium costs less than a chocolate bar to buy. What is the minister’s reaction to evidence, including from Police Scotland, that one unintended consequence of minimum unit pricing for alcohol is that it has pushed people with problem alcohol use to switch to cheap drugs such as benzodiazepines?

Concerns regarding the availability and use of street Valium predate the introduction of minimum unit pricing. We know that the key driver of the recent increase in the number of deaths associated with street Valium is the extremely low price of the pills. Mr Tomkins talked about the price of a bar of chocolate, but the reports are that the figure is as low as 20p a pill, and there is increased evidence of poly-drug use.

NHS Health Scotland is looking closely at all the implications in relation to minimum unit pricing. One of its studies assesses the impact of the policy on those drinking harmful levels, and includes considering substitution with other substances. We will absolutely keep an eye on that issue.

I have been informed of significant issues for people in seeking support for benzodiazepine dependency from health services, including general practitioners, which can force people into the hands of dealers pushing the potentially deadly so-called street Valium. Will the minister consider how health services can better help those with such a dependency?

Health services and general practitioners in particular have a significant role to play in helping to tackle the challenges that we are seeing with drug use and the associated health harms. The Royal College of General Practitioners is represented on the drug deaths task force. It is the role of GPs to assess the clinical needs of their patients, using relevant evidence to take a person-centred approach that identifies their preferences and, where it is clinically appropriate, to follow those.

There are clinical guidelines in place for the management of drug misuse and dependence, and we expect clinicians to take the person-centred approach that is advocated in our alcohol and drug strategy in relation to issues relating to addiction to any type of drug.

Street drug use has been primarily responsible for the HIV outbreak in Glasgow, with the injection of heroin and cocaine. Of course, Scotland was the first part of the United Kingdom to make pre-exposure prophylaxis available on the national health service. PrEP is a game-changing treatment but many people might not be are aware of it. The minister will be aware that it is taken by people who are HIV negative and that it has been shown to reduce the risk of infection by up to 86 per cent. What is the Government doing to increase awareness of the existence of PrEP to drug users?

I thank Pauline McNeill for asking that important question. I was pleased to visit Waverley Care in Glasgow, which is one of the partners that we are working with in order to try to reach people who have been more difficult to reach, particularly in relation to the particular issue in Glasgow that the member raises.

The point that the member makes is important, and I think that we can all do what we can to ensure that people are aware of the benefits of PrEP, and we must also raise awareness of the undetectable equals untransmittable—U=U—campaign, which aims to remove the stigma around HIV. We have treatments in place, and we have PrEP, which is part of a preventative approach.

---

NHS Resource Allocation Committee Funding (NHS Grampian)

To ask the Scottish Government whether NHS Grampian will receive its full share of NRAC funding in the next Scottish Government budget. (S5O-03631)

The Scottish Government will publish its spending plans in due course as part of the Scottish budget.

Under this Government, NHS Grampian’s budget has increased by almost 30 per cent above inflation, and this year, the board is receiving record investment that is in excess of £957 million. In 2019-20, the Scottish Government continues to ensure that no board is more than 0.8 per cent from NRAC parity.

Well, 0.8 per cent sounds great, but the Scottish Parliament information centre has confirmed that over the past 10 years, the Scottish Government has given NHS Grampian £239 million less than it was supposed to receive under the Scottish Government’s own funding formula. That has led to 30 per cent of patients waiting longer than 18 weeks for treatment for chronic pain, and to cancer treatment times not being met for a quarter of patients. Will the cabinet secretary find at least some of that missing £239 million in order to put this situation right?

I have to point out to Mr Rumbles that NHS Grampian is a great deal closer to parity than it ever was when his party was in government in Scotland. I also point out the significant additional funding that NHS Grampian has received and say that, given the significant additional investment in waiting times and other areas, being 0.8 per cent away from parity is not a sufficient reason for NHS Grampian or any other board to continue to fail to meet its targets—we have had that discussion before.

I also point out that between 2015-16 and 2019-20, in being moved closer to parity, along with other boards in the area, NHS Grampian has received additional recurring funding of £56.2 million. I think that that places NHS Grampian in a good position to deliver the healthcare that the citizens of that area deserve.

I call Tom Mason.

Thank you, returning officer—[Laughter.] I mean thank you, Presiding Officer. My apologies, but I was caught up in the by-election in Bridge of Don in Aberdeen.

NHS Grampian has recently missed its targets for delayed discharge, accident and emergency waiting times, drug and alcohol treatment waiting times, chronic pain waiting times and the 18-week referral-to-treatment period. Since the NRAC formula was introduced in 2009, NHS Grampian has never reached parity, resulting in a total shortfall of £239 million over that period. Does the cabinet secretary accept that those two things might just be related?

No, I do not, because other boards are in the same position and are performing better than NHS Grampian, as indeed NHS Grampian is performing better than other boards.

We have the £850 million additional investment in waiting times and the additional investment in mental health services and care, because our real focus with those boards is on the trajectory that is set out in the waiting times plan that I published last year—if Tom Mason would care to go back to look at it—in order to improve performance and meet waiting times targets.

Much of the issue is down to service design and delivery, and it is not as much about the resourcing of our health service as members might care to argue. I remind members that the resourcing that our health service receives is the highest that it has ever been since the Parliament reconvened.