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Chamber and committees

Meeting date: Wednesday, October 4, 2017

Meeting of the Parliament 04 October 2017

Agenda: Business Motion, Portfolio Question Time, Employment Support, Gender Pay Gap, Complaint, Business Motion, Parliamentary Bureau Motion, Decision Time, Radiologists


Contents


Portfolio Question Time


Health and Sport


Sports Clubs and Leisure Centres

1. Gordon Lindhurst (Lothian) (Con)

To ask the Scottish Government what role sports clubs and leisure centres play in maintaining a healthy lifestyle. (S5O-01315)

The Minister for Public Health and Sport (Aileen Campbell)

Sports clubs and leisure centres play an important role in helping people to maintain a healthy lifestyle. People of all ages and abilities can benefit from participating in sport and physical activity to improve both their physical and their mental health.

Gordon Lindhurst

The Barclay review has floated the recommendation of ending rates relief for arm’s-length external organisations such as Edinburgh Leisure. That could foot them with a bill of millions of pounds. If the Scottish Government decides to implement that recommendation, is the minister concerned about the potential effects on health if public leisure facilities are stripped back or made more expensive as a result?

Aileen Campbell

I am well aware of the good work that Edinburgh Leisure carries out. I met representatives of Edinburgh Leisure and saw at first hand some of the interesting and innovative work that it has been doing to try to get the inactive active. When the Cabinet Secretary for Finance and the Constitution made his statement on 12 September, he accepted the majority of the recommendations, but there are certain recommendations and points of detail that he is now considering further, and he is engaging with relevant stakeholders ahead of publishing an implementation plan by the end of the year. We will continue to engage further with members on that point of interest, and we would be happy to meet Gordon Lindhurst if he so wishes, but the cabinet secretary is still considering some specific points of the Barclay recommendations, and the point that the member has raised is one of the issues to which he is giving further consideration.

Ivan McKee (Glasgow Provan) (SNP)

The minister will be aware of the great success of the Gladiator weightlifting club, based in Easterhouse in my constituency, which won gold and bronze medals at the recent Commonwealth youth championships in Australia. The minister will also be aware that the young medal winners and their teammates had to raise funds themselves to pay for the trip, because no official funding was available. What steps are being taken to ensure that funding for sport finds its way to grass-roots sports clubs such as the Gladiator weightlifting and Phoenix boxing clubs in Easterhouse and in other socially deprived areas of the country, so that the Commonwealth games legacy can deliver increased sports opportunities for young people who might not otherwise be able to participate?

Aileen Campbell

One of the big planks of the Commonwealth games was appropriate planning for the legacy of the games to be felt not just across Glasgow but throughout the country, and ensuring that the legacy reaches areas of deprivation is an important concern. Via sportscotland, clubs from across Scotland are able to access support through various funding streams, direct club investment, awards for all and the facilities fund. As well as that, sportscotland is committing additional support to the seven community sports hubs that are based in the areas of highest deprivation.

With regard to Ivan McKee’s specific question about weightlifting, I am happy to meet him to discuss support for weightlifting clubs in his constituency, and I commend the weightlifting club based in Easterhouse on the gold medal and bronze medal from the Commonwealth championships. I look forward to meeting the member to discuss the wider issues.


HIV (Information in Schools)

2. Ruth Maguire (Cunninghame South) (SNP)

To ask the Scottish Government what role national health service boards can play in ensuring that young people receive information at school that will reduce their risk of contracting HIV. (S5O-01316)

The Minister for Public Health and Sport (Aileen Campbell)

Relationships, sexual health and parenthood education is key to ensuring that all young people across Scotland make healthy choices with regard to their sexual health, including knowing how to protect themselves from HIV. NHS boards work with local authorities and other partners to support the delivery of high-quality, consistent and inclusive RSHP education in schools across Scotland, and boards can also play a role in supporting the training of teaching staff delivering RSHP education, ensuring that schools are aware of NHS services for young people in their areas and directly participating in the co-delivery of teaching sessions by NHS staff.

NHS boards are also working with local authorities on a national RSHP resource to support effective RSHP teaching. That new resource will cover a range of issues including consent, healthy relationships and the impact of digital technology, and it will also be fully inclusive of lesbian, gay, bisexual, transgender and intersex issues.

Ruth Maguire

Today, HIV Scotland was announced as winner of a prestigious British Medical Association award for improving HIV healthcare. Its recent report “HIV and Education: Guaranteeing Lessons for All” highlighted that, every month, two young people are diagnosed as being HIV positive. Is it time that we had stronger partnership working between health boards, local authorities and the third sector to ensure that young people receive the best information on how to lead long and healthy lives? Does the minister agree that this is a public health issue?

Aileen Campbell

I certainly commend HIV Scotland for winning that award and for the work that it does in this area. I also welcome the organisation’s report, because, as the member has highlighted, HIV prevention absolutely remains a public health challenge and NHS boards will continue to work with schools and local authorities to deliver change and stage appropriate RSHP education on the risks of HIV. There is an opportunity in the work that is being taken forward by boards and authorities on the new RSHP resource, but we also need to consider wider opportunities to properly engage people on safe-sex messages, such as those around the administration of pre-exposure prophylaxis. We should consider all such opportunities, and we will certainly build on HIV Scotland’s good work and the work that is under way across authorities and NHS boards.

Tom Arthur (Renfrewshire South) (SNP)

This year marks the 30th anniversary of the first broadcast of the AIDS “Don’t die of ignorance” public health advertisement, which, with its macabre imagery and alarming tones, cemented in the minds of a generation the idea that an HIV diagnosis meant almost certain death. Unfortunately, it still informs perceptions to this day. Given that HIV has not been the death sentence that it once was since the introduction of highly active antiretroviral therapy in 1996, does the minister agree that ensuring that young people are aware that HIV is now a manageable medical condition is essential to tackling the HIV stigma that sadly persists to this day?

Aileen Campbell

Tom Arthur has articulated the memories that many of us have of the HIV campaigns of the 1980s. Although I agree that we need to continue to raise awareness of HIV risks, prevention and treatment, we also need to look at tackling the stigma and discrimination that are so associated with contracting HIV. I believe that there was a cross-party group in this Parliament whose specific ask was that we did not lose sight of the stigma that many people with HIV continue to face in our country, and I think that, across the parties, we will agree on the need to be resolute in tackling the discrimination that too many people face.


NHS Lanarkshire (Meetings)

3. Linda Fabiani (East Kilbride) (SNP)

To ask the Scottish Government when it will next meet NHS Lanarkshire. (S5O-01317)

The Minister for Mental Health (Maureen Watt)

Ministers and Scottish Government officials regularly meet representatives of all health boards, including NHS Lanarkshire, to discuss matters of importance to local people.

Linda Fabiani

There is one important issue that I feel should be raised at the next meeting with NHS Lanarkshire. Is the minister aware that although Kilbryde Hospice opened to day patients some time ago, it has in-patient beds that are not being utilised? The situation is really frustrating for all the volunteers and local residents who worked to bring the hospice to East Kilbride and Lanarkshire. Will the minster intervene and raise the matter to bring clarity to the situation and, I hope, ensure provision of hospice in-patient beds in East Kilbride and South Lanarkshire?

Maureen Watt

I have been made aware of the situation, and I am happy to meet the member to discuss it further, if she so wishes. I think that she knows that the health and social care partnerships in South and North Lanarkshire are working together to agree on how to make best use of local palliative care services and supports to meet their populations’ needs.

Earlier this year, NHS Lanarkshire established a short-life working group to consider how best to do that, and I understand that the group will shortly share its recommendations, with a view to engaging further with stakeholders in the near future. Following that, a proposed way forward will be presented to the North and South Lanarkshire integration joint boards, which I hope will be before the end of this year.

Brian Whittle (South Scotland) (Con)

In 2009-10, NHS Lanarkshire spent £13,000 on agency nurses but, by 2016-17, that had rocketed to more than £1.8 million. Over the same period, the number of unfilled nursing and midwifery vacancies in Lanarkshire increased from 18 to 254. Does the minister agree that a major contributory factor in that was Nicola Sturgeon’s decision when she was health secretary to slash training places for nurses? What will the minister do to rectify that situation and ensure that Lanarkshire hospitals are not chronically understaffed?

Maureen Watt

As the member knows, NHS agency spend is an extremely small part of the overall health budget. As he also knows, we are currently working on NHS workforce planning.

In relation to Linda Fabiani’s question, perhaps the member would like to join me in congratulating nurses in the field of palliative care and in recognising a report from the University of Bath, the lead author of which says that Scotland is “leading the way” with ambitious targets on palliative care and reorganisation and is a place to come to on that.

Monica Lennon (Central Scotland) (Lab)

I whole-heartedly agree with Linda Fabiani. I know that the Lyons family, who lost a much-loved father and husband, Frank Lyons, who was a motor neurone disease campaigner, would really appreciate it if that point was followed up.

Is the minister aware that ward 18 at Hairmyres hospital in East Kilbride, which is a care of the elderly ward, has been closed to new admissions? Can she clarify whether that has resulted in a reduction in the number of available beds for elderly patients at Hairmyres and whether the measure is permanent?

Maureen Watt

I am not aware of that issue about ward 18, but I am happy to investigate the issue and write to the member with information on it.


National Health Service Resource Allocation Formula

4. Liam Kerr (North East Scotland) (Con)

To ask the Scottish Government what plans it has to review the NHS resource allocation formula. (S5O-01318)

The Cabinet Secretary for Health and Sport (Shona Robison)

The national resource allocation formula is updated every year to take account of changing demographics across Scotland. The most recent review, relating to the morbidity and life circumstances adjustment for the acute care programme, was reflected in the NRAC shares issued for 2017-18 onwards.

Liam Kerr

Vacancies and long waiting lists are leading to NHS Grampian patients potentially being sent as far as Newcastle for surgery. Under the allocation formula, NHS Grampian receives only 89p per head, compared with the national average of £1, which is a smaller share than it received a decade ago. The board also lost £15 million in the last financial year. Does the cabinet secretary accept that funding decisions made by the Government are causing delays and crisis in the north-east? When will the Scottish Government fund NHS Grampian at the level that the Government’s own allocation formula requires?

Shona Robison

NHS Grampian’s resource budget for 2017-18 has increased to £898.6 million, which includes an additional £3 million of NRAC parity funding. Such funding ensures that no board is further than 1 per cent from its target share of funding. Since 2015-16, NHS Grampian has received additional funding of £47 million for the specific purpose of accelerating funding parity in line with the NRAC formula. Grampian has been one of the biggest gainers from the formula in recent years.

On the point about patients being sent to Newcastle, that arrangement is clearly part of a process of boards helping one another. Glasgow and Edinburgh are the first ports of call for patients from Grampian, to support Grampian while it recruits and works its way through some of its difficulties. Newcastle is the third option. I am sure that neither Liam Kerr nor anyone else in the chamber would suggest that we should not utilise resources wherever they are offered. This is not the first time that mutual aid has been given north and south of the border. That approach is to be welcomed and I certainly applaud Grampian’s efforts in doing that while it sorts out the recruitment issues in its area.

Anas Sarwar (Glasgow) (Lab)

The health secretary must recognise that resource is not meeting demand in the NHS. Health boards are telling us that they are having to make more than £1 billion-worth of cuts over the next four years, and that is having devastating consequences on the workforce and on patient care.

One shocking example of that is the revelation that women in Glasgow who suffer a miscarriage are having to wait up to five weeks to have a surgical removal of the foetus. That is a shocking and heartbreaking revelation. What will it take for the cabinet secretary to wake up, realise that there is a problem in the NHS and give patients and NHS staff the treatment that they deserve?

Shona Robison

Anas Sarwar raises two very different issues, and I will take the first one first. He will be aware that there are more resources going into the NHS than there ever have been before. Of course, under Labour’s proposals in its 2016 election manifesto, less money would be going into the NHS than we are delivering. However, he makes a point with which I would agree, which is that demand for the NHS continues to grow and put pressure on services, which is why we need to reform the way in which services are organised. We are working through the integration partnerships to ensure that more people avoid admission and are kept out of hospital, which is very important, given the growing frail elderly population.

Anas Sarwar spoke about a very serious case in NHS Greater Glasgow and Clyde that has been raised over recent days. I understand that a complaint has been raised about the case and a full investigation is going on, and I have asked the chief medical officer to look into the issue in Glasgow and the rest of Scotland. The initial indications from Glasgow and Clyde are that it is an isolated case. It is totally unacceptable and I am determined that we will absolutely not accept that standard of healthcare for anybody anywhere in Scotland, but it is not reflective of the rest of the service in Glasgow and Clyde. The chief medical officer is seeking assurance on the issue not just in Glasgow and Clyde but elsewhere, because I want to ensure that women across Scotland get the highest level of care, particularly in very sensitive circumstances such as this.


NHS Grampian (Cancelled Operations)

Mike Rumbles (North East Scotland) (LD)

Does the minister not see that with 3,500 fewer planned operations, the second-worst waiting times record—

The Presiding Officer (Ken Macintosh)

Mr Rumbles, you have to read your first question first. I think that you are on your supplementary.

5.

Mike Rumbles

To ask the Scottish Government what its position is on the number of planned operations that have been cancelled in NHS Grampian. (S5O-01319)

The Cabinet Secretary for Health and Sport (Shona Robison)

The decision to cancel a patient’s operation is never taken lightly. All boards, including Grampian, work very hard to keep cancellations to a minimum, and we continue to work with them to see sustained improvements.

It is important to remember that cancellations are a small percentage of the overall number of planned operations taking place. The latest cancelled operations figures, which are for August, show that in Grampian 1,947 operations were carried out and 83 operations were cancelled due to capacity or non-clinical reasons.

Mike Rumbles

We have seen 3,471 fewer planned operations, the second-worst waiting times record of any national health service board, hundreds of cancelled operations for non-clinical reasons, and, most recently, specialist veterans services pulling down their shutters due to a lack of funding support from NHS Grampian. I am not the only Grampian MSP raising the issue. Does the cabinet secretary not believe that now is the time to fund NHS Grampian properly? It receives only 89 per cent of the average funding per head of population. The problem is not the amount of money that the cabinet secretary has mentioned; the share of the budget needs to be addressed.

Shona Robison

As I said in my answer to Liam Kerr, NHS Scotland resource allocation committee funding has been an important element of the funding that Grampian has received in recognition of the challenges that it faces. Since 2015-16, it has received additional funding of £47 million for the specific purpose of accelerating funding parity in line with the NRAC formula.

As I said, a very small number of operations are cancelled due to capacity or non-clinical reasons—for August, that amounted to 2.8 per cent. A number of other operations are cancelled for clinical reasons or because patients are not fit to have the procedure, or are cancelled by patients. The vast majority of operations go ahead.

Mike Rumbles mentioned the veterans services, which have been important. We have supported boards to continue to provide veterans services in a very difficult backdrop, because they were previously funded through London interbank offered rate—LIBOR—money; as Mike Rumbles will be aware, that money has been withdrawn. We have tried to help boards to sustain those services and have offered them a partnership arrangement for funding. It is up to those boards to either accept or not accept; most have, but a small number have not decided to go down that route. That is a local decision for those boards.

Gillian Martin (Aberdeenshire East) (SNP)

What measures have been taken by NHS Grampian, in conjunction with local universities and colleges, to train more theatre staff for Aberdeen royal infirmary to address staffing issues?

Shona Robison

Gillian Martin touches on an important point, because a key issue for NHS Grampian is its ability to recruit and retain staff, in particular theatre staff for Aberdeen royal infirmary. The board is taking a number of important measures to plan and sustain its theatre workforce; for example, it is one of a number of boards that have piloted a new approach to developing the theatre workforce. It is working in partnership with the north-east of Scotland colleges to develop and deliver a professional development award in perioperative practice, which has enabled existing theatre staff to further develop their skills and experience, ensuring a clearer career pathway and helping to attract and retain theatre staff.

A lot of work is going on; the board has entirely restructured the way in which it organises its theatres in the Grampian area and I am confident that, over time, it will be able to build up its capacity and to sustain and provide quicker access to procedures than it currently provides.

Tom Mason (North East Scotland) (Con)

We have heard a lot of information from the cabinet secretary about how many extra resources are going in and about the partnership arrangements with Newcastle, Glasgow and Edinburgh. We have not heard how long this will go on for; it has gone on for several years so far. Will she give the north-east of Scotland a promise on when things will normalise, when there will not be cancellations and when waiting lists will come down to what could be considered a normal level?

Shona Robison

The arrangements for cardiac patients are new and have not gone on for years. The board had to come to those arrangements because of the particular issues of not being able to recruit to those specialties within the Grampian area. It is important to make sure that cardiac patients in the Grampian area in the north of Scotland get access to the cardiac specialists that they need, so that is why the board has come up with the important arrangements with Glasgow, Edinburgh and Newcastle—although it has not had to utilise any capacity in Newcastle so far.

The most important people in all this are the cardiac patients. I know that they would want to get their treatment as quickly as possible, and, if that means travelling outwith Grampian, I am sure that that is what they are prepared to do. Meanwhile, NHS Grampian is working very hard to try to recruit those specialists to Grampian, so that it can get its service back up and running to be able to meet the demands from the Grampian area.

The Presiding Officer

Question 6 has not been lodged.


Access to New Medicines

7. Sandra White (Glasgow Kelvin) (SNP)

To ask the Scottish Government what action it is taking to increase access to new medicines. (S5O-01321)

The Cabinet Secretary for Health and Sport (Shona Robison)

In December 2016, Dr Brian Montgomery published his independent review on access to new medicines, which recognised that the Scottish Government has made significant reforms and investment to improve access to newly licensed medicines in recent years. The review found that, following our previous reforms, Scottish Medicines Consortium acceptance rates increased markedly.

We are committed to continuing to build on those improvements and are taking forward the recommendations set out in Dr Montgomery’s report. We are working in collaboration with stakeholders, including the SMC, NHS Scotland and the pharmaceutical industry, to implement the recommendations as quickly as possible. We encourage drug manufacturers to make reforms too, so that they bring forward medicines at a fair price.

Sandra White

I thank the cabinet secretary for her answer, especially the part about the pharmaceutical industry and fair prices.

I know that the cabinet secretary will be as aware as members and the public are that working across countries is important in accessing new medicines. What impact will leaving the single market have on our access to new treatments and medicines?

Shona Robison

That is an important issue. Should the United Kingdom choose to take us out of the single market and withdraw our membership of the European Medicines Agency, there is a clear risk that pharmaceutical companies could be less committed to the UK market than they would be to the larger attractions of the European Union and the United States, and that patients in Scotland and the wider UK could face delays in accessing the medicines that they needed within the timescales that we currently enjoy as a full member of the EU.

I am also concerned that medicine manufacturers could be negatively impacted by additional costs as a result of having to work separately with the UK. As a result, some manufacturers could choose not to work with the UK all, or could increase the costs of our medicines.

In light of all that, in July, I wrote to the Secretary of State for Health, Jeremy Hunt, seeking clarity on the UK’s future relationship with the European Medicines Agency. I have also requested the full and regular involvement of the Scottish Government in those crucial discussions and decisions.

Miles Briggs (Lothian) (Con)

Will the cabinet secretary give an update to my constituents and to members on what steps the Scottish Government is taking to allay the fears of cystic fibrosis patients who are campaigning for access to the drug Orkambi?

Shona Robison

Miles Briggs will be aware that decisions made by the Scottish Medicines Consortium have been and continue to be independent of ministers and Parliament. Those decisions are based on clinical issues and cost effectiveness at a national population level for all of Scotland.

In March, I wrote to Vertex Pharmaceuticals to encourage it to hold discussions about the cost of Orkambi with colleagues in the NHS National Services division who are best placed to advise the company on pricing approaches and a fair price that could support the securing of a positive recommendation from the SMC for the prescribing of such products in the NHS in Scotland. The talks are under way and I am sure the member will agree that we should allow them to continue.

Through those discussions, I hope that the manufacturer will make its best offer on price and indicate that it will resubmit an application to the SMC at the earliest possible opportunity.

Pauline McNeill (Glasgow) (Lab)

Will the Scottish Government consider funding Sativex, a cannabis-based medicine, as NHS Wales has done? Drugs such as Sativex can help to treat multiple sclerosis, arthritis and other musculoskeletal conditions.

Tony Wiggins, the chair of the Cardiff and Vale MS Society, has trialled Sativex and called it a “tremendous step forward”. He also said:

“It’s good for spasms and other effects of MS—and it does work”.

I realise that Sativex is not authorised by the SMC but the cabinet secretary will be aware that doctors can prescribe it should they wish to. However, will she consider going down the same road as Wales?

Shona Robison

As Pauline McNeill said, when the SMC decides not to accept a medicine for routine use, clinicians can still request access to it for their patients on an individual case-by-case basis when they feel that it would be of significant clinical benefit. That is currently done through the individual patient treatment request system, which is changing to the new peer-approved clinical system. The new system will improve consistency and ensure that patients get access to the right treatment at the right time, and there will be a national appeal panel to ensure greater equity of access. For the patients Pauline McNeill is talking about, that route would be the suggestion. They could also make a further submission to the SMC. I am not sure whether there are plans to do that with any specific cases, but I could certainly write to Pauline McNeill with that information.


NHS Shetland (Locum Costs)

8. Tavish Scott (Shetland Islands) (LD)

To ask the Scottish Government how much of the reported £1.3 million that NHS Shetland is to pay in locum costs in 2017-18 will be used to cover general practitioner vacancies. (S5O-01322)

The Cabinet Secretary for Health and Sport (Shona Robison)

The information requested is not held centrally. However, my officials have contacted the board and I understand that more than £1 million is available to cover GP vacancies and single-handed GP leave cover in NHS Shetland.

Tavish Scott

The island of Yell used to have two GPs running an independent practice. To save money, locum cover is now to be replaced by an advanced nurse practitioner. Does the cabinet secretary accept that that will put a clinical burden on that individual, who will have to refer cases to a GP in Lerwick by phone? Is that acceptable? Would it not be better to have a GP on the island of Yell?

Shona Robison

I am aware that there have been challenges and difficulties in trying to recruit to a number of GP posts in the area. A lot of work has gone on to try to incentivise some of those posts. I am sure that Tavish Scott is aware of that work. I also understand that a successful GP training scheme is being run through the Lerwick practice, with four GP registrars currently in training and due to qualify in about 18 months’ time. Those people want to stay in Shetland, although where they will end up being located is a matter for discussion.

The role of advanced nurse practitioners is important. I know that that is being considered as a way of addressing GP recruitment issues. Of course, those people are experienced nurses in their own right. The issue of the clinical back-up that they have is important, and they should have access to that GP support.

I am happy to discuss these issues further with Tavish Scott. If we can help, through the rural medicine collaborative and other incentives, I would hope that NHS Shetland would take advantage of that.


NHS Dumfries and Galloway

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

To ask the Scottish Government what recent discussions it has had with NHS Dumfries and Galloway regarding equity and equality of service across its area. (S5O-01323)

The Cabinet Secretary for Health and Sport (Shona Robison)

The Scottish Government has regular contact and discussion with NHS Dumfries and Galloway, and it was in contact last week as part of the board’s annual review. At that meeting, a range of topics were covered, including performance, finance, the new £200 million Dumfries and Galloway royal infirmary and the positive on-going engagement with the integration joint board.

Finlay Carson

The cabinet secretary will be aware of the cross-party petition, which has received widespread support in Stranraer and Wigtownshire, that seeks a long-term commitment from the Scottish Government to the retention and improvement of services in the Galloway community hospital. I thank the cabinet secretary for accepting my invitation to come to Stranraer to collect the petition and to hear the real concerns of local people.

Given the ever-increasing pressure on hospital bed numbers, does the cabinet secretary agree that cottage hospitals play a vital role in transitioning patients from hospital to their homes? Can she confirm that there are no plans to close any cottage hospitals in Galloway and west Dumfries?

Shona Robison

I am fully aware of the strength of local feeling in support of Galloway community hospital—not only Finlay Carson but all local members have made me aware of that. The temporary changes over the summer were made in order to ensure patient safety, and services at Galloway community hospital are now running as normal, which I hope the member welcomes.

The board has worked hard to overcome some of the recruitment and retention issues at the hospital. The hospital is valued and provides high-quality services, including services well beyond those that are found in other community hospitals.

NHS Dumfries and Galloway has given assurances that it will continue to keep local communities fully informed of any changes to services at the hospital, when those are unavoidable for patient safety reasons, and it is keen to engage with local people and their representatives. In July, it held a public meeting to discuss the issues, which I understand was productive.

Emma Harper (South Scotland) (SNP)

I remind the chamber that I am a registered nurse.

Does the cabinet secretary agree that health boards have a duty to undertake any service redesign in close consultation with stakeholders including patients and parliamentarians?

Shona Robison

Yes. Emma Harper has raised the issue on a number of occasions. Boards have a duty to carry out full and meaningful engagement with all stakeholders when they consider taking forward any service change proposals, in line with well-established Scottish Government guidance.

It is also important that boards engage anyway, not just around service change proposals. One issue that emerged from the public meeting with the board about Galloway community hospital in July was the need for full information to be provided. People appreciate that, due to staff sickness or other issues, unavoidable challenges sometimes arise that require the board to ensure that services continue to be provided in a safe way. However, the board also needs to make sure that the information is provided in full and that the community is fully aware of any changes. Dumfries and Galloway NHS Board has learned a lesson from the experience at Galloway community hospital.

Colin Smyth (South Scotland) (Lab)

Does the cabinet secretary accept that the biggest challenge in delivering equity and equality of service in a rural area such as Dumfries and Galloway is the current NHS recruitment crisis? In that region, there are 150 nursing and midwifery vacancies, 28 allied health professional vacancies and 28 consultant vacancies, which is 22 per cent of all such posts. In addition, 42 per cent of GP practices in the region have an unfilled GP post. The recent Audit Scotland report on workforce planning revealed that two thirds of interviews for consultant posts in the region were cancelled because of a lack of suitable applicants. When is the Scottish Government going to take responsibility for letting down patients in Dumfries and Galloway, and will it apologise for 10 years of abject failure to ensure proper NHS workforce planning?

Shona Robison

Like other health boards, NHS Dumfries and Galloway has more staff than it has ever had. It also has more posts than it has ever had. However, there are vacancy issues within certain areas of the country, particularly in more remote and rural areas. That is why we are trying to attract staff to come to Scotland and making sure that we train enough staff. It is why, over the past five years, we have increased the number of nursing and midwifery training posts, and it is why we are expanding the number of undergraduate medical courses and adding a new graduate medical school. It is also why we published a workforce plan in the summer, through which we will work with boards to ensure that we have the staff going forward.

We are not the only part of the country to have issues with recruitment and retention. Those are issues for all health systems in the United Kingdom and beyond, as some specialties are very difficult to recruit to. NHS Dumfries and Galloway is no different in that respect. Therefore, we will continue to support the board to successfully recruit and retain staff.

As members will be aware, we are working hard on the GP issue through our work on the new GP contract, which will make a real difference by attracting GPs to come and work in Scotland and by making general practice an attractive career for young doctors.

The Presiding Officer

Question 10 has not been lodged.


Medical Professionals (Freedom of Movement)

11. Emma Harper (South Scotland) (SNP)

To ask the Scottish Government what its position is on the Law Society of Scotland’s warning that ending freedom of movement may deter medical professionals from moving here and have implications for people already living and working here. (S5O-01325)

I remind the chamber that I am a registered nurse.

The Cabinet Secretary for Health and Sport (Shona Robison)

Scotland’s health workforce benefits enormously from the contribution that is made by staff from across the European Union, and we need to retain the ability to recruit freely from that diverse and experienced talent pool. I agree with the Law Society that any restrictions on the current free movement arrangements will inevitably pose recruitment and retention challenges for health boards.

I have met a number of EU staff directly, who have told me of colleagues who have already left Scotland. Staff are understandably anxious and uncertain about the impact of Brexit on their right to live and work in Scotland. Therefore, we urgently need clarity from the UK Government on future immigration policy.

The Scottish Government has signalled its desire to retain freedom of movement and access to the single market, and we will continue to do all that we can to protect Scotland’s interests in Europe.

Emma Harper

Does the cabinet secretary agree that we need urgent clarity on what the rights of EU nationals who are working in the national health service will be after we are taken out of the EU?

Shona Robison

Yes, I do. A number of members have raised issues about recruitment and retention, and it is important that the Scottish Government does everything it can to grow the workforce in Scotland. We are doing that by expanding the number of training places in nursing, in medicine and elsewhere.

Stopping the flow to Scotland of EU nationals, who are an extremely important part of the workforce both for the here and now and for the future, is a retrograde step that will make the situation in Scotland much worse. I send out the message to EU citizens who are living here that they are very welcome and that we want them to stay. Indeed, we want future generations of EU citizens to come here and work in our health and care services.