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Chamber and committees

Meeting date: Thursday, October 10, 2019

Meeting of the Parliament 10 October 2019

Agenda: Business Motion, General Question Time, First Minister’s Question Time, Portfolio Question Time, Business Motion, Transport (Scotland) Bill: Stage 3 (Day 2), Point of Order, Transport (Scotland) Bill, Non-Domestic Rates (Scotland) Bill: Stage 1, Non-Domestic Rates (Scotland) Bill: Financial Resolution, Business Motion, Decision Time


Contents


First Minister’s Question Time


Transvaginal Mesh Implants (Removal)

1. Jackson Carlaw (Eastwood) (Con)

Does the First Minister agree that, in Scotland and beyond, mesh has become the greatest medical scandal of modern times?

The First Minister (Nicola Sturgeon)

In general terms, yes, I share the concern that Jackson Carlaw has articulated today and on previous occasions.

There have been two on-going priorities for the Scottish Government, which I hope have the support of members across the chamber. The first was to ensure that there was a halt to new mesh procedures. Earlier this week, we saw statistics that show that there have been no such procedures in Scotland since the Cabinet Secretary for Health and Sport took action to draw a halt to them.

The second priority, which is certainly on-going, is to ensure that women who have suffered complications from mesh procedures that were done in the past get the care and treatment that they need and to which they are entitled. The Scottish Government takes that extremely seriously, and will continue to take the appropriate steps.

The wider matters around mesh that we have discussed in the chamber previously—approval of the particular procedures and of what is used in those procedures—are governed by the Medicines and Healthcare products Regulatory Agency. They are not within the responsibilities of the Scottish Government. However, with the support of members from across the chamber—including, I think, Jackson Carlaw—we have urged action at United Kingdom Government level.

Jackson Carlaw

The First Minister is right. There has been an heroic and successful effort by Scottish mesh survivors to secure a moratorium on the practice. We were delighted by the action of the Cabinet Secretary for Health and Sport, and by the fact that statistics this week show that there no further procedures have been done.

We had hoped that Scotland would, for the women who are in desperate need of mesh removal surgery, welcome the pioneering American surgeon Dr Dionysios Veronikis to undertake mesh removal, which would change hundreds of lives. We now learn, however, that Dr Veronikis has called off—mostly, it seems, due to a co-ordinated attempt to block him by powerful people within the national health service and the medical hierarchy.

My constituent Lorna Farrell raised thousands of pounds to travel to the United States to be operated on privately to have her mesh successfully removed by Dr Veronikis. Surely the First Minister will agree that it is unacceptable that women who have been harmed, however inadvertently, by our Scottish NHS, should have to raise thousands of pounds to undergo a horrendous journey, while enduring severe pain and difficulty, in order to have that wrong righted privately in the United States.

The First Minister

I have enormous sympathy with the sentiments that Jackson Carlow expressed on behalf of his constituent. Of course, those sentiments could be expressed on behalf of any woman who has suffered complications, and who is suffering from a mesh procedure.

Let me address very directly the issue of the specialist from the United States, Dr Veronikis. It remains the case that the Scottish Government wants him to come here. However, if he is to be able to treat patients here, certain General Medical Council requirements must be met, which the Scottish Government has no discretion to waive.

One of those requirements is the need for a contract of employment from the national health service, which necessitates clinicians from here going to see him in the United States. Although we had hoped that that would happen in August, it had to be postponed because of the clinical commitments of clinicians here. Clinicians will visit the United States in November—next month—and remain willing to meet Dr Veronikis, if he agrees to reconsider his position. I respectfully concede that that is entirely a matter for him.

Jackson Carlaw talked about efforts by senior influential people. Let me make it very clear that I am not aware of any such efforts. It would not be acceptable for anybody in the medical community here to seek to block Dr Veronikis. My understanding is that that is not the case; indeed, the chief medical officer personally invited Dr Veronikis to come to Scotland. As I said at the outset of my answer, it remains our wish that that will happen.

Jackson Carlaw

The clear suspicion of many people is that there is a professional and institutional campaign to frustrate Dr Veronikis’s involvement. It is the view of many people that establishment figures in the NHS are trying to protect their own backs. I exclude from any blame or suggestion of it the Cabinet Secretary for Health and Sport.

Last night, I contacted Dr Wael Agur, who is the leading mesh expert in Scotland, and one of my constituents. This is what he had to say about Dr Veronikis’s visit:

“I can confirm that surgeons here felt deeply threatened by Dr Veronikis’ offer to visit Scotland. No doubt there is a professional conspiracy against his visit. The surgeons suggested another US surgeon instead: Howard Goldman—who is one of the most prominent proponent of the continuing use of mesh. In addition, he promotes partial (rather than total) mesh removal, the complete opposite of Dr Veronikis. Inviting Dr Goldman would undoubtedly support the local surgeons in their efforts to reintroduce mesh procedures in Scotland.”

If that is true, it is an outrage. Will the First Minister now personally intervene?

The First Minister

As Jackson Carlaw and others would expect, I have already looked very closely at the matter. If there is the suspicion that Jackson Carlaw described, I will not stand here and second-guess it. If that is what people feel, it is a suspicion that requires to be addressed. However, I say genuinely to Jackson Carlaw that I am not aware of evidence that backs that up. If there is evidence, I certainly want to see it, and to be in a position to take action on it.

I have set out—I have tried to do so very clearly and calmly—the requirements that need to be met before somebody from outside the UK can treat and practice in the UK. They are set not by the Scottish Government but by the General Medical Council. Those requirements require clinicians from here to go the States. It is regrettable that the visit that was planned for August had to be postponed. However, a visit will take place, and if Dr Veronikis is prepared to reconsider his position, it will be an opportunity for that requirement to be fulfilled.

I want—as everybody wants—patients to have the treatment that they need. Let me make the point very clearly that that means treatment that is considered to be clinically right for them, in which they have confidence, and of whose efficacy they can be assured. As First Minister, I am prepared to consider all options to make sure that women get that treatment. We will continue to do that, because I do not underestimate in any way, shape or form the suffering, stress, pain and anxiety that many women have suffered as a result of mesh.

Jackson Carlaw

I thank the First Minister for that. I can say that the women have complete confidence in Dr Agur, who is acting in the Scottish Government’s review group. The women also have complete confidence in Dr Veronikis—especially my constituent, who is a living example of the success of his mesh-removal procedures. Her life has been transformed, and it is hugely emotional to meet her and see that.

My principal concern remains firmly the women who have been affected. The moment for a public inquiry might, depending on events, be coming. However, during this decade-long scandal, many of the affected women feel that they have been unable to meet and discuss their experience directly with the First Minister. They feel that the urgency of their situation now needs the direct support and engagement of the head of their Government. So, will the First Minister agree today to meet, together with MSPs from across the chamber, the affected women directly in early course, to listen to them and to give them the personal commitment, leadership and attention of the First Minister to get their lives sorted?

The First Minister

Yes, I will. However, in doing that, I also want to make it very clear to the women who have been affected that the matter has my personal attention and the close personal attention of the health secretary. That has been demonstrated by the actions that have been taken; it will continue to be demonstrated by actions that will be taken.

I obviously understand the deep emotion that many people feel about the issue. Obviously, the women who have been affected do, but so do people who have been in direct contact with the women.

I also understand the scepticism and concerns about how it is perceived that elements within the medical community in Scotland are addressing the issue. We must tackle that and take action systematically to ensure that that perception is not the case.

I want any patient who considers it best—and where there is a clinical view that it is best—to be treated by somebody like Dr Veronikis to have that available. I obviously cannot stipulate that he agree to come here, but if he is willing to reconsider his position, steps are in progress to fulfil the requirements that would allow that.

Beyond that, we will openly consider any other options to ensure that women get access to the care and treatment that they need. That is a commitment that the health secretary and I have given previously, and which I have no hesitation in giving again today.


Transvaginal Mesh Implants (Removal)

2. Richard Leonard (Central Scotland) (Lab)

I remind the First Minister that the mesh-injured women have suffered years of pain and injustices, so when she meets them, will she apologise to them? One woman who contacted us spoke of having six surgeries, including a hysterectomy. She states that the surgery was necessary to

“rid me of the daily pain. I now live with a prolapsed bladder, bowel and vaginal vault. I need to take a cocktail of medication daily—18 tablets.”

She contacted us this week because she was so deeply upset to learn that Dr Veronikis is not coming to Scotland. She is concerned that without his treatment she may lose her job. What does the First Minister have to say to her?

The First Minister (Nicola Sturgeon)

As I have said in the chamber previously, I, as First Minister, apologise to any patient who suffers in the national health service—people have a right to expect such an apology. There is a long history in terms of mesh procedure, some of which we have often rehearsed in the chamber. The approvals for the procedure and the equipment used are matters that are outwith the Scottish Government’s responsibility, but we have come together as a Parliament to demand action where it can be taken.

However, on the treatment that is provided in the health service and the actions that we have taken, first, the moratorium to halt mesh procedure is, in itself, an indication of how seriously we treat the issue. Secondly, on the issue of women who are suffering from complications, in the interests of time I will not run through again all the requirements around the doctor from the United States coming here, but I stress again that it is my desire to enable him to come here to allow patients to have access to his specialism without having to travel. Beyond that, we remain open to any options that are right for women both clinically and in order to give women the peace of mind that they want.

One of the things that distresses me when I read the material and the personal testimonies is that, as First Minister, I have been advised that full mesh removal has been carried out on many patients in Scotland.

Neil Findlay (Lothian) (Lab)

It has not.

The First Minister

I am about to address the very point that Neil Findlay seems to be making.

I also understand that many women believe that, although they were told that they were to have full mesh removal, that was not undertaken. There are real issues that we need to get to the heart of; I am determined to do that and so is the health secretary. Many members of the Parliament have been incredibly constructive in their approach to this issue. I hope that, together—taking the full responsibility of Government, as it is incumbent on me to do—we can ensure that some of the historic issues are fully looked into and that, in the here and now, women who are suffering get access to the treatment that they need.

Richard Leonard

There was indeed cross-party support for the moratorium and this week’s figures are welcome.

Earlier, the First Minister spoke of looking for evidence of obstruction. In a letter to Labour’s Neil Findlay, Dr Veronikis explained why he has rescinded his offer. He cited “delays and disrespectful behaviours”. However, he also raised a matter of serious concern that reflects the point that the First Minister has just mentioned. He said:

“The Scottish mesh injured women are vindicated in what they presented to Minister Freeman in March 2019. What has been recorded in their medical records as a ‘full removal’ was not. It was a partial removal.”

Why have those women been misled and what will the First Minister do about it?

The First Minister

I alluded to that point very openly—it causes me deep concern and we are determined to help women get to the bottom of that. I stand to be corrected if I am wrong, but I understand that last night, at the cross-party group on chronic pain, an issue was raised about access to scans for women who feel that they have not had the full mesh removal that they were told that they had had. That is one of the things that we want to consider fully. We are determined to ensure that, as far as we can, we get to the bottom of where women have been given treatment that has damaged them, or where treatment that was meant to rectify that damage was not what they were told it was and to explore where they can get access to the treatment that they need now.

I have set out clearly and openly some of those issues. I regret the delays around trying to meet the requirements to have Dr Veronikis come here, but the Scottish Government was not able simply to waive those requirements—they are the requirements of the General Medical Council. However, clinicians from Scotland will be visiting the United States next month. If Dr Veronikis is willing to reconsider his position—that is entirely a matter for him, although I would very much welcome it if he were to do so—those requirements can be met and I still hope that he will come to Scotland.

Dr Veronikis has also written to the health secretary. If there is information in the letter that Richard Leonard has referred to that we do not have, I would be very happy to look at that—Richard Leonard could pass that letter on to us, if he has not already done so.

I cannot stress enough the determination on my part, and on the part of Jeane Freeman and the entire Scottish Government, not just to get to the bottom of why women are in this position, but to ensure that we are giving women access to the treatment that will bring an end to the pain and suffering that they are so unjustly experiencing.

Richard Leonard

It is such an important issue. Dr Veronikis offered those women the first glimpse of hope that they might get their lives back. The fact is that the Cabinet Secretary for Health and Sport looked Scotland’s mesh-injured women in the eye and gave them a commitment to a course of action that could give some of these women their lives back. The world-leading, pioneering surgeon, whom the health secretary invited to come here, now feels that officials and senior surgeons in Scotland—working for our NHS and accountable to the Scottish Government—obstructed that course of action. At the centre of all that are women who have been left languishing in pain.

The Government has lost the confidence of the mesh-injured women and the health secretary appears to have lost control of the situation. Will the First Minister now step in and take the decisive action that is needed?

The First Minister

I am closely involved in ensuring that we take the action that we are required to take, as is the health secretary. It is because of Jeane Freeman’s action that the moratorium or halt was put in place and that no more of the procedures are taking place. It is not because of Jeane Freeman that Dr Veronikis is not coming to Scotland. I have set out the requirements that have to be met, which are not Scottish Government requirements, and how we are trying to meet them. I am more than happy to speak to the doctor personally. I say openly that, if anybody has evidence of the kind of obstruction that is being talked about, I want to know about that. However, based on the information that I have, attempts to get the doctor here have been and will continue to be made, if he remains willing.

I cannot be any clearer. There is an absolute determination to ensure that we take the necessary action. I hope that we continue to have the constructive support that we have had in the past from members from across the chamber, including Jackson Carlaw and Richard Leonard, because this is not a matter of party politics; it is a matter of doing the right thing, and we are all determined to do that.


Her Majesty’s Prison Inverness (Staff Safety)

Edward Mountain (Highlands and Islands) (Con)

The new Highland prison has been delayed for years and the current prison is no longer fit for purpose. It is overcrowded, and 200 prisoners from the Highlands and Islands have been dispersed elsewhere. Seizures of drugs, weapons and mobile phones have increased. Today, thanks to the work of The Press and Journal, we learned that key areas of the prison are without closed-circuit television, which endangers prison staff. Is it not time that the safety and welfare of our Highland prison staff was made a top priority? Will the First Minister or her Cabinet Secretary for Justice meet me and prison staff to try to resolve the safety issues at HMP Inverness?

The First Minister (Nicola Sturgeon)

The Cabinet Secretary for Justice would of course be happy to meet members to discuss issues in our prisons. We are committed to on-going investment in our prison estate and to modernising and improving it. Security, not just in terms of prisoners but for the staff who work in our prisons, is extremely important. CCTV is important, but the Scottish Prison Service has measures beyond that for the staff and people in the service’s care in HMP Inverness in particular. We will continue that work, and we are happy to discuss the plans in more detail.

We will also continue to take action to reform our justice system to tackle the fact that, although crime levels are among the lowest for 40 years or more, we have proportionately the highest prison population in the western world. That is why we are taking action to introduce a presumption against short sentences and more alternatives to custody, which are better for rehabilitation and reducing reoffending. To the best of my memory, the Conservatives have opposed every single one of those reform proposals. The issue is serious and, if the Conservatives were to engage with it a bit more seriously and constructively in the round, we might make more progress than we have to date.


Gambling Advertisements (Glasgow)

John Mason (Glasgow Shettleston) (SNP)

The First Minister will be aware that Glasgow City Council has expressed concern about the level of gambling adverts that young people in particular are exposed to. Has she had discussions with the council about that, or will she do so?

The First Minister (Nicola Sturgeon)

That is an important issue. I am aware of recent discussions in Glasgow City Council about problem gambling in the city and the impact that advertising is having on it. I understand that the council plans to hold a summit to develop plans to ensure that people are aware of the risks and harms that are associated with gambling. Although advertising is the responsibility of the United Kingdom-wide Advertising Standards Authority, we are committed to exploring what more we can do to help deal with the problem of gambling. Of course, it would be more effective if all powers associated with gambling were devolved to the Parliament so that Scottish solutions could be taken forward more quickly.


Her Majesty’s Prison Barlinnie (Overcrowding)

James Kelly (Glasgow) (Lab)

This week, the chief executive of the Scottish Prison Service, Colin McConnell, told the Justice Committee that a replacement for Barlinnie prison in Glasgow will not be operational until 2025, which is six years later than planned. Audit Scotland deems the building “high risk”. Barlinnie is 50 per cent over capacity, with many prisoners having to share cells. Of the cells that are shared, 92 per cent were designed for single occupancy. The chief executive also stated that current contingency plans in the case of an emergency involve simply moving prisoners to another location, with mattresses on the floor, which is unacceptable and unsustainable.

What steps will the Scottish Government take to address the chronic position of Barlinnie prison? What plans will the Scottish Government put in place to address the overcrowding, underfinancing and staffing crises of the Scottish Prison Service?

The First Minister (Nicola Sturgeon)

Those are serious issues to which the Government pays close and regular attention at Cabinet level. A replacement for Barlinnie prison is one of our key infrastructure priorities. The SPS is progressing with plans for the development of the new prison in Glasgow, and negotiations for the purchase of an identified site are under way.

However, we acknowledge that, as a result of the recent rise in the prison population, interim measures are needed to improve current conditions at Barlinnie. Action will be taken in that regard. We are working closely with the Scottish Prison Service to ensure that robust measures are in place to ensure the safety of staff and the prisoners who are in the care of Barlinnie.

In addition to my point about investment in our prisons being important in response to an earlier question, it is worth pointing out that we have a challenge as a country to rebalance our justice policy, so that we do not have as many people going into our prisons when more effective sentences are available that could be served elsewhere.

It is also worth pointing out that, since 2007, the Scottish Government has invested almost £600 million in the prison estate for three new prisons—Low Moss, Addiewell and Grampian—and the refurbishment of the existing prisons at Polmont, Edinburgh, Glenochil, Shotts and Perth. We will continue to ensure that such investment is made, so that we ease the pressure on the prison estate overall and, in particular, on Barlinnie.


Lord Provost of Glasgow (Expense Claims)

Adam Tomkins (Glasgow) (Con)

The Scottish National Party’s Lord Provost has ripped off the people of Glasgow. Is it not time that she went?

The First Minister (Nicola Sturgeon)

Eva Bolander, who is an excellent Lord Provost for the city of Glasgow, has rightly and frankly reflected on some of the expense claims that she made. All the claims were within the rules; nevertheless, she has reflected on them and decided that she should not have made certain claims. I think that that was the right decision.

As elected politicians, we all have to be careful and considered about our expense claims, but none of us wants a situation in which the only people who can take on roles—in particular, roles such as Lord Provost, which require attendance at a lot of formal functions—are those who can afford to equip themselves.

The Lord Provost has herself reflected, and I think that she was right to do so.


Prestwick Airport Service Fees

3. Patrick Harvie (Glasgow) (Green)

I hope that the whole chamber will join me in expressing solidarity with the Kurdish people, who have been betrayed and abandoned by the US, and are now enduring an assault by Turkey, which is a NATO member. I hope that the First Minister will join me in condemning those actions.

Ministers have been aware for more than a year that the US military is getting a seven-figure discount to refuel at Prestwick airport, which is owned by the Scottish Government on behalf of the public. It is a growing scandal, and there is already a US Congress inquiry into the relationship. If the First Minister is against Scotland being used as a nuclear submarine base for the United Kingdom, why should we be any happier about being used as a cut-price petrol station for the US Air Force?

The First Minister (Nicola Sturgeon)

Earlier this week in the chamber, in response to a topical question, the Cabinet Secretary for Transport, Infrastructure and Connectivity outlined the position with regard to Prestwick airport.

Prestwick airport is state owned, but it runs commercially completely independently of the Scottish Government. That is the case not just for convenience; it is essential that there is an arm’s-length relationship for us to be compliant with state aid rules. If we were to interfere in the running of Prestwick airport, we would put in jeopardy the future operation of the airport. For those who want to see the airport continue and have a future, and for those who want to see the jobs that are dependent on the airport continue, I think that that is the right and responsible thing to do.

In terms of Patrick Harvie’s question about Syria, I say very clearly and strongly that I and the Scottish Government are deeply concerned about and are strongly opposed to Turkey’s unilateral military action in northern Syria. We are also extremely concerned by Donald Trump’s decision to withdraw support and leave Kurdish allies to the mercy of whatever Turkey chooses to do. That is particularly reprehensible, given the sacrifices that Kurds have made in helping to defeat Isis.

I hope that there is a very strong response from the international community to the action that Turkey has taken—we have seen on previous occasions the consequences and implications for Kurds of Turkish action of this nature. I therefore hope that there is strong opposition to Turkey’s action, and that there is strong international support for Kurds as well.

Patrick Harvie

The First Minister is keen to tell us about the arm’s-length relationship with Prestwick airport, but the Prestwick governance structure clearly shows that two of the First Minister’s officials sit on the board of the holding company. That is supposed to provide a line of democratic accountability, so that we are not reliant on investigative journalists to uncover the facts of what is going on. The Scottish Government should be giving us updates.

Will the First Minister update us now? Is there any business plan for Prestwick, other than to provide a bargain service for Trump’s military and book its taxis to Turnberry? Will the Scottish Government and the First Minister stop ignoring the nature of the scandal, accept responsibility for ensuring that our public assets are not used to support the military operations of a dangerous, far-right regime, and end the relationship between Prestwick and the US military?

The First Minister

I have set out the situation in terms of state aid requirements. If we want to ensure that Prestwick airport has a future, we have to comply with those requirements.

The sources of revenue for Prestwick airport are laid out in the accounts that Prestwick airport publishes. The last set of accounts cover the period to the end of March 2018, and the accounts are published annually. Beyond that, with regard to the future for Prestwick airport, as we have always said, we want to return it to the private sector as soon as we are able to do so.

The senior management team at the airport has continued to engage with potential buyers and investors, and we will continue to take the action that we require to take to ensure that the airport has a future. That is what is important for the economy in that part of Ayrshire and for the many jobs that depend on Prestwick airport having a future.


National Health Service (Waiting Times)

4. Alex Cole-Hamilton (Edinburgh Western) (LD)

A year ago, the Scottish Government published its waiting times plan. It said that nothing that had happened before should count against its record now, and the Parliament swallowed that. Since then, accident and emergency targets have been missed every week—all summer, performance was worse than last year. There are more young people waiting more than a year for mental health treatment. We have seen the worst ever performance against the treatment time guarantee and, this week, we learned of a patient who waited four years for dental surgery.

The situation is causing people pain, anxiety and suffering. Will the First Minister take the opportunity to apologise to them?

The First Minister (Nicola Sturgeon)

Our national health service is seeing and treating more patients than ever before. If we take accident and emergency, for example, this year, more than 1.5 million patients have been treated within the four-hour target, which is the highest number in any year since 2012. We are seeing more cancer patients treated within the target times, and our investment in the waiting times improvement plan is helping to ensure that the investments are in the right places in order to see waiting times continue to come down.

Demand in our NHS is rising, which is why we are building the capacity to meet that additional demand.

Although there remain big challenges for our national health service, not least at the front line in our accident and emergency units, Scotland’s core A and E service performance was 10.5 percentage points higher than that of A and E units in England and 17.6 percentage points higher than in Wales. There are big challenges for everybody’s NHS, but the evidence suggests that this Government is making the investments and taking the actions that are right for patients across the country.

Alex Cole-Hamilton

I am sure that the comparison with other nations is cold comfort to people who are waiting, and those people are still waiting. In fact, the Government is not even meeting the one cancer target that it was meeting before the recovery plan any more. The reason why those people are not being seen is that there is nobody there to see them. In mental health, psychiatry vacancies hit crisis levels this week and the workforce plan has been delayed yet again by the Government; it is nearly a year late. When will we see it? When will A and E targets and mental health targets start to be met? On world mental health day, is the First Minister really going to tell those patients to sit back, shut up and wait for another year?

The First Minister

No; I would never tell anybody to do that. I should, of course, have welcomed Alex Cole-Hamilton to his place for First Minister’s questions. He is covering for Willie Rennie, who is on holiday.

Alex Cole-Hamilton mentioned a number of areas in the health service, including psychiatrist vacancies. I point out to him that, since we put additional funding in place, the number of child and adolescent mental health service psychiatrists has increased by 15 per cent, our accident and emergency departments are performing better than any others in the United Kingdom and we are investing to make sure that across our national health service we are building the capacity to meet the increased demand. Cancer has been mentioned, too, and we are seeing more cancer patients within the target times than previously. We will continue to make those investments so that we have a health service that is delivering the excellent treatment for patients that the vast majority of patients across the country already consider that our national health service is delivering.

The Presiding Officer

There is not much time today, but I will squeeze in a couple of constituency questions.


No-deal Brexit (Medicine Supplies)

Clare Adamson (Motherwell and Wishaw) (SNP)

This weekend, I received at my home a handwritten note from an elderly constituent who is deeply worried about the impact of Brexit on her health. I kept her informed of the ministerial statement on Tuesday and hope that she takes some comfort from the work that the Scottish Government is doing to mitigate any circumstances. However, is the First Minister aware of the comments of Dame Sally Davies, the outgoing chief medical officer of England, who this morning said of medicine supply in the event of a no-deal Brexit that

“there may be deaths, we can’t guarantee there won’t”?

The First Minister (Nicola Sturgeon)

I have seen the comments that Dame Sally Davies made this morning. They are absolutely horrifying. She said that lives are at risk and it cannot be guaranteed that people will not die because of potential medicine shortages and the impact of a no-deal Brexit. If nothing else that has been said over recent weeks and months about the consequences of a no-deal Brexit has made any difference to the United Kingdom Government, I really hope that those comments today will make that difference.

I know that Michael Gove is in Scotland for meetings later today and the question for him has to be: do people have to die before this UK Government comes to its senses and rules out a no-deal Brexit completely? It is absolutely unconscionable that it is still being contemplated and that at times it appears to be the desired policy of the Prime Minister and others. It is beyond belief, particularly in light of the comments from Dame Sally Davies, that Jackson Carlaw and the Scottish Conservatives seem happy to back Boris Johnson in taking the UK out of the European Union with no deal. I do not think that people in Scotland will readily forgive them for that.


Alesha MacPhail

Liam Kerr (North East Scotland) (Con)

On 11 September, the Cabinet Secretary for Justice tweeted that he would meet Alesha MacPhail’s family to discuss their concerns with the justice system. As of yesterday, the family was very upset that they have had no contact, not even a phone call. Will the First Minister tell her justice secretary to get in touch with the family without further delay?

The First Minister (Nicola Sturgeon)

I will continue to support my justice secretary in taking the appropriate, sensitive and right action that he is taking. I make it clear that the justice secretary made a commitment to meet Alesha MacPhail’s mum before meeting any other members of the family. Unfortunately, for entirely understandable reasons, that meeting had to be postponed by Alesha’s mum.

The justice secretary will honour that commitment to meet the little girl’s mum and, when he has done so, he will—as he said he would—meet other members of the family. I honestly do not think that we should be trying to make party-political points on such a tragic case.


Challenge Poverty Week

5. Tom Arthur (Renfrewshire South) (SNP)

To ask the First Minister how the Scottish Government is marking challenge poverty week. (S5F-03635)

The First Minister (Nicola Sturgeon)

Challenge poverty week is very important. It is a reminder that we must continue with the actions that we are taking to tackle poverty. Our current actions are supporting low-income households. Last year, we provided targeted support of £1.4 billion. In addition, we have delivered more than 87,000 affordable homes since 2007. Our increase in early learning and childcare will be transformational in supporting parents, and we are investing in new parental employment support. Through our new Scottish child payment, we will lift 30,000 children out of poverty.

Of course, it is clear that the biggest danger as regards increasing poverty is presented by the UK Government’s continued welfare cuts and the risk of a no-deal Brexit, which could push 130,000 people in Scotland into poverty.

Tom Arthur

Parliament will be aware that, last week, the United Nations special rapporteur said that Scotland is on “a very different trajectory” from the rest of the United Kingdom. He also said that the spirit of the welfare state is “alive and humming” in Scotland but is “waning” elsewhere. The introduction of the new Scottish child payment shows that this Scottish National Party Scottish Government is determined to do things differently in Scotland. The policy will be transformative.

What impact could the Scottish Government make if it did not have to spend millions mitigating the most harmful UK Government policies, such as welfare cuts and a no-deal Brexit?

The First Minister

Right now, even before we contemplate a no-deal Brexit, we are spending £100 million every year to protect people from the UK Government’s welfare cuts. The UN special rapporteur described that as an outrageous situation, and I thoroughly agree with that. I think that all of us would rather be investing those funds in our own policies to tackle poverty.

We are taking bold and radical action. The new Scottish child payment was described by poverty campaigners as “a game changer”. We will continue to take such action to make sure that we are doing everything that we can to tackle poverty.

The continuation of the seemingly rapid acceleration towards a no-deal Brexit makes it all the more obvious that we need to get powers out of the hands of Boris Johnson and his ilk and into the hands of this Parliament so that we do not have to put up with Tory welfare cuts any more, because we can take the right decisions here in the first place to help to lift people out of poverty and to create a better, fairer country for everybody.


Psychiatric Services (Staffing)

6. Brian Whittle (South Scotland) (Con)

To ask the First Minister what action the Scottish Government is taking to address the reported staffing shortfalls in psychiatric services, particularly those for children. (S5F-03631)

The First Minister (Nicola Sturgeon)

We are investing £54 million in a package of support to improve access to mental health services for adults and children, providing funding for additional staff and workforce development. In 2018, there was an improvement in recruitment to psychiatric specialities. There has also been an increase of 15 per cent in the number of child and adolescent mental health services psychiatrists since additional funding was put in place in March 2016. In addition, we have provided funding of more than £12,000 to the Royal College of Psychiatrists for its choose psychiatry campaign to promote psychiatry as a career in Scotland.

Brian Whittle

I was interested to listen to the First Minister’s answers to Alex Cole-Hamilton’s questions, because I received correspondence from the Royal College of Psychiatrists that stated that more than one in six consultant child and adolescent psychiatrist posts are vacant. To compound that pressure on services, according to the report on CAMHS, it is anticipated that 40 per cent of child and adolescent psychiatrists will retire within five years. It takes six years’ training for a junior doctor to gain consultant status, and a decrease has been reported in the number of people who are choosing to progress from core to higher psychiatric training.

We have a growing demand and an already high vacancy rate compounded by a large number of psychiatrists approaching retirement age. When will the Government produce a realistic workforce plan that can meet those escalating challenges and ensure that our children receive the mental health care that they deserve?

The First Minister

We are already taking action and, as I am about to set out, that action—although there is still work to do—is already having an effect. There are challenges in recruiting to a number of medical specialties, which are not unique to Scotland—they are experienced in other parts of the United Kingdom and, indeed, other parts of Europe and the world—and those challenges are not made easier if we make it harder for people to come here as a result of Brexit or Tory crackdowns on immigration. Those are points that we should not stop making.

On psychiatry, as I said in my original answer, we have seen an increase in the number of CAMHS psychiatrists since we made additional funding available in 2016. Consultant psychiatrist vacancies remain unfilled in a number of health boards, but over the past five years, we have increased the number of psychiatric posts by 8.5 per cent. In 2018—this is important—we saw a significant improvement in recruitment to psychiatric specialties, with a fill rate of 72 per cent compared with 55 per cent in the year before that.

Those are important steps, but there is still work to be done and we remain focused on ensuring that the investment and plans are in place to do that work and to make sure that we have the right medical specialists in place where they are needed.

The Presiding Officer

That concludes First Minister’s questions. There is no members’ business today, so I suspend the meeting. We resume at 1.30.

12:46 Meeting suspended.  13:30 On resuming—