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Chamber and committees

Meeting date: Wednesday, January 24, 2018

Meeting of the Parliament 24 January 2018

Agenda: Portfolio Question Time, Justice, Railway Policing, Business Motions, Decision Time, Adverse Childhood Experiences


Contents


Portfolio Question Time


Health and Sport


Football (Coaching Appointments)

1. Ross Greer (West Scotland) (Green)

To ask the Scottish Government what steps it is taking to encourage the Scottish Football Association and football clubs to follow the lead of the English FA in adopting the principles of the Rooney rule for future coaching appointments. (S5O-01704)

The Minister for Public Health and Sport (Aileen Campbell)

We are absolutely determined that people from all backgrounds should be involved in football—and sport generally—at all levels, reflecting the diversity of modern Scotland. We want our national game to be more diverse, and there is no doubt that more can be done, particularly to improve representation in key roles. I want to see more black, Asian and minority ethnic players and coaches in the game, and I want to see other groups represented, too. I have discussed with the SFA how more progress can be made so that Scottish football can be held up worldwide as a game where all are welcome.

I welcome and support the good work undertaken by Hala Ousta, diversity and inclusion manager at the SFA. Hala is an established and well-respected campaigner for equality, diversity and sports in a number of areas, and I will continue to work closely with her at the SFA, as well as with the Scottish Professional Football League, clubs and all other partners to promote equality and diversity in football and all other sports.

Ross Greer

The first black international player played for Scotland in 1881. Since then, we have come a long way in the diversity of our football teams, but not particularly far in the diversity of our football management. The Rooney rule has been very successful where it has been implemented. In the American National Football League, it has increased the proportion of black and Hispanic management from 6 per cent to 20 per cent.

The Rooney rule does not require a quota; it simply requires that an opportunity for interview is given to at least one black or minority ethnic candidate. I ask the minister again: does the Scottish Government support the principle of the Rooney rule?

Aileen Campbell

I am aware that the English FA has recently announced that it will introduce the Rooney rule across its national set-up later this year. I am extremely interested in the outcome of that, and I know that the Scottish FA will consider whether lessons can be learned.

Nothing will be ruled out, but we need to ensure that any measures that we introduce in Scotland are based on Scottish circumstances and what would be most effective here. Again, I highlight the role and the work of Hala Ousta, who has done a lot of work in the SFA to promote diversity and equality. It is the SFA’s intention to implement positive action measures that will build up the capacity of coaches from underrepresented groups, through relevant training and qualifications, to allow them an equal opportunity to apply for roles.

I am happy to continue to engage with the member and to keep him updated on the progress of our work with the SFA and more generally.

David Stewart (Highlands and Islands) (Lab)

I refer members to my entry in the register of members’ interests as the unpaid chair of Inverness Caledonian Thistle Trust.

As Ross Greer has made clear, the Rooney rule originates from the American NFL, which requires teams to interview at least one ethnic minority candidate for every head coach vacancy. As we have heard, the English FA has adopted that principle.

The Rooney rule is an idea whose time has come. Will the minister write to the SFA to encourage it to adopt the principle in Scotland, not least for the international manager vacancy?

Aileen Campbell

I am sure that the issue is vexing the people at the SFA as they seek to find a new manager.

Dave Stewart mentioned his role in a community trust. That area of football is not well reflected in the wider press. The work that our clubs and trusts do to promote many of the issues that have been described today should get much more coverage and publicity, because of the key role that they play in our communities.

I say again that I am interested to see the outcomes of the research on the Rooney rule. As I said to Ross Greer, nothing will be ruled out, but we must make sure that any measures that we introduce in Scotland are based on Scottish circumstances and what will be most effective here, are impactful and achieve the desired outcome that we all want to see, which is far more diversity in our game at all rungs of the ladder.

We continue to work closely with the SFA, the SPFL, the clubs and other partners to promote equality and diversity. That is Hala Ousta’s specific role, and she has achieved an awful lot.

Again, I cite the fact that it is the SFA’s intention to implement positive action measures to build up the capacity of coaches from underrepresented groups through the provision of relevant training and qualifications. Work is being done in a host of areas by the SFA and others to promote the diversity that we need to see, and I will continue to engage with the member on the issue and to keep him updated as that work progresses.


Children (Ill Health)

2. Neil Findlay (Lothian) (Lab)

To ask the Scottish Government what action it is taking to provide care for children who experience ill health. (S5O-01705)

The Cabinet Secretary for Health and Sport (Shona Robison)

The Scottish Government funds NHS Scotland to provide a range of services to promote and protect the health of children. Hospital, general practice and nursing services provide on-going healthcare to children with illnesses ranging from minor ones to more serious long-term medical problems.

Neil Findlay

Since July, 414 sick and seriously ill children have been transferred from St John’s hospital to the Royal hospital for sick children, with 341 being admitted because their local hospital ward was closed to admissions.

On a weekly basis, I hear from parents harrowing stories of desperately ill children. They have had enough of getting excuse after excuse. On their behalf, I ask the cabinet secretary to provide us with the timescale that she and NHS Lothian are working to to get the ward at St John’s fully operational as a 24/7 service.

Shona Robison

In the interests of the children that Neil Findlay mentioned, the timescale is as soon as possible.

I want to take the opportunity to give an update. As Neil Findlay and other members know, NHS Lothian took the step in question because of safety concerns, but it has been working extremely hard to address recruitment in that area. A 24/7 paediatric service at St John’s hospital is, of course, the preferred option for NHS Lothian. As Neil Findlay also knows, the Royal College of Paediatrics and Child Health’s report in the autumn of 2017 endorsed NHS Lothian’s aim of maintaining that service, but it recognised that the recruitment issues were significant.

NHS Lothian has been doing extensive work as part of its recruitment campaign, and it has confirmed that the medical team in paediatric in-patient services at St John’s is increasing. A consultant who was recruited at the end of last year has now joined the team. The sixth and most recent recruitment campaign, which ended last week, was successful and an offer has been made to another candidate. When that has been finalised, it will take the total to seven. I am sure that Neil Findlay is aware that NHS Lothian is working to recruit eight additional consultants, as well as to strengthen the number of advanced nurse practitioners, in order to support children’s services at St John’s and the Royal hospital for sick children in Edinburgh.

Good progress is being made on recruitment, which I hope Neil Findlay would welcome.

Fulton MacGregor (Coatbridge and Chryston) (SNP)

I remind the chamber that I am the parliamentary liaison officer to the Cabinet Secretary for Health and Sport.

A recent report by the Royal College of Paediatrics and Child Health has shown that Scotland is ahead of the rest of the United Kingdom on the progress that is being made on children’s health. What political commitments has the Government made to build on the improvements that have already been made?

Shona Robison

I was very pleased that the report cited a number of policies that have been adopted in Scotland to ensure that children’s health is at the core of the Government’s policies not just on health but across other areas. Our investment in expanding the health visitor workforce will ensure that, in their early years, children make the best start in life. We are on track to increase the number of health visitors in Scotland by 500 by the end of 2018. That represents an unprecedented 50 per cent increase in the number of health visitors.

The Royal College of Paediatrics and Child Health’s report was extremely positive as far as Scotland is concerned, and we should be proud of that.

Peter Chapman (North East Scotland) (Con)

Around 450 infants, children and young people die in Scotland every year, and many of those deaths are entirely preventable. In the light of that, does the Scottish Government intend to take the advice of the Royal College of Paediatrics and Child Health and create a system to ensure that child deaths are properly reviewed?

Shona Robison

Obviously, systems are already in place to review any death through the significant adverse event review process, but work is being done specifically on child deaths. That work, which is being taken forward by Aileen Campbell, is extremely important.

The work covers many issues including accidents and whether more can be done through the preventative agenda. If there are any preventable deaths and if there is anything more that this Government can do around those approaches, those steps will, of course, be taken. I will be happy for Aileen Campbell to write to Peter Chapman with an update on the progress that is being made.

Neil Bibby (West Scotland) (Lab)

Yesterday, I asked the cabinet secretary whether she would come to Paisley to explain her decision to close the children’s ward at the Royal Alexandra hospital directly to the parents who are affected. She failed to accept that invitation. People cannot have confidence in the health secretary’s decision if she does not have the confidence to defend it to local parents. I ask her again: will she come to Paisley to explain her decision directly to the parents who are affected, or will she snub them again?

Shona Robison

The most important thing about the decision is to get on with its implementation. It is important that families are given reassurance by the clinicians who provide care and treatment to their children that the new arrangements are safer and are well supported by those clinicians. It is important that they help to address and overcome any concerns that have been expressed by families and ensure that the individual care plans that need to be in place before the change happens address concerns and give reassurances. That should be the priority, and I hope that Neil Bibby and other members will encourage families to engage with their health professionals to make that happen. That is the most responsible thing that Neil Bibby could do in this situation, and I hope that that is what he will do.


Sporting Facilities

3. Claudia Beamish (South Scotland) (Lab)

To ask the Scottish Government what steps it is taking to ensure that the sporting facilities at Ravenscraig in Motherwell, and others that are used by people in the South Scotland region, will be maintained in their present form. (S5O-01706)

The Minister for Public Health and Sport (Aileen Campbell)

I was extremely concerned to hear about the potential reduction in facilities for sporting communities and residents in North Lanarkshire and beyond, particularly as North Lanarkshire Leisure will continue to benefit from charity relief from non-domestic rates, following our recent rejection of the external Barclay review’s recommendation to end that relief. I asked the chief executive of sportscotland to engage directly with North Lanarkshire Leisure on the matter, and I can confirm that the chief executive of sportscotland has now spoken to North Lanarkshire council’s chief executive, who has agreed to pause any decision making on Ravenscraig until all relevant parties are round the table.

As the MSP for Clydesdale, I also maintain a constituency interest in the issue, given the number of my constituents who use the regional sporting facility, and I have made representations on that basis.

Claudia Beamish

I welcome the minister’s comments. However, the concern of Law and District Amateur Athletic Club is that a significant part of the indoor facilities at Ravenscraig centre is likely to be cut, impacting on our communities’ fitness, happiness, welfare and opportunities for developing elite athletes. The importance of the indoor training facilities, weather-wise, will not be lost on anyone in the chamber. If the proposed cuts in the Scottish Government’s draft budget are implemented and funding cancelled, those facilities will be jeopardised. The legacy of the Glasgow Commonwealth games in promoting athletics will be lost if the facilities are not available. What is the strategy to ensure that local sporting facilities are at the centre of Scotland’s health and wellbeing?

Aileen Campbell

I remind Claudia Beamish that sportscotland invested more than £7 million in the North Lanarkshire Council area in 2008 to provide a regional sporting facility, as part of the strategy for Scotland, with the aim of developing a network of multisport facilities across Scotland through a partnership approach.

I reiterate that I sought the direct engagement of sportscotland’s chief executive with North Lanarkshire Leisure and, through that action, North Lanarkshire Council has now agreed to pause decision making on Ravenscraig until all relevant parties are round the table. I am well aware of the importance that Law and District Amateur Athletic Club attaches to the facility at Ravenscraig from representations that it has made to me. I have received many other representations from athletics bodies across Lanarkshire and beyond because of the regional role that the particular facility fulfils in Scotland. That is the basis on which sportscotland will engage with all the relevant partners around the table to ensure that we can get a successful way forward.

I was extremely concerned to hear about the reduction of facilities for those sporting communities, particularly because of the good and significant progress that we have made on the 2014 Commonwealth games legacy. I will continue to keep members who have an interest updated, but I am pleased that the chief executive of sportscotland has sought and managed to get a pause on the decision until further work has been carried out.

Clare Adamson (Motherwell and Wishaw) (SNP)

While this is primarily a decision for the Labour-controlled council’s arm’s-length external organisation, North Lanarkshire Leisure, does the minister agree that it is vital that future decisions take into account the inclusivity of activities and the impact that such decisions have on the desired effect of maximising sport uptake for all?

Aileen Campbell

Absolutely, which is why it is positive that, given the significant investment that had gone into North Lanarkshire Council back in 2008, sportscotland has managed to facilitate a meeting of everyone who has an interest in the issue to work out a way forward. I understand that there are financial issues around the element of athletics participation at Ravenscraig, but that should not be the only driver for such a regional facility. All sports should have the opportunity to access the good sporting facilities that we have in Scotland due to the significant public investment that has gone in. Given the constituency interest that the member has, I will continue to keep her updated on how the discussions progress.

Brian Whittle (South Scotland) (Con)

The Ravenscraig facility received significant public funds, so what protocols are in place to ensure that usage of the facility matches that in the investment application? At the time of the application, a plan was in place to maximise usage of the facility for the purpose for which it was designed.

Aileen Campbell

Sportscotland continues to take a real interest in the operation of the regional facilities that are around the country. The reason for its engaging so thoroughly on the issue is to ensure that we can secure access for all sports to the regional facility, and because of the significant interest and investment that it put in nearly 10 years ago.

Given that we took the decision that we did—to reject the recommendation from the Barclay review—it is very disappointing and concerning to hear of North Lanarkshire Leisure’s proposals and also the feeling of many local athletics clubs that they have not been properly engaged in the process. That is why it is important that we await the progress from the meeting that sportscotland will convene to engage all the relevant partners.


Safe Injection Room (Glasgow)

4. Rona Mackay (Strathkelvin and Bearsden) (SNP)

To ask the Scottish Government what discussions it has had with the United Kingdom Government regarding introducing a safe injection room for drug users in Glasgow. (S5O-01707)

The Minister for Public Health and Sport (Aileen Campbell)

Following advice from the Lord Advocate on Glasgow’s proposals, I wrote to the UK Government’s Parliamentary Under-Secretary of State for Crime, Safeguarding and Vulnerability on 9 November 2017, requesting a meeting to discuss devolving to the Scottish Parliament powers that would allow Glasgow to progress its proposals for a safer injecting facility. I await a response to that request. However, at the end of a Westminster debate last week, the UK Government said that it had no intention of supporting the proposal or of devolving the necessary powers. I urge it to reconsider, particularly in light of the specific public health needs in Glasgow.

Rona Mackay

I thank the minister for that answer. Given that such projects elsewhere have proved to be successful in reducing harm, for example by preventing increases in HIV infection rates, does she agree that if and when such powers come to Scotland, we should introduce safe rooms for addicts as quickly as is practicable?

Aileen Campbell

I agree that there is evidence that safer injecting facilities are successful in reducing harm for people who inject drugs. Importantly, they also offer a real opportunity to engage with a specific population who may not ordinarily use existing treatment and support services. If we were to have the relevant powers, we could consider, on its merits, any business case to introduce such a facility, particularly in areas where is a clear public health need.


Women’s Football and Rugby

5. Gillian Martin (Aberdeenshire East) (SNP)

To ask the Scottish Government what it is doing to support women’s football and rugby. (S5O-01708)

The Minister for Public Health and Sport (Aileen Campbell)

The Scottish Government is a strong supporter of women’s and girls’ football and rugby, and recognises the strong contribution that they make to encouraging women’s and girls’ participation, as well as to raising Scotland’s profile on the international stage. We work closely with the Scottish Football Association, Scottish Women’s Football, the Scottish Rugby Union and many other partners to raise the profile of the women’s games, and we provide support and investment through sportscotland. Also, both sports are represented on the women and girls in sport advisory board that I established in September 2017.

Gillian Martin

I must declare a family interest: my niece, Elis Martin, is an under-19 Scotland rugby sevens international. I asked her to ask her team mates what issue they would like me to raise with the minister. With women’s rugby and football becoming more popular, it makes sense that the women’s games should be able to reach a wider audience. A new BBC Scotland television channel is due to be launched, so has the minister had any discussions with the channel about how women’s rugby and football could be better represented on television?

Aileen Campbell

I wish, and I am sure everybody else wishes, Gillian Martin’s niece well with her rugby career. I have recently taken up the game, so if she has any hints and tips to give me, I would welcome them.

I agree that raising the profile of the games is important, and I would warmly welcome more television coverage for women’s rugby and football. We are determined to raise the profile of women’s sport in order to increase participation, so any steps that broadcasters take to support that would also be warmly welcomed.

I will explore the issue directly with my colleague the Cabinet Secretary for Culture, Tourism and External Affairs, Fiona Hyslop, and we will consider what steps could be taken. Gillian Martin might also like to know that I recently met the director of strategy and partnership at MG Alba, and we discussed that channel’s strong commitment to women’s football. BBC Alba supports women’s football and rugby and I hope that that support continues into the new BBC Scotland television channel.

Rachael Hamilton (Ettrick, Roxburgh and Berwickshire) (Con)

The Scottish Borders has a rich and strong rugby history. Does the minister agree that efforts to help more women—an example to them being Scotland player Lisa Thomson from Hawick—to take up rugby as part of a healthy and active lifestyle would be welcome? Does she also agree that it is essential to support schools and clubs at grass-roots level to break down the barriers and overcome the challenges of promoting rugby as a game for young girls as well as boys?

Aileen Campbell

The whole country recognises the strong link that the Borders has with rugby, especially as we prepare to watch the six nations tournament with an optimistic-looking Scotland team. I am sure that that will inspire more people to take up the sport.

The six nations women’s tournament will also be happening. That should, again, provide opportunities to raise the profile of girls playing a fast-growing sport. It is one of the sports that we highlighted in our women and girls sports week last year as a key area of strength.

I am not sure whether Rachael Hamilton was at last week’s Scottish Rugby Union reception in Parliament, at which we heard many stories about how important the club structure is for promoting rugby. I am sure that she is well aware from the many clubs in the region that she represents—there are also many in my area—of how important the club structure is. They provide nurture, care and attention to young sporting stars of the future—girls and boys—and ensure that we will have in the future the players to continue the sense of optimism of our current rugby squads.

Mary Fee (West Scotland) (Lab)

Only one woman sits on the Scottish Football Association’s board of directors, and only one woman sits on the SRU’s board of directors. I am sure that the minister is aware that positive role models can have a significant impact. What will the minister do to improve and promote female participation at board level, which would have the knock-on effect of improving participation in sport?

Aileen Campbell

I thank Mary Fee for the question, which links back to the question that Ross Greer asked earlier. In her question, she acknowledges a whole area that needs improvement. That is particularly true in the SFA, because there is already opportunity in the SRU, whose vice-president is Dee Bradbury, who will become president of the SRU later this year. She will be the first woman in that tier of rugby to hold the position. She realises the opportunity that the position gives her to make greater strides forward in increasing participation of girls and women in playing and being involved in the structures in rugby. There could be an opportunity to push forward with the same agenda in football.

For Mary Fee’s interest, I say that Dee Bradbury sits on our women and girls advisory board because of the significant role that she plays in rugby, and she advises us on what more we can do to ensure that women and girls participate in sport, and that they get the opportunity to establish themselves in the operating structures of sport. Whether we are talking about football or rugby, we need to do far more to have women represented at all rungs of sport.


Hospitals (Waiting Times)

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

To ask the Scottish Government what proposals it has to reduce waiting times in hospitals during next winter. (S5O-01709)

The Cabinet Secretary for Health and Sport (Shona Robison)

First, I would like to thank health and social care staff for the tremendous contribution that they are making to maintaining safe patient care this winter.

Although we have seen exceptional pressures on accident and emergency services across Scotland, eight out of 10 patients were seen, treated, and discharged or admitted within the four-hour target. Performance in the latest week—the week ending 14 January—was 85.8 per cent. We routinely review winter each year so that we can learn lessons from what went well and identify areas for improvement.

NHS Fife received £1.36 million from the £22.4 million that was allocated to national health service boards this year to help them to prepare for winter.

Jenny Gilruth

I thank the cabinet secretary for that response.

The latest figures from NHS Fife show that only 81.4 per cent of those who had planned operations were seen within the 18-week initial referral to treatment guidelines. What guidance will the cabinet secretary provide to NHS Fife to ensure that the issue is addressed?

Shona Robison

I have made £50 million available to NHS Scotland specifically to reduce waiting times for hospital-planned care in the current financial year, with NHS Fife receiving £3.4 million of that funding. That funding will reduce waiting times across the whole patient pathway—for out-patient, diagnostics, in-patient and day-case treatment—and I expect NHS Fife and all other boards to make improvements by spring this year.

That funding and the work of the access collaborative, which is led by Professor Derek Bell, should support significant improvement in delivering the 18-week referral to treatment time in NHS Fife and elsewhere during this year.

Miles Briggs (Lothian) (Con)

Short staffing was the root cause of a lot of the problems that we have seen across Scotland this winter. There are currently 3,000 vacant nursing posts in Scotland, which is a shortfall that I believe can be directly linked to Nicola Sturgeon’s decision to cut nurse training places in 2012. Can the cabinet secretary tell Parliament how she will ensure that that shortfall is reduced by next winter?

Shona Robison

First, I remind Miles Briggs that we have a huge expansion programme for nurse training, with 2,600 training places being made available over the current session of Parliament. That will be important in expanding the workforce. We are recruiting more nurses.

Some of the measures that we have taken have put us in a very strong position. For example, we have retained the bursary and support for student nurses and midwives. If we look at what is happening south of the border because of the loss of that funding—

Miles Briggs

I am talking about Scotland.

Shona Robison

Miles Briggs’s party is in charge south of the border and has made decisions that have led to a huge reduction in the number of nurses. If he had watched the BBC over the past few weeks, he would have seen the crisis in nursing south of the border. The Conservatives cannot be in charge in one part of the United Kingdom, where nurse recruitment is in crisis, and come to this Parliament and accuse the Scottish Government of not doing enough to recruit and retain nurses.

I have laid out the plans for recruitment and retention of nurses. There are 2,600 extra training places for nurses and midwives. That represents a huge investment of more than £40 million, which will go a long way towards ensuring that we reduce reliance on agency nurses and that we can recruit to the substantive posts.

Anas Sarwar (Glasgow) (Lab)

Let me take us back to Scotland and the real world.

I start by joining the cabinet secretary in thanking all our NHS staff, who have gone above and beyond the call of duty over the winter. The reality is that the challenge is not only during winter: we have problems in meeting our waiting times all year round, but the challenge is put under the microscope over the winter.

There are three ways to reduce our waiting times. One is to fund adequately our NHS, but the reality is that over the next four years health boards will be making £1.5 billion of cuts. The second is to staff our wards adequately, as there are currently 3,500 nursing and midwifery vacancies. The third is to have appropriate local services, which would mean saving services such as the Royal Alexandra hospital paediatric ward, and not transferring those cases to the already overstretched Queen Elizabeth university hospital. Does the cabinet secretary recognise that her rhetoric does not meet her decisions? What action will she take?

Shona Robison

Anas Sarwar seems to have forgotten that we are talking about the brand new state-of-the-art Royal hospital for children and not the Queen Elizabeth university hospital. I thought that he would have known that that hospital now exists. The performance of the hospital is fantastic—I think that the last published figures show its accident and emergency performance to be around 98 per cent. It has the capacity; there are no issues with capacity at that hospital. It has adequate beds and is able to provide a first-class service.

Anas Sarwar

It does not.

Shona Robison

Anas Sarwar is saying that our new state-of-the-art children’s hospital does not provide a first-class service. [Interruption.] It is outrageous that he is talking down our first class state-of-the-art hospital, which has been held up as one of the best children’s hospitals in the United Kingdom.

Anas Sarwar

Shocking!

The Presiding Officer (Ken Macintosh)

Order.

Shona Robison

Instead of talking down that hospital, he should be talking it up. Given that it is one of his local hospitals, I find it quite shocking that he is not.

I will address the issue of funding. Over the course of the current parliamentary session, there will £2 billion more funding for the NHS—far more than the Labour Party offered in its manifesto. There are no budget proposals from that party to put more money into the NHS for 2018-19. If Anas Sarwar wants to lodge a budget amendment that would put more money into the NHS than we will put into it, I would be interested to see it. However, he has brought nothing. He comes to Parliament and argues for more money, but is not prepared to develop budget amendments that would deliver that money.

We will continue to fund the NHS to record levels. There are more staff working in the NHS than ever before. We will continue to put resources into the NHS and we will leave Labour to snipe from the sidelines.


NHS Grampian (NHS Scotland Resource Allocation Committee Funding)

7. Mike Rumbles (North East Scotland) (LD)

To ask the Scottish Government what action it is taking to correct the £165.6 million discrepancy in NHS Grampian’s funding, which the Scottish Parliament information centre has suggested has arisen because the board’s NRAC funding targets have not been met since 2009. (S5O-01710)

The Cabinet Secretary for Health and Sport (Shona Robison)

NHS Grampian will receive a resource budget uplift of 2.1 per cent in 2018-19, the highest percentage uplift of any territorial board. That includes a £5 million share of additional NRAC parity funding and takes the board’s annual resource budget to £921 million.

The Scottish Government has invested significantly in supporting the boards that are behind parity and, over a seven-year period, has committed an additional £1.2 billion to the boards that are below their NRAC parity levels. In 2018-19, all boards will be within 0.8 per cent of NRAC parity. NHS Grampian will have received additional funding of £52 million since 2015-16 for the specific purpose of accelerating NRAC parity.

Mike Rumbles

Over the past nine years, Shona Robison and her predecessor have consistently underfunded NHS Grampian with regard to their own targets. NHS Grampian is already the lowest-funded health board in the country by the Scottish Government’s targets. Therefore, to underfund it again—this year, it is underfunded by £12 million—is not satisfactory.

Is the cabinet secretary satisfied with that level of funding for NHS Grampian? If she is, will she explain her position to all the people who are waiting for planned operations that have been cancelled and the people who have to wait more than eight or 12 hours to be seen in accident and emergency departments?

Shona Robison

I encourage Mike Rumbles to occasionally turn up to the briefings that are provided by NHS Grampian to local members. The important information on funding to NHS Grampian that was presented at the last meeting, as I understand it, would have helped Mike Rumbles to better understand the funding position.

Given the year-to-year movements in the NRAC target allocations, it would not have been appropriate or possible to move NHS Grampian—or any other board that is below parity—to absolute parity, as that would result in an equivalent reduction in funding for boards that are above parity, such as NHS Greater Glasgow and Clyde, NHS Borders, NHS Dumfries and Galloway and NHS Western Isles. If Mike Rumbles is saying that money should have been stripped out of those boards and given to NHS Grampian over a single year, I say to him that that would not have been fair, appropriate or a responsible thing to do.

The NRAC formula works by bringing about a gradual movement in the funding of the boards that are below parity. The Scottish Government is supporting all boards that are behind parity. As I said in my initial answer, we have committed an additional £1.2 billion over a seven-year period to the boards that are below their NRAC parity levels. Importantly, they are all now within 0.8 per cent of parity, which is the closest to parity that we have ever been. I would have thought that Mike Rumbles would welcome that.


Malignant Melanoma

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

To ask the Scottish Government what progress has been made to add malignant melanoma to the detect cancer early programme. (S5O-01711)

The Cabinet Secretary for Health and Sport (Shona Robison)

The Scottish Government’s detect cancer early programme is supporting five pilot projects that focus on improvements in the early diagnosis of malignant melanoma across five national health service boards. The pilots are due to report at the end of March 2018, when the detect cancer early programme board will consider the reports and the potential to scale up any projects for regional and national activity.

The Scottish Government has reinforced its commitment to earlier diagnosis and treatment, as outlined in “Beating Cancer: Ambition and Action”. That cancer strategy, which is accompanied by £100 million of investment, serves as a blueprint for the future of cancer services in Scotland and aims to improve prevention, detection, diagnosis, treatment and aftercare for people who are suspected to have, or who have a confirmed diagnosis of, cancer of any type.

Peter Chapman

The detect cancer early programme was launched in 2012, focusing on lung, breast and colorectal cancers. Between 2012 and 2016, there were 882 recorded mortalities from malignant melanoma in Scotland. NHS Grampian, which covers my region, had the fourth highest rate, with 79. Cancer early diagnosis rates have failed to increase enough to meet the Government target. Will the cabinet secretary commit to adding malignant melanoma to the programme and raising the early detection targets, with the hope of reducing mortalities?

Shona Robison

The member raises an important point. We have seen an increase in the instances of malignant melanoma. In 2015, there were 1,363 diagnoses of melanoma, which was a 36.6 per cent increase in the number of instances over the previous 10 years. We know a lot of the reasons for that, and I am sure that the member will know about those, too. The important thing is what we do about it.

As I said in my initial answer, the detect cancer early programme board agreed an options appraisal process to look at the potential to include additional tumour groups in the DCE programme. Following that process, it was agreed to consider malignant melanoma as the next tumour type of interest in the programme. The clinical consensus was that a large-scale public awareness campaign would not be beneficial and that funding should focus on improvements in the existing diagnostic pathways to ensure that those who are most at risk are prioritised as requiring urgent assessment. Boards were invited to bid for funding to develop those local tests of change projects for delivery and, as I said, there will be a report in March 2018. Once we have that report, I am happy to write to the member to set out what it says, and we will take action thereafter depending on what the report tells us.


NHS Boards (Performance)

9. Ivan McKee (Glasgow Provan) (SNP)

To ask the Scottish Government how it measures the performance of national health service boards to ensure that they deliver the highest quality services for the populations that they serve. (S5O-01712)

The Cabinet Secretary for Health and Sport (Shona Robison)

NHS board performance is measured using a broad range of measures including those contained in the local delivery planning standards, the hospital scorecard and the winter NHS service weekly suite. Measures include important areas such as healthcare associated infections, waiting times, activity, delayed discharge, patient safety and flu consultations. I am happy to provide a comprehensive list of the measures that we currently use, if the member would find that helpful.

Ivan McKee

Each year, the Scottish Government entrusts health boards with more than £13 billion of public money and, more importantly, with serving the health needs of the people of Scotland. What processes are in place to ensure that any performance gaps in health boards are identified and managed?

Shona Robison

We do that in a number of ways. Officials in the Scottish Government work on an on-going basis with their counterparts in local boards and health and social care partnerships. For example, our director of finance works with the directors of finance in the local boards to make sure that, with regard to financial performance, the boards are setting out their plans, meeting key milestones and achieving their targets. Likewise, with regard to performance, work is laid out in terms of the plans that we expect boards to deliver, not least the plans for the funding that we put in for specific purposes, such as £50 million for reducing waiting times.

In addition to all that on-going monitoring, we have the annual appraisal, which is led by either officials or ministers to ensure public accountability on an annual basis for the money that the public put into funding our NHS, as I think that the public are entitled to know what that money is spent on.

The Presiding Officer

I thank the ministers and members for their contributions. That concludes portfolio question time.