Meeting of the Parliament

Meeting date: Thursday, February 2, 2023

Official Report 1172KB pdf

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General Question Time

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Maternity Services (Caithness)

To ask the Scottish Government whether it will conduct an independent review into the maternity model in Caithness. (S6O-01860)

The maternity model in Caithness was put in place by NHS Highland following a review that was led by Professor Hugo van Woerden, who was then NHS Highland’s director of public health, following the tragic death of a full-term baby at the unit in 2015. The report of the review, which included two external reviews, recommended that the maternity unit in Caithness move to a midwife-led unit to address safety issues. That change was unanimously agreed by NHS Highland’s board.

The model of care that operates in Caithness is, of course, similar to models that operate in other parts of NHS Highland and, indeed, other NHS boards in Scotland.

Rhoda Grant will be aware of the work that is under way in the best start north review, which was commissioned jointly by NHS Grampian, NHS Highland and the three island health boards. The work of the review group was paused during Covid, but it recently restarted, led by the directors of midwifery from all six northern boards.

The cabinet secretary has carried out independent reviews of Moray maternity services, and he has now commenced a review in Dumfries and Galloway. The review that was carried out by NHS Highland was not independent of NHS Highland, and concerns about maternity services have been on-going since the change was made back in 2016, when obstetric cover was removed. Women have to travel over 100 miles to give birth. That is like asking a woman from Edinburgh to travel to Newcastle to give birth. It is absolutely unacceptable.

Will the cabinet secretary stop the centralisation of maternity services away from Caithness, admit that that was a mistake and commit to having a full, independent review as soon as possible?

I regret the tone and implication of Ms Grant’s question. As I stated in my original answer, it is important for us to remember that the review was carried out after the tragic death of a full-term baby at the unit in 2015. Those were the circumstances behind why there was a review. Two external reviews were included as part of the overall review. On the basis and the back of that tragic death, the review recommended that Caithness move to a midwife-led unit to address the safety issues.

Ms Grant was wrong to say that I have commissioned an independent review in relation to maternity services in Wigtownshire. The local health board decided to commence an independent review of maternity services in Wigtownshire on 18 January. That is a decision for the health board. The health board in Highland is, of course, part of the best start north review, which will look at how maternity services operate throughout Highland. I hope that Rhoda Grant will collaborate with and take part in that review—she undoubtedly will.

Can the cabinet secretary confirm whether the Scottish Government has reviewed the conclusions of the risk assessments for each maternity patient in labour who has been transferred from Caithness general hospital to Raigmore hospital? If it has not done so, will it?

Again, those are important decisions and important risk assessments for local health boards to take. Of course I understand the concerns that are legitimately raised by Edward Mountain and Rhoda Grant.

I met the Caithness Health Action Team—or CHAT—campaign group last year. As a result of that, I know that there are now face-to-face formal meetings between NHS Highland and the campaign group.

NHS Highland has in place protocols to mitigate the risks associated with the transfer of pregnant women, particularly in an emergency situation. The best start north review has commenced, and I encourage Edward Mountain, as I encouraged Rhoda Grant, to engage with that review.

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Menopause Specialist Network

To ask the Scottish Government whether it will provide an update on the development of a menopause specialist network. (S6O-01861)

The action in the women’s health plan to develop a national menopause specialist network has been completed. The network has been meeting since 2021 to provide consistent advice and peer support and to share good practice among healthcare professionals, including primary care teams. The network meets on a quarterly basis and includes representatives from all mainland national health service boards.

I thank the minister for that answer. It was recently estimated that, in the United Kingdom, during an undefined period, more than 900,000 employees left their jobs because of the impact of menopause symptoms. In addition to better clinical support for women during menopause, better understanding and support is needed in workplaces. I know that I am potentially creeping into another minister’s remit but, in the spirit of cross-portfolio working, could some work be done within the women’s health brief to better inform workplaces on the menopause and get meaningful policies in place? Perhaps that could start with our NHS—after all, it employs many women whom we cannot afford to lose from the workplace.

Our women’s health plan highlights the need to consider women as rounded individuals with a range of needs, and we are committed to working across portfolios to achieve our aim of reducing health inequalities and improving health outcomes for women, including in the workplace. Menopausal women are the fastest growing demographic in the workforce, so it is now more important than ever to speak openly about the menopause at work. Through the women’s health plan, we are developing support for employers and those who experience symptoms of the menopause. That work includes a menopause and menstrual health workplace policy for NHS Scotland as an example of best practice to promote across the public, private and third sectors.

Last week, the Scottish Government published its women’s health progress report, which was delayed by six months. Can the minister explain why the establishment of a dedicated menopause policy post has not been achieved? In the Government’s implementation plan, that was classed as a short-term action, so it should have been delivered within the year. When will an appointment be made?

I am very proud of the progress that we have made in the first year of the women’s health plan and, of course, Scotland was the first country in the United Kingdom to put forward a women’s health plan. From the moment that I took up my post, I have been very clear that we have a great deal of work to do to overturn the millennia of discrimination and disadvantage that women face. I think that we have done great work on the menopause. As I said in my previous answer, we have brought forward access to a specialist menopause workforce. On our NHS Inform website, we have busted myths about the menopause, and I am really proud of the progress that we have made.

I am happy to write to Jackie Baillie with an update in response to the specific question that she asked.

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Speech Difficulties (Support for Young People)

To ask the Scottish Government what steps it is taking to support young people with speech difficulties. (S6O-01862)

We want to intervene early to prevent speech difficulties from arising in young people. An important part of our efforts to address that has been increasing our health visitor workforce by more than 500 since 2014 and expanding funded early learning and childcare to 1,140 hours for all eligible children. Both measures are critical to supporting children’s early language development.

We also recognise the importance of timely access to speech and language therapy. We have increased health boards’ flexibility in reducing waiting times, to ensure that those with the greatest need are seen first, while maximising prevention and early intervention approaches for those who are waiting.

The cabinet secretary talks about early intervention, but the reality is that there is a two-year waiting list in North Ayrshire to see a children’s speech therapist. In fact, the list is now closed, and parents have to go private and pay for assistance for their children. There is a two-tier system in speech therapy in Scotland, due to chronic underfunding and a nationwide lack of speech therapists. I am sure that members across the chamber will be experiencing similar issues. How have we let things get so bad? Early intervention is absolutely key to young people’s learning and development, but if there is a two-year waiting list, the outcomes will be much poorer. Will the cabinet secretary reflect on that? What is he going to do about it?

I will not only reflect on it, but make sure that we take action. Jamie Greene is right to raise the issue of NHS Ayrshire and Arran. I know about the specific challenges that NHS Ayrshire and Arran has had with recruitment and that it has lost some staff in its speech and language therapy department.

I have asked the chief allied health professions officer to engage directly with the board. She has asked NHS Ayrshire and Arran to resume the waiting list for routine referrals, which I know was an issue of concern. I understand NHS Ayrshire and Arran’s decision to close the list for routine referrals, and it is important to say that that decision never affected urgent referrals, which are still being seen. The average referral-to-assessment time is four days.

I do not agree with Jamie Greene’s suggestion that the national health service has been chronically underfunded—that is incorrect. We are putting record investment into our NHS, with a record £19 billion for 2023-24.

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Ferries Task Force (Orkney)

To ask the Scottish Government whether it will provide an update on the work of the ferries task force with Orkney Islands Council. (S6O-01863)

The transport minister and I had a useful meeting with representatives of Orkney Islands Council earlier this week. We discussed a range of matters about how best to support the Council with the challenges that it faces in delivering its ferry responsibilities, and we look forward to continuing discussions.

I welcome the meeting on Tuesday and, given how late in the day the meeting was arranged, I welcome the fact that a further meeting is due to take place in, I think, April.

It is important—vital, I would say—that ministers remain involved in the process. Given the impact on island communities in Orkney of increased disruption to services due to the age of the internal ferry fleet, not to mention the costs and the impact through higher emissions, what reassurance can the Deputy First Minister offer my constituents that this process will ultimately lead to a funding package that will allow the replacement of that fleet?

I think the fact that the work is under way should be reassurance to Mr McArthur’s constituents. I recognise the significance of the issues that are involved and the necessity of there being reliable interisland ferries and connections for his constituents. We have embarked on the work that is necessary to explore those issues, and we look forward to sustaining that work with Orkney Islands Council.

I am pleased that that meeting finally took place and that the talks were, at least in the Scottish Government’s finest ministerial technospeak, positive and constructive. However, I am not aware of any agenda having been published ahead of the meeting. Will the cabinet secretary ensure full transparency of the discussions so that residents in Orkney can have confidence that this is not just another talking shop or, as one local councillor put it, a “placating tactic”? When will full, detailed minutes of the meeting be publicly available, and when will the agenda for the next talks be published?

It is nice to see that Mr Halcro Johnston is able to summon up a really warm welcome for the Government’s dialogue with Orkney Islands Council. [Interruption.] It really is another further descent into the miserableism of the Scottish Conservative and Unionist Party. There is an abundance of miserableism on the Scottish Conservative benches on a constant basis.

If you would answer the question briefly, please.

As with all things—[Interruption.] As with all things, there will be full transparency from the Scottish Government—[Interruption.]

Members! We will hear the cabinet secretary. We have a finite amount of time and a lot of interest, and I would be grateful if we could get through business.

There is a finite time for having to put up with the nonsense that we get from the Scottish Conservatives. I simply reiterate that the Government will apply full transparency to all the deliberations that we have with Orkney Islands Council.

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Commissions and Commissioners (Costs)

To ask the Scottish Government what its position is on whether any increased number and cost of commissions and commissioners for which it is responsible will mean resources being diverted away from front-line services. (S6O-01864)

The financial resources that are sought by such office-holders to support their respective functions are provided for in relevant acts, which are a matter for the Parliament. It is a simple matter of fact that the more office-holders there are, and the more resources they utilise, the less will be available for public services.

I have been open with Parliament about the scale of the pressures that we currently face in the public finances, and it is vital that all public bodies and office-holders contain their costs.

It has been suggested that we might be heading towards having 14 commissioners. Does the cabinet secretary agree that that could mean that sectors with a commissioner might have a louder voice and that sectors without a commissioner will not be heard so well?

This is a difficult issue for the Government to judge upon, because the legislation to establish commissioners is essentially a matter for Parliament. Parliament also, through the work of the Scottish Parliamentary Corporate Body, has to regulate, or advise on the regulation of, the financial assistance that is made available to office-holders. That is a difficult issue for the Government to control, because doing so would potentially mean the Government intruding on the right and proper space that is available for Parliament to determine these issues. I am acutely conscious of the necessity to respect that boundary.

Having said that, all of us—whether we are members of the Government or of the Opposition—have a duty to recognise the pressures that exist on the public finances. That should be reflected in the financial support that is available to office-holders and the number of office-holders that we have in place.

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Town Centre Action Plan (Impact in Mid Scotland and Fife)

To ask the Scottish Government what impact its town centre action plan is having in communities in the Mid Scotland and Fife region. (S6O-01865)

In Mid Scotland and Fife, the Scottish Government is delivering on town centre action by providing more than £22 million in funding to local authorities for local projects since 2019 through our place-based investment programme and the town centre fund. A further £4.5 million is being invested through the regeneration capital grant fund over the period 2020-23 alone.

We are also supporting community wealth-building pilots in Fife, and we are working collaboratively with the Coalfields Regeneration Trust in the Fife area on climate action.

I appreciate the response from the minister, but I think that he is missing the point. I have asked this question in three different ways—twice in writing and again today. I keep getting told that we have a plan, and another plan—but the plans are not working. [Interruption.]

11:56 Meeting suspended.  

11:58 On resuming—  

We may recommence. Minister Tom Arthur will complete his response to Ms McCall.

Presiding Officer, I had completed my response.

Sorry—excuse me. Ms McCall.

Thank you. I do appreciate the response from the minister, but I think that he misses the point. I have asked this question in three different ways—twice in writing and again today. I keep getting told that we have a plan, and another plan—but the plans are not working.

Shop vacancy rates remain unchanged, with one in six stores in our high streets lying empty. That is the highest rate in the United Kingdom. The volume of empty units in shopping centres remains at more than 20 per cent, which is completely unchanged. Calls from industry bodies to match the 75 per cent rates relief for small businesses that is in place in the rest of the United Kingdom are being ignored. Given that, what tangible evidence does the minister have that those multiple plans will make any impact whatsoever on the communities in Mid Scotland and Fife?

This is a complex area. Our town centres face systemic challenges going back many years. They have also faced the acute crisis of the pandemic and the current cost crisis.

There are three aspects to how we address that. There is clear strategic direction, which we are providing; there is partnership working with the Convention of Scottish Local Authorities and local communities; and there is funding, which I outlined in my original answer. There is no short-term fix and no overnight solution to the challenges that our town centres face.

The issue is not unique to Scotland, but we have a strategic approach, through our town centre action plan, through our retail strategy and through our community wealth building aspirations. Indeed, I launched the consultation on community wealth building earlier this week. In Mid Scotland and Fife, Clackmannanshire and Fife, there are pilot areas that are supported by the Scottish Government.

As I said, this is a complex area. We are providing funding and we are working in partnership. If the member, or indeed any member, wishes to discuss these complex issues in more detail, I am more than happy to meet them to do so.