Meeting of the Parliament

Meeting date: Thursday, May 4, 2023

Official Report 986KB pdf

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General Question Time

Good morning. Our first item of business is general question time. As ever, I would appreciate short and succinct questions and responses to match.

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Health Outcomes (Data Gathering)

To ask the Scottish Government how it is improving data gathering in relation to health outcomes. (S6O-02188)

The Scottish Government gathers or supports the gathering of data on health outcomes in a number of ways. We constantly strive to improve in that area, as is noted in our recently published data strategy for health and social care. We work closely with partners such as Public Health Scotland and wider stakeholders to continue to develop outcomes data, and we collect data directly through surveys such as the Scottish health survey and the health and care experience survey.

Recent examples of improvements include the better use of online data collection, better linkage and new analyses of outcomes data. In addition, most of our major programmes of work have dedicated data improvement strands, such as in adult social care and for drug deaths.

The Royal College of Physicians of Edinburgh has made it clear that there is “overwhelming”

“evidence that air pollution harms the health of ... school children”.

To properly protect children, we need better data, which is why I have spent more than six years in calling for air quality monitors to be installed in Scottish schools. I was pleased to see a similar call from the royal college in its recent submission to the Net Zero, Energy and Transport Committee for air quality monitors to be installed at all urban primary schools for a year, then extended to secondary schools. Will the cabinet secretary now listen to those experts, make that commitment and install those air quality monitors?

Maurice Golden will be aware that we have undertaken a range of work in order to improve air quality—for example, through the introduction of low-emission zones, the first of which will be in force in Glasgow as of next month. We can already see the impact of that on air quality.

I recognise the direct impact that air quality can have on an individual’s health—in particular, on their respiratory and cardiovascular health—and I am always keen to explore more actions to address those issues. I am aware of the issues that have been raised by the Royal College of Physicians of Edinburgh, and I will certainly give consideration to whether we can take further measures in order to address those concerns.

On data gathering, will the cabinet secretary outline how the Scottish Government will ensure that the opportunities that are created by new technology, data and analytical services will be delivered by a sustainable, well-trained and supported workforce?

Data can play an important part in supporting not just the design but the delivery of services. That is why we have the health and social care data strategy, published in February, which sets out the actions that we will take over the coming years to improve data collection and the linkage between different parts of our health and social care system. Alongside that, data from the use of other forms of technology can play an important part in improving health outcomes.

Some of the work that we are taking forward through the strategy aims to ensure that we deploy technology and use the data from it to its absolute maximum, to improve the way in which services are delivered across the country.

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Free School Meals (Secondary Schools Pilot)

To ask the Scottish Government whether it will provide an update on the plans for a pilot scheme to provide free school meals in secondary schools. (S6O-02189)

In Scotland, all primary school pupils in primaries 1 to 5, children in funded early learning and childcare, and eligible pupils in primary 6 through to secondary 6 can already benefit from free meals. That is the most generous provision anywhere in the United Kingdom, and it saves parents £400 per eligible child per year.

We will go further. Our additional investment, which was announced on 15 December, will fund the continued expansion of free school meals to all primary 6 and 7 pupils who are in receipt of the Scottish child payment, and we remain committed to delivering a pilot of free school meals in secondary schools and to continuing to work closely with key delivery partners on our free school meal expansion programme. I would be happy to provide an update once planning work has progressed further.

I say at the outset that I really welcome the initiative and think that it is making, and will continue to make, a huge difference across the country.

The minister will know that North Lanarkshire, which includes my Coatbridge and Chryston constituency, has high levels of deprivation. Would she consider making that council area part of the pilot scheme? Initiatives such as club 365, which has been run by North Lanarkshire Council, have shown that there is a real need for them and that they can help a lot of people.

Absolutely. It is important that we undertake the planning work required for our free school meal expansion programme, and we will further consider which areas will be included in any pilot in due course. I am happy to keep Fulton MacGregor updated on that.

According to the Scottish Government’s own reports, the take-up of school meals is down. Why?

To begin with, Covid certainly did not help with that, but that is a matter for local authorities, whose responsibility it is to encourage the take-up of free school meals.

As the minister said, the budget provided for the programme’s expansion to those children in primaries 6 and 7 and in receipt of the Scottish child payment. However, in the absence of the delivery of that, families are paying out more than one third of their benefit to bridge the gap. Does the minister accept that Government delay is costing families, and will she tell them when she will get it sorted out with the data from Social Security Scotland?

As I mentioned, in Scotland, we have the most generous free school meal provision anywhere in the UK, with all primary school pupils in primaries 1 to 5, all pupils in special schools and additional support needs schools and eligible pupils in primary 6 through to S6 able to access a free meal. We are continuing that roll-out with children on the Scottish child payment, and I am happy to provide the member with more updates as that progresses.

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Scottish Child Payment (Young Parents)

To ask the Scottish Government whether it will introduce a Scottish child payment top-up for parents under the age of 25 who are in receipt of universal credit, as called for by the “End young parent poverty” campaign, in light of it reportedly being supported by more than 30 charities and civil society groups. (S6O-02190)

Universal credit is reserved to Westminster, and the United Kingdom Government has deliberately introduced age discrimination within it. We agree with campaigners that it should be paid at the same amount to everyone.

We already take action to protect people against the impact of UK Government policies, including the bedroom tax and the benefit cap, but we cannot mitigate every action on our fixed budget. The Scottish child payment was doubled in April 2022, to £20 per eligible child, and it increased again to £25 when we extended it to under-16s, in November. That is an increase of 150 per cent in less than eight months.

The campaign coalition is led by One Parent Family Scotland, but it now has 46 organisations, including Barnardo’s Scotland, the Poverty Alliance, Oxfam Scotland, Scottish Women’s Aid and many more. There are clear asks of both the UK and the Scottish Government. More than half of children in Scotland with a mother aged under 25 are living in poverty. I have offered to host a meeting with the campaigners. Will the cabinet secretary join us at that meeting as soon as possible?

Given that I have just come into post, I am, of course, already due to meet stakeholders and I am setting up meetings with them. Clearly, I am happy to receive any invites for any other opportunities that are coming up.

I would just make it clear to Monica Lennon that we spend £777 million more on social security than we get through the UK Government block grant. That shows that we are determined to move forward and support families and others who are really suffering from the benefits that are given by Westminster. That includes spending £442 million on the Scottish child payment this year and other mitigations that we make to support against, for example, the bedroom tax. I say to Monica Lennon that it is very difficult to mitigate against everything that the UK Government is doing, because that it is a very long list.

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National Health Service Dentistry

To ask the Scottish Government what action it will take to reverse the reported decline of NHS dentistry. (S6O-02191)

The new policy prospectus that the Scottish Government set out on 18 April commits us to providing sustained and improved equitable national access to national health service dentistry by 2026. That reaffirms our commitment to the sector and to patients in all parts of Scotland.

The previous Cabinet Secretary for Health and Social Care recently confirmed the continuation of the bridging payment until 31 October 2023, while we prepare for the implementation of payment reform. Payment reform will comprise a new modernised system that will provide NHS dental teams with greater clinical discretion and transparency for NHS patients.

Having to wait until 2026, which is a long time away, does not help people who are waiting to see a dentist right now.

A recent survey found that there has been an exodus of dentists from the NHS. Some 59 per cent of dentists say that, since lockdown, they have reduced the amount of NHS work that they undertake by an average of more than one fifth. For example, the Old Bank dental practice in Tayport in my constituency has shut altogether. The survey found that the situation is only going to get worse.

In a letter dated 20 March, the then Minister for Public Health, Women’s Health and Sport, Maree Todd, said:

“we will confirm the negotiation period and new showcase date as soon as possible.”

There is concern about further delay. When will the revised payment system for NHS dentistry be announced?

I thank Willie Rennie for his question and recognise the amount of work that he has done for his constituents with regard to dentistry services.

The timeline for reform of dentistry services has necessarily been slightly altered by the process that has been under way to replace the First Minister. We still intend to implement dentistry reform on the agreed date, which is 1 November 2023. We will confirm the negotiation period and new showcase date as soon as possible.

With many people living to be older and, therefore, keeping their teeth for longer, many elderly patients who are housebound or in care homes are presenting with untreated tooth decay and advanced gum disease. In fact, recent studies suggest that periodontal disease and the resulting chronic inflammation are associated with the development of vascular dementia.

Will the minister explain how she plans to properly resource the declining domiciliary dental care service, as Shona Robison promised when she was Cabinet Secretary for Health and Social Care? At a meeting of the local dental committee, members of Scotland’s dental profession told me that that is simply not happening.

I, too, was at the local dental committee meeting, at which—as Sandesh Gulhane will know—I faced some pretty probing questions. The Scottish Government is absolutely committed to ensuring that we provide a sustainable dental service. I am currently in discussions on how that will happen.

I take on board the points that Dr Gulhane made on care of older people. However, I ask him to note that the Scottish Government is moving on a pathway towards ensuring that everyone gets the right dental care at the right time and in the right place.

I continue to receive correspondence from constituents who find themselves unable to access non-emergency dental care because dental practices in Inverclyde remain closed to new NHS patients. Will the minister outline what is being done to support dental practices that currently offer NHS treatment to begin taking on such patients?

We are constantly in dialogue with dentists to ensure that we are doing that; my officials meet dentists regularly. We have introduced a number of processes—for example, funding dentists to the extent of £100,000 for additional practices, and providing additional funding of up to £25,000 for extra support in areas where there is greatest patient need.

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Digital Prescribing and Dispensing

To ask the Scottish Government whether it will provide an update on the digital prescribing and dispensing pathways programme. (S6O-02192)

I am sorry that I did not respond immediately, Presiding Officer; I did not hear the question.

I ask Ms Mackay to repeat question 5.

To ask the Scottish Government whether it will provide an update on the digital prescribing and dispensing pathways programme.

I offer my sincere apologies, Presiding Officer.

The digital prescribing and dispensing pathways programme is on track to replace the current paper prescription system in Scotland, with a view to establishing a digital approach by the end of this parliamentary session.

The early focus is on in-hours fixed general practice prescribing and community pharmacy dispensing across Scotland. Initial user engagement is complete, and planning is under way for the design of an initial prototype approach. I expect to be able to provide more detail later this year, subject to on-going work on the business case.

I thank the minister for that answer.

Last week, I met a group of local general practitioners who told me about technical problems that they are having in using the electronic system, which have resulted in patients waiting for paper prescriptions that GPs need to print and sign. They also asked about potential expansion of the programme to secondary care patients, who need to wait for paper prescriptions from hospital doctors. Can the minister confirm whether the programme will be progressed in order to alleviate the burden on general practices and hospitals?

I heard that question; I thank Rona Mackay for her supplementary.

Digital prescribing is a strategic priority and the DPDP programme will focus on primary care and GPs. It will improve the user and patient experience while reducing use of paper prescriptions. We expect to commence implementation for in-practice GP prescribing and dispensing from 2024-25.

In secondary care, hospital electronic prescribing and medicines administration—HEPMA—is being rolled out across Scotland and has already been implemented in 13 NHS boards. [Jenni Minto has corrected this contribution. See end of report.]

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Victims, Witnesses, and Justice Reform (Scotland) Bill (Victims Consultation)

To ask the Scottish Government which victims groups it has consulted with on its proposed Victims, Witnesses, and Justice Reform (Scotland) Bill. (S6O-02193)

The bill is directly informed by the work of the victims task force and the Lady Dorrian review and governance groups, all of which include representation from victims organisations. We have also engaged directly with a range of victims groups, as well as with victims, survivors and their advocates and families, through two public consultations and the jury research engagement events that fed into the bill.

Ministers and officials regularly meet victims organisations and meet directly with individual victims and survivors to discuss a range of issues, many of which are relevant to the content of the bill.

I thank the cabinet secretary for that answer.

The bill is a victims bill in name only. My colleague Jamie Greene has proposed a true victims law that would put the interests of victims at the heart of the justice system. In particular, it promises to implement Michelle’s law, which would prevent criminals, when they are released on licence, from entering the local areas of victims. That measure was promised by Humza Yousaf when he was the Cabinet Secretary for Justice, but it does not appear in the bill. Why not?

Let me reassure Mr Stewart that the bill, when it comes to advancing the rights of victims and witnesses, is one of the most significant pieces of legislation to be introduced in the history of this Parliament, and will represent transformational change that is informed by the very strongest of evidence and debate. Building on our engagement with victims and witnesses, we have a statutory automatic right to anonymity for victims of sexual offences, new specialist courts for sexual offences and the abolition of the not proven verdict.

With respect to Michelle’s law, I again reassure Mr Stewart that the Parole Board for Scotland has already adjusted its rules in order to give appropriate consideration of the very important matter that he raises.

We are getting on with the job, representing the needs of victims and witnesses and ensuring that they are, indeed, at the very heart of our justice system.

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Palliative Care (Hospice Funding)

To ask the Scottish Government whether it will increase funding for hospices to ensure that they can manage any rising costs, in light of the reported increase in the number of people in need of palliative care. (S6O-02194)

We are considering the issues that the hospice sector raised at its meeting in March with the then Cabinet Secretary for Health and Social Care and the then Minister for Public Health, Women’s Health and Sport, including funding and the long-term sustainability of the hospice sector.

We are aware of Scottish research that shows a rise in the number of people with palliative care need, and the Scottish Government is developing a new palliative and end-of-life care strategy to ensure that everyone who needs it can access seamless, timely and high-quality palliative care.

Although I welcome the pay uplift for national health service staff under the agenda for change in Scotland, hospices are crying out for funding to help them to match that uplift and ensure that their salaries remain competitive with those of the NHS.

Considering that Ayrshire Hospice is facing the perfect storm of rising staff costs, increasing energy and running costs and a tough fundraising environment, what discussions have ministers had with the sector on a new model of funding to help hospices to retain staff? Will the minister commit to meeting the chief executive officer of Ayrshire Hospice, Tracy Flynn, to discuss its issues with funding and how its work impacts the people of Ayrshire?

I thank Sharon Dowey for her question. As I said, we have met and started discussions with the hospice sector. I would be happy to meet more to hear its concerns. We have to recognise the hospice sector and support it as best we can, given all the impacts on it.

That concludes general questions.