Contents
- Portfolio Question Time
- Two-child Benefit Cap
- Energy Bill
- Business Motions
- Parliamentary Bureau Motions
- Motion without Notice
- Decision Time
- Stoma Care
Portfolio Question Time
Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business is portfolio question time, and the first portfolio is rural affairs, land reform and islands. Any member who wishes to ask a supplementary question should press their request-to-speak button during the relevant question. The usual appeal for brevity in questions and answers applies.
UK-Australia Free Trade Agreement (Impact on Agriculture)
To ask the Scottish Government what its most recent assessment is of any impact of the United Kingdom-Australia free trade agreement on Scotland’s agricultural sector. (S6O-02584)
Research undertaken by the Andersons Centre to assess the long-term impact of the UK-Australia and other free trade agreements on the Scottish agricultural sector outlined that both the Australian and New Zealand deals will exert significant pressure on sectors, particularly beef and sheep, that are important to our rural economy. We have always been concerned about the precedent that the negotiation of those initial deals would set, yet further pressure could be placed on the agricultural sector if other deals are poorly negotiated by the UK Government—for example, with Canada, which exports more than a third of its beef produce.
Although it is too early to determine the full impact of the UK-Australia trade deal, all indications are that it will be negative for Scottish farming. Unless the UK Government listens to and takes seriously the concerns that I have raised repeatedly and which have been echoed by our farmers and crofters, the sector will continue to suffer from bad deals, with bad outcomes for Scotland foisted on us by Westminster.
Earlier this month, the price of Australian lamb reportedly sat at around less than half the price in Scotland, and Australian lamb exports to the UK reportedly almost trebled in August to 1,028 tonnes. Now, the Australian red meat sector looks poised to make further inroads, having launched the Aussie Beef and Lamb brand. What would the cabinet secretary say to those farmers who, while working tirelessly to provide food of unparalleled quality, might be fearful about what the consequences of this Brexit-based Tory betrayal could mean for the future of their livelihoods?
That is why I argued strongly during the negotiation of that deal and urged the UK Government not to give away those enormous tariff-free quotas needlessly. As we have now seen, the UK Government has changed its mind. Former Department for Environment, Food and Rural Affairs Secretary of State George Eustice, who was in post during the negotiation of that deal and who gave farmers and crofters assurances that what they were looking for and their interests would be protected, criticised the deal after he left post, saying that the Australia trade deal is
“not actually a very good deal”
for the UK and that we
“gave away far too much for too little in return”.
The Scottish agri-food sector deserves so much better than that, especially when we consider the deals that the European Union has managed to negotiate with Australia and New Zealand. It has negotiated a far better deal for its members. It is not only frustrating but an absolute disgrace that the UK Government did not see fit to do the same.
The ability of Scottish farmers to trade competitively with the rest of the UK is vital to Scotland’s agricultural sector. Will the cabinet secretary give clarity on the percentage of direct support that will be attributed to replacing common agricultural funding for farmers and crofters?
I do not think that that is related to the initial question on trade deals. Is there anything that you can add to what you have already said, cabinet secretary?
I completely agree with the first point in Rachael Hamilton’s question. She is also referring to the future budget and what that might be. We have committed to maintaining direct payments in Scotland, but we do not have any clarity on the future budget from the UK Government, and it has refused, to date, to engage in any meaningful conversations on the matter.
Food and Drink Producers (Support)
To ask the Scottish Government what action it is taking to encourage people to support their local food and drink producers. (S6O-02585)
We want everyone to have the opportunity to enjoy food and drink that is produced locally and for producers of all sizes to access the markets that are on their doorsteps. We will shortly be publishing “Local food for everyone”, which will set out our local food strategy and is about connecting people with food, connecting Scottish producers with buyers and harnessing the power of public sector procurement.
We have also provided more than £700,000 between 2020 and this financial year to the Scottish Grocers Federation for its go local programme, which is helping transform convenience stores with dedicated display space for Scottish produce.
I attended the Stranraer oyster festival—the cabinet secretary did as weel—where some fantastic Dumfriesshire and Galloway producers such as Stacy Hannah Chocolate, Moffat Distillery and Sulwath Brewers were selling their products. In addition, over the summer, many people supported our local food and drink producers at various agricultural shows. What further practical steps can the Scottish Government take to support the public to choose local, particularly with Food Standards Scotland pointing out that the Tory-made cost of living crisis is impacting on people’s ability to shop locally?
I welcome Emma Harper’s points about the Stranraer oyster festival. It was a fantastic event, and it is great to hear that about 25,000 people attended. I take this opportunity to extend my gratitude to Romano Petrucci as well as all the other volunteers who helped to make the event such a success.
In relation to Emma Harper’s question, we continue to support Scotland’s Town Partnership. This year, we provided it with a grant of £400,000 to develop the Scotland loves local programme as part of its overall work programme of activities, and as a means of putting localism at the heart of a stronger, greener and fairer Scotland. An additional £250,000 of funding was agreed earlier this year, which will enable significant development of the Scotland loves local gift card programme during this year, including further promotional activities, digitisation and further expansion and reach of the programme.
We have a couple of supplementaries, the first of which is from Brian Whittle.
The cabinet secretary and I have rehearsed the topic of local public procurement many times and I know that she agrees with me that it is a significant way in which we can support our food producers and our rural economy. Does she agree that bean counters using cheap imported food is a false economy and that we must ensure that as many councils as possible use local food procurement? If so, what is the Scottish Government doing to ensure that that approach is expanded?
I welcome the member’s question. It is not just us who agree on that; members across the chamber agree on the power of public procurement and how it can strengthen both our local economy and our economy more widely. Indeed, we heard that in our recent food and drink debate.
As we know, this is a complex area, and that is why we have a number of initiatives to help us get round some of the issues and to support our local producers as much as possible. One such initiative is the Food4Fife scheme, which I know the member will be aware of. Over this financial year, we have provided £490,000 of funding for the expansion of that scheme and for a wider pilot project in Glasgow to examine how we can strengthen local public procurement not just in schools but across the wider public sector.
We will continue to monitor that and will look to do all that we can in that respect, particularly through the good food nation plan, the draft of which will be coming forward shortly. I look forward to engaging with Brian Whittle and other members on how we can look to improve what we are doing already.
Rhoda Grant joins us remotely.
The issue is that most procurement, especially that for schools and other Government organisations, is done centrally. What steps will the cabinet secretary take to work with those who procure, including in relation to their wherewithal to procure, to ensure that local people have in their hands the ability to procure small amounts locally?
The member raises a really important point. We know that there is a complex legislative framework around procurement, and that is why, as I outlined in my previous response, we are undertaking a number of different initiatives and finding ways in which we can look to strengthen that.
One thing that we are taking forward is the Supplier Development Programme, which delivers free training and guidance on how to submit and win public procurement bids. Our legislation, through the sustainable procurement duty, requires public sector contracting authorities to consider and act on opportunities to facilitate the involvement of small and medium-sized enterprises, third sector bodies and supported businesses through public procurement.
Again, as with my offer to Brian Whittle, I am more than happy to continue to engage with Rhoda Grant and other members on considering what other improvements we could make in this area, because we want to ensure that we have strong local supply chains that really benefit our producers as well as our local economies.
Fishing Industry (Support)
To ask the Scottish Government what role it will play in supporting the fishing industry over the next 10 years. (S6O-02586)
The Scottish Government already plays an active role in supporting and managing Scotland’s vital fishing industry, and it will continue to do so in the future. Through our delivery of the actions in our 10-year fisheries management strategy, the funding that we provide and the operational functions that we deliver, we are focused on ensuring that both Scotland’s fishing industry and our marine environment can thrive sustainably, and that our seafood sector can continue to support jobs and provide a high-protein source of food for our communities.
North-east fishing communities expressed cautious delight when, in response to warnings that highly protected marine areas would close 47 per cent of our waters to fishing and decimate the industry, the Cabinet Secretary for Rural Affairs, Land Reform and Islands halted their implementation. However, almost immediately, Government minister Lorna Slater and Ariane Burgess MSP said that the Scottish Government will still bring in HPMAs as they are a red line in the Bute house agreement.
Can this minister clear up the Scottish Government position? Have the hated HPMAs been ditched, or was the pre-recess announcement simply a cynical delaying tactic?
That is probably a question for the cabinet secretary, Màiri McAllan, but I hope to clear things up, if I can, with regard to the support that we are giving to fishing.
We want to ensure that communities across Scotland are central to any process in which we involve them. Since I took on responsibility for inshore fisheries, we have been consulting on inshore tracking and monitoring. That consultation is open until 7 November. That will allow people to look at what more data we can get on what species are out there and where they are in our seas. That is for vessels under 12m.
Given that Liam Kerr mentioned north-east fisheries, I can let him know that I am actually speaking to them in about an hour’s time.
We have a number of supplementaries. We will try to get through all of them, but the questions will need to be brief, as will the responses.
A fisherman has described the recent experience of the industry as “the hardest three years”. That same fisherman described how the industry was “sold a lie” over Brexit. How will the Government’s long-term support plans seek to protect the Scottish fishing industry from the disaster politics of the Tories and Labour, neither of whom offer support to the Scottish fishing industry?
What Kate Forbes has outlined that she has heard from her local fisherman is something that I and my colleagues, such as Karen Adam, who represents Banffshire and Buchan Coast, have also heard.
We warned of the effects of Brexit on the Scottish fishing industry. Those have been exacerbated by the Tories’ hard Brexit—-a hard Brexit need not have been imposed on Scotland. Those effects include higher export costs, barriers to trade, loss of access to labour and broken promises about lost European Union funding being replaced in full.
This Government will always champion Scotland’s fishing industry and do all that we can to support it, and we will adapt and innovate to ensure a just transition to a sustainable and resilient fishing fleet. That includes annual negotiations in which we work to secure the best outcomes that we can for Scottish fishing businesses. However, as long as we are part of the United Kingdom, whether there is a Labour or a Tory Westminster Government, we in Scotland will not have a direct seat at the table—
Thank you, minister. I call Colin Smyth.
The Scottish Government has a legal duty to support and incentivise fishing methods that have a lower environmental impact and are selective. What specific measures has the Government taken, and planned to take, to deliver what is a legal responsibility?
I refer Colin Smyth to part of my answer to Liam Kerr’s question, on what we are doing with the inshore tracking and monitoring consultation. We are proposing to put monitoring cameras on vessels under 12m. That has already been piloted in the Hebrides, and it will be able to give us a picture of, and some more robust data on, where the species are and where we can fish sustainably. I think that that will be a game changer with regard to what we see in the marine environment. We will know what is where, and when.
I call Maggie Chapman, who is joining us remotely.
Can the minister outline what the benefits would be from applying a future cap to current high-impact fishing activity in Scotland’s inshore waters?
We are not proposing any cap. We are looking to use science and the available data from our fishing fleet to have a better idea of what species are where in Scotland’s inshore waters. That will be the absolute bedrock of any decisions that we make in future. It is not a case of applying caps as such; it is a case of knowing what is where, where we need more sustainable fishing methods, and what species we will protect and allow to thrive more through the decisions that we make. It all has to be based on scientific data.
Have the hated HPMAs been ditched—yes or no?
I refer Douglas Lumsden to the statement that Màiri McAllan gave to the Parliament. Everything that he needs to know is in that statement.
Crops (Durability)
To ask the Scottish Government what action it plans to take to improve the durability of Scottish crops over the coming years. (S6O-02587)
I refer members to my entry in the register of interests regarding farming.
The Scottish Government invests nearly £50 million a year in a portfolio of strategic research to ensure that Scotland maintains its position at the forefront of research into advances in sustainable crop production, natural resources and the environment. That includes research that is aimed at improving crop resilience. We have also made capital investments in new technology, including a new educational vertical farming facility at Scotland’s Rural College, which will provide a fully controllable facility for researching crop growth.
The provision of high-quality advice for growers is supported by Government via the Farm Advisory Service and the SRUC crop-monitoring grant, to ensure that producers can make the best decisions for their current crops and future planning. Further, we have promised up to £6 million for our fruit and vegetable producers to allow them to continue to work together to invest in ensuring the viability of fruit and vegetable production.
Recent work by the James Hutton Institute has shown that advances in gene sequencing can help to protect staple Scottish crops such as potatoes, barley and raspberries from the changing climate. Will the minister accept that those technological advances are essential for Scotland’s food security?
What I will accept is that, before we make any decisions on anything to do with gene sequencing or gene editing, we must listen to organisations such as the James Hutton Institute and many more, such as our partners in SEFARI—the Scottish Environment, Food and Agriculture Research Institutions. As I said in response to the fishing questions, this is all about data, research and listening to the advisers, of whom we have many in Scotland, to inform our policy decisions.
The climate crisis and changing weather patterns will undoubtedly affect the durability of Scottish crops. Does the minister agree that there is an astonishing level of hypocrisy in the Tories’ posing that previous question when the Government’s plans seeking to mitigate climate change and its impact on society, including arable farming, are utterly undermined by the watering down of climate commitments?
Jackie Dunbar is right. Climate change is the biggest threat not just to farming but to human, plant and animal health. The Prime Minister’s watering down of climate policy is an unforgivable betrayal of current and future generations in all those respects.
In Scotland, many of our farmers and crofters are already taking extremely positive action to produce food sustainably in ways that actively benefit both climate and nature, and we are supporting them through our agriculture reform programme. The vision for agriculture outlines a transformation in how we support farming and food production in Scotland so that we become
“a global leader in sustainable and regenerative agriculture.”
That approach will allow agriculture to be more resilient to changes in the climate and will build on existing grants and advice.
However, Jackie Dunbar is right. We can do what we can to mitigate the effects of climate change, but the best way to deal with it is to halt it.
The overuse of fertiliser on our cereal crops can result in excess fertiliser run-off and the release of nitrous oxide, which is a greenhouse gas that is more than three times more potent for global warming than carbon dioxide. Understanding the soil microbe genome will lead to significant changes in our agricultural practice and improve crop yields while reducing dependency on synthetic nitrogen, which damages our environment. One solution is to get micro-organisms to fix more nitrogen for crop use, and we can do that now by using genetically engineered bacteria. When will the Scottish Government consider starting the process that would allow the world-renowned scientific institutions that we have in Scotland to carry out work to exploit the soil microbe genome to solve the problem?
I point Mr Carson to the strategic research programme, which is already looking into quite a lot of those areas. For example, the SRP is looking at disease resistance and pathogen biology, various tools and technology, the development of new populations and genotyping tools, and methods for trait dissection to support horticultural crop improvement. The programme is also looking at crop improvement for sustainable production in a changing environment, and it is exploring barley diversity for resilience and sustainability. Mr Carson asks when the Scottish Government will start that work, but our funded organisations are well under way in looking at all those issues.
Neglected Land
To ask the Scottish Government how it is helping to provide capacity for community groups to buy any neglected land in their local communities. (S6O-02588)
The Scottish Government is committed to supporting community ownership across Scotland through our Scottish land fund and our asset transfer and community right-to-buy policies.
The community right to buy abandoned, neglected or detrimental land came into force in 2018. It gives community bodies the right to compulsorily purchase land that is wholly or mainly abandoned or neglected or that is causing harm to the environmental wellbeing of the community. Through the Scottish land fund, community groups can access grants of up to £1 million—or, in exceptional circumstances, potentially more than that—to help them to take ownership of land and buildings.
Does the cabinet secretary agree that capacity building in areas of multiple deprivation is a key component of the land reform agenda?
The member raises an important point. I reiterate what I said in my initial response. Community ownership is a vital component of our land reform programme as it presents huge opportunities for communities in deprived areas to acquire land and buildings. We are well aware of the transformational impact that improving derelict and vacant land in deprived communities can have, and that there can be economic, social and environmental benefits for the people who live there. It is vital not only that such projects put communities at the heart of their activities but that communities are empowered to take on the ownership and management of such projects and spaces.
On the point about capacity building, we provide support to community groups in a variety of ways. Advice and guidance are available from Community Land Scotland, the community ownership support service and the Development Trusts Association Scotland. They work with community groups on a range of support and capacity-building activities, some of which are supported by grants from the Scottish Government.
Only two communities have applied for the right to buy neglected land since 2018, and both were unsuccessful. Proving that land has been neglected is very difficult. Communities are being blocked by overly bureaucratic processes, so what changes will the Scottish Government make to the right to buy in its upcoming land reform bill?
The member raises an important point. In fact, three such applications have been made. One of the transfers eventually took place through a negotiated sale, but the other two were not successful because improvement work was done on the land by the person who owned it.
A few weeks ago, when I gave evidence to the Net Zero, Energy and Transport Committee, we discussed that exact issue. I am more than happy to look at the potential barriers that are in the way, and at what we can do to resolve some of the challenges that communities can find themselves coming up against when they try to take ownership of vacant or derelict land.
Team Accommodation (Support for Rural Businesses)
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding support for businesses in the rural economy that provide team accommodation for employees due to a lack of affordable rural housing. (S6O-02589)
The Cabinet Secretary for Rural Affairs, Land Reform and Islands frequently has discussions with ministerial colleagues on a range of matters, including housing. My ministerial colleagues and I recognise the importance of housing to our rural economy, which is why our commitment to a rural delivery plan explicitly includes housing.
We have also committed to developing a rural and islands housing action plan, which will be published shortly. The plan will set out how we are supporting the delivery of housing in our rural and island communities, including through the £25 million demand-led rural affordable homes for key workers fund and proposals to give local authorities new powers to apply higher council tax rates for second homes.
The Auchrannie resort in Arran is employee owned, independent and locally run. Staffing is an issue because of the lack of affordable housing. About 110 staff live on site, and, without their own homes to rent or own, turnover is high. Does the minister accept that the exclusion from the figures of staff who are, in effect, homeless presents a false picture and that there is a real need for more affordable island housing? Will staff and team accommodation therefore be included in the figures in the future?
I welcome the action that businesses such as the Auchrannie resort are taking to meet the accommodation needs of their staff, but I accept the point that Mr Gibson, as a long-standing local MSP, makes about the permanency of that accommodation. Everyone wants not just somewhere to live but somewhere that they can make their home, which is a particular issue in rural and island communities.
I understand that work is being done in Arran to consider the island’s housing needs and that a local lettings initiative has been introduced that gives additional priority for housing on the basis of being a worker or resident on Arran. Again, I am happy to meet Mr Gibson to talk about that matter.
I have spoken with employers from across the Highlands and Islands who, having recruited the right people for their organisation, have been left struggling to secure accommodation for them. The SNP-Green Government has made big and bold statements on rural and island housing, but the simple fact is that the dedicated rural and island housing funds are not being fully utilised, despite extensions to the scheme. What has the Scottish Government learned from those failures, and what will it do differently in the future?
I referred to the rural and islands housing action plan, which is coming out. I also undertook a summer tour, during which I met a number of stakeholders, including the National Farmers Union Scotland, the Scottish Crofting Federation, the Scottish Islands Federation, Scottish Land & Estates and the Crown Estate. That informed what the rural and islands housing action plan will include. However, I am happy to meet Mr Halcro Johnston to talk about the matter.
Thank you, minister. Questions 7 and 8 were withdrawn, so that concludes portfolio questions on rural affairs, land reform and islands.
There will be a brief pause to allow the front benches to change before we move to the next portfolio.
NHS Recovery, Health and Social Care
The next portfolio is national health service recovery, health and social care. As ever, any member who wishes to ask a supplementary question should press their request-to-speak button during the relevant question. Brevity in questions and responses would be appreciated. Maggie Chapman joins us remotely to ask question 1.
Healthcare (Support for Trans People)
To ask the Scottish Government whether it will provide an update on what support is provided to trans people and their companions when accessing healthcare, including gender reassignment surgery. (S6O-02592)
I call the minister, Jenni Minto.
Minister, is your microphone on? Please can we switch on the minister’s microphone? There we go.
I apologise.
Since December 2022, we have invested more than £2.8 million to support improvement in access to, and delivery of, NHS gender identity healthcare in Scotland. More than £2 million has been allocated directly to health boards that provide gender identity clinics to expand staffing, reduce waiting times and put in place increased support for people on waiting lists.
As with any healthcare, the “Charter of Patient Rights and Responsibilities” sets out that patients have the right to be treated with respect and fairly and equally, whatever their health needs. The charter also states that another person can accompany them to an appointment to provide support.
I thank the minister for that response. Constituents have contacted me about their difficulties in accessing services, in terms of geography and insufficient support where there is a clinical recommendation that patients are accompanied for treatment.
Can the minister outline how the “NHS gender identity services: strategic action framework 2022-2024” will ensure that all health boards—not just those that have GICs—take a more proactive role to ensure the wellbeing of trans people living in their areas? Can she confirm that, where clinically recommended, health boards should provide travel reimbursements for companions?
I thank Ms Chapman for the question. As the member will understand, I am unable to comment on individual decisions made by a health board. However, financial support for travel is available for patients and authorised companions, according to eligibility criteria and medical requirements. Health boards are responsible for reimbursing patients’ travel expenses in line with Scottish Government guidance. That is expected to consider individual circumstances and ensure that patient care is at the centre of all decisions.
Our framework outlines a range of national work that is already having a positive impact on service provision across NHS Scotland. Perhaps the most relevant to Ms Chapman’s question includes the on-going development of Healthcare Improvement Scotland’s standard for gender identity healthcare, which is applicable to all health boards.
Independent Living Fund
To ask the Scottish Government whether it will provide an update on what steps are being taken to re-open the independent living fund. (S6O-02593)
Our approach to re-opening the independent living fund will be centred around co-design with disabled people and their representative organisations as well as with other stakeholder groups. We have already started the process of setting up a working group with Independent Living Fund Scotland that will co-design the re-opened fund, including developing eligibility criteria that will ensure that funding is targeted at those who will benefit the most.
I understand that the Glasgow Disability Alliance has welcomed the announcement that the Scottish Government will re-open the independent living fund, saying that it plays a vital role in Scottish social care in supporting disabled people to live the lives that they want to live. Can the cabinet secretary say any more about how the fund can support disabled people, including those living in my constituency, to live independently and participate in the community?
The announcement of the fund’s re-opening has been universally welcomed and I really welcome the question, which allows me to put on the record that ILF Scotland currently supports nearly 1,900 disabled people. Recipients can use their award to employ personal assistants or regulated support workers to meet their individual care requirements, which supports them to live in their own homes and play a part in the community through work, learning, training or hobbies.
The fund makes it easier for them to look after their physical, mental and spiritual wellbeing and to maintain relationships with family, friends and wider networks. Recipients are supported to have the choice and control to live their lives as they choose. By re-opening the fund, we will expand those benefits to more disabled people, starting with up to 1,000 new recipients in 2024-25.
Community Pharmacies
To ask the Scottish Government whether it will provide an update on what steps it is taking to support community pharmacies. (S6O-02594)
This year, we have increased community pharmacy funding by 6 per cent and have increased the guaranteed minimum income by 15.95 per cent, taking the total minimum funding package to £299 million.
We have also invested in a programme to support community pharmacists across Scotland to become independent prescribers. As of December 2022, a total of 1,852 pharmacists were qualified prescribers or currently undertaking an independent prescribing qualification, 474 of whom were working in a community pharmacy.
We also continue to invest in technology to support community pharmacy teams in delivering their services. We are currently investing in a digital prescribing and dispensing programme that will replace the current paper prescriptions and associated electronic prescription messages with a digital, paperless approach by the end of this parliamentary session.
I met Marie Curie and the Royal Pharmaceutical Society when they were in Parliament a few weeks ago. They discussed the daffodil standards with me and felt that having those standards could help not only community pharmacies but patients and their families. Does the Scottish Government welcome the daffodil standards and will it commit to helping community pharmacies to meet those asks?
We welcome the development of the daffodil standards by the Royal Pharmaceutical Society and Marie Curie UK. Those standards were adapted for community pharmacy teams and are based on the work completed by the Royal College of General Practitioners. They align with the eight standards used in general practice but reflect the way that pharmacies work. We encourage community pharmacists to sign up to the daffodil standards to help pharmacy teams to build on their existing palliative care provision and improve the quality of care provided to both patients and their carers. In order to increase sign-up, I am happy to raise the issue at my next meeting with Community Pharmacy Scotland.
We have a couple of supplementaries.
Earlier this year, Community Pharmacy Scotland warned that the Scottish National Party Government’s funding arrangements for 2023-24 will not support the pace of service development and that the year ahead will be one of recuperation and consolidation. Given the important role of the pharmacy first scheme in reducing pressures on the national health service, how will the Scottish Government support community pharmacies to provide clinical services when they continue to face significant financial and workload pressures of their own?
As I outlined in my first answer, we have been working very closely with Community Pharmacy Scotland to ensure that we are providing it with the correct funding package to enable it to continue the incredibly important work that it does in supporting our NHS in our communities.
Can the minister provide an update on the progress of the joint programme with NHS Education for Scotland and the Royal Pharmaceutical Society, which is aimed at encouraging more students to consider careers in pharmacy? Specifically, given the challenges that rural pharmacies face, what cross-portfolio discussions has the minister had within Government to ensure that the appropriate choices are in place for young people in education in rural regions, such as my own, so that they can embark on a path towards pharmacy from school age?
I thank Carol Mochan for that question and I recognise the issues that she raises, given that I, too, represent a rural constituency. Working with schools and, as she highlighted, working with NES, we are encouraging participants from parts of Scotland where there are gaps in the pharmacy workforce. It is important to work with local schools to encourage people into pharmacy. I visited a pharmacy in Ellon in the summer, and we talked about the issue there.
The chief pharmaceutical officer has established a national pharmacy workforce forum to provide strategic influence and national co-ordinated actions to support short, medium and long-term evidence-based pharmacy workforce planning.
Stoma Care Nurses
To ask the Scottish Government what its position is on whether there are enough stoma care nurses to care for the around 20,000 stoma patients in Scotland. (S6O-02595)
We recognise the valued contribution that clinical nurse specialists make to individual patients, their families and the wider delivery of specialist services. Their role is vital to supporting patients and families who require specialist care. To support that, the Scottish Government has invested more than £2.4 million annually in the specialist nursing and care fund.
However, although the Scottish Government has overall responsibility for health and social care policy in Scotland, the statutory responsibility for delivery and commissioning of services lies at a local level—with local authorities, national health service boards and integrated health and social care partnerships. Operational decisions, including whether there is a need for stoma specialist nurses, are therefore matters for those bodies to make and should take into account the numbers of patients in their local areas.
I thank the minister for that answer, although I am not sure that I heard an answer on the specifics.
I think that we need workforce planning for the future to be done across Scotland and not to allow the stoma nurses’ provision to be under the threat of retirals, which I fear it is at the moment.
Will the Government also commit to instigating an annual review for all stoma patients?
I am happy to look at that and discuss it with my officials. Perhaps Mr Mountain and I can meet again to talk about it further.
Epidermolysis Bullosa
To ask the Scottish Government what work is on-going to support the development of new treatments for those living with epidermolysis bullosa, which is commonly known as EB. (S6O-02596)
The Scottish Government wants people in Scotland with rare diseases such as EB to be able to access the best possible care and support. We support research through the chief scientist office by providing funding opportunities for research on a wide range of conditions, which could include EB treatments, with open competitive grant schemes and Scottish access to National Institute for Health and Care Research programmes.
Through NHS research Scotland, the CSO also invests in infrastructure to support health boards to host and participate in clinical trials, including support for studies on rare diseases and skin conditions.
I thank the minister for that answer and for her attendance at the DEBRA event that I hosted recently in the Scottish Parliament. As the minister knows, at the event we heard that advances in EB treatment over the years have been painfully slow, but that there is currently a real opportunity to repurpose up to 10 drugs that are used to treat other conditions.
How can the Scottish Government work in partnership with other United Kingdom healthcare systems to identify the required funds, which are estimated at £10 million, to allow clinical trials to proceed and, I hope, provide improved treatments for that dreadfully painful condition?
I thank Bob Doris for hosting the DEBRA event in Parliament a few weeks ago. I heard the very personal experiences of what it is like to live with EB, as well as hearing from the clinicians about the potential of drug repurposing research to identify treatments that might improve the quality of life for people with EB. It was a very powerful event.
We recognise the potential of drug repurposing research to find new, safe and effective treatments for health conditions. We participate in NHS England’s medicines repurposing programme, which seeks to identify and progress opportunities to use existing medicines in new ways, and the chief scientist office works in partnership with other health research funders, including the National Institute for Health and Care Research and medical research charities, to support research. The CSO’s partnership with NIHR opens NIHR’s large programmes to researchers in Scotland, thereby providing funding opportunities for large studies and trials of treatments across the range of health conditions. Applications are subject to independent expert peer review, and funding recommendations are made by independent expert committee.
Scottish General Practitioners Committee (Engagement)
To ask the Scottish Government when it last engaged with the Scottish general practitioners committee and what was discussed. (S6O-02597)
Scottish Government officials regularly meet the Scottish general practitioners committee of the British Medical Association, and they last held a bilateral meeting on 14 September, at which contractual and funding issues were discussed as part of our joint endeavour to ensure the sustainability of general practice.
I understand that, today, officials are holding an all-day discussion with the committee to discuss the future development of the GP contract.
My constituents have raised concerns that they are not receiving up-to-date information about the changes that are happening at their local GP surgeries. It is my understanding that the Scottish general practitioners committee previously identified that as an issue and called on the Scottish Government to educate the public on changes in GP practices.
Are there any steps that the Scottish Government can take to support GPs to amplify the “Right care, right place” message and provide their patients with impactful communications that explain what to expect from their GP primary care team, how to access the right health professionals directly and any changes in the day-to-day operations of practices?
The member raises an important point and correctly referred to the “Right care, right place” campaign. That programme, which has been running since 2021, is about providing the general public with targeted information to ensure that they consider what the right route is for them to access healthcare services. The next phase of that campaign is due to run throughout this autumn and winter to help to ensure that the public have a broad range of information available to them. I assure the member that we intend to continue to have a phased programme of investment over the course of the next 18 months to support education to ensure that patients access the right service in the right place.
I will allow a couple of supplementaries, the first of which comes from Sandesh Gulhane, who joins us remotely.
The Scottish Government failed to deliver the original GP contract that was negotiated in 2018. It created a second memorandum of understanding in 2021, in which it made further promises on primary care and pharmacy. The Scottish Government is failing deprived communities, rural communities and island communities. Does the cabinet secretary consider that the Scottish Government is on track to deliver on its contractual promises, including on community link workers and community pharmacy for rural and island areas, as promised in the second memorandum of understanding?
I declare my interest as a practising national health service GP.
We encourage members to have their cameras on at all times, wherever possible.
In short, yes, I do—and we will continue to make progress with phase 2 of the contract.
I have been contacted by numerous GPs in Glasgow who face the prospect of losing, from next April, the vital community link workers who are based in their practices. Last week, official figures confirmed that people in Glasgow have the lowest life expectancy in Scotland. Despite that fact, the number of link worker posts in what are some of the most deprived communities is to be reduced from 70 to 42. Does the cabinet secretary accept that any cut is at odds with the programme for government commitment to ensuring that link worker services can respond to local needs? What is being done to save those jobs in the poorest communities in Glasgow?
I recognise the value of the important role that community link workers play in our GP practices. As I have repeatedly said, I want the existing number of community link workers to be maintained. For a number of weeks, my officials have been engaging with the integration joint board in Glasgow in order to address concerns about the way in which the primary care improvement fund is operating.
The funding from the Scottish Government has not changed; rather, there has been a change of approach by the IJB, and we are engaging with it in an effort to address the issue. I hope that we can continue to make progress with the IJB on the matter. It is my intention that the Scottish Government’s investment in the programme continue into the future, and I want the IJB to be open to ensuring that it looks at every possible avenue for continuing to invest in community link workers in GP practices in Glasgow.
Health Services (Highlands and Islands)
To ask the Scottish Government what its position is on whether the provision of health services across the Highlands and Islands region meets the needs of local communities. (S6O-02598)
Everyone should receive the best possible care and treatment from our health and care services. Service delivery is the responsibility of individual health boards, but we set out the wider policy within which national health service boards are expected to deliver high-quality care that is safe, effective and person centred, in order to meet the needs of local communities.
I recognise that rural and island NHS boards experience particular challenges, which is why work is on-going to ensure that services are delivered in a flexible way that responds to local population needs and geographic challenges. An example of that is the national centre for remote and rural health and care, which will be launched later this month.
The transfer of vaccination from general practitioners to NHS Highland has been fraught with difficulty. NHS vaccinators are travelling upwards of 100 miles to carry out vaccinations that local GPs are perfectly capable of doing. As winter approaches and new vaccination schemes are rolling out, what steps is the Scottish Government taking to ensure that the efficacy of vaccinations in Scotland’s remote, rural and island communities is significantly improved?
I recognise that there are some specific challenges with vaccination programmes in rural areas. However, the member will be aware that the change was instigated in NHS Highland as a result of the British Medical Association’s negotiations on the GP contract. The organisation wanted vaccinations to be removed from GP practices and to be done by the NHS. That was the approach that has been taken and which was agreed to.
Clearly, there have been some challenges around that. I know that we are continuing to engage with NHS Highland to try to address those issues and to make sure that a proper vaccination programme is delivered as locally as possible to constituents across the Highlands.
I am interested in the cabinet secretary’s answer. The 2018 contract review, which was carried out by the BMA, was not supported by GPs across the Highlands, who want to carry out vaccinations themselves. On that basis, will the cabinet secretary renegotiate that agreement in order to allow rural areas to get the vaccination cover that we deserve and that we are not getting?
I recognise the on-going concerns. However, the member will appreciate that the GP contract applies across all GP practices in Scotland. That formed the basis of the approach. I recognise the concerns that the member is raising about the matter and I am not dismissing them. However, the GP contract applies across all GP practices in Scotland. It is difficult to provide carve-outs for specific areas because of the difficulties that that creates. Notwithstanding that, we are continuing to engage with NHS Highland and it is continuing to engage in looking at how it can address some of the local concerns.
National Health Service Recovery Plan
To ask the Scottish Government whether it plans to publish winter updates to its NHS recovery plan and winter resilience overview. (S6O-02599)
Our NHS recovery plan for 2021-26 was published in August 2021 and sets out our key ambitions and actions to be delivered over the next five years, in order to address the backlog in care and deliver the recovery and renewal of NHS services. We are investing £1 billion over the lifespan of the plan in order to support increased NHS capacity, deliver reform and ensure that everyone has the treatment that they need at the right time, in the right place and as quickly as possible.
In addition, a separate winter plan, which has been developed jointly with the Convention of Scottish Local Authorities, will be published later this month. The plan sets out the actions that are being taken across the whole health and social care system to alleviate the inevitable and considerable pressures across NHS Scotland this winter.
This year, preparedness work for the coming winter began earlier than ever before, and builds on lessons learned from previous winters on what we know works to ensure that people are able to access the best and most appropriate healthcare for their needs. We have been working with all parts of the system to ensure the actions that are set out in the winter plan are being undertaken consistently and as a matter of priority in order to help to build capacity and cope with increased demand over the winter months.
Similar to the previous health secretary, it is quite clear that this cabinet secretary is simply not doing enough to prepare health boards for the winter. During a recent visit to Borders general hospital, dedicated staff told me that they were already at capacity and were facing a crisis this winter across the hospital. On the day that I visited, 80 out of 310 beds were blocked as a result of delayed discharges, and there was simply no further capacity to flex. Despite what the cabinet secretary says, is it not time that the distracted and divided Scottish National Party Government focused on delivering a real and meaningful NHS recovery plan and a real strategy to deliver resilience this winter?
I am a bit surprised by Mr Hoy’s question, because—given that we have not published it yet—he seems to have jumped to a conclusion on whether the winter plan contains the right actions.
Mr Hoy probably does not recognise that our NHS is now under pressure throughout the year, rather than just during the winter. In the winter, the pressure becomes much more acute, which is why we are taking forward a range of measures including additional investment and redesign of services.
I assure Mr Hoy that we will continue to invest in our NHS—in particular, in the staff who do a first-class job across our NHS, in the way that Mr Hoy made reference to. We are doing that by giving them the best pay in the UK and, importantly, by making sure that we avoid industrial action in our NHS and allowing services to be delivered to patients on a consistent basis, unlike his colleagues south of the border.
It is welcome that the Covid vaccination and winter flu vaccination programmes were started earlier this year, particularly in light of there being a new Covid variant. I am sure that we all encourage everyone who wishes to get the flu or Covid vaccine to take up that offer. Can the cabinet secretary provide an update on the progress that has been made on the programme to date?
We have made excellent progress on our flu and Covid vaccination programme, with more than 34,000 flu and 176,000 Covid vaccinations having been delivered in the first three weeks of the programme, up to 24 September. Further public figures detailing vaccine uptake by Joint Committee on Vaccination and Immunisation eligibility groups will be made available in the coming weeks via Public Health Scotland’s dashboard. All invites for people aged 12 and over who are eligible have now been sent out, and invites for under-12s will follow shortly.
The cabinet secretary mentioned building capacity and how it is key to tackling our backlogs, but the national treatment centres are the backbone of that solution. I am concerned that many are behind schedule, and the one that was BMI Carrick Glen hospital will not be open for the foreseeable future. How will we tackle our backlogs when there is such a backlog in producing the capacity?
Tackling the backlogs is done through a combination of providing additional capacity and making better use of existing capacity. As the member will know, by the end of this year, five of the new national treatment centres will be open. The member will also be aware that her colleagues in Westminster have cut our capital budget, which has resulted in less capital spending being available to us.
Alongside that, because of the disastrous mini-budget last year and the inflation that it caused, construction costs have gone through the roof. That means that capital budgets now have much less value—as an Audit Scotland report highlighted last week—as a consequence of the UK Government’s decisions on those matters. Those matters have an impact on how much capital investment we can make, so I hope that the member will encourage her colleagues down in Manchester to make sure that they make the capital investments that are needed to allow us to roll out more national treatment centres across the country.
That concludes portfolio questions on NHS recovery, health and social care. There will be a brief pause to allow front benches to change before we move to the next item of business.
Air adhart
Two-child Benefit Cap