Meeting of the Parliament

Meeting date: Thursday, March 9, 2023

Official Report 1001KB pdf

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General Question Time

Good morning. The first item of business is general question time.

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General Practitioners (Recruitment Target)

To ask the Scottish Government whether it will provide an update on its target to recruit 800 additional general practitioners by the end of 2027. (S6O-01988)

We are making good progress. Since 2017, the GP head count has increased by almost 300—by 291—and a record 5,209 GPs are now working in Scotland.

In addition, we have increased the medical undergraduate intake by 448 places since 2015-16, and we will increase GP specialty training by 100 places over the next three years. The fill rate for specialty training is also at a record high, at 99 per cent for 2022. Last year, I launched our GP recruitment marketing campaign, and we are providing significant investment in initiatives that ensure that being a GP remains an attractive career option.

Audit Scotland has found that the Scottish Government will fail to meet its own target for increased GP numbers, which is indicative of its failure in workforce planning over many years. However, it is not just a recruitment issue. There is also a significant issue with capacity in GP surgeries. Surgeries are bursting at the seams, and the British Medical Association has found that 81 per cent of practices currently exceed capacity.

In the village of Neilston, which I represent, I spoke with GP partners of the Neilston medical centre, who told me that they are struggling to find the physical space to meet demand. They applied to the Scottish Government for loans to increase space, but the application was rejected. If the practice cannot expand, it might be forced to close its books. Why is the Government not giving GP surgeries the support that they need to expand the provision of general practice in their communities?

They are being given that support. That is why we have increased GP numbers by 291 and multidisciplinary team numbers by 3,220. It is about not just having enough GPs—that is very important, which is why we are increasing the numbers—but having those multidisciplinary teams in GP surgeries right across Scotland. We have a loan scheme, which Paul O’Kane has mentioned. If he has a particular issue, I am more than happy for him to write to me, but we are providing support for our general practices and for our general practitioners.

The reality is that the Scottish Government is nowhere near meeting its target of recruiting 800 additional GPs. That is yet another example of promises but no delivery, with £65 million cut from the primary care budget.

This week, we heard from the BMA that four in 10 doctors are actively looking to leave and that it is looking at balloting to strike. A surgeon in Lothian said that one in four operations for children—life-saving surgery—is being cancelled at short notice due to a chronic shortage of critical care nurses, who are not included in the figures. Does the health secretary seriously expect us to believe that the situation is improving? What steps will he take to address those catastrophic failures?

Sandesh Gulhane asks whether I expect him to believe that the position is improving. The fact is that we have 291 more GPs than we had in 2017. The head count has increased. We have a record 5,209 GPs. We have 3,220 multidisciplinary staff, many of whom work across general practice up and down the country. We will continue to support general practice.

I have mentioned that we are increasing our medical graduate intake as well. On top of that, we have a record high 99 per cent fill rate when it comes to specialty training. I will continue to work with the British Medical Association and the Royal College of General Practitioners, but the Government has an excellent record not only in supporting but in helping and assisting our general practices, particularly in rural Scotland, where we know there are some challenges. The Scottish graduate entry medical programme is just one example of that.

Short questions and responses help me to get more questions in.

I do not think that what the cabinet secretary has said is what Kate Forbes says. The minister has a sunny disposition, but he is spinning a bogus argument. According to Public Health Scotland estimates, the number of whole-time equivalent GPs—not the head count—fell by 26.4 between 2017 and 2022. The minister is making no progress; in fact, things are worse than when he started. Why is he not listening to the warnings?

We are. That is why the head count has increased by 291. On whole-time equivalents, it is, of course, a good thing that we are introducing flexible working, which helps with retention.

I have already outlined all the key lines and all the key measures that we are taking to support general practice. I do not think that Willie Rennie is in any position to lecture anybody on electoral success. He has presided over disastrous election defeat after disastrous election defeat for his party. His party could not even field a five-a-side football team, for goodness’ sake.

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Crime Statistics

To ask the Scottish Government what its response is to the recorded crime in Scotland statistics for the year ending December 2022. (S6O-01989)

Those figures show that Scotland continues to be a safe place to live in, with recorded crime at one of the lowest levels since 1974 and down 42 per cent since 2006-07. That is testimony to the continued efforts across policing, justice and community safety partners to deliver a safer Scotland for everyone.

Of course, we recognise that challenges remain, which is why, for example, we have taken robust action to tackle sexual offending and have invested £93 million over the past five years to ensure that victims’ rights and needs are at the centre of Scotland’s criminal justice system.

At the end of last month, when those recorded crime statistics came out, the cabinet secretary boasted about how safe Scotland is, but I think that domestic abuse victims will have a different take on those statistics. The data reveals that, for the year ending December 2022, there were more crimes recorded under the Domestic Abuse (Scotland) Act 2018 than in any other year since its introduction. Instead of boasting to victims of those heinous crimes about how safe Scotland is, will the cabinet secretary work with me by backing my plans to tackle domestic abuse in Scotland?

It is not a boast to acknowledge the efforts of policing, justice and community safety partners and to say that Scotland is a safe place in which to live. I do not know whether or not Pam Gosal welcomes that. Their efforts have contributed to a 42 per cent reduction in recorded crime since this Government came to office. That is a statement of fact. I do not know whether Pam Gosal is uncomfortable with that, but that is simply the case.

A great deal has been done to increase the reporting of domestic abuse, which is to be welcomed.

As to Pam Gosal’s bill, I do not know how many times she is going to demand of me that I support her bill without seeing it—indeed, without even seeing, as yet, the analysis of the consultation on it. By all means, let us have a discussion—I have happily already entered into a discussion with her—but at least let us see the evidence before we come to a conclusion.

I, too, welcome the continued decrease in recorded crime in Scotland, which remains at one of the lowest levels for any 12-month period since such records began. Nonetheless, we all agree that there is much more to be done for those who experience crime. What steps are being taken to strengthen support for victims of crime?

Audrey Nicoll rightly asks what steps we have taken. We have established the victim-centred approach fund, invested £48 million over 2022 to 2025 and awarded more than £917,000 from the victim surcharge fund to provide practical help and support.

Furthermore, as was announced yesterday, the forthcoming criminal justice reform bill will introduce new rights to independent legal representation in sexual offence cases, alongside providing anonymity for victims and abolishing the not proven verdict. The bill will also be informed by recent consultation on improving victims’ experiences, including proposals for a victims commissioner.

That will indicate to Audrey Nicoll the breadth of measures that we are taking in that area.

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Deaf Community

To ask the Scottish Government what support it provides to the deaf community. (S6O-01990)

The Scottish Government provides around £2.2 million in funding through the equality and human rights fund and the children, young people and families early intervention fund to third sector projects that work with deaf people.We also provide funding of £600,000 per year to Contact Scotland BSL, an online video relay service enabling deaf and deafblind British Sign Language users to make phone calls. We also fund the Scottish Sensory Centre and CALL Scotland to provide advice and training to school staff on support, including the use of assistive technology for children and young people with specific communication and sensory needs.

I recently met the local deaf club in my constituency to discuss the problems faced by people whose first language is British Sign Language. What actions has the Scottish Government taken to promote the provision of written information and correspondence from Scottish businesses and organisations such as the Office of the Scottish Charity Regulator to BSL users in a format that they can access, read and understand?

The Scottish Government is committed to promoting the use and understanding of BSL as a fully recognised language across the Scottish public sector. BSL users can contact businesses using the Contact Scotland BSL online video relay interpreting service, and businesses can contact their deaf customers in the same way. Contact Scotland BSL is widely promoted to deaf BSL users and to service providers through a series of free online webinars and visits to deaf clubs.

The minister will be aware of the damning findings of the audit into NHS Lothian’s audiology department and how that situation affects the deaf community. Last week, a number of local MSPs met the families directly and heard about how it is affecting them.

Will the Government confirm that it will meet local MSPs and families from the families failed by Lothian audiology action group in order to ensure that the treatment support needs of those children can be met and that, most importantly, we find out how many children have been affected?

The responsibility for national health service audiology lies with my health colleagues, some of whom are in the chamber today. I am sure that they will respond appropriately to Mr Whitfield.

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Adult Neurodevelopmental Pathway Trials

To ask the Scottish Government when the final report of the national autism implementation team’s adult neurodevelopmental pathway trials, which were conducted within four national health service board areas, will be available. (S6O-01991)

The adult neurodevelopment pathways pilot ran for 12 months from January 2022, funded by £650,000 from the Scottish Government. The report will be published on 16 March and will be available on the national autism implementation team’s website. A national learning event hosted by the implementation team is also planned for 16 March, and the Scottish Government will be considering the next steps.

The ADHD Foundation states that undiagnosed and untreated ADHD in women and girls can have further impacts beyond health, including on their education, employability and economic independence. Given that, does the Scottish Government have any data on the potential impact that such a national pathway roll-out could have on socioeconomically disadvantaged women across health boards throughout the country, for whom the private assessment fees are simply unaffordable? Are there any plans to focus aspects of the roll-out across all health boards to include such groups?

We are aware that ADHD can have significant impacts. The ultimate aim of the pathway is that people can access the support that they need when they need it. We will be happy to think about socioeconomic factors in taking all that work forward.

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NHS Lanarkshire (Engagement)

To ask the Scottish Government when it last engaged with NHS Lanarkshire. (S6O-01992)

Both ministers and Scottish Government officials meet regularly with representatives of all health boards, including NHS Lanarkshire. I last met the leadership of NHS Lanarkshire last month to discuss plans for sustained improvement in local unscheduled care.

The Lanarkshire local medical committee represents general practices across Lanarkshire. It tells me that it has significant concerns around the vast increase in the number of patients seeking fit notes from their general practitioner when the fit note should have been issued by the patient’s hospital consultant at the time of treatment. Our consultants do an amazing job, but that issue needs to be ironed out. The LMC tells me that thousands of unnecessary GP appointments are taken up by those patients each year as a consequence. My constituency office is aware of similar cases—

Can I please have a question, Ms Callaghan?

—for patients who are referred to Glasgow hospitals, so there is a wider issue. What steps can be taken to ensure that hospital consultants are issuing fit notes to patients to reduce the unnecessary pressure on GPs?

I am not aware of that issue being raised directly with the Government by the Lanarkshire local medical committee, but the member is right that it is an issue that affects health services and general practices across the country. I will work closely with the British Medical Association, the Royal College of General Practitioners and our health boards to see what we can do, because we know that our general practice colleagues up and down the country are under enormous pressure. That is why the Government has a record of increasing the head count of GPs by 291, and we aim to go much further.

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Windsor Framework (Impact on Scotland)

To ask the Scottish Government what its response is, regarding the potential impact on Scotland, to the Windsor framework. (S6O-01993)

The Scottish Government welcomes the Windsor framework agreement. The dispute over the Northern Ireland protocol was of the United Kingdom Government’s own making and was deeply damaging, threatening what would have been a catastrophic trade war with the European Union in the middle of a cost of living crisis. The Scottish Government also fully supports the Good Friday agreement. However, Scotland is, by the Prime Ministers own admission, now at a major competitive disadvantage. Mr Sunak said that Northern Ireland was in an

“unbelievably special position, a unique position in the entire world”.

Has the cabinet secretary detected any substantial difference between the positions of the UK Government and the Labour Party on Brexit? Given that, as he said, Scotland and the UK are no longer in the “unbelievably special position” that the Prime Minister has outlined for Northern Ireland, will the Scottish Government assess the impact on Scotland of it being placed outside the European Union single market and customs union, which is the policy of both the Tories and the Labour Party?

Scotland is feeling the full damage of the UK Government’s hard Brexit despite our overwhelming vote to remain and despite the fact that the Scottish Government put forward a compromise plan in 2016 to keep both the United Kingdom and Scotland in the single market—a compromise that was dismissed by UK ministers. [Interruption.]

Let us hear the cabinet secretary.

We are reading the legal text of the Windsor agreement and requesting more detail from the UK Government so that we can establish in more detail what the framework will mean for Scotland.

There appears to be no significant difference between the Conservative Party and the Labour Party on this. They both support a hard Brexit, which is hugely damaging. It has never been clearer that the only way to regain the benefits of European Union membership is for Scotland to be an independent country.

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Livestock Safety (Responsible Countryside Access)

To ask the Scottish Government what action it is taking, with lambing season about to begin, to support farmers to keep livestock safe, including in relation to promoting responsible countryside access. (S6O-01994)

The Dogs (Protection of Livestock) (Amendment) (Scotland) Act 2021, which has been in force for over a year, provides Police Scotland and the courts with greater powers to deal with those who allow their dogs to worry, attack or kill livestock in Scotland’s countryside.

Increasing awareness is a key factor in the prevention of livestock-worrying incidents and the associated unnecessary suffering. The Scottish outdoor access code is clear on the rights and responsibilities of land managers and those who exercise access rights, and it is widely publicised. More generally, the Scottish Government, in partnership with the Scottish Society for the Prevention of Cruelty to Animals, has delivered a digital awareness-raising campaign to promote responsible dog ownership, which ran in early 2021 and was rerun during 2021-22.

As well as facing high costs due to the cost of living crisis and Brexit, farmers are still being financially and emotionally impacted by attacks on their livestock by out-of-control dogs. As the lambing season begins, will the cabinet secretary join me in again encouraging everyone, when enjoying Scotland’s beautiful countryside, to do it responsibly and follow the Scottish outdoor access code, keeping dogs under close control to prevent livestock from coming to harm?

I thank Emma Harper for raising this important matter in the chamber today, because I do not think that we can emphasise enough the impact that it has on our farmers. As she said, that impact is financial but, importantly, it is emotional as well.

I encourage everyone who wants to enjoy our beautiful countryside to follow the Scottish outdoor access code and keep their dogs under close control to prevent livestock from coming to harm. The national access forum, which includes NatureScot, NFU Scotland, Police Scotland, the Scottish Kennel Club and Scottish Land & Estates, agreed that common high-level messaging for dog owners in 2020, and I know that NatureScot will employ it widely in the coming spring lambing season and throughout the rest of the year on its social media platforms as a key part of the on-going access code campaign activity.

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Animal Welfare Legislation

To ask the Scottish Government what its position is on introducing legislation in Scotland similar to the United Kingdom Animals (Low-Welfare Activities Abroad) Bill. (S6O-01995)

The Scottish Government takes animal welfare very seriously and remains committed to ensuring the highest standards in Scotland. I thank Christine Grahame for raising the issue with me. In our recent correspondence on it, I shared my extreme disappointment that the bill has been handled so poorly by the UK Government, which has ultimately left us with insufficient time to properly consider this important matter.

I remain absolutely committed to improving animal welfare and I am of course open to considering similar proposals to restrict the advertising in Scotland of unacceptable animal experiences abroad. However, that has to be done in a manner that respects the role of the Scottish Parliament and the other important animal welfare issues that the Scottish Government wants to address.

The legislation refers to the use of animals such as Asian elephants for the entertainment of tourists. The cabinet secretary referenced her letter to me. Will she meet me and the chief executive of Save The Asian Elephants to see what measures the Scottish Government can take to help end exploitation of those magnificent beasts?

Briefly, cabinet secretary.

We are happy to have those discussions. The Government has reached out to stakeholders, and my officials met Duncan McNair and Peter Stevenson on Monday of this week to discuss the bill. As a result of that constructive engagement, I thank them and Save The Asian Elephants for their kind offer of assistance as we look to explore ways in which we can improve the welfare of not only elephants but all animals that are subject to low-welfare conditions.

That concludes general questions.