Meeting of the Parliament

Meeting date: Tuesday, May 9, 2023

Official Report 924KB pdf

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Topical Question Time

The next item of business is topical question time. In order to get in as many members as possible, I would appreciate short and succinct questions and responses.

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Junior Doctors (Industrial Action)

To ask the Scottish Government what steps it is taking to avoid industrial action by junior doctors, in light of the decision in favour of action by almost 97 per cent of British Medical Association Scotland members who voted. (S6T-01364)

I have begun direct negotiations with the junior doctors committee at BMA Scotland; those commenced on 20 April. Talks are progressing and we are scheduled to meet again on 11 May. I agreed with all parties that negotiations would be held in confidence and, as such, I cannot provide any further details at the moment.

I will continue to do all that I can to avoid industrial action in the national health service, which would be in no one’s interests. However, I have been clear that the BMA’s ask for a 35 per cent pay uplift is simply unaffordable. I will update Parliament when negotiations have concluded.

The outcome of the ballot was overwhelming, indicating the strength of feeling among our hard-working junior doctors. Since 2008, pay for newly qualified doctors has been eroded by a staggering 23.5 per cent in real terms. A recent BMA survey showed that 44 per cent of junior doctors are actively thinking about leaving the profession and going to New Zealand or Australia. There are even junior doctors who are relying on universal credit to cover childcare and energy bills. In the wake of the clear mandate for strike action, will the cabinet secretary commit to tabling a credible pay offer?

I recognise the strength of feeling among junior doctors. The outcome of their ballot, which was published on Friday last week, demonstrates the scale of their concern. I have gone into the process of negotiation with junior doctors in an open and genuine way, to seek to try to address short-term, medium-term and long-term issues that I believe need to be addressed. I want NHS Scotland to be a place of choice for junior doctors to work throughout their careers, and am determined to do everything that I can to try to achieve that.

I will not be drawn into giving details about pay negotiations. That is not in the sense that I am being disrespectful to Parliament; it is because I went into the process assuring people that I would act on a confidential basis while those negotiations were still taking place. I intend to keep the commitment that I gave to the junior doctors committee at BMA Scotland. However, the member can be absolutely assured that I will do everything in my power to try to help to avert the risk of industrial action by junior doctors in NHS Scotland.

I very much welcome the fact that the cabinet secretary is engaging with junior doctors and their representatives and I wish those negotiations well. However, the cabinet secretary will understand that, with one in seven patients currently on waiting lists, and the worst ever performance on record in tackling cancer, the Scottish Government simply must avoid strike action, which will make matters worse.

The cabinet secretary will agree that warm words will not cut it. The First Minister, in his first week in office, announced spending of £61 million, so we know that, where there is the political will, there is a way. If, however, the cabinet secretary is unable to negotiate a settlement, can he outline the contingency plans that he has in place to cover the proposed 72-hour period of industrial action?

As a Government, we have a very strong track record, in that we are the only part of the United Kingdom that has not experienced industrial action in our national health service. The reason is that we have had meaningful engagement with trade unions and their representatives in order to address concerns that have been raised with us.

On the issue of junior doctors, we need only look at the statistics on recruitment into NHS Scotland. We filled more posts in 2022 than in any other year since records began back in 2013. NHS Scotland is still a very attractive place for junior doctors to work, but clearly there are serious concerns that we need to address, and I am determined to do that.

What I can also say to the member is that I have already asked health boards to put contingency plans in place, should we be in a situation where industrial action unfortunately takes place, because such action will be very destructive. The nature of those contingency plans depends on any derogations that are agreed with the junior doctors committee, if it takes industrial action. However, I want to ensure that we have the plans in place and, in the time that is available to us, that I do everything I possibly can to try to avert the risk of industrial action by junior doctors in NHS Scotland.

I am keen to take supplementaries, so I ask again for concise questions and responses.

I welcome the fact that the Scottish Government will continue to do everything that it can to achieve a deal with junior doctors to ensure that Scotland continues to avoid industrial action in our NHS. Meanwhile, it is concerning that Labour’s shadow health secretary, Wes Streeting, recently said that he does not support the junior doctors strike, and the Westminster Tories’ proposed anti-strike legislation is a barefaced attack on workers and their right to demand better pay.

Therefore, will the cabinet secretary affirm that the Scottish Government will continue to support the right to strike? Does he agree that the only way to protect workers’ rights, just like our European neighbours do, is for Scotland to escape Westminster control?

I am aware of the comments that were made by Wes Streeting, which I find deeply surprising from a Labour politician, but I think that that is a reflection of the fact that Labour at Westminster is just a pale imitation of the Tories these days.

In relation to the anti-trade-union legislation that the UK Government is taking forward, we have already raised our concerns. The UK Government is also seeking to take powers through that legislation in order to reach into devolved areas, which is unacceptable.

Nevertheless, my focus is to ensure that we do everything possible to avert the risk of industrial action in Scotland, so that we do not have the same challenges that we have witnessed through the seven days of industrial action in NHS England, which has resulted in hundreds of thousands of procedures and appointments having to be cancelled.

I will do everything within my powers to try to avert such action, but I assure members that, should industrial action take place, we will have contingency arrangements in place.

I have been there, as a junior doctor struggling against the system. Many junior doctors are now experiencing burnout. I recently visited University hospital Ayr and saw the difference that access to good nutritious food can make to concentration levels and to preventing fatigue and burnout. However, that is not replicated across the country. Conditions matter, as does pay. Night-shift staff across Scotland do not have access to hot nutritious food at night, so will the cabinet secretary commit to mandating the provision of hot nutritious food that is not from a vending machine, for night staff across all health boards in Scotland?

I recognise the concerns that the member has raised; it is not the first time that they have been raised with me, and I will give them due consideration.

The member is right to highlight that it is important that we recognise that some staff feel burned out, and that conditions matter. That is why it is all the more important for Government to engage with junior doctors in an open and sincere way in order to try to address their concerns.

I would hope that Governments across the whole UK would do that with junior doctors in order to reduce the risk of further industrial action taking place, even where the member’s party is in control in England, given that England has already had seven days of disruption.

I assure the member that I will do everything that I can for the areas for which we are responsible in Scotland. That is why we have undertaken detailed open dialogue in negotiations with junior doctors, as a means to try to address their concerns. I assure the member that that is the approach that this Government will take, which is in stark contrast to the approach that his colleagues at Westminster have been taking, to date.

The cabinet secretary’s predecessor in the role, the now First Minister Humza Yousaf, used to set great store by the same statement that we have just heard from the cabinet secretary: that there has not been strike action in Scotland, whereas there has been in England. However, that situation will soon end, given the distance between the pay claim and the Government’s position.

If we are moving to a period of strike action, what discussions has the cabinet secretary had with NHS England about lessons learned from the period of disruption there, and about steps to mitigate strike action if and when it happens?

In trying to resolve the matter, I have not looked to NHS England for much in the way of lessons, given the seven days of industrial action that it has already experienced. I am determined to resolve the issue in the short, medium and long terms, and will do everything that I can to try to achieve that.

As I have mentioned in my comments in the chamber, I have already asked NHS boards to put in place contingency arrangements should industrial action occur, but I will do everything that I can to try to avoid that so that we do not have the same type of disruption—significant disruption, with hundreds of thousands of appointments and procedures being cancelled—as has been the case in NHS England.

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Forensic Spiking Testing (Scottish Police Authority Contract Award)

To ask the Scottish Government what its position is regarding reports that a new contract has been awarded by the Scottish Police Authority, valued at around £663,000, for the provision of additional forensic testing in relation to suspected cases of spiking. (S6T-01368)

The act of spiking is utterly abhorrent. We remain absolutely committed to working with partners, including Police Scotland, health services and third sector organisations, in order to tackle all forms of violence against women and girls. It is absolutely appropriate that Police Scotland should take whatever operational decisions it considers appropriate to have additional capacity in place to address spiking cases, should that be required.

Police Scotland’s increased testing will be welcomed by victims, who have been failed for far too long. I commend Jess Insall, who has campaigned on the issue after having been spiked during a night out in Glasgow. It took 34 hours before Jess was tested, and 10 months to get the result. That is far too long—time is critical in spiking cases. That is just part of the problem.

My proposed bill would ensure that spiking is recorded as a specific criminal offence and that the police, the national health service and licensed venues would deal with cases more consistently and efficiently. Would the cabinet secretary be willing to back those important measures, at least in principle?

We will always listen to views on the need for a stand-alone offence. However, spiking can already be prosecuted in Scotland: section 11 of the Sexual Offences (Scotland) Act 2009 has an offence of “Administering a substance for sexual purposes” and, depending on the facts and circumstances of the individual case, the common-law offence of assault can also apply.

The Government will await further details on the proposed member’s bill and how it would interact with the measures that are already in place. I assure the member that such proposals will always be given a fair hearing.

On the points about the times in that end-to-end journey for testing and results, we will continue to look at the process very closely, because we need to improve the experience of people who are the victims of such an abhorrent crime.

Every time I talk about spiking, more people come forward with their stories. Spiking appears to be endemic in pubs and clubs and on university campuses—some people even view it as a terrifying rite of passage.

The cabinet secretary referred to legislation that can be used to address that just now. However, in the past three years, there have been only seven convictions for administering a substance for sexual purposes. Predators know that the law is failing to protect young people. In a spirit of cross-party co-operation, will the cabinet secretary agree to join me in a meeting with spiking victims and others?

I am always happy to meet the member and other members from across the political parties. I look forward to seeing the detail of the member’s proposed bill. He might be interested to learn that the most recent Police Scotland statistics, which were published last December, report that, from October 2021 to October 2022, there were 601 recorded crimes related to spiking.

I reassure the member that we continue to work not just with those across the justice system, but with all partners, including victims organisations and the prosecution, in addition to representatives from colleges and universities, and the night-time economy sector, to see what further steps we can take to tackle that very important issue.