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Meeting of the Parliament [Draft]

Meeting date: Tuesday, February 20, 2024


Topical Question Time

National Health Service (Capital Projects)

1. Carol Mochan (South Scotland) (Lab)

To ask the Scottish Government whether it will provide an update on the reported decision to delay the progress of all new NHS capital projects for up to two years, including the Ayr national treatment centre. (S6T-01801)

The Cabinet Secretary for NHS Recovery, Health and Social Care (Neil Gray)

The twin challenge of a United Kingdom Government cut to our capital grant over the next five years and unprecedented levels of inflation caused by Brexit, Russia’s illegal invasion of Ukraine and the handling of the UK economy has impacted on our ability to fund capital projects. The 10 per cent real-terms cut to our capital budget is the equivalent to a reduction of around £540 million a year by 2027-28 and a cumulative reduction of £1.6 billion over the period.

Unfortunately, that has meant that all NHS capital projects, including the national treatment centre in Ayr, will be paused. Our emphasis now has to be on addressing backlog maintenance and essential equipment replacement. All capital projects are now under review, and I expect the Deputy First Minister to set out the results of that review in the coming weeks. The Deputy First Minister will be writing to the Chancellor of the Exchequer ahead of the budget, asking him to reverse the cuts to our capital investment budget.

Carol Mochan

The cabinet secretary knows that I am no fan of the Tory Government at Westminster, but it is fair to say that, after 17 years of the Scottish National Party Government being in power, patients and staff alike are starting to get fed up with it deflecting blame and responsibility.

NHS Ayrshire and Arran has already purchased the Carrick Glen site, which will now lie unused. All the while, patients in that health board area are suffering on long waiting lists and have less provision close to home because of long-term underfunding. Will the cabinet secretary set out a timescale for Parliament to get the critical delivery of Ayr national treatment centre back on track, or will the people of Ayrshire just have to record this as yet another example of the SNP saying one thing and doing another? They need a timeframe.

Neil Gray

Obviously, I would rather have those projects going ahead, for reasons including those that Carol Mochan has set out. I want there to be an increased capacity and ability to address the needs of the people of Scotland through our NHS. However, the financial reality is that we are facing increased costs due to spiralling inflation that has been driven, to a large extent, by the disastrous mini-budget from Truss and Kwarteng, and a budget that is diminishing by £1.6 billion over the coming years. Those are the consequences that we are discussing today.

As I have set out, the Deputy First Minister will be returning to the Parliament with a response to the review of all capital projects, and I would expect to be able to give the member information off the back of that.

Carol Mochan

The impact of the delays will be felt not just in Ayrshire. Across Scotland, important promises have been broken. Neil Gray’s constituents will have similar feelings to my own, as the SNP Government cannot even deliver a new Monklands hospital in the cabinet secretary’s own back yard. Those promises were made by the SNP Government. Patients wait for years on waiting lists, and staff are working in buildings that are literally crumbling. In response, rather than delivering the local health provision that it has promised, the SNP has put the brakes on developments that are critical for the future. If the Government cannot be trusted to deliver the project in the cabinet secretary’s own back yard, the Parliament has to be updated on the timescale for the projects to be undertaken.

Neil Gray

I should set out that, in order to avoid a conflict of interest, I have recused myself from any Government decision making in relation to the Monklands replacement project, as Carol Mochan would expect, as it is in my constituency. However, it is clear from a briefing that I received in my constituency capacity from NHS Lanarkshire at the start of the month that its work continues towards a full business case for the much-needed new hospital by 2031.

The Deputy First Minister will write to the UK chancellor, asking for a reversal of the cut to the capital budget, which has a material impact on our ability to invest in capital projects. Having £1.6 billion less over the coming years is a material factor in the decisions that we are having to take.

I would be keen to work with Carol Mochan on ensuring that an incoming UK Labour Government would seek to invest in our public sector services and our economy by reversing the cuts to capital projects. At the minute, Labour’s position is unsustainable, because it wants to follow the Tories’ spending plans.

We have much interest from members, so I insist on concise questions and responses.

Stuart McMillan (Greenock and Inverclyde) (SNP)

In addition to the letter that he mentioned, will the cabinet secretary provide an update on the Scottish Government’s latest engagement with the UK Government on the capital budget, bearing in mind, as the cabinet secretary touched on, that the UK Government’s disastrous autumn statement slashed the Scottish Government’s capital budget and the UK Government’s reckless spending decisions have a substantial impact on capital investment? It is clear that the chancellor needs to rectify the funding situation in the spring budget.

Neil Gray

Absolutely. Stuart McMillan sets out very well the context of the situation that we are in. There was a lack of investment in public services in the autumn statement. We decided to ensure that all the consequentials that we have available to us continue to be invested in public services, including a real-terms increase for our NHS and social care services. However, a reversal of the capital cuts that are coming forward would have a major impact on our ability to invest in what we need to in our NHS estate, as has been pointed out.

The Deputy First Minister met the Chief Secretary to the Treasury last month and made it clear that the UK Government must prioritise investment in public services and infrastructure over tax cuts in the forthcoming UK spring budget.

Sharon Dowey (South Scotland) (Con)

The delay to treatment centres in Ayr and across Scotland is unacceptable, especially given that Carrick Glen was already a working private hospital. The former health secretary, now the First Minister, announced the treatment centre at Carrick Glen just before the local elections, but, yet again, we have a broken promise from the Scottish National Party that will have serious consequences for people who are in agony and waiting for treatment from our NHS.

Some people in Ayrshire think that it was just another election gimmick. Can the cabinet secretary promise that the treatment centre in Ayrshire will not be scrapped altogether, and what does he have to say to people waiting for treatment, such as my constituent who urgently needs surgery, without which he will be unable to continue caring for his wife?

Neil Gray

I obviously have great sympathy for anyone in the situation that the member sets out. Two new national treatment centres have just come on track, and we have two to come on track this year at the Golden Jubilee hospital and the Forth Valley royal hospital, which will mean an increased capacity of 20,000 in those national treatment centres. I obviously would have wanted us to go further than that. That was our plan, but the financial reality of increased costs due to spiralling UK inflation and a cut to our budget of £1.6 billion over the coming years means that we have to review our capital projects.

Kate Forbes (Skye, Lochaber and Badenoch) (SNP)

Although I fully appreciate that the capital settlement for the Scottish Government from the UK Government is dire, the news could not have come at a worse point, because progress is finally being made on planning for a new Belford hospital in Fort William after years of being promised one. NHS Highland has been asked to suspend that work. Even if there is no capital yet to build the hospital, which we accept because of the settlement, will the Scottish Government at least allow the planning process—RIBA stage 3—to progress so that the work to date on planning is not wasted?

Neil Gray

I thank Kate Forbes for a very sensible approach. We are absolutely engaged with that issue at the moment, and we will certainly seek to take forward her suggestion.

It is essential that NHS boards continue to plan for how they will improve and reform services, and we will remain committed to supporting them in that process.

I go back to the point that many capital projects across the country are under threat not because of anything that the Scottish Government has done, but because of the UK Government’s disastrous management of the economy—[Interruption.]


Neil Gray

—as well as the 10 per cent cut to our budget. The £1.6 billion cut over the coming years will impact not just on health projects but on capital projects across the country. Once again, we appeal to the UK Government to use the spring budget next month to reverse that devastating cut to allow us to see important health capital projects going ahead.

Edward Mountain (Highlands and Islands) (Con)

To solve the Moray maternity issue, the Scottish Government promised £5 million of investment in Raigmore hospital’s maternity unit. That is now on hold. I do not see what the Government is going to say to people in Caithness and others who might have to travel four hours in labour to get to a maternity hospital in Aberdeen or Perth. Will the cabinet secretary work with me to see whether there is a way of resolving that issue and ensuring that the long-overdue investment in Raigmore hospital is continued?

Neil Gray

I appreciate the question from Edward Mountain, and I well appreciate that the situation that he has described is incredibly challenging. I cannot give a direct commitment in respect of the Raigmore hospital investment, but I can commit to his suggestion of working with him to see whether anything more can be done to ameliorate some of the difficulties that women in his region face. I would be more than happy to follow up on that point with him in due course.

Alex Cole-Hamilton (Edinburgh Western) (LD)

We have heard about Belford hospital in Lochaber and the reprovisioning of Caithness general hospital and the Princess Alexandra eye pavilion in Edinburgh. All of those projects are much needed, and all of them are already delayed. There is nothing more than a hard stop by the Government on those much-needed projects, and the public are having none of the excuses that are being offered.

The cabinet secretary will know that the Government pledged that the national treatment centres would conduct 40,000 in-patient procedures a year from next year. With the hard stop put on those treatment centres, what does he have to say about the impact that that will have on his Government’s efforts to drive down waiting times?

Neil Gray

I do not disagree with the assessment that those projects are much needed. As I set out in reply to Carol Mochan’s question, if we had the finance available, we would be deploying it. That is absolutely clear. However, Alex Cole-Hamilton and others across the chamber cannot ignore the financial reality that we have increasing costs and a diminished budget because of decisions that have been taken elsewhere. I would be keen to work with Alex Cole-Hamilton to persuade UK ministers to reverse the capital cuts rather than trying to lay the blame on the Scottish Government, which is doing all that it can to invest in those projects.

The national treatment centres will deliver an increased capacity of 20,000 elective surgery cases. We are not where we wanted to be. We want to have all those national treatment centres up and running, which is why we need a reversal to the cuts to our budget.

Annabelle Ewing (Cowdenbeath) (SNP)

I welcome the cabinet secretary to his new post, and I wish him well.

In the light of the current financial challenges that the cabinet secretary has outlined, it seems to me that it is, sadly, inevitable that a prioritisation of current capital projects in the health sector will now be required. Given that the Scottish Government first promised a new medical centre for Lochgelly in 2011, surely it must be Lochgelly’s turn now.

Neil Gray

I thank Annabelle Ewing for her kind wishes, which I appreciate. I also appreciate the situation that she faces in her constituency, with regard to the project in Lochgelly that she has described. I have no doubt that she will, as a strong constituency advocate, continue to make that case, and I would be more than happy to have a discussion about what might be possible—I have offered such discussions to others.

Annabelle Ewing is aware that all Government capital projects are under review at the moment. The Deputy First Minister will return with the results of that review, which will set out the trajectory for our capital investments.

Graham Simpson (Central Scotland) (Con)

We are told that the full business case for the replacement Monklands hospital will be ready next year. That is a year late. Can the cabinet secretary promise that we will have a new hospital open in 2031, as we were promised?

Neil Gray

As I have already set out in response to a question from Carol Mochan, I have—as Graham Simpson would expect—recused myself from a Government decision-making perspective in relation to the Monklands replacement project, because it rests in my constituency. He was on the same call with NHS Lanarkshire at the start of the month as I was in my constituency capacity, in which the board set out that progress continues to be made towards the full business case for that much-needed hospital by 2031.

Fulton MacGregor (Coatbridge and Chryston) (SNP)

I appreciate that the cabinet secretary has just answered Graham Simpson’s question on the new Monklands hospital. Nevertheless, he will be aware, as I am, that there is great concern among constituents, given the news yesterday. He will also be aware of the urgent need for a new Monklands hospital. I, too, was on the call with NHS Lanarkshire, which seems to be confident that the project will go ahead. What discussions has the Government had in relation to the new hospital?

Neil Gray

I thank Fulton MacGregor for that question and for reiterating that the project is much needed. I have a constituency interest in the matter, so I have had to recuse myself from a Government decision-making perspective, but I will make sure that Fulton MacGregor gets a written update from a Government perspective from one of my ministerial colleagues, to ensure that he is kept up to date. In addition, I share Fulton MacGregor’s understanding of our call with NHS Lanarkshire.

A96 Dualling (Inverness to Aberdeen)

To ask the Scottish Government whether it will provide an update on whether the A96 will be dualled from Inverness to Aberdeen. (S6T-01797)

The Minister for Transport (Fiona Hyslop)

We remain committed to improving the A96, including dualling the road from Inverness to Nairn and the Nairn bypass, despite a worst-case scenario for Scotland following the United Kingdom autumn statement. I am acutely aware of the importance of the route to those who live along the corridor, and our current plans are to fully dual the route.

As part of that process, we are undertaking the corridor review, which, through initial consultation, generated 11,000 improvement options. It is only right that those are fully appraised, and I expect that draft outcomes from the review will be ready for final public consultation in the coming months, before a final decision is reached.

Liam Kerr

In 2011, the Scottish National Party promised that the A96 would be dualled in full by 2030—no ifs, no buts and no climate corridor review.

In the past four years, 11 people have been killed and 69 have been seriously injured on the A96, and two more lives were tragically lost just last week. It turns out that this Government has spent just £800,000 on road safety improvements in that time but £5 million on its climate review. Does the cabinet secretary have any concerns that spending more than five times as much on a climate review as on saving people’s lives might suggest that this central belt-focused Government has its priorities wrong?

Fiona Hyslop

I express my condolences to the families following the two fatalities in the accident on 12 February at Redhill, near Inverness. I can relay that, only last year, £610,000 was spent on road maintenance and safety and that, in total, £31 million has been spent on the development and planning, and all the necessary design work, for the dualling aspect in particular of the Inverness to Nairn part of the road.

However, as we have already heard in answers today, if we have a UK Government that has not invested in infrastructure and has cut the infrastructure budget not just for Scotland but for the rest of the UK—[Interruption.]

Members, let us hear the minister.

Fiona Hyslop

—and if we also have a Labour Party that would want to continue that financial position, it puts capital infrastructure, whether it is in the central belt, the north of Scotland, the Highlands or the north-east, in a very difficult position. I will continue the job of ensuring that the review develops and that the important work on the A96 Inverness to Nairn bypass continues.

Liam Kerr

The question was not about how much has been spent but about the £800,000 that has been spent on road safety improvements. That is pitiful.

Over the weekend, The Northern Scot reported that the promise to dual the A96 by 2030 was “abandoned” more than three years ago. Responses to freedom of information requests suggest that the disgraced former cabinet secretary for transport, Michael Matheson, ensured that the public was not told of that. Will the minister say, clearly and concisely, whether the Scottish National Party will dual the A96 in full by 2030, as was promised? Yes or no?

The SNP Government will respect the review that is taking place and all the thousands of people who have had input into that. [Interruption.]

Let us hear the minister.

Our current plans are to dual the A96, and the dualling between Inverness and Nairn is a particular priority, as the member well knows.

Fergus Ewing (Inverness and Nairn) (SNP)

On 19 February 2021, the then cabinet secretary for transport, Michael Matheson, announced that the made orders for the Nairn bypass and the dualled section of the A96 from Inverness would be issued that summer. Three years on, that still has not happened. Has the three-year delay been deliberate, as a means of ensuring that the Scottish Government does not have to spend the money on delivering on its promise of a Nairn bypass, which my constituents have waited more than 15 years for? If the minister refutes that proposition, will she now publish a detailed plan setting out when construction will begin and when it will be completed?

Fiona Hyslop

As I advised Mr Ewing during our recent meeting, Transport Scotland is pressing forward with the significant work—and it is significant work—that is required to publish the made orders for dualling the A96 from Inverness to Nairn, including the Nairn bypass. I look forward to that happening in the first quarter of 2024. That also includes provision for the compulsory purchase orders, with a view to our completing the statutory process for the scheme.

As the member well knows, delivery of the scheme can commence only if approved under the relevant statutory authorisation process. Thereafter, a timetable for progress can be set in line with available budgets.

Rhoda Grant (Highlands and Islands) (Lab)

The minister has again given a commitment to dual the A96 from Inverness to Nairn, including the Nairn bypass. However, I was surprised to discover through an FOI request that, thus far, only one piece of land, at Milton of Culloden, has been bought and that no other compulsory purchase orders have been made. How much land will the minister require to be purchased for that work, and when will that be completed?

Fiona Hyslop

As I have said in previous answers, there is a statutory, staged process in relation to the work that is required, and the made orders will enable the compulsory purchase orders for that section to be delivered. We expect to announce that in the first quarter of 2024, which is very soon indeed.

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