Official Report 1298KB pdf
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.
Scottish Economic Link Licence
To ask the Scottish Government whether it will provide an update on how the Scottish economic link licence is working. (S6O-05190)
A review of the amended economic link licence condition was published in August. It showed that the policy has delivered significant benefits. Landings of mackerel and herring into Scotland have risen sharply, meeting phase targets and bringing record values to Peterhead and Lerwick ports. That has strengthened coastal economies, supported jobs and driven major investment in processing facilities, which has in turn improved business security and enabled expansion. Scottish processors report greater confidence to invest, extended employment and improved access to premium export markets in the far east. Overall, the policy is achieving its aims but continues to be under review.
Given the United Kingdom Government’s decision to short-change Scotland’s fishing and coastal communities, tools such as the economic link licence are important for keeping value in our ports and our onshore sector. Processors in my Banffshire and Buchan Coast constituency tell me that economic link changes have helped, but they still see some unused capacity and are concerned that, without increases, businesses might suffer. Will the cabinet secretary consider commissioning further analysis of whether the current licence condition is maximising landings and processing in Scotland? If not, what options might there be to strengthen the condition in support of coastal jobs?
I thank Karen Adam for raising that important point. I recognise how important the licence condition has been for Scotland’s processors and for our ports.
This year, we have received challenging advice from the International Council for the Exploration of the Sea, which is recommending major quota cuts for mackerel and herring. That raises real concerns about throughput and about the impact on our processors and the jobs that depend on them. We are in active discussion with processors and catchers to assess what the full supply chain impact would be and what, if any, Government intervention might be needed. We also recognise that there are strong and differing views on any further intervention. In any action that we take, we will be guided by the public interest. I emphasise that, at this point, no decisions have been made on intervening to increase mackerel and herring landings in 2026. We will carefully consider stakeholders’ views.
Fishermen face many challenges, not least the economic link, which can impact the market and impede competitive opportunities for vessels to get the best value for their catches. Does the cabinet secretary recognise that, without an economically viable pelagic fleet, the impact on processors, the supply chain and island and coastal communities will be considerable ?
I absolutely recognise that. I hope that Beatrice Wishart will take some assurance from the points that I have made. We are trying to assess the impact of that advice on our catching and processing sectors, and we are having discussions to see what, if any, intervention might be needed. I want to provide assurance that no decisions have been made. We are engaging closely, because we have to do all that we can to mitigate the impacts of that advice.
Agricultural Sector (Fatalities)
To ask the Scottish Government what recent work it has undertaken with the agricultural sector to reduce the number of fatalities within the industry. (S6O-05191)
The Scottish Government works closely with the agricultural sector to improve safety and wellbeing. The Farm Advisory Service offers practical risk management support, and the next generation practical training fund helps new entrants to access accredited safety-focused courses.
We have awarded £25,000 to Farmstrong Scotland for its social wellbeing project, which fosters supportive networks and reduces isolation through community engagement. We have also provided £75,000 to the Royal Scottish Agricultural Benevolent Institution so that it can continue to deliver emotional, practical and financial assistance, including counselling, mental health support and help with essential living costs. Together, those measures strengthen resilience and wellbeing across Scotland’s agricultural community.
Since April this year, there have been 22 farm fatalities in the United Kingdom, including the tragic loss of life at a farm in South Lanarkshire in October. The Health and Safety Executive says that farm vehicles continue to be the leading cause of fatalities and injuries. A Farm Safety Foundation survey found that women in agriculture are less likely to carry out a risk assessment before taking on a new job and that they receive less training than men. Is there disaggregation by sex when injuries and fatalities are recorded? Do we have an understanding of where the increased risks for women working in agriculture are? What is being done to reduce those risks?
I thank Claire Baker for bringing up the subject, which is very close to my heart. I will need to come back to her on her specific point about disaggregation by sex, as I do not have an answer to that right now.
The overall safety of farmers is not just about the actions that they take; it is also about their mental wellbeing. There are a number of risks to Scotland’s farmers, and it is essential that we put as much help and support in place as we can to protect them and to ensure that the fatality numbers are reduced.
I remind members of my entry in the register of members’ interests. I am a partner in a farming business and a member of NFU Scotland.
Is the minister aware of the high number of lives lost to suicide in the agriculture sector, with the winter months being a particularly difficult time for many farmers and crofters? The pressures on farmers can be exacerbated by the impact of Government actions and the frustration, anger and disappointment that they can often bring. How will the Scottish Government ensure that, in the decisions that it makes and the way in which it administers schemes and delivers its policies, it recognises that behind every application is a farmer or crofter who is already under pressure?
I hear exactly what the member is saying about the loss of lives due to suicide. It is a subject that is incredibly close to my heart.
I put on record that every time a decision is made by anyone in the Scottish Government on how we help, support or work with people to get through difficult situations, the subject is very much at the forefront of their mind. Our officials are very clear about that, as I know they have always been up to now in all the circumstances that have been brought to my attention.
NatureScot Species Licensing Review
To ask the Scottish Government whether it will provide an update on the progress of NatureScot’s species licensing review, including timelines for producing and implementing recommendations for improvements alongside charging for licensing services. (S6O-05192)
The species licensing review is being finalised by NatureScot following the completion of the external review phase. Once the review has been presented to ministers for consideration, it will be published alongside our response to the recommendations and any timelines for taking the recommendations forward. We expect to be in a position to respond to the report once it is received in early 2026.
I think that we were expecting the report in January 2025, and then in July 2025, and now all we hear is that the review “is being finalised”. Can the minister assure us that NatureScot has been listening to the RSPB and the Scottish Raptor Study Group, and that their input will influence recommendations?
As I have said, there has been an awful lot of input into the review, and NatureScot will take all of it into account before the finalised report comes to ministers and is then presented to Parliament.
Our public money is being spent on mitigating the environmental damage caused by polluting private companies. We cannot afford to go on like this. It is therefore welcome that NatureScot is exploring the potential to apply the principle of cost recovery in its species licensing review.
I have previously asked whether the Scottish Government supports the principle that polluters must themselves pay for the environmental damage that they cause, but the minister did not answer, so I am asking again: does the Scottish Government agree with the polluter pays principle?
The member has asked the question before, and I gave her a fairly succinct answer at the time. We will have a report on any review that comes forward and we will bring it to the Parliament.
I have given the minister notice of this question. He has received the outcome of the muirburn licensing test phase from representatives of Scottish Land & Estates and the Scottish Gamekeepers Association, which was to see whether NatureScot would be able to grant muirburn licences to prevent and reduce the risk of wildfire on peatland. It is clear from the testing that the legislative provisions that are currently in place are unduly prohibitive when it comes to issuing licences for muirburn to take place to prevent and reduce the risk of wildfire. What consideration is the minister giving to amendment 271, which seeks to amend the Natural Environment (Scotland) Bill in—
Thank you, Mr Ewing—that is not to do with the species licensing review. If there is anything that you can add in response to that, minister, I am happy to let you do so.
All that I can say is that I am carefully considering all licences that are in front of me at this moment in time.
Aquaculture (Economic Benefits)
To ask the Scottish Government what assessment it has made of any economic benefits of the growth of aquaculture in Scotland. (S6O-05193)
Several assessments, including the marine economic statistics and annual fish and shellfish farm production surveys, have demonstrated that the growth of aquaculture in Scotland has led to significant economic benefits for our country.
The marine economic statistics report for 2023 is due to be published in December, but in 2022, aquaculture generated £337 million in gross value added, which is 7 per cent of the marine economy GVA, and it directly employed 2,200 people. The latest Scottish fish farm protection survey reported that, in 2024, salmon farming achieved a record value of more than £1.3 billion.
In our “Vision for Sustainable Aquaculture”, which was published in 2023, we set out our support for the sustainable development of the sector and recognise
“the considerable social and economic benefits the sector delivers”.
The cabinet secretary is aware of recent estimates that put the annual contribution of the salmon industry to the Scottish economy at more than £1 billion. Given that, and given the fact that some 11,000 jobs are supported by the industry—including more than 600 at Mowi, in Rosyth in my constituency—will she reaffirm the Scottish Government’s commitment to do all that it can to promote the industry here and abroad? Will she welcome the significant contribution that it makes to sustainable jobs across Scotland?
I am happy to reaffirm that commitment to Annabelle Ewing and to members across the chamber. We remain committed to promoting the sector at home and abroad. We are continuing to work with our enterprise and innovation agencies on the international stage to ensure that Scotland has a key presence at the major trade shows, targeting new business opportunities and ensuring that Scotland remains a global leader as well as, more broadly, a collaborator.
We are also working to ensure that more people can enjoy Scottish salmon. This year, £50,000 was awarded through the marine fund Scotland—which was match funded by the sector—to try to grow sales under the coveted Label Rouge label. We continue to work together to capitalise on new market opportunities. I am delighted that Scottish salmon is on track to deliver another record year for exports in 2025.
I remind members of my entry in the register of members’ interests: I have an interest in a wild salmon fishery on the east coast.
The salmon farming industry is known for unacceptably high mortality, its use of antibiotics and the number of escapes, resulting in the royal warrant being withdrawn from Mowi. Surely it is time for this Government to consider withdrawing its blanket support for an industry that can only be described as suspect.
I must make it absolutely clear that Scottish aquaculture is a highly regulated sector. There are robust controls on planning and environmental impacts as well as on fish health.
Edward Mountain raised the issue of the royal warrant, but such decisions are not a matter for the Scottish Government.
We protect fish health through regulation, through communication and through legislation. The Animal Health and Welfare (Scotland) Act 2006 protects farmed animals from unnecessary suffering and places a duty of care on those who care for animals to meet their welfare needs.
We know how important the aquaculture sector is in Scotland. It supplies well-paid jobs in some of the most rural parts of our country, as well as in our island communities. It is a highly regulated sector that is very important for our wider economy.
The salmon farming industry makes many claims about itself that have proved to be misleading. It claims to be transparent with mortality data, but it does not include cleaner fish, salmon in transport or certain smolts. It tells us that it wants to protect wild salmon, but it puts in legal appeals against the very framework that is designed to do that. It does many other things. Will the cabinet secretary commit to commissioning an independent, Scotland-wide cost benefit analysis, as per best practice, so that future policy in the salmon farming sector—
Thank you. Briefly, cabinet secretary.
Ariane Burgess raised a point on transparency. The information that is published in relation to the aquaculture sector is very transparent. More data is published in relation to aquaculture than in many of our other sectors. I appreciate the point—we discussed it when the Rural Affairs and Islands Committee was undertaking its inquiry into salmon farming. There are issues about the amount of data that we have and how that data is used and communicated more widely. In relation to that point and in relation to the other matters that Ariane Burgess raises, the committee made a number of recommendations and I made a number of commitments in response. I offer the assurance that several pieces of work are under way.
Brexit (Impact on Food and Drink Producers)
To ask the Scottish Government whether it will provide an update on how Brexit has impacted Scotland’s food and drink producers. (S6O-05194)
The food and drink sector continues to suffer the consequences of a hard Brexit, which has disrupted supply chains and created new trade barriers. Many Scottish producers continue to face reduced European Union market access, which resulted in a 50 per cent decline in the value of fruit and vegetable exports between 2019 and 2024.
While the full economic consequences of exiting the EU are still to be realised, we know that businesses face higher trading costs, and some producers have lost the ability to export goods to the EU altogether.
Today’s official statistics show that Scottish food and drink exports are worth £7.5 billion. Although the food and drink sector remains Scotland’s largest international export sector and accounts for a fifth of Scotland’s international exports, there has been a 5 per cent real-terms decrease since 2018. That decrease, which is a result of Brexit difficulties, has had an impact on jobs, the economy and communities, yet Westminster Labour will not even consider re-entering the EU, the single market or the customs union to help exporters. Is Westminster Labour wrong?
I could not agree more with the points that Kevin Stewart has made. He has highlighted the massive economic damage that has been done by Brexit—in particular, the hard Brexit that was pursued by the UK Government at the time.
Research by the centre for economic performance at the London School of Economics and Political Science shows that UK households have paid £7 billion to cover the cost of post-Brexit trade barriers on food imports from the EU, which has pushed up household food costs by an average of £250 since December 2019. We know that low-income households, which spend a greater proportion of their income on food, have been disproportionately affected.
Brexit has undoubtedly increased the barriers and the costs for industry. Kevin Stewart rightly highlighted the value of our food and drink exports. We hope that some of that damage could be mitigated by a new sanitary and phytosanitary agreement, but such an agreement will never fully reverse the damage that has been done by Brexit.
Fishing and Coastal Growth Fund
To ask the Scottish Government whether it will provide an update on what response it has had to its letter to the United Kingdom Government regarding the fishing and coastal growth fund. (S6O-05195)
There has been no response to my letter to UK ministers of 22 October, in which I set out our serious concerns about the announced approach of allocating to the Scottish Government just 7.78 per cent of the £360 million fishing and coastal growth fund, which is, of course, an insult to the Scottish fishing industry.
On 4 November, together with other key Scottish stakeholders, I wrote to the UK Government, calling for the Scottish seafood industry action group to be reconvened to discuss that urgent issue, alongside other concerns. Once again, to date, there has been no reply from the UK Government.
The UK Government’s unresponsiveness is appalling. The Scottish Government was clear in its expectation that Scotland’s fishers needed and deserved to maintain an arrangement outside the Barnett formula that recognised the relative size and importance of fishing industries across the UK, and that Scotland should receive at least 46 per cent of the fishing and coastal growth fund. The Labour Party has ignored Scotland’s Government and insulted our fishing industry. Does the cabinet secretary agree that Scottish Labour MSPs need to decide whether they are backing our fishing industry and communities or their bosses at Westminster?
I could not agree more with that. As Keith Brown highlighted, we were clear right from the outset that Scotland should receive at least 46 per cent of the fishing and coastal growth fund, in recognition of the sheer size and importance of an industry that is vital to Scotland.
The decision to apply the Barnett formula to the fund was taken by UK ministers. It completely ignored what we asked for and is an insult to our industry, as well as to our communities. I remain steadfast in urging the UK Government to reconsider its approach and to enter into discussions with us and with fishing industry leaders with a view to agreeing a way forward that, ultimately, treats our industries and communities with the respect that they deserve.
United Kingdom Budget (Support for Scottish Farmers)
To ask the Scottish Government what correspondence it has had with the UK Government regarding support for Scottish farmers ahead of the upcoming UK budget. (S6O-05196)
We have repeatedly raised intra-United Kingdom agricultural funding allocation concerns with the UK Government, most recently with the Secretary of State for Environment, Food and Rural Affairs at the interministerial group meeting on Monday. The Cabinet Secretary for Finance and Local Government also wrote to the chancellor on 15 October, highlighting the issue among our priorities for the UK budget.
We have been clear that a population-based Barnett settlement for land and sea support is inappropriate. It misses the opportunity to recognise Scotland’s larger share of land and seas and their potential to contribute significantly to the UK’s climate and nature restoration goals.
The Labour Government showed its contempt for farmers this afternoon when it refused to reverse its cruel family farm tax. However, Scottish farmers, including those in my West Scotland region, have also been let down by the SNP Government, most recently through the inconsistent future farming investment scheme. This year, the SNP Government has also failed to publish the rural support plan, tp provide multi-annual ring-fenced funding and to return the missing money in full to the agriculture budget. Can the minister assure farmers that this year’s Scottish budget will support them?
The one thing that I agree with Pam Gosal on is that the inheritance tax introduced by the UK Government is an absolute disaster for family farms in Scotland. However, it is a bit rich that we have a Tory telling us about all the things that we are doing wrong here, given that the Tories started the dismantling of farm support in the rest of the UK while the Scottish Government continued with direct payments and schemes to ensure that we protected our hill and upland farmers and continued to support our industry—to the point where we have proper working relationships, whereas things are absolutely disastrous for people down in England.
I am unclear what the Tories did for Scottish farmers when they were in government in the UK other than utterly fail to advocate for them. That is perhaps one of the many reasons why the Tories have not won an election in Scotland since 1955. Will the cabinet secretary—[Interruption.] Will the cabinet secretary outline how the Scottish Government is engaging with the UK Government for farmers, following the budget?
Every time that I meet with the UK Government, or the cabinet secretary does, we absolutely insist that it take on board all our concerns about ensuring that we have the funding for Scottish farming.
However, since leaving the European Union, Scotland’s farmers have lost the certainty of multi-annual rural funding, which is essential for farming. UK Government funding remains inadequate, with future increases now based on population share rather than land use, agricultural needs or environmental potential. That is unfair to Scotland, which has a far greater share of the UK landmass, much of which is used for extensive livestock and upland farming, with huge potential to contribute to the UK’s climate, nature and food security goals. We have consistently pressed the UK Government for a fair long-term funding settlement, and we will continue to do that in the future.
Bakkafrost Scotland (Animal Welfare)
To ask the Scottish Government what its response is to reports of alleged animal welfare abuse at a Bakkafrost Scotland salmon farm. (S6O-05197)
The Scottish Government takes the welfare of farmed fish seriously. Robust legislation, policies and industry standards are in place to safeguard fish health and welfare, and I am clear in my expectation that all producers must comply.
The Animal Health and Welfare (Scotland) Act 2006 protects farmed animals from “unnecessary suffering” and places a duty of care on those caring for animals to meet their welfare needs. The Animal and Plant Health Agency is responsible for considering and investigating complaints and potential welfare breaches relating to farmed animals, including farmed fish.
It has been alleged that salmon infested with sea lice were left in a pen that was meant to be completely empty. Animal Equality UK carried out covert filming at the Bakkafrost Scotland farm on Loch Torridon and claims that welfare regulations were breached. Tesco has suspended the farm while it investigates the supplier. In its first report of 2025, the Rural Affairs and Islands Committee found that the Scottish Government is not being responsive enough to the complex needs of the Scottish salmon farming industry and how it interacts with biodiversity, animal welfare and the workforce. Can the cabinet secretary tell me what is being done to ensure that the industry receives better support as well as improved oversight?
There are a number of matters involved. I am happy to send Pauline McNeill the list of commitments and to outline some of the work that we are taking forward in that area, because we recognise the recommendations that the Rural Affairs and Islands Committee made in its most recent inquiry, which updated the recommendations of the previous salmon inquiry. I want to offer some assurances that there are specific strands of work on animal health and welfare in relation to this matter. We have also made a commitment to publish guidance, which we will look to engage and consult with people on. I am regularly updating the committee on the work as it progresses. I am happy to follow that up and to send the information to Pauline McNeill.
Thank you, cabinet secretary. I apologise to those members whom I was unable to call. That concludes portfolio questions on rural affairs, land reform and islands. There will be a brief pause before we move to the next portfolio questions, to allow members on the front benches to move seats.
Health and Social Care
The next portfolio is health and social care. I advise members that there is an incredible amount of interest in supplementary questions. With the best will in the world, I will not be able to bring in everybody who wants to ask a question. However, I will get more in if the questions are brief and the responses likewise.
NHS Ayrshire and Arran (Financial Sustainability)
To ask the Scottish Government what its response is to the report by the Auditor General into the financial sustainability of NHS Ayrshire and Arran, which found that the board is facing a deficit of £33.1 million in the current year. (S6O-05198)
The Scottish Government is aware of and has received the section 22 report that was issued to NHS Ayrshire and Arran, and will continue to work with that health board to resolve the issues that have been highlighted.
NHS Ayrshire and Arran is already at stage 3 of the NHS Scotland support and intervention framework for finance, and we continue to work closely with the board’s executive team to improve performance across all areas, not just finance. Targeted support has been provided to help strengthen financial sustainability, and the board received baseline funding of £1 billion in the budget—which, I note, neither Katy Clark nor her Labour colleagues voted for.
The Auditor General said that the board needed a £51.4 million loan in 2024-25 to break even, and that NHS Ayrshire and Arran has outstanding loans totalling £129.9 million, which is
“the highest amount ... across the NHS in Scotland”.
The Auditor General also stated that the severity of the financial challenge was “unprecedented” and warned that the board was relying on “overly optimistic” savings plans that might not be achievable.
What can the cabinet secretary do, given that the position seems unsustainable, and what further support can the Scottish Government give, given the huge concern about the current situation?
We have provided increased investment in the baseline funding of national health service boards; for NHS Ayrshire and Arran, that comes to more than £1 billion, which represents an increased investment of £123 million compared with 2024-25. We continue to provide support to the new interim chief executive, Professor Gordon James, and I am confident that the work that is being done in partnership with the Scottish Government’s escalation team will continue to bring NHS Ayrshire and Arran’s finances into better order as well as bringing the performance improvement that patients need.
We move to brief supplementary questions. The first one is from Kenneth Gibson.
I welcome the uplift of £123 million—or 13.9 per cent—in NHS Ayrshire and Arran’s funding for this year, and the additional non-recurring funding for escalated health boards to improve financial sustainability, which includes £43.7 million for NHS Ayrshire and Arran this year. How will Scottish ministers ensure that those additional funds are being used effectively, and will the cabinet secretary advise how escalated boards will be supported in the coming financial year?
I thank Kenneth Gibson for putting those details on the record. The Scottish Government has provided NHS Ayrshire and Arran with several strands of support to improve financial sustainability, including leadership support and funding to support the delivery of improvement. The NHS Scotland financial delivery unit routinely challenges NHS Ayrshire and Arran on its financial performance and trajectories, including the utilisation of additional support funding.
The additional funding that is being provided for NHS boards is starting to have a positive impact on waiting times. For example, boards have reported significant reductions in new out-patient waits, including a 72.2 per cent decrease in ear, nose and throat waits in NHS Ayrshire and Arran, which is a demonstrable indicator of improved performance to go alongside the financial rigour that we need to see in Ayrshire and Arran and elsewhere in Scotland.
This morning, Auditor General Stephen Boyle described NHS Ayrshire and Arran as being in a “loop of unsustainability” since being escalated to level 3 on NHS Scotland’s support and intervention framework in 2018. That is seven years of Scottish Government support and the situation is getting worse, if anything.
Does the cabinet secretary agree that seven years should have been more than enough time to see significant improvement? Is that lack of improvement a failure of the Scottish Government in its support, or is it an indication that the NHS Scotland resource allocation committee formula, which determines health board funding, is fundamentally flawed?
The NRAC formula is an objective measure of the needs of healthcare services across Scotland. It takes explicit account of the variation in need for healthcare due to age, sex profile, morbidity, life circumstances, local populations and the cost of delivering services across different geographies.
We are providing significant support to the new interim chief executive of NHS Ayrshire and Arran, Professor Gordon James, and I am confident that the rigour that he will bring to its finances and performance will see improvements for patients in the locality.
Tooth Decay (Children)
To ask the Scottish Government what action it is taking to address tooth decay in children. (S6O-05199)
We continue to invest in our flagship Childsmile programme, which provides universal oral health interventions for all children and additional targeted measures for children from vulnerable backgrounds. The programme has supported significant improvements in child oral health, with the latest national dental inspection programme results showing that 81.5 per cent of primary 7 children have no obvious tooth decay, compared with 52.9 per cent in 2005.
We have also made significant improvements to children’s dental care as part of our payment reforms, which were introduced in 2023, with dentists now able to undertake a much wider range of preventative treatments for all children.
Whatever the minister says, and whatever the Government is doing, it is not enough. I have a freedom of information request reply that shows that almost 3,000 children in NHS Tayside have been admitted to hospital because of tooth decay during the past five years, while more than 3,000 have had a tooth extracted in hospital. That is on top of the percentage of primary 7 pupils with tooth decay increasing this year for the first time since 2005. That is unacceptable.
What does the minister say to families in my region who are dealing with the consequences of the dentistry crisis, and what urgent action is the Government going to take to fix this?
I am sure that Ms McCall will recognise that tooth extractions done under general anaesthetic fall under secondary care. I recognise that there are waiting time issues in that area, and my team and the chief dental officer are having in-depth conversations with health boards to try to relieve the waiting time pressure.
I hope Ms McCall will also recognise that the Scottish Government has invested more than £135 million in reducing waiting times. She might say that that is not enough, but it is noticeable investment to reduce waiting times.
Data released only yesterday revealed that NHS Dumfries and Galloway has the third lowest rate of child dentist registrations in Scotland. Significant inequalities exist, with more than a 10 per cent gap between children living in the most and least deprived areas. Why are children in Dumfries and Galloway considerably worse off when it comes to registration? What is the Government’s response to that inequality, and what action will it take to address it?
I recognise the importance of ensuring that we support people and children, specifically those in the more deprived areas of Scotland.
Dumfries and Galloway has been impacted by a reduction in the number of dentists, and we are working closely with the health board. We have additional funding—Scottish dental access initiative allowances—to increase the number of dentists in various areas.
The progress that was being made through Childsmile has stalled, and the poverty gap is still pretty stubborn. I am sure that the pandemic had an impact on that, but there is no doubt that the lack of national health service dentists in large parts of the country, including in North East Fife, is also having an impact. What more will the minister do to improve the service in areas such as mine?
I remind Willie Rennie and other members that I have been working hard with those in the equivalent role to mine in the other three United Kingdom nations. Unfortunately, a number of the levers are held at Westminster, and Stephen Kinnock has not, to date, provided us with the support that we need to ensure that dental therapists are put back on the visa list. However, I point out that the latest national dental inspection programme results show that 81.5 per cent of primary 7 children have no obvious tooth decay, which represents a vast improvement since 2005.
Hip and Knee Replacement Surgeries (Waiting Lists)
To ask the Scottish Government what specific action it has taken to address waiting lists for hip and knee replacement surgeries. (S6O-05200)
As part of our record £21.7 billion budget investment in health and social care, we have targeted, this year, more than £135.5 million, including £32 million for trauma and orthopaedics, to tackle long waits. Yesterday’s update from Public Health Scotland confirmed that the number of waits of more than 52 weeks has fallen for the fifth consecutive month, which is testament to the dedication of our national health service staff. Our investment is delivering results. For example, in 2024, the number of hip and knee operations reached a record high, with more than 17,000 first replacements completed.
There has been progress in bringing down long waits in NHS Lanarkshire, with the number of waits of more than 52 weeks for new orthopaedic out-patients having reduced by 27 per cent and the number for in-patients and day cases having reduced by 31 per cent since the end of July, just after Mr Russell took up his position as MSP for his constituency. I am sure that he will welcome that fact.
I thank the cabinet secretary for that answer, but none of that helps my constituent Eileen, who has been waiting for a knee replacement since January 2024. She was bandied about to various meetings and assessments, because she could not join the waiting list until her full care plan was determined. It took 20 months for her to be added to the waiting list, despite her general practitioner telling her at the outset that she would need the surgery. Even now, she has no date for her surgery, with no sign of treatment on the horizon, despite the 12-week legal guarantee having passed and it being nearly two years since she first presented to a doctor. Does the cabinet secretary not see that creative accounting being applied to NHS waiting lists is hurting patients?
No. I ask Mr Russell to furnish me with more of the details of Eileen’s case, because I think that there has been some confusion in what has been presented in relation to the treatment pathways that she should be able to access. I expect NHS Lanarkshire to respond to such cases timeously, especially given the investment that has been made and the progress that is being made to out-patient, in-patient and day-case processes, to which Aileen will need to be subject. The measures of waiting times that Public Health Scotland has updated are very similar to the measures in NHS Wales, for which Mr Russell’s colleagues in the Labour Party are responsible.
I remind members that I am employed as a bank nurse by NHS Greater Glasgow and Clyde.
As the cabinet secretary mentioned in his previous answer, the number of knee and hip replacement surgeries is at a record high under the Scottish National Party Government, which proves once again that, although waiting lists have risen under Mr Russell’s bosses in NHS England, the Scottish Government’s plan to bring down NHS waiting lists is working. Will the cabinet secretary advise how the Scottish Government will continue to drive such improvements in the months ahead?
I thank Clare Haughey for that question, not least because I noted with interest the UK Parliament’s Public Accounts Committee’s analysis of the challenges with waiting times in Labour-run England. In Scotland, as part of our plan to reform the NHS, I announced proposals for subnational planning, which will ensure that NHS health boards work together in the east and in the west of Scotland, allowing teams to work across their boundaries to better support patients to get the care that they need in a timely manner. This year, we have allocated more than £135.5 million to specialty areas, in which the money can have the greatest impact in reducing the longest waits. As I said, yesterday’s figures show that the number of waits of more than 52 weeks has reduced for the fifth month in a row.
NHS Grampian
To ask the Scottish Government when it last met with the chief executive of NHS Grampian to discuss healthcare in Moray. (S6O-05201)
Both ministers and Scottish Government officials regularly meet representatives of all national health service boards, including NHS Grampian, to discuss matters of importance to local people. Douglas Ross will be interested to know that I will be carrying out NHS Grampian’s annual ministerial review on Monday in Aberdeen.
Yesterday, the Independent National Whistleblowing Officer stated that NHS Grampian was not properly handling concerns raised by staff. I have had cases raised with me by staff in the orthopaedic department at Dr Gray’s hospital. I have had a number of conversations with the chief executive of NHS Grampian and—to be frank—I do not believe that I have had full or truthful answers from her.
When I said that I would raise the matter in the chamber, I was told that she would brief the cabinet secretary, so my worry is that he has been fed the same lines as I have, which have been put back to constituents who still do not believe what they are being told by the head of NHS Grampian.
Given the grave concerns that constituents are highlighting, does the cabinet secretary agree that the issue should be reviewed by someone from outwith NHS Grampian?
I thank Douglas Ross for raising that question. I have seen some of the correspondence that has gone back and forth between Mr Ross and Laura Skaife-Knight. She understandably has to ensure that the confidentiality of employees is respected. However, there are clear processes in place to enable whistleblowers to raise concerns, including through the Independent National Whistleblowing Officer. There are whistleblowing champions in every NHS board; I have met them all.
It would not be appropriate for me to comment further, other than to point Mr Ross and his constituents in that direction to ensure that, where they have a concern, it is not just listened to but acted on appropriately.
Covid-19 Vaccination Programme
To ask the Scottish Government, regarding its decision to narrow the eligibility criteria for the autumn Covid-19 booster, what assessment it has made of the cost to the national health service and the impact on hospitalisation rates. (S6O-05202)
Eligibility for the Covid-19 vaccine is based on the advice of the Joint Committee on Vaccination and Immunisation and is identical across the four United Kingdom nations this winter. JCVI advice is based on its standard cost-effectiveness analysis, which shows that the oldest in the population and individuals who are immunosuppressed are at the highest risk of serious Covid-19-related disease, hospitalisation and death.
The recent Public Health Scotland “Viral Respiratory Diseases in Scotland Surveillance Report”, covering the period from 10 November to 16 November, shows that
“COVID-19 activity decreased or remained stable overall”,
with 73 hospital admissions that week—a decrease from 81 in the previous week.
One of my constituents is a type 1 diabetic, and so is her son. She recently paid almost £300 to get booster jabs for herself and her son, and for her husband, who is an unpaid carer.
I am sure that the Scottish Government will agree that it is unacceptable to expect vulnerable families across Scotland to pay hundreds of pounds at a time to protect themselves from Covid. Will the Scottish Government therefore consider applying a discount for type 1 diabetics who are under 75?
I understand that the groups who are no longer eligible for Covid vaccination—namely, those aged 65 to 74, those in wider clinical at-risk groups and front-line health and social care workers—might be feeling anxious. To them, I say that the overall threat of Covid has thankfully diminished over time as a result of high levels of vaccine-based immunity and naturally acquired immunity from the infection.
National Health Service Patient Complaints and Feedback
To ask the Scottish Government whether patient complaints and feedback about the care they have received from NHS boards are used to inform inspections undertaken by Health Improvement Scotland. (S6O-05203)
Healthcare Improvement Scotland has a duty to improve the quality of healthcare in Scotland, and its inspection programme is a key part of fulfilling that duty. HIS determines what inspection activity it should undertake, using a risk-based, proportionate and intelligence-led approach. That includes consideration of patient complaints and feedback, which are a valuable source of information and intelligence for making improvements.
HIS also gathers information from patients, families and staff during inspections. Through the process of responding to concerns, HIS addresses complaints in a person-centred manner, upholding the rights of everyone involved.
The cabinet secretary and I have previously spoken in the chamber about the impact that a negative experience of birth can have on women and their babies. I have shared a letter with him that my constituent submitted to NHS Ayrshire and Arran in May 2025, which gave a detailed account of her negative experience. NHS Ayrshire and Arran will not engage with MSPs once a complaint process has been triggered, which I find to be a defensive approach. On behalf of my constituent, I chased up the matter with NHS Ayrshire and Arran on 5 October, when I was told that a draft response was in progress, and again on 30 October.
At the end of her letter, my constituent said that she wished that her complaint would be
“handled with the seriousness that it deserves, and that corrective actions will be taken to improve patient care”.
Does the cabinet secretary agree that this is far too long to have to wait for answers to help her to process the trauma and distress that she has experienced? Does he also agree that a defensive, bureaucratic response to feedback is wholly unhelpful?
I am grateful to Ruth Maguire for putting that detail on the record. Clearly, it is unacceptable for a response to take that long. I am very sorry to hear about her constituent’s experience, which I know that she has written to me about and to which I will be responding in writing. After portfolio questions, I will ensure that our exchange is shared with the interim chief executive of NHS Ayrshire and Arran in order to underline the concerns that have been raised with me and to ensure that the process is sped up for her constituent, as well as for MSPs who interact with NHS Ayrshire and Arran.
The NHS complaints handling procedure sets a 20-day target for responses, emphasising timely and effective resolution. Complex cases may require more time, which I think that we would all understand, and extensions are allowed. However, if the target cannot be met, the complainant must be informed and given an expected response date. I will ensure that both I and NHS Ayrshire and Arran respond to Ms Maguire as soon as possible.
I will need briefer responses and, certainly, briefer questions.
Following an unannounced HIS inspection in June 2025, NHS Lothian’s maternity service has been escalated to level 3, requiring Government oversight after failing to meet 26 basic standards of care. Only two health board maternity services have been inspected. Will the cabinet secretary accept that now is the time for a nationwide review into our maternity services?
I and the Minister for Public Health and Women’s Health have set out in detail our response to NHS Lothian’s position and the wider concerns that were raised following the BBC’s “Disclosure” documentary. We are taking the issues seriously and are establishing a task force that can help to inform a review. As an immediate update, this morning, I and Ms Minto had a further discussion with NHS Lothian to get a progress update. The board gave us an assurance on the progress that is being made, and I will be updating the Parliament in due course on the outcome of that discussion.
I welcome the work that is being done by Healthcare Improvement Scotland, but the context is that public satisfaction with the NHS in Scotland has dropped to its lowest in a decade, according to the latest Scottish household survey. Complaints to NHS boards have gone up and appear to be taking longer to resolve. What is the cabinet secretary doing to improve performance with complaints?
I have already set out our expectation for performance with complaints, as well as what I expect to happen in the case that Ruth Maguire has brought to our attention.
On the performance of the health service, although we have more work to do, I am pleased that yesterday’s Public Health Scotland figures demonstrate the progress that has been made and the corner that is being turned thanks to the efforts of staff. I expect that that will boost confidence in the health service among patients and staff and reduce the need for complaints.
Audiology Waiting Lists (NHS Grampian)
To ask the Scottish Government what progress it is making on reducing audiology waiting lists at NHS Grampian. (S6O-05204)
I recognise the steps that NHS Grampian is taking to reduce audiology waiting times. The board has recruited a qualified audiologist and is appointing a new team member for Moray to support older adults with hearing loss. Increased staffing will help, although high demand means that progress will take time.
NHS Grampian has shortened some clinic appointments, prioritised adult reassessments and introduced text reminders to reduce missed appointments. Workforce pressures remain significant, with one audiologist serving around 28,000 patients, which is well above the average across other health boards.
I can tell from my inbox that it is well above the average. If the Scottish Government committed to delivering a community audiology service, high street audiologists would be able to deliver the service in as little as 18 weeks and clear more than 70,000 people from audiology waiting lists. What is preventing the minister from scoring an easy win and delivering on her party’s manifesto commitment to put community audiology services on par with the successful community eye care model?
I and the Scottish Government remain committed to our vision for integrated and community-based hearing services across Scotland. We recognise the difficulties that are faced by health boards, as highlighted by the independent review of audiology, and we wanted to check and ensure that we introduced all the recommendations in that regard. I have also asked officials to continue to have conversations with the audiology community to improve the service that we are offering people who live in Scotland.
Can the minister advise what steps the Scottish Government is taking to look at improvement and reform of audiology services, particularly in relation to engagement and collaboration with stakeholders?
As I indicated, we are continuing to engage with national health service boards, the third sector and private providers to scope out potential models for any future community hearing care services, ensuring that the voices of those with lived experience inform that work.
Sport (Child Poverty Reduction)
To ask the Scottish Government what discussions the health secretary has had with ministerial colleagues regarding the use of sport to support its goal to reduce child poverty. (S6O-05205)
Eradicating child poverty in Scotland is a national mission and is this Government’s top priority, with ministerial collaboration across portfolios to identify and implement effective measures such as the Scottish child payment.
We know that sport can change lives, creating meaningful and hugely positive opportunities for children who are affected by poverty. The benefit that it delivers can improve children’s and young people’s health and their educational and social outcomes. Through Government and sportscotland-funded initiatives such as active schools, the sport facility funds, the active play development project and the extra time programme, we improve opportunities for children to be active, ensuring that sport continues to contribute to our efforts to tackle child poverty and promote inclusion across Scotland.
I thank the minister for that comprehensive response and I hope that she will also join me in congratulating the efforts of Pollok United, which offers an outstanding range of community services, including the extra time programme, which was mentioned by the minister, parent and toddler groups and groups for older people, in addition to its multiple football sessions for young people in my constituency. At the heart of its efforts is its desire to make its community thrive and be a place that is prosperous and inclusive for all.
What concrete action is being taken to support Pollok United and similar sporting organisations to maintain and expand their vital community efforts, particularly in challenging financial circumstances?
The Scottish Government recognises the incredible impact and reach of sports organisations and community clubs such as Pollok United. I know that, when the Cabinet Secretary for Health and Social Care met the club last month, he was incredibly impressed by the work that it does. We will continue to work alongside it to support the communities that it serves.
We provide the Scottish Football Association with £1.3 million annually via sportscotland to support grassroots football. Additionally, in partnership with the SFA, we are investing £5.5 million in the extra time programme, which supports up to 5,000 children and families through breakfast, after-school and holiday clubs. That improves children’s health and wellbeing while enabling parents to work, thus tackling poverty right at its roots.
I apologise to those I was unable to call. That concludes portfolio questions on health and social care.
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