Seòmar agus comataidhean

You have not directly asked the accountable officer whether they recall who made that decision.

Thank you. I will try and be as quick as I can.

At the start of the process, the NHS Scotland resource allocation committee—NRAC—settlement was not paid in full to NHS Highland. Is that the case now? In relation to the challenges coming down the road, obviously, there is Covid recovery, but there is also the taking on of maternity services on behalf of Grampian for Moray until Dr Gray’s hospital is restored. You also talked about the elective centre. How will you cope with those challenges, and are you receiving the funding that you require in order to deliver for the people of the Highlands?

That, and the level at which such decisions are taken. At what level would you expect a decision of such magnitude to be taken?

Thank you, convener—I appreciate that. I know that others have a lot more questions, so I will keep my questions quite short.

I am just seeking some clarification. Having listened to the discussion, I think that it is clear that communication between CMAL and Transport Scotland was documented. It was Transport Scotland that came back to CMAL with ministerial decisions, but is there any paperwork on Transport Scotland’s discussions with ministers to show how it put these things to ministers and which ministers responded?

So, there is no documentation on ministers’ decisions and how they were carried out.

I understand that this particular decision was taken within a day. Is that normal? How would you expect a decision of such magnitude to be taken within Government?

Thank you.

I just have a very quick comment.

I am reasonably disappointed by the Scottish Government’s response, in that it just goes over what it has said before. There is not an awful lot that is different in it.

I note that the National Services Division has not yet responded although, at the time of the previous meeting, it said that it was working with NHS Tayside and was due to meet it at the end of January. It also said that it might be able to consider a formal application in either May or June. It is important to keep the petition open until summer, so that we can see what conclusion the National Services Division reaches.

Mary Ramsay has pointed out that a number of people are affected by the condition, so it is important that we make some progress. Mary has also stated that she would be happy to give further evidence to the committee, if it wishes, and Ian Sharp, who has benefited from focused ultrasound treatment, has also made that offer.

I encourage the committee to keep the petition open and to keep scrutinising the issue in the hope that we make some progress.

I agree with everything that Liam McArthur has said. The news that there has been a pause is welcome, because that is what Prospect was asking for and, indeed, what the staff and communities were asking for—they want time to look at the alternative solutions.

Nobody is arguing that we do not need to improve safety; the argument was that HIAL’s proposals did not provide additional safety but were about centralisation. They would cause huge economic damage without providing the safety that people want.

I would be grateful if the committee would look at a number of things. The proposed discussions about Benbecula and Wick were overlooked because of the enormity of the proposals, which impacted all the airports. There is concern that the downgrading of Benbecula and Wick will go ahead. Those airports need safe surveillance and locally based air traffic control. Both Benbecula and Wick are looking at becoming satellite launch sites, so they need safe airspace.

Benbecula is also host to QinetiQ’s Hebrides range, which means that there is often a huge amount of air activity when tests are taking place. The Hebrides range also provides a potential solution, in that it has radar. HIAL could work with the range to provide that in Benbecula. That would be a very affordable course of action that would not cause huge disruption.

One of the issues in all of this was the recruitment of air traffic control staff. The air traffic control staff in Benbecula tend to be young, so that airport has staff into the future. They are local people—they are not going to move anywhere. They will be lost to HIAL if it ends air traffic control at Benbecula.

There is also talk of a new island’s impact assessment. Therefore, any downgrading of Benbecula should surely wait until that impact assessment has been done. That would be within the spirit of the law.

With regard to Wick, people will be aware of the closing of Dounreay and the need for an economic focus on the area. A lot of work is going on with renewables and with the maintenance of devices, but the area needs good air traffic links to other parts of the United Kingdom to be able to attract jobs. It is very important that it has a safe airspace. Indeed, we are trying to encourage more traffic there.

I will not repeat what the convener said about the CAA’s comments, but it would be well worth the committee speaking to the CAA to find out what is happening, including about Wick perhaps being managed from Orkney. There was some discussion about that, and the CAA was not keen.

HIAL used to be very good at staff recruitment. It used to recruit from local communities. It would train people up and those people stayed. HIAL had its biggest recruitment issue in Inverness, where people tended to be more mobile. The committee should make HIAL look at that again and ensure that it starts recruiting again, because that is one of its reasons for stepping back—it says that if it cannot recruit, it will continue with the position as it was.

I know that the petitioners were keen to see Digital Scotland’s second report published. HIAL has it so it would be useful if the committee would ask it to publish that report.

There is also the centralisation of radar surveillance at Inverness. That does not make sense given that we are to have air traffic control at the airports, so how that decision was reached could be scrutinised. I know that there are concerns in Shetland about that, because the airport there has its own radar and there might be an impact if radar were centralised at Inverness.

I agree about the other issues that have been mentioned, such as the use of New Century house—I do not want to repeat everything.

As you have said, convener, over the past 14 years, the Rest and Be Thankful has been closed on quite a number of occasions, and it has cost over £87 million in efforts to keep it open and keep traffic safe.

You referred to the large landslide in August 2020, in which 10,000 tonnes of debris fell on the A83 and the old military road. The old military road, which sits in the valley below, is used as a temporary route when the A83 is closed. In that situation, the traffic could not use the A83 or the old military road, and there was a 60-mile additional journey over the A82 because of the closure. Another landslide occurred in September, only six days after the A83 reopened. That led to the A83 being open for less than 50 per cent of the time in the four months at the end of 2020.

It has been estimated that £5.5 million was lost to the local economy between August 2020 and March 2021. That does not take account of potential economic development that has gone elsewhere because of the uncertainty over the route. Depopulation is also a big issue in the area, and it will get worse because of that uncertainty.

As you said, convener, options were consulted on, and there is a preferred solution that follows a similar route. However, that requires quite a lot of work to examine rerouting and building a viaduct or tunnel. A medium-term solution through Glen Croe is also being discussed. There is real frustration locally about the length of time that that is taking and the money that it is costing.

We know that 100,000 tonnes of unstable material is risking lives and livelihoods in Argyll. Given the impact that was caused by 10,000 tonnes, we can imagine what 100,000 tonnes would do. Despite all the time that has passed, there is no clear indication of when a solution will be in place. We need a clear timetable for emergency measures and for medium and long-term solutions, and we need to know whether finance will be available to carry out that work. Hence the petitioners’ call for a public inquiry.

Thank you, convener. If I seem to be here a lot of the time, it simply shows how important the committee is to my constituents. It makes a real difference to people’s lives, and I hope that this petition will also have that impact.

Since the committee last considered the petition, I have spoken to and met Mary Ramsay virtually on a number of occasions. Following some of those meetings with Mary, and with other stakeholders who have an interest, I wrote to Ralph Roberts, who is chair of the national specialist services committee.

He told me that the national services division is due to meet the clinical team in Dundee towards the end of this month to discuss how a formal application for designation and the relevant paperwork can be prepared for consideration by both the national patient, public and professional reference group and the national specialist services committee. He told me that the next meetings of those groups are scheduled for February and March, but that it is unlikely that they will discuss focused ultrasound at those meetings. The issue is more likely to be discussed at the May or June meetings, and there is no guarantee that a conclusion will be reached at that time.

It feels to me that there is still no real recognition of the issues that people with essential tremor face in having to travel to London for assessment and again if they are assessed as suitable for the procedure. There is also no acknowledgement of the waiting times that people face and the impact on their lives.? There are real fears that the decision will be further delayed beyond the spring or summer.

The committee knows how long the petition has been before it and the previous committee. I share Mary Ramsay’s frustration that we appear to be moving at a snail’s pace in bringing this much-needed treatment to patients in Scotland.? Patients have to consider joining a waiting list in London, where the treatment is available. However, that is a long waiting list; indeed, NHS England is looking to create another centre to deal with the demand.

It makes no sense whatever to me that we have the equipment and knowledge in Scotland but we are not using those for our patients, who are forced to travel to access the treatment.? That is not good for them, and it is certainly not good for the public purse. I am not sure whether the committee is aware that 80 patients were referred for assessment in Dundee last year from their health boards, and that around 25 per cent were considered to be appropriate for treatment.

I urge the committee to keep the petition open and to put pressure on the bodies that I mentioned to ensure that the treatment is approved as quickly as possible. I think that the committee already knows that Mary Ramsay and Ian Sharp, who has had the treatment, are happy to give evidence on their experience and show at first hand the difference that treatment can make to those with essential tremor. Perhaps the committee could also contact the NPPPRG and the NSSC to ask them to give priority to their consideration of the treatment and to do so at their earlier meetings. As you said, convener, because of Covid, those bodies have not met for a long time.