Seòmar agus comataidhean

There is a proposal, which is that fair notice be given to the cabinet secretary.

I support Mr Choudhury’s recommendations.

I thank the petitioner, Dr Shotton, who describes herself as a deep end GP working in the heart of Glasgow, which, I gather, has no shortage of health problems. In her submission, she says that only 8 per cent of the capital budget that is applied to health service capital projects goes to primary care and that the lion’s share goes to hospitals. We all want modern and efficient hospitals, and the announcement of capital funding for the Belford hospital at Fort William, the new University hospital Monklands and the Edinburgh eye pavilion is welcome. However, we all have our constituency needs and, following on from Dr Shotton’s analysis, I want to make a particular point on which I would be grateful for the cabinet secretary’s response.

In my constituency, the population is growing. Inverness is arguably the fastest-growing city in Britain, if not in Europe. I am sure that that has nothing whatsoever to do with the quality of the political representation. The problem is—

I am grateful to Mr Kerr for his contribution this morning. I find myself largely in agreement with it.

I should say that the witnesses that we heard from last week were not enthused about moving from FAST to BE FAST. To be fair to them, there were various reasons: they thought that it would bring people from the emergency department to the stroke department who would then be referred back to the emergency department. A separate issue was the overload problem that Mr Kerr mentioned. There was also a hint of a suggestion that the general public are not quite sophisticated or clever enough to cope with and spit out six letters as opposed to four. I must say that I was not particularly impressed by that argument. On the other hand, we have heard from a newly published document in America that BE FAST was found not to work as well as FAST. We will want to study that.

However, we should pursue the matter further. Perhaps we should write to NHS Fife seeking further information on the BE FAST pilot trial that it undertook. We heard in NHS Fife’s written submission that it undertook a pilot scheme, but it did not say what the findings were, including any available analysis and evaluation of the pilot.

We might also write to NHS Ayrshire and Arran, which offered to carry out a pilot—it was the only health board to make that offer, and it did so gratis; it was voluntary, not conscripted. The minister Jenni Minto said that she would be sympathetic to a pilot, although she did not go as far as advocating for it.

Were there a pilot in Ayrshire and Arran, it would have to be properly and rigorously set up so that its findings had statistical validity. That might involve a bit of thought and organisation by the experts—otherwise, to put it bluntly, it is rubbish in, rubbish out. If Ayrshire and Arran wants to do that, I think that we should contact the board and ask whether it would be willing to consider that further with the relevant bodies, with the Bundy family also contributing if they wish to do so.

We could also write to Chest Heart & Stroke Scotland and the Scottish Ambulance Service seeking further detail about the training programme and resources referred to during the round-table discussion and specifically about the guidance being produced for clinicians to increase awareness of atypical stroke symptoms, such as changes to balance and eyesight, that are absent from the FAST acronym but would be present in the BE FAST one.

Lastly, there would probably have to be some sort of public awareness campaign prior to the launch of the pilot so that people in Ayrshire and Arran are aware that it is happening. I think that a modest public awareness campaign would continue to create further interest and awareness nationally, because I am sure that newspapers and the media would cover that campaign very well in the way that, to be fair to them, they do. That in itself would be an opportunity to continue raising awareness and arguably, as Mr Kerr has said, to save further lives, which must be a good thing.

I am impressed by how much Mr Golden knows about rubbish.

Yes. I know that the petitioner will be disappointed but, as you said in relation to a previous petition, convener, a lot of work has been done up to this time by the clerks to get a response from the minister and the petitioner. Were there any prospect of any reform, it would be our duty to explore and examine that, but my personal view—members may take a different view—is that there is no prospect at all of the Scottish Government changing its mind. If there is a different Government in the future, the petitioner might bring the issue back, if she so wishes.

If I phone up and say that my balance and eyesight are affected, what does the triage do? You have protocols and matrices—I do not know what the right word is—that determine the response given by the NHS operatives. However, I am not sure to what extent they are qualified—excuse my ignorance, Dr Cook. If I am asked whether I feel dizzy or I have slurred speech and I say, “No, but my balance is affected and my eyesight has suffered a bit”, what would you do then?

I am sure that all the witnesses will be well aware that the petition arose because of the tragic loss of the life of Tony Bundy. The petitioner stated that, when Tony suffered a stroke, his face and arms were unaffected and his speech was not slurred, and that meant that he passed the FAST test because face, arms, speech and time were not affected. The petitioner went on to say that the family is now raising awareness of the symptoms of stroke, including the inability to stand, which is balance, cold sweats, and eyes struggling to focus. That is where the B and the E come from—balance and eyes.

The evidence that you have all given is consistent: you do not think that, from the available studies and the evidence, the alteration of the awareness campaign from FAST to BE FAST would work. Mr Watson began by stating that there is a problem. To put that problem in layperson’s terms, the current system is not identifying all of those who might have suffered a stroke, but you think that FAST is best, and if we are to depart from that, it might make things worse, not better.

I can understand that. I am not a clinician, so it is not for me to second guess anybody. However, the committee wrote to all the health boards in Scotland and the written response from NHS Ayrshire and Arran describes the work that it has already done, which is quite substantial and quite impressive. I will not read it all out because it would take too long, but it says that

“the team at NHS Ayrshire and Arran would very much welcome the opportunity to be a pilot site if this was agreed.”

I have a point that I want to try out on you, to see what you say. Studies are one thing, but a health board is willing to carry out a pilot, and the Minister for Public Health and Women’s Health, Jenni Minto, has said that it is up to health boards to do that. As I understand it, she is not standing in the way of a pilot, although I am not sure that she is advocating one. Given all that, would it not be sensible to actually try it out? I do not mean to be impertinent in any way. Your evidence and knowledge come from your experience as professionals and clinicians, but a layperson might say, “For goodness’ sake, give it a try.”

Studies are one thing and, as has been pointed out, studies from the USA may be of limited efficacy because of different circumstances and the profit element, but surely it would make sense to have a pilot scheme. If it were conducted under scrupulously pre-arranged terms, it might be possible to measure the outcome and see whether it actually works.

I know that that idea was promoted by Stephen Kerr and Alexander Stewart, two other MSPs who have been supportive of the family in this case. I would like to know from all the witnesses whether they think that that might be worth trying.

The petitioner has said that, on some points, he was

“satisfied with the answers given”

by the minister. The minister has taken an interest in the matter, all of which is to be welcomed. I think that the petition has probably gone as far as it should, and I agree that a ministerial statement would be of use. I particularly support the recommendation that, in closing the petition, we write to the minister to draw attention to the importance of financial support being available under future agri-environment and climate schemes in order to maintain and increase predator control.

I should say that I have known Alex Hogg as a friend for 25 years, and there are very few people in Scotland who know more about managing wildlife and the countryside than he and many of his colleagues in the Scottish Gamekeepers Association, of which I am a member. Indeed, I hope that I have paid my subscription.

The serious point is that Alex Hogg has made the case for funding very well. He says that, over the several decades during which he has worked, there has been a

“change in balance between predator and prey”.

Now, the predator has the whip hand, the prey is often unprotected, and there is not much that can be done about it. That results in carnage in the countryside, with the loss of livestock, particularly lambs, from foxes and other predators. It is essential that they are properly controlled. Mr Hogg concludes with the point that, if there is a specific strand in the new agri-environment schemes, that would help not only to control predators, which cause enormous damage, worry and stress to farmers, crofters and land managers, but to protect some of the species that are under threat, too. He makes that point in his submission.

The evidence that we have had from the Scottish Tourism Alliance, which you helpfully read out to us, deputy convener, should be pursued—namely, the recommendation that the Scottish Government should have power to challenge a local government decision. We need to explore that further.

The petitioner’s previous comments state that he was “fobbed off” with various excuses, and there has not really been any answer to that. On one occasion, he was told that he could not use the land because someone else might want it—for goodness’ sake, what sort of an excuse is that? I know that the Scottish Tourism Alliance represents a huge range of tourism bodies, so its voice is significant. The fact that it has chosen to respond with that specific suggestion makes me feel that we should pursue the matter further rather than close the petition at this juncture, to be fair to the petitioner. It may be that the Scottish Government will refuse to do that—I would not be surprised if it were to do so—but we should at least ask it.

Thank you. It would be very helpful, convener, if Dr Cook would follow that up with a letter setting out what the protocols say—just for our information, on a sort of factual, evidential basis.