Rural Affairs, Land Reform and Islands
Good afternoon. The first item of business this afternoon is portfolio question time. The first portfolio is rural affairs, land reform and islands. As ever, any member who wishes to ask a supplementary question should press their request-to-speak button during the relevant question.
Question number 1 has not been lodged.
Farmed Salmon
To ask the Scottish Government what its position is on whether any further action is required to address reported concerns around the environmental, sustainability and welfare impacts of farmed salmon. (S6O-03782)
We have in place robust legislation, policies and operational practices to ensure that farmers are meeting statutory requirements related to the environment, sustainability and welfare, such as sea lice reporting and management, mortality reporting and listed disease surveillance.
It is important to recognise that Scotland’s salmon industry is a significant contributor to our economy, particularly in rural and island communities. It produces high-quality nutritious products with a lower carbon footprint than many other sources of farmed protein.
It is also important to highlight our document “Vision for Sustainable Aquaculture”, which sets out how we will support the development of our aquaculture industry to operate within environmental limits and deliver social and economic benefits for Scotland.
As the cabinet secretary is no doubt aware, there have been long-standing concerns about the welfare and environmental impact of farmed salmon. Those have included on-going reports of mass fish deaths on salmon farms, the increasing impact of sea lice on those farms and increased use of chemicals and antibiotics to combat the levels of disease. Is the Scottish Government not concerned that continual reports of disease-ridden farms have potential to ruin the global reputation of Scottish salmon? What more could and should be done about that issue?
I recognise some of the concerns that Mr Rowley raises, and I completely understand wider public concern about fish health and mortality. However, to touch on one example that was used recently, misinformation was reported in relation to what happened in advance of a visit to a fish farm by members of a Parliament committee last week. That misrepresentation of some of the issues shows a lack of understanding of some operations. Notwithstanding that, Mr Rowley raises really important issues.
It is important to mention our work on the back of the Griggs review and its recommendations. Fish health and welfare is of paramount importance, and we continually strive to improve that. That is a key pillar in our “Vision for Sustainable Aquaculture”, which we published last year. We want to see improvements in fish health and welfare. I know that the industry is committed to doing that and to reducing mortalities to the lowest possible levels.
We continue to engage in discussions with industry and our regulators. More widely, I chair the Scottish Aquaculture Council—
Briefly.
—which brings together a range of different bodies to try to address some of those issues.
I have a couple of supplementary questions from members. They will need to be brief, as will the responses.
Will the cabinet secretary tell members how many jobs the finfish aquaculture industry supports in rural Scotland? Will she also set out some of the detail of the economic importance of the industry nationally and in rural and island communities?
It is important to recognise the significant economic contribution that our fish farming sector makes to our rural economy and Scotland’s economy more widely. The overall figures show that the industry was worth £1.2 billion at farm-gate prices in 2022. It employs more than 12,000 people throughout the supply chain; it also provides well-paid jobs in some of our most rural communities and in our island communities. The industry makes a significant economic contribution.
I remind members of my entry in the register of members’ interests. I am a proprietor of a wild salmon fishery on the east coast of Scotland, where there are no fish farms.
We heard this morning in committee that mortality in salmon farms has been around 20 to 25 per cent, but it is somewhat better this year because of colder seas. Given that the industry seems to be predicting a 2 per cent drop in mortality, how long should it be before the industry should consider whether expansion is right until it has fish mortality under control?
It is important to remember that a range of different issues contribute to fish mortality. I know that the industry would be committed to driving that to the lowest possible levels, as we are. We expect producers to drive it to the lowest possible levels because it is not in anyone’s interests to see high mortality, whether from a fish health and welfare perspective or from an economic perspective.
I know the challenges that we are seeing. The industry invests quite a lot in research, innovation and development to tackle them. As we recognise in our “Vision for Sustainable Aquaculture”, investment in innovation will be critical to our ability to address the challenges that we see in relation to climate change and other issues.
Food and Drink (Impact of Brexit)
I apologise for being late to the chamber.
To ask the Scottish Government whether it will provide an update on what assessment it has made of the impact of Brexit on Scotland’s food and drink sector. (S6O-03783)
The easy answer is that it has been very bad. The food and drink sector has undoubtedly borne the brunt of Brexit, which has disrupted supply chains, created new trade barriers and driven up food prices.
The value of food imports from the European Union into Scotland fell by 13 per cent in 2023 compared with 2019. That slowdown is particularly acute for fruit and vegetable imports, which are down 51 per cent, and for fish and seafood imports, which are down 67 per cent. Many Scottish food industries are also suffering from lower exports to the EU, including a 45 per cent fall in the value of fruit and vegetable exports between 2019 and 2023.
The Association of Independent Meat Suppliers—AIMS—has warned that failures in
“veterinary oversight and inaccuracies in certification processes are leaving UK businesses ‘at risk of economic loss, waste and an increasingly unmanageable burden of bureaucracy’.”
We know that the way back to the full benefits of the EU is with independence, but the Tories promised fewer trade barriers, no diminution of food standards and lower costs, while Labour remained silent on Brexit.
Does the minister agree that the United Kingdom Government must seek a new deal with the EU that reflects the wishes of the people of Scotland and gives us the benefits that are enjoyed by our Northern Ireland counterparts?
I absolutely agree, and the Scottish National Party is the only party in Scotland to advocate for rejoining the EU, not least to remove the harms from Brexit, such as the one that Clare Adamson has highlighted.
The new immigration rules have imposed a minimum salary for veterinarians, who now require skilled worker visas. That obviously adds costs and will potentially impact on recruitment.
Although we continue to work across the Government, we also continue to call for negotiation between the EU and the UK on a veterinary and sanitary and phytosanitary agreement, which would remove many Brexit barriers and, therefore, benefit our businesses and consumers. It is our view that any such agreement should be comprehensive—it should be broad and deep—because that would offer the most benefits for Scotland. Indeed, one study undertaken by Aston University estimates that such an agreement could increase agri-food exports from the UK to the EU by at least 22.5 per cent.
However, it is vital that devolved Governments are central to any negotiations. Therefore, as always, we stand ready to work collaboratively to achieve the best possible results for Scottish consumers and businesses. I hope that the UK Government is minded to do the same.
I alert members to my entry in the register of members’ interests as a small farmer.
I do not think that it is helpful to continue to talk about the negatives of Brexit when we are coming up on 10 years since the vote. Last year, a Quality Meat Scotland report revealed that red meat exports had, in fact, reached a new high of £93 million, 95 per cent of which were export revenues that were generated in the EU market. However, QMS warned in the report that those sales were being limited by reduced abattoir provision in Scotland.
Instead of talking down Brexit all the time, will the cabinet secretary and minister now take action to fix the abattoir shortage in Scotland?
I am afraid that I am not buying that at all. Tim Eagle talks about there having been no damage to the food and drink sector in Scotland, when it has been catastrophic.
On our ability to ensure that the Scottish abattoir sector continues to work, we are already looking at that, as the Deputy Presiding Officer knows. However, there are huge issues involved. Tim Eagle talks about abattoir provision when we cannot get vets to come here from Europe because of new, Brexit-imposed wage restrictions. I am sorry, but I do not buy his point at all.
Tree Planting
To ask the Scottish Government whether it will increase funding to enable more trees of commercial species to be planted in Scotland. (S6O-03784)
Despite the pressures on the Scottish Government’s budget, nearly £40 million is available this year to support the planting of a wide range of woodland. The planting of timber-producing species is an important part of that balance and normally represents around half of the new planting in Scotland. Productive species also make up 60 per cent of the restocking that is supported by the forestry grant scheme. Although we are not able to increase funding this year for tree planting, we have introduced flexibility to adjust grant contributions so that existing funding is spread across more projects and enables the planting of more productive species.
The cabinet secretary will know that our sawmills and panel products businesses contribute £1 billion a year to the economy and provide 25,000 jobs. They can do far more, because we import more timber than any country in the world except China. However, without a continuous, regular and guaranteed steady supply of commercial species, those businesses’ future is in question.
If the minister wants to know where the money can come from to spend more on trees, I suggest that she takes it from rewilding and peatland restoration of dubious value and that she avoids throwing further millions of pounds on futile attempts to avoid the extinction of the capercaillie, which is surely already the most expensive bird in world avian history.
The member has made a few points that I will try to touch on. There is no getting around the fact—I have been quite transparent about this—that, with the budget that we have for tree planting this year, we are absolutely not in the place that we would want to be, especially when we have been on such a good trajectory on levels of tree planting in Scotland, with 15,000 hectares planted in the previous year. We had a target of 18,000 hectares for this year, which, unfortunately, we will not be able to meet with the available funding. However, that is largely down to the massive cuts that we have received from the United Kingdom Government. There is a 10 per cent cut to our capital budgets overall, which means that we are restricted in what we can do.
The member touched on a lot of other areas. On peatland restoration, our peatland is responsible for about 15 per cent of our emissions, so the funding that we put into developing the industry to restore our peatlands is vitally important. It is also important that we maximise the budget that we have and get as many trees in the ground as possible with what is available.
Scotland’s forestry sector achieved record tree planting last year, but budget cuts will limit new woodland creation to around 10,000 hectares this year. At that level, the sector advises that jobs and industry confidence will be lost and that the infrastructure for planting will shrink, consigning Scotland to years of failure. Given the sector’s £1.1 billion annual contribution to Scotland’s economy, will the Scottish Government provide the £10.5 million of additional funding that is needed to prevent long-term industry damage?
I covered that point in my opening response. If that funding is to come from the budget in-year, I would like some suggestions from the member as to where it could come from, because right now we simply do not have it. However, the important point is that teams in Scottish Forestry are undertaking work this year to maximise the tree planting that we can undertake with the resources that we have available. We are trying to be as flexible as possible within that and ensure that we make the best of the budgets that we have.
Question 5 is from James Dornan, who joins us remotely.
Food and Drink Produce (Labelling)
To ask the Scottish Government what communication it has had with the United Kingdom Government, since the general election, regarding the potential impact on Scotland’s food and drink sector of the reported proposal for “not for EU” labelling on food and drink products in the UK. (S6O-03785)
Since the general election, officials have been meeting regularly with UK Government officials to discuss their plans for the proposed Great Britain-wide “not for EU” labelling. I am pleased that the Government appears to be taking a more measured and evidence-based approach to that labelling. The cabinet secretary and I are keen to work together to develop a proportionate and workable solution to address some of the concerns around the free flow of goods into Northern Ireland.
I welcome the discussions that are taking place between both Governments. Labelling is a wholly devolved matter and policy decisions in that space should rest with Scotland’s democratically elected Government. GB-wide labelling proposals are merely another assault on Scotland’s devolved political settlement, although I obviously welcome the abandonment of the scheme. Scrapping Tory schemes aside, does the minister have any further indications that the Labour Government intends to act differently from its predecessor and respect this Parliament and Scotland’s Government?
The Scottish Government has made clear its commitment to working collaboratively with the UK Government in order to achieve better outcomes for Scotland. We are working constructively with the UK Government on areas of common ground, such as helping the economy grow and transition to net zero, in a way that respects devolution and all the powers of the Scottish Parliament.
The cabinet secretary and I were in London a few weeks ago to meet Steve Reed, the Secretary of State for Environment, Food and Rural Affairs, Huw Irranca-Davies from the Welsh Government, and Andrew Muir from the Northern Irish Government. We had a very positive and constructive discussion, which was based on mutual respect for devolved competencies and a much closer, more collegiate working relationship. We hope that that becomes the norm.
Scottish Food and Drink Produce (Supermarkets)
To ask the Scottish Government what data it holds on the availability and prominence of Scottish food and drink produce in supermarkets operating in Scotland. (S6O-03786)
Market data suggests that, in 2023, there were sales of £541 million on Scottish brands in supermarkets, with independent consumer insights commissioned by Scotland Food & Drink highlighting that Scottish consumers want to buy more Scottish products. That is why we have committed more than £10 million over the course of 2023 to 2025 to support the delivery of Scotland’s food and drink strategy, “Sustaining Scotland. Supplying the World.” That strategy contains a number of actions to increase local sourcing and get more of our quality products on supermarket shelves so that we can continue to ensure that consumers increasingly have easier access to Scottish products.
The cabinet secretary will be aware of some of the finest products that are available in my constituency and across Ayrshire, including Dunlop cheese, Darvel Dexter beef, Ayrshire Riviera cider, Lochlea whisky and, of course, the world-famous Kilmarnock pie. However, not all of those products can be found on our supermarket shelves. Aldi, which has the highest overall percentage of Scottish products at 49 per cent, and Lidl, with 100 per cent Scottish lamb, are the standouts. However, our friends at Asda, Tesco and Sainsbury’s all appear to have less than 10 per cent Scottish products on their shelves.
Does the cabinet secretary agree that we should all be united in calling on supermarkets to back Scotland’s food producers and buy Scotland’s produce so that consumers can, in turn, do the same and enjoy our wonderful food and drink from every part of Scotland?
Absolutely. I could not agree more with Willie Coffey’s point. Some of the facts that he mentioned relate to the important work that is undertaken by NFU Scotland and its shelf watch campaign. I believe that we are waiting on the results of the most recent iteration of the work that it has undertaken.
Retailers know that people want to buy Scottish. We are seeing more campaigns in retail settings that are providing leading positioning in store and marketing opportunities for more Scottish products than ever. I also emphasise the work that we are undertaking to make that as easy as possible for people and to increase those opportunities. We are working with the Scottish Wholesale Association and the Scottish Grocers Federation to increase sales through wholesale and convenience channels. We also host regional sourcing Scotland meet the buyer events to ensure that we link up our retailers and some of the fantastic Scottish products that we have available. That work will very much continue.
I call Brian Whittle. Please be brief, Mr Whittle.
Willie Coffey highlighted some of the fantastic small and artisan producers that we have in East Ayrshire, and we have such producers across Scotland. The cabinet secretary mentioned the amazing support from our wholesalers. However, what can the Scottish Government do to help those businesses to scale up and ensure that they have access to supermarket shelves?
Please answer as briefly as possible, cabinet secretary.
I re-emphasise the work that I have already mentioned. I appreciate the point that Brian Whittle makes. We want to see more Scottish products on shelves in all sizes of stores across Scotland. The go local programme is about ensuring that we have local products in convenience stores. I also touched on the meet the buyer events, which are really important as they link up some of our producers with retailers. Through investing in that work and ensuring that we build those relationships, we hope to see more local produce on our shelves.
Hunting with Dogs (Scotland) Act 2023 (Licensing Scheme)
To ask the Scottish Government what action it is taking in response to reported concerns that the licensing scheme introduced by the Hunting with Dogs (Scotland) Act 2023 is acting as a loophole in the fox hunting ban. (S6O-03787)
The licensing scheme in the 2023 act is not a loophole. The use of more than two dogs is strictly controlled under licence for specified purposes—in particular, the protection of livestock. All licence applications are scrutinised by NatureScot and, where licences are granted, both NatureScot and Police Scotland must be notified before any activity commences. NatureScot has carried out a number of visits to ensure that any activity that is undertaken is strictly in accordance with the licence. It is currently carrying out a planned review of the licensing scheme, and we will consider the findings and take any further action as required.
Parliament has voted repeatedly, over many years, in favour of ending fox hunting in Scotland. In the most recent legislation, which was intended to close the loopholes that have been used by those who continue to perpetrate that cruel practice, a licensing regime was introduced that was intended to be for exceptional purposes. The Scottish Government’s position was that fox hunting should have no place in a modern Scotland. With 41 licences having been issued in the first hunting season since the 2023 act came into force, is it not clear that we simply do not have the rigorous enforcement of the legislation that we need? Will the Scottish Government ensure that, in the future, a great deal more rigour is applied?
I simply disagree with Mr Harvie’s characterisation of the situation. Fox hunting is absolutely against the principles of the people of Scotland, but predator control is not. Hunting with more than two dogs is licensed in specific circumstances to make sure that farm managers and landowners can protect the livestock and the wildlife in their area.
I will call a couple of members to ask supplementary questions, but they will need to be brief, as will the responses.
Criminal activity against wildlife must be pursued, and there is a straightforward way for concerned parties to do that. However, in rural areas such as Dumfries and Galloway, it is crucial that farmers, conservationists and land managers have access to methods of species management and predator control. Does the minister agree, and will he reaffirm, that that will remain the Scottish Government’s position?
I absolutely agree that the Scottish Government’s position is to allow predator control as we go forward.
No wonder the Scottish National Party dumped its hapless coalition with the Greens. Patrick Harvie and his colleagues passed the Hunting with Dogs (Scotland) Act 2023, which ensured a licensed approach. Furthermore, NatureScot has strengthened the licensing process, making it more difficult for packs to get a licence. Will the minister confirm how many times the licence conditions have been broken?
At this moment, to my knowledge, there have been none.
“The National Islands Plan”
To ask the Scottish Government what its position is on whether the first statutory national islands plan, published in 2019, has been a success. (S6O-03788)
The implementation of the first national islands plan has faced a succession of crises since its introduction, including the Covid-19 pandemic, the on-going cost crisis and the full effects of Brexit. However, significant policy efforts and investments have been delivered across Government to drive progress towards the strategic objectives of the plan. We know that more remains to be done to address islands’ priorities and to help them to fulfil their ambitions. That is why we have announced that a new plan will be published next year, and we will continue to be guided by islanders to inform its content.
The answer to the question is no. It has not been a success. The minister has given a litany of excuses as to why the plan has not provided better outcomes for islands. We all know the reality that life in island communities is difficult, but it has simply got worse with regard to the availability and affordability of housing; access to health, social care and education; the growth of businesses; and depopulation, and that is not to mention the F-word—the continuous chaos on our ferry network. What hope can we give islanders from this, their national Parliament, that the next national islands plan will be worth more than the paper it is written on?
I know that the Tories would like to brush away all the key issues that I have mentioned, some of which they were largely responsible for, let alone the massive cuts to our budgets that we have seen over previous years. That is why this Government is committed to delivering for our islands. As I set out, after a consultation last year, we committed to publishing a new national islands plan, which will be based on what our islanders see as important and will be driven by the objectives that they want to address. We will also set out how the Government will deliver across those objectives. We look forward to the process of developing that plan and working with our islanders as we do it.
Again, brevity will be required for both supplementary questions.
My office is contacted almost daily about problems with the ferry service. For example, yesterday, a constituent phoned about a service that was diverted to Troon and about the conditions on board. Does the cabinet secretary agree that the Government’s handling of the ferry crisis has undermined the strategic goals of its national islands plan?
I recognise that our infrastructure—whether it is our transport infrastructure, housing or other matters—is critical to our islands and the people who live on them. On the particular points about ferries, if the member would like to raise any issues, I ask her to raise them with the Cabinet Secretary for Transport, who will respond to her.
The member’s question indicates why the development of the national islands plan is so important. The plan considers all the issues that matter to our islanders and sets out how the Government will address them in the coming years. We also publish how we are performing against those objectives every year. I look forward to members feeding into that process.
The islands plan discusses improving the quality of life for island communities. Will the cabinet secretary give some concrete examples of how the Scottish National Party has done that since the plan’s publication? Will she also remind members of the impacts of Tory austerity and the Tory cost of living crisis on our island communities? [Interruption.] Tory members are complaining, but that is the legacy of the Tories in the islands.
Austerity has undoubtedly had a huge impact, not least with the 10 per cent cut to our capital budgets. In spite of that, we have continued to deliver an islands programme that has delivered 61 different projects across 50 different islands with more than £12 million of funding. We are set to announce shortly the outcome of the most recent applications to that programme, in which a further £3 million-worth of investment is planned.
That concludes portfolio questions on rural affairs and islands. Before we move on to the next portfolio, there will be a brief pause to allow front benchers to change positions.
Health and Social Care
The next portfolio is health and social care. Any member who wishes to ask a supplementary should press their request-to-speak button during the relevant question. Brevity would be appreciated, given the number of supplementaries that have already been indicated.
Paramedics (Employment)
To ask the Scottish Government what support is in place to help newly qualified paramedics find suitable employment. (S6O-03789)
The Scottish Government is committed to attracting a diverse workforce into national health service employment and hugely values the role of our paramedics, who provide effective, person-centred care for the people of Scotland. We work closely with the Scottish Ambulance Service to set annual numbers for the university student intake programme for people who wish to study to become paramedics.
Overall responsibility for the recruitment of newly qualified paramedics rests with the Scottish Ambulance Service. We continue to work with SAS to explore how the role of a paramedic can be utilised more widely in the healthcare system to improve patient care in areas of high demand.
I have been contacted by a constituent who graduated with a distinction in their paramedical science degree. They are now a registered paramedic and were informed that they had a job with the Scottish Ambulance Service after passing the interview. Despite that, my constituent advised that the closest job posting that they were offered would involve an unmanageable daily commute. They were then advised that, if they did not accept that remote posting, their application would be void and they would have to reapply for a position next year.
What support can the Scottish Government give to paramedics who do not receive a posting offer close to their home?
I thank Fulton MacGregor for bringing that issue to the chamber. I commend his constituent on their progress and I obviously sympathise with them about their situation.
As autonomous institutions, health boards are responsible for their own recruitment activity. The Scottish Government is not directly involved in such recruitment plans and processes.
The Scottish Ambulance Service remains committed to maximising the opportunities for newly qualified paramedics to find employment. We continue to support it in that endeavour, and paramedic numbers are up by 46.9 per cent in the past 10 years. Although it is hoped that all graduates will be able to join SAS in their chosen location upon graduation, that is not always possible, as vacancies in each area can fluctuate significantly each year, depending on factors such as local retention and absence rates.
Ambulance technicians who want to train as paramedics are unable to access training places due to a lack of funding. What steps will the cabinet secretary take to make it easier for technicians to retrain as paramedics, especially given that paramedic vacancies have been steadily increasing since 2016?
I will take away Jackie Baillie’s point and consider it. As I pointed out to Fulton MacGregor, the number of paramedic places has gone up by 46.9 per cent, and the number of ambulance technicians has gone up by 32.4 per cent in the same period. The Scottish Ambulance Service’s resource budget also increased by 29.9 per cent in real terms between 2010-11 and 2024-25. However, I will take away the point that Jackie Baillie has raised to see whether there is more that we can do.
Alcohol-related Deaths (Lothian)
To ask the Scottish Government how many alcohol-related deaths were reported in the Lothian region in the last year for which data is available. (S6O-03790)
The number of alcohol-specific deaths in 2023 was published by National Records of Scotland on 10 September 2024. In the NHS Lothian health board area, there were 163 alcohol-specific deaths in 2023—an increase of 10 deaths from the 153 deaths that were reported in 2022.
I am sure that the minister will agree that that is too many.
In the most recent Scottish budget, the Scottish Greens secured a commitment that the Scottish Government would consider the reintroduction of a public health supplement, which would be a small surcharge on the non-domestic rates for large retailers that sell alcohol and tobacco, in recognition of the harm that those products can cause and the cost to the public purse of treating those harms. Research by the Fraser of Allander Institute that was commissioned by Alcohol Focus Scotland has found that a public health levy could raise approximately £57 million of additional funding for public services. Does the minister agree that we cannot pass up the chance to invest tens of millions of pounds more in addiction services through a public health levy?
I agree with Lorna Slater that one death due to alcohol is one too many, and I send my sincerest heartfelt apologies to the families who have been impacted by those deaths.
A public health levy is still under consideration by the Scottish Government, and I point out that the minimum unit price of alcohol has increased this week.
A number of members would like to ask supplementary questions. I will try to get in as many as I can, but brevity will be required.
Will the minister provide further information on the implementation of the minimum unit price increase and how it is anticipated that it will help to reduce alcohol harm?
The Scottish Government has engaged broadly with key business associations and retailer groups to ensure maximum awareness of the minimum unit price of alcohol increasing to 65p from 30 September. We have collaborated with trade bodies and industry representatives to produce a variety of materials for retailers to use in their stores to inform customers and raise awareness of the price increase. We have also co-funded guidance for retailers that has been produced by the Scottish Grocers Federation.
Our business and regulatory impact assessment, which was published earlier this year and was based on modelling that was undertaken by the University of Sheffield, set out that, in the first year of the policy, the number of deaths from all causes was estimated to reduce by 60, compared with the control group with the MUP continuing at the same level in real terms when adjusted for inflation.
The decision to close NHS Lothian’s life-saving alcohol-related brain damage unit has been paused while options are assessed. There is no other specific ARBD residential rehab unit in Scotland, and evidence shows that the treatment for people with ARBD in non-specialist units is often unsatisfactory.
On 4 July, the Scottish Government requested clarification on the function of the service to allow it to be reclassified as a specialist rehabilitation unit. That information has been provided—
Question.
—but no response has been received. Minister, do you agree that the reclassification is crucial for funding, and will you seek to determine what is preventing the life-saving service from being assessed as a rehabilitation unit?
Speak through the chair.
Sue Webber asked me a question on that issue a couple of weeks ago. I recognise that we are still waiting for a response, so I am very happy to engage with officials to understand the delays before getting back to her.
The minister will know that people in the most deprived areas are seven times more likely to end up in hospital due to alcohol-related conditions and that certain hospitals serve a disproportionate number of such areas. Is anything being done to provide extra support for those hospitals, specifically for accident and emergency departments, which are reportedly dealing with an increase in the number of people presenting who are at risk from serious alcohol harms?
I thank Carol Mochan for the question. I do not have specific information on that, but I remind the member that alcohol and drug partnerships have had record levels of funding this year. I will respond to the member’s question in writing.
Everyone cares about alcohol deaths, and given the significant work of organisations such as the Portman Group and Community Alcohol Partnerships, which support local partnerships that reduce alcohol harm, particularly among children and young people, will the minister and the Government commit to listening carefully to the real concerns of the industry as it consults on new measures to restrict alcohol marketing and sponsorship?
As part of any consultation process, the Government is clear that we need to consult and engage with business as well as stakeholders, and that will be being done with regard to the issue.
Neurodivergent People (Support)
To ask the Scottish Government what it is doing to support neurodivergent people, in light of reports of people waiting years for diagnosis, and subsequent access to support and treatment, which is seriously impacting their lives. (S6O-03791)
There have been significant increases in the number of neurodivergent people seeking a diagnosis and requiring support. Although that creates challenges for a range of services, we also recognise how important a diagnosis and support can be.
We are working closely with national health service health boards and local authorities to improve services and support for neurodivergent people. In 2021, we published a national neurodevelopmental specification, which sets out the standards that all children’s services should follow to ensure that access to support is effective and consistent across Scotland, supported by funding including £1 million for tests of change.
Neurodivergent children and young people also benefit from the £15 million per annum that is provided to local authorities for community-based supports and the £120 million that is provided to NHS boards under the enhanced mental health outcomes framework.
I thank the minister for that answer. There have been reports that some people are waiting for more than four years for diagnosis of autism and attention deficit hyperactivity disorder, and many of those who are undiagnosed or are waiting for treatment are struggling with school and employment. Has the Scottish Government considered providing a fast-track to diagnosis and access to treatment following diagnosis? Can the Scottish Government also please give an update on pauses to treatment as a result of medicine shortages?
We want patients to get the help that they need when they need it, and we understand how important a timely ADHD or autism diagnosis is for individuals. We also recognise the pressure that services face, given the rapid but welcome gains in awareness. That is why we continue to fund and work with the national autism implementation team, to support health and social care partnerships and to consider best practice and improved service in the redesigning of neurodevelopmental diagnostic services.
We would expect employers or schools to explore with individuals what adjustments are appropriate, as formal diagnosis is not required for educational adjustments or for disabled people to receive support through the access to work programme.
The supply of medicines is reserved to the United Kingdom Government. Information that has been provided by the UK Government indicates that some of the ADHD medicine supply issues will continue into winter 2024. The shortages are caused by a combination of manufacturing issues and an increase in demand. Anyone who is affected should speak directly to their clinical team.
There is information on things such as diet, exercise and sleep that can help, whether or not people get a diagnosis. What information can be extended to people so that they can wait well?
The member is absolutely correct. We regularly talk about the fact that support and adjustments should be possible without a diagnosis. The whole improvement that is possible in the individual does not require a diagnosis to be in place. We invest a great deal in community support to make sure that those adjustments are easily accessible to people who suspect that they have a neurodivergent diagnosis. A diagnosis is not needed to access healthcare in Scotland.
Brain Tumours (Diagnostic Pathways)
To ask the Scottish Government what it is doing to ensure that diagnostic pathways in Scotland are appropriate for those affected by brain tumours. (S6O-03792)
We know that diagnosing brain cancer can be challenging, as symptoms are wide ranging and often vague. We continue to work with primary care to ensure that it has direct access to diagnostic tests and quality education sources. A clinical review of the Scottish referral guidelines for suspected cancer is under way and a new national headache referral pathway has been published to ensure that the right patient is on the right pathway at the right time.
We are opening another rapid cancer diagnostic service in 2024-25, bringing our national total to six. These services are ruling cancer in or out faster for those with non-specific symptoms, supporting our early cancer diagnosis vision.
I thank the minister for that response. What steps is the Scottish Government taking to ensure general practitioners’ access to imaging—specifically computed tomography head imaging for those with non-specific symptoms that are suspected to be symptoms of cancer, such as a brain tumour? Are those steps being regularly monitored to ensure that the pathway is utilised efficiently and effectively?
That is exactly the reason why the rapid cancer diagnostic services have been set up, and that is exactly the pathway that I expect to be followed.
In March, I hosted a members’ business debate to mark brain tumour awareness month. Many members highlighted the need for greater research to improve the outcomes for those living with brain tumours. I welcomed the announcement of the establishment of the Scottish Brain Tumour Research centre of excellence in July. Has the Scottish Government engaged with the centre since its launch, and how does it plan to support the research into the most aggressive form of brain cancer?
Yes, the Scottish Government engages regularly with the Brain Tumour Research centre. I, too, met Brain Tumour Research in September, and it was agreed that it would send to the chief scientist office a funding proposal to support brain tumour research in Scotland. I am looking forward to that. I believe that we have the inaugural meeting of the cross-party group on brain tumours next week, and I hope to see Mr Choudhury at that meeting.
Dental Treatment
To ask the Scottish Government what compensation is available for any families that are paying for private urgent dental treatment due to delays in accessing national health service treatment. (S6O-03793)
In primary care dental services, when a patient is registered for NHS dental services and has an urgent dental problem, they should be seen as soon as possible by their NHS dental practice and treated in line with their clinical priority. Unregistered patients are able to access urgent and emergency care via public dental service clinics.
In common with the whole of NHS care provision, there is no compensation available when patients choose to seek healthcare privately.
I thank the minister for that answer. A constituent in my region was told that her daughter had a severe dental condition that required urgent orthodontic treatment in hospital. There, they were told that there would be an 18-month wait, as there was no consultant available to carry out treatment. They were left with no choice but to seek treatment privately because there was a risk that her daughter could, if left untreated, lose all her front teeth, which would have a lifelong impact.
The treatment would normally be funded through the NHS but, because there was no consultant available, a private route had to be sought. What steps is the Government taking to address consultant shortages in NHS dental services, particularly in Ayrshire and Arran?
This summer, I visited the dental hospital in Glasgow and had exactly that conversation with people there. The Scottish Government is supporting NHS boards to drive improvements in secondary care waiting times, and we are targeting resources to ensure that people who are waiting the longest are treated as soon as possible.
We are also driving improvements in children’s oral health, through our flagship childsmile programme. I recognise that that programme is on the prevention side and that that is not directly what Sharon Dowey asked about. However, we are working closely with NHS boards to ensure that they are making the most efficient use of their surgeries and clinical time to reduce waiting lists in order to improve the dental care that young families are getting.
NHS Ayrshire and Arran (Cost of Repairs)
To ask the Scottish Government what support it can provide to NHS Ayrshire and Arran, in light of reports that the health board requires over £85 million to cover the cost of backdated repairs. (S6O-03794)
The Scottish Government is working with all health boards to develop a whole-system infrastructure plan. In the context of a very challenging financial position, that is a positive and practical approach that will support the continued safe operation of existing facilities as well as the determination of longer-term investment priorities.
Arran war memorial hospital requires more than £1.2 million of repairs; for Ayrshire central hospital, the figure is more than £6 million; for University hospital Crosshouse, it is more than £32 million; for Ailsa hospital, it is more than £10 million; for University hospital Ayr, it is more than £16 million; and, for Townhead surgery, it is almost £700,000. The list goes on.
Does the cabinet secretary agree that the deteriorating state of national health service buildings has a negative impact on quality of care?
I would like to see an improved situation in the capital position for the NHS and investment in our infrastructure, partly for the reasons that Katy Clark outlined. She will be well aware of the infrastructure investment review that is going on across Government, and I am doing what I can within my portfolio to ensure prioritisation of capital investment. That would be much easier if we had capital investment coming from the United Kingdom Government as well, rather than what we have at the moment, which is a proposal for a near 9 per cent cut in our capital provision—£1.3 billion less—which will not help us to fix our NHS estate.
Brian Whittle has a very brief supplementary question.
One of the biggest problems in the NHS in relation to capital projects is that we still do not have a basic technology platform that enables countrywide adoption of artificial intelligence and technology.
What is the Scottish Government doing to enable swift adoption of technology and to give healthcare professionals the tools that they need to tackle the backlog?
That was very gracious of you, Presiding Officer.
We are embarking on work. With regard to the reform and improvement work that needs to be done across the NHS, it is a priority of mine that we apply innovation better to our health service. That is how we will see continued improvement. The chief scientist office is leading on that, including the accelerated national innovation adoption—ANIA—pathway, which is about having once-for-Scotland adoption of good innovation practice. I would be happy to refer Mr Whittle to that work.
I commend your adaptability, Mr Gray.
National Treatment Centres (Impact of Delays on Waiting Lists)
To ask the Scottish Government whether it will publish revised modelling to show any impact of delays to the opening of the remaining national treatment centres on bringing down waiting lists, as outlined in its national health service recovery plan. (S6O-03795)
The national treatment centres that are in operation—at Highland, Fife, the national eye centre and the new surgical centre at NHS Golden Jubilee, and NTC Forth Valley, which will begin treating patients this month—will provide around 20,000 additional procedures a year.
I have acknowledged that that is less than the full NTC programme that was set out in the NHS recovery plan. New health capital projects are currently subject to review, including the five planned NTCs that are not currently in construction.
Therefore, we are investing the resources that are available to us now to deliver additional activity. This year’s £30 million additional investment in waiting times is projected to deliver more than 60,000 additional appointments and procedures, with significant additional activity already under way.
In 2021, the then First Minister promised Cumbernauld a new national treatment centre, but there has been no sign of it since. The cabinet secretary will know that waiting lists for in-patient and day cases stand at 11,500 in NHS Lanarkshire, with 2,500 of those people having been waiting more than a year. When will the Government make good on its promise for a national treatment centre for Cumbernauld and Lanarkshire?
I am pleased to report that, as part of our investment in waiting times finance, the latest figures show that NHS in-patient and day-case activity has increased: in-patient and day-case activity for quarter 2 was the highest since the start of the pandemic. That was the 10th quarterly increase in a row, with 65,106 patients being seen in quarter 2, which is up by 1.6 per cent on the previous quarter and by 9.9 per cent on quarter 2 last year.
I say to Mark Griffin, as I did to Katy Clark, that it will be much easier for us to invest in capital projects in the health service and across the rest of Government if, in the budget at the end of October, there is investment in capital, in our public services, in our people and in our economy, rather than what we see in newspaper reports, which is the Treasury asking Whitehall departments for capital savings. That continued austerity will harm our health service.
I will take a supplementary question, if it is brief and the response is likewise.
I refer members to my entry in the register of members’ interests: I hold an NHS Greater Glasgow and Clyde bank-nurse contract.
The national treatment centres are playing a key role in bringing down waiting lists in Scotland, but it is of considerable concern that the opening of new centres has been delayed as a result of the United Kingdom Government’s cut to Scotland’s capital budget. Will the cabinet secretary join me in calling on Labour members in the chamber to join us and press their colleagues at Westminster to reverse that cut as a priority, so that that work can be progressed?
I thank Clare Haughey for her question, and yes—I will join her.
She is absolutely right that the national treatment centres that are in operation are making a difference, as is the investment that we are making in waiting times. However, the capital funding position is extremely challenging. There is to be an expected 8.7 per cent real-terms cut to our UK capital budget in the medium term, which is because the Labour Party at Westminster is following Tory spending plans. That is a cumulative loss of more than £1.3 billion.
Ahead of the budget this month, I urge the UK Government to reflect on Lord Darzi’s findings and the previous calls from this Government, and organisations including the International Monetary Fund, to prioritise investment in infrastructure and public services. We need that to happen.
Mental Health Services (Locums)
To ask the Scottish Government what its position is on the use of locums in local mental health services. (S6O-03796)
The use of temporary staff in an organisation as large and complex as NHS Scotland will always be required to ensure vital service provision during times of unplanned absence, sickness and increased unforeseen activity.
It is critical that we seek to secure the best value whenever we deliver mental health services within NHS Scotland, allowing us to maximise the impact that our investment has on the quality and availability of patient care. We are working with colleagues across NHS Scotland to explore how we can reduce our reliance on agency staffing for nursing and medical staff.
I thank Maree Todd for that answer, but a freedom of information request revealed that the cost of agency locums in the Borders has tripled in the past three years and reached more than £7 million in 2022-23. Furthermore, locums make up up to a third of the consultant psychiatrist workforce in the Borders, with 75 per cent not holding their certificate of completion of training. That is concerning and precarious. Why has the Scottish National Party Government chosen to decimate mental health services for my Borders constituents?
The context is that there is a global shortage of psychiatrists. I recognise that although things are improving in many areas of Scotland, there are challenges in recruiting to particular areas. My area in Highland is being impacted in the same way as the Borders.
It is undoubtedly more difficult to recruit to particular geographical areas and to particular specialties in psychiatry—for example, learning disability psychiatrists are fewer and farther between. We have in place the medical locum engagement task and finish group, which is co-chaired by the NHS Fife chief executive and the Scottish Government’s director of health workforce. That has been established to ensure appropriate locum usage across NHS Scotland. That task and finish group is exploring the case for a set of identified interventions.
Very briefly, we will hear Paul Sweeney.
Health boards in Scotland spent £30 million on locum psychiatrists in 2022. Will the minister confirm whether she thinks that expenditure is best value for money, and say how much was spent on locum psychiatrists in the past financial year?
I would need to get back in writing to the member on the second part of that question.
As I said at the beginning of my answer, there is no doubt that, in an organisation as large and complex as NHS Scotland, it is appropriate to hire temporary staff at times. Hiring temporary staff is a better outcome than having the service delivery fail entirely. We need to work towards having more locum psychiatrists employed in permanent full-time posts. I hear time and again from people who are accessing mental health care that they would like continuity of care, so I assure the member that we are working towards that in Scotland.
That concludes portfolio questions on health and social care.
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