Good afternoon. The first item of business is portfolio question time. If a member wishes to request a supplementary question, they should press their request-to-speak button or indicate as much in the chat function by entering “RTS” during the relevant question.
Rural Affairs, Land Reform and Islands
Community Gardens
To ask the Scottish Government whether it will provide an update on its plans to support community gardens. (S6O-02680)
We recognise the benefits that community gardens can bring to the wellbeing of individuals, bringing communities together and improving local biodiversity. This year, we are providing £100,000 to the Green Action Trust to deliver the growing food together fund. Eight community food growing projects will benefit from that fund, which aims to increase the land available for community growing and to improve food-growing skills, empowering communities and individuals to grow their own food.
Community growing projects have also benefited from investment through the empowering communities programme, and a further £3.7 million from the vacant and derelict land investment programme will directly support six growing projects.
The Greyfriars biophilic community garden, in my constituency, has been shortlisted for the Evening Times community garden champion team awards later this year, with the winners being announced on 5 December. With projects involving the local community and improving primary schools, the community garden has been a force for good in the local community. Does the minister agree that community gardens provide significant improvements and wellbeing benefits and that Greyfriars is a shining example of what can be achieved by involving the community?
I absolutely agree. I am delighted to hear that Greyfriars biophilic community garden has been nominated for the Evening Times community champion team awards. I wish it all the best in that. I am sure that the garden is a wonderful place, and I will put it on my list of gardens to visit. It is an excellent example of the huge range of benefits brought by community gardens, which include but are not limited to increased nature-based volunteering opportunities and education. Communities up and down the country are already reaping the many benefits of community gardens, which, as the member says, include significant environmental and wellbeing benefits. I wish them all the best.
I put on record my thanks to James Barnes, David Lydiat and Stan Green for hosting an amazing meeting of the cross-party group on gardening and horticulture in the Parliament last week, at which we discussed the need for horticulturists, gardeners and farmers for future generations. How can the minister and the Government support skills and training to contribute to those sectors?
I had a good discussion with Stan Green, who had a stand on horticulture in the corridors of the Parliament. It was great to meet him, and it sounds as if the CPG meeting was great, too.
Our vacant and derelict land investment programme demonstrates our commitment to bringing sites back into use, particularly for horticulture. There are a number of such sites throughout Scotland, and they can use the funding for whatever they want to do in that space, including training. As I mentioned in response to Kaukab Stewart, that is what the two streams of funding are doing. We are talking not just about equipment, plants and soil; the funding can be used for training, too. It is up to individual projects to decide how to use the money, but there is certainly funding available.
Peatland Restoration
To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the development of rural skills to help deliver its commitments in relation to peatland restoration in the programme for government 2023-24. (S6O-02681)
Training and retention of a skilled rural workforce is critical to delivering peatland restoration targets. A variety of skills initiatives is under way, including on-site demonstration days, a newly launched training course, a new entrants initiative and training on Public Contracts Scotland tendering.
Rural Skills Scotland was included in a discussion by the ministerial working group on the rural delivery plan. That meeting was attended by the Deputy First Minister as well as the cabinet secretaries for rural affairs, land reform and islands, skills and education, transport, net zero and just transition, myself and other ministerial colleagues. My officials are now increasing efforts to expand our work in that area, including by utilising existing links with other ministerial responsibilities.
The programme for government 2023-24 outlines plans to
“Restore 10,700 hectares of degraded peatland”
during the next year, as well as plans to “progress action with crofters” with regard to Scottish ministers’ crofting estates to support further peatland restoration. Can the minister advise how the Scottish Government is measuring the restoration of peatland and ensuring the maintenance of its unique carbon catching properties across Scotland’s rural lands?
I thank the member very much for his interest in the topic. We are ramping up our progress towards achieving our targets in peatland restoration. Between 2023 and 2024, we will have increased our restoration of peatland by 40 per cent, while between 2022 and 2023 we increased it by 35 per cent. That shows that it is ramping up significantly.
NatureScot, for example, is delivering activities through its peatland skills plan and supplier development programme to assist small and medium-sized enterprises in tendering successfully for such work, and we are also putting in place a range of training opportunities focused on key crofting areas in the Western Isles, Shetland, Sutherland and Skye.
In recent weeks, we have heard both the justice secretary and the environment secretary talk about the need to include peatland restoration in plans to bolster natural flood defences, and the minister has also talked about ramping up peatland restoration, but the Scottish National Party-Green Government is well behind on its peatland restoration targets. Will the minister ensure that farmers and land managers are included in the Scottish Government’s flood resilience planning as we move forward?
I have come to the chamber to answer questions about skills development in peatland restoration, but I am very happy to write to the member with an answer to his question about including farmers in managing flood plains through peatland.
The peatland restoration industry is in its infancy, and there is likely much that we can learn from the rewetting of peatlands that has occurred in countries such as Germany, Poland, Lithuania and Latvia. Can the minister say to what extent Scotland’s peatland restoration industry has been disadvantaged by being cut off from the skills and experience of practitioners in Europe by the hard Brexit that we have now—and that Labour now seems to support?
It is clear that a hard Brexit has had a detrimental impact on our rural skills sector. However, the Scottish Government is alive to that risk, and it recognises that international co-operation is crucial in addressing the dual challenges of the climate crisis and biodiversity decline.
We sponsored the peatland pavilion at the 26th United Nations climate change conference of the parties—COP26—to champion international co-operation on conservation, restoration and sustainable management of peatlands. Moreover, NatureScot is working with counterparts on the island of Ireland through its involvement in the shared island fund, which is supporting, among other things, a new investment of €15 million in peatland restoration that will benefit cross-border collaboration, knowledge sharing and expertise building.
Scotland’s Botanic Gardens
To ask the Scottish Government how much grant funding it provides directly to each of Scotland’s botanic gardens annually. (S6O-02682)
Scotland is home to many world-class botanical gardens, including the Royal Botanic Garden Edinburgh, which operates across four locations in Scotland. The RBGE receives funding from the Scottish Government, as well as from a range of other sources, and, in the current financial year, the Scottish Government grant in aid to the RBGE was worth £30.4 million.
Glasgow botanic gardens has provided free access to generations of visitors for more than 180 years, with huge benefits, including for health and wellbeing. In recognition of that, free access has been sustained for nearly two centuries. However, like so many cherished facilities and vital public services, it does not seem to have survived the Scottish National Party-Green Government cuts, with Glasgow City Council now suggesting charges of £3.50 for an adult and £1.50 for a child.
I note that the cabinet secretary did not mention Glasgow botanic gardens in her answer. What funding does she provide to Glasgow botanic gardens, and what is her view of charging during a cost of living crisis?
I will address a couple of points in Pam Duncan-Glancy’s questions. First, I specifically mentioned the Royal Botanic Garden Edinburgh and its gardens in four different locations, and the fact that we directly fund it through grant in aid, because it is a non-departmental public body. It is a statutory body that was set up and established through the National Heritage (Scotland) Act 1985. I did not mention Glasgow botanic gardens because we do not directly fund it.
I completely appreciate the member’s points about free access. The last thing that we would want to do is exclude people from green spaces, particularly those in our city centres, but we are in a really tough time with regard to our budgets. We are feeling that in the Scottish Government, and I know that local government is feeling it, too.
Last year, there was an uplift in local government funding. I would just come back to the point that—
Thank you, minister. I need to move on.
—in relation to Glasgow botanic gardens, that is a decision—
Minister, I need to move on. Thank you.
Question 4 has not been lodged.
Crop Protection (Flooding)
To ask the Scottish Government what measures it is taking to support farmers to protect crops, including from future flood-related damage. (S6O-02684)
The Scottish Government places a high priority on supporting farmers to protect crops from a wide range of threats, including pests, diseases and adapting to the changing climate. Key elements include our investments in the Plant Health Centre and the Farm Advisory Service. Overall, we invest almost £50 million a year in a portfolio of strategic research to support advances in sustainable crop production, natural resources and the environment, including research that is aimed at improving crop resilience.
In terms of future flood-related damage, I have seen and discussed at first hand the impacts on crops for farms that have been affected by the recent severe flooding. At NFU Scotland’s autumn conference on 26 October, I committed to working with the farming sector to provide support for repair of flood banks that were damaged by the extreme rainfall during October to protect our vitally productive farm land.
As the cabinet secretary will be aware, it has been widely reported that Scotland’s farmers suffered extensive flooding and storm-related damage during October, with the cost being expected to run into millions of pounds. Will she commit to a support fund, and will she ensure that future food security remains a top priority in the Agriculture and Rural Communities (Scotland) Bill?
What makes the situation so concerning is that, although there have been some immediate impacts, it will be a while before we can assess the full extent of the damage that has resulted from the recent flooding events and storms.
I have already outlined an initial funding package and have said where we believe we can add the most helpful support at the moment. We will consider any measures as the Agriculture and Rural Communities (Scotland) Bill proceeds through Parliament.
I have visited farmers and I have seen at first hand the damage to flood banks in Perthshire, so I appreciate the seriousness of the situation. The damage is impacting on some of the most productive land in our country, so it is vital that we work together to try to improve the resilience of our farmland.
I agree with the cabinet secretary and with Mr Balfour about the need to compensate farmers for lost crops. However, could we involve farmers in offsetting floodwater at the start of a flooding episode in order to stop damage downstream and make sure that that is properly compensated and planned for?
It is clearly vital that we work across catchment areas. Given the recent flooding events, we need to consider the wider impact and what more we can do on various parts of rivers. Engagement at catchment level will, of course, have to include farmers and land managers in consideration of solutions to increase resilience and adapt to what could be—it is looking as if it will be—an increasing number of flooding events in the future.
As well as needing practical support to mitigate and adapt to climate change, we know that the impact of extreme weather takes an emotional toll on people’s mental wellbeing. As we know, farmers face particular challenges with mental health and isolation. What more can the Scottish Government do to support farmers who might be struggling emotionally right now?
Karen Adam has raised an important point. As I outlined in one of my previous responses, I have been out to visit farmers and other people and businesses in my constituency, and I have seen at first hand the real and significant emotional toll that such events take on everyone. That includes our farmers as well as the professionals and the volunteers who were involved in responding to the events and are now involved in the recovery work.
We cannot forget that extreme weather events have devastating consequences and can really test people’s resilience. As an acknowledgement of the effects of flooding on farmers, and in recognition of the increased need—as Karen Adam mentioned—for emotional, financial and practical support now and over the weeks to come, I recently announced £50,000 of funding for the Royal Scottish Agricultural Benevolent Institution to enable it to continue to provide help and to bolster the support that is available through its own flooding crisis fund. I record my thanks to RSABI for all the incredible work that it is doing.
Farmers (Succession Planning)
To ask the Scottish Government how it will help farmers to plan for their succession. (S6O-02685)
Scotland’s Farm Advisory Service, which is funded by the Scottish Government, currently offers farmers and crofters access to up to £1,000 in funding for specialist one-to-one advice on succession planning. The Farm Advisory Service also provides extensive guidance and advice on succession planning.
In addition, the Scottish Land Matching Service, which is also funded by the Scottish Government, is a free service that engages with those who are seeking or offering joint-venture arrangements in relation to land. It provides a platform for planning for succession for farmers and crofters who want to step back from their business.
As the cabinet secretary will be aware, many of Scotland’s farmers are elderly, and the younger generation are not attracted by the profession. Succession planning is essential, not only for the future of Scottish agriculture but in order to ensure that we tackle rural depopulation. Will the cabinet secretary ensure that the commitment to farmers for succession planning remains in place for the foreseeable future?
Annie Wells has raised an important point. I am glad that she asked the question, because we need to encourage our farmers, landowners and land managers to think about succession planning.
I highlight the Scottish Land Matching Service’s valuable work in that regard. It is currently working with the Crofting Commission to discuss succession in relation to crofting. I am committed to maintaining that support, and to ensuring that we do all that we can to get new entrants into the industry, because this is—as much as there are challenges—a really exciting time in our rural economy. It has a strong future, so I encourage people to get involved and to think of agriculture as a career choice for the future.
Farming is an intergenerational affair, and succession is often about custodianship and the viability of the farm business in the future. I was recently at the Dalmally blackface tup sale; the place was full of young people who are desperate to get involved in blackface sheep breeding.
Does the cabinet secretary agree that Scotland’s farmers are better served in that regard by the Scottish National Party’s commitment to active farming and food production, and that the best thing that the Tories could do to help farmers to plan for the future would be to demand from Westminster clarity about future funding for agriculture?
I agree entirely with that. We need certainty and clarity from the United Kingdom Government about future rural funding after 2025, because we have no idea what funding we are going to receive beyond then. Of course, if we were still in the European Union we would not only have certainty about funding but would have it for a seven-year period, so we would be able to provide longer-term assurance.
Agriculture is devolved, and it is crucial that Scottish Government policies are unhindered by the threats that are posed by the United Kingdom Internal Market Act 2020, the subsidy control regime and the lack of a long-term replacement for EU funds.
Agricultural Development Projects (Net Zero Targets)
To ask the Scottish Government how its agricultural development projects will boost organic produce and improve environmental practice, as part of its work towards achieving its net zero targets. (S6O-02686)
I am fully committed to supporting organic farming under our vision for agriculture, in which we outlined our ambition for Scotland to become a world leader in sustainable and regenerative agriculture.
We have funded the role of an organic development manager, with a key objective of addressing market opportunities, domestic and international, for Scottish organic produce. That has included significant research into organic abattoir provision in Scotland, as well as having contributed to work on a small producers pilot scheme. We are working with the organic sector to establish a new organic food and farming action plan to deliver sustained growth in the organic market.
On the back of the Deputy First Minister’s recent visit to Marshill farm, in my region, to highlight Scottish Government funding for the Scottish organic dairy goals 2023 project, how can the project identify meaningful measurements of natural capital in carbon and address issues relating to organic protein in central Scotland?
First, I am delighted that we have been able to fund that project through the knowledge transfer and innovation fund. The project, among a range of other outputs, undertakes a series of carbon audits and soil analysis testing among members of the organic co-operative. The tests are being discussed and benchmarked across the co-operative, with the support of experts, to explore the value in conservation management and the potential marketable value in measurables. The co-operative is having similar peer-to-peer support by hosting meetings about grasslands and soils in order to optimise forage utilisation and home-grown proteins.
The outcome that we hope to see across all that work is increased confidence for informed decision making on carbon efficiency, natural capital management and organic proteins. Overall, the work that the group is taking forward should offer a more efficient, resilient and market-led Scottish organic dairy sector.
Recent flooding has demonstrated how vulnerable Scottish agriculture can be to bad weather and has exposed the impact that it can have on crop resilience, including in East Lothian and the Scottish Borders.
Will the Scottish Government finally commit to kicking its political prejudices into touch and commit to using genetic technology as a means to bolster our future food resilience?
I think that Ms Mackay’s question related specifically to organic produce and improving environmental practice, but the cabinet secretary might want to answer, perhaps in that context.
In previous responses, I have outlined that I recognise the damage that the recent flooding has done and how important it is to build resilience. I have outlined a number of measures that we are looking at in relation to how we need to work with our farmers and land managers. I have addressed that in previous responses.
Compulsory Sales Orders (Scottish Land Commission)
My entry in the register of members’ interests shows that I was previously an owner of a privately rented property in the North Lanarkshire Council area.
To ask the Scottish Government what continued engagement it has had with the Scottish Land Commission about its proposal for compulsory sales orders since it first proposed them in August 2018. (S6O-02687)
The Scottish Government regularly engages with the Scottish Land Commission on a broad range of matters. That includes recent discussions relating to the “Rural and Islands Housing: Action Plan”, which affirms our programme for government commitment to taking forward work in 2024 to consider the justification for, and practical operation of, compulsory sales orders, particularly in the light of our commitment to reforming compulsory purchase orders.
The cabinet secretary will, no doubt, be aware that there was cross-party support, including from Government party back benchers, for taking forward compulsory sales orders. Can the cabinet secretary give a timeline for delivering the potential new powers so that councils have the ability to address the blight that empty homes are on rural communities?
Mark Griffin has raised an important point and is absolutely right that there is cross-party support for considering the issue. That is why we had in our programme for government this year a commitment to continuing the work on that. However, the matter of compulsory sales orders is complex. It is only right that we consider that alongside the review of compulsory purchase orders that is getting under way.
As I have said, the PFG commitment says that we will continue the work on that this year, but I will keep Parliament updated, and I am happy to keep in touch with Mark Griffin as the work develops and progresses.
Setting aside the fact that land reform is the latest subject of Labour U-turns, does the cabinet secretary agree that the stifling of community progress by absentee landlords reveals why the relationship between communities and the land must continue to be reformed?
I agree. Kate Forbes has raised an important point. Absentee landowners, who are often really difficult to trace, represent a substantial barrier when it comes to supporting communities to thrive. From all the community ownership that we have seen, we know that community-owned assets have a real and positive impact in rural and urban communities. That is why we are committed to strengthening and encouraging community ownership, and to continuing on our journey with land reform on an on-going basis.
We have made great strides in relation to land reform since devolution, and the Government is committed to progressing more land reform legislation. We have already consulted on proposals, and have published the results of that consultation. Again, we will bring forward legislation to the Scottish Parliament.
That concludes portfolio questions on rural affairs, land reform and islands. There will be a short pause before we move on to the next portfolio, in order to allow front bench teams to change positions, should they so wish.
National Health Service Recovery, Health and Social Care
The next portfolio is national health service recovery, health and social care. Again, if a member wishes to ask a supplementary question, they should press their request-to-speak button during the relevant question or, if they are online, they should indicate by entering the letters RTS in the chat function during the relevant question.
Winter Preparedness Plan
To ask the Scottish Government whether it will provide an update on how its winter preparedness plan will aim to reduce pressure on the national health service. (S6O-02688)
Our winter plan, jointly published with the Convention of Scottish Local Authorities on 24 October, sets out a whole-system approach to respond to surges in demand for health and social care services and actions to relieve pressure points across the system.
The new funding measures include a £50 million boost for the Scottish Ambulance Service to assist with recruitment and up to £12 million to expand hospital at home services. That expansion will enable more people to be treated at home rather than in hospital, and it will deliver at least 380 additional beds this winter, which will relieve pressure on NHS wards.
The additional funding that is set out in the plan for hospital at home is welcome, and it will, no doubt, reduce pressure on our accident and emergency departments this winter. Can the cabinet secretary say any more about how the expansion of hospital at home will help people across Scotland, including my constituents, this winter?
The additional £12 million of investment for this winter, which will provide for the expansion of hospital at home services, will assist constituents in the member’s constituency and throughout the country by providing additional capacity for a range of services, including those for children and people with respiratory conditions. That will help to support boards that are taking forward a range of initiatives to develop hospital at home in their respective areas to expand provision over the course of the winter. The funding that we are making available to them will allow them to go ahead and develop those services this month and into the winter months, in order to provide greater capacity.
I draw members’ attention to my entry in the register of members’ interests, which states that I am a practising NHS general practitioner.
Dr Donald Macaskill of Scottish Care has said that the Scottish Government’s winter plan
“is not worth the paper that it is written on.”
He also said:
“It says nothing. It gives no hope.”—[Official Report, Health, Social Care and Sport Committee, 31 October 2023; c 37.]
Rachel Cackett of the Coalition of Care and Support Providers in Scotland agrees with him.
Further, Reform Scotland’s recent report tells us that waiting times for hip operations are soaring, and the chair of the British Medical Association Scotland has commented that we have a system that is
“bursting at the seams, with a workforce running on empty.”
In light of all of that, how confident is the cabinet secretary that, this winter, patients are going to get the service that they need and deserve, that he can maintain social care, and that this winter will not be, as previous winters have been, the worst winter on record?
We have taken forward a range of measures with our winter plan. We started its development earlier this year, and we have taken a partnership approach to its development. That is why it takes a joint whole-system approach with COSLA to meet some of the pressures that we know exist and expect to develop in our health and social care system. We have also engaged with the social care sector in the development of the plan.
Of course, the additional investment of some £50 million in our ambulance service and the additional £12 million investment in the expansion of hospital at home are part of the package of measures that we are putting in place to help to meet the demand that we will face over the winter months.
The cabinet secretary will have seen the troubling statistics yesterday that show increased waiting times in A and E, delayed discharge rates—which are sky high—and the level of cancelled operations up again. This is only autumn. How much will his plan reduce A and E waiting times by over the winter period? Will his plan also eradicate waits of more than 12 hours?
As Jackie Baillie will be aware, the plan is to help to meet some of the challenges that we will face over the winter months. I have not hidden from the fact that A and E performance is not where we would want it to be. A big part of that is because acuity rates are greater and because we have numbers of people staying in hospital for longer periods than previously was the case, with greater hospital occupancy levels.
All of those factors will present challenges, which is why we have made very specific interventions with additional funding to help to reduce and manage some of that demand over the winter months. I cannot quantify exactly by how much the interventions will improve matters because, due to the varying nature of winter illnesses, we do not know what the demand or the pattern of demand will be over the winter months. However, I assure Jackie Baillie that we are determined to do everything that we can to support the system through what we know will be a very challenging period at the health and social care levels. That is why we have taken a whole-systems approach, in partnership with COSLA, to the plan’s development.
Erskine Park Home
To ask the Scottish Government what its response is to the reported planned closure of Erskine Park home. (S6O-02689)
Renfrewshire health and social care partnership and the Care Inspectorate are aware of the planned closure and have met the provider. We know that the national care home contract has been cited as the reason for the closure, and we are sympathetic to the rising cost of specialist care. However, we understand that Erskine is offering all residents the opportunity to move to its veterans village, which is very close by, should they wish to do so.
Regrettably, there will be situations in which independent sector or local authority-run care homes close. It is outwith the Scottish Government’s remit to intervene. Our focus is on ensuring that local partners that are responsible do what is required to ensure a transition to suitable alternative placements.
Erskine, the charity for veterans, provides fantastic and specialist services to many older people in my region, and the closure will clearly be disruptive to residents. If a charity such as Erskine is having to make such a difficult decision because of the challenging financial situation that it and other independent care providers are in, how will the Scottish Government ensure that there is adequate funding in place for the whole social care sector, to ensure that staff are well paid and that people are kept out of hospital and looked after so that they can receive the appropriate and quality care that they need?
Neil Bibby will welcome the fact that social care funding has increased by over £800 million compared with 2021-22, as part of a record-high health and social care budget of over £19 billion. We have made a commitment to increase in this parliamentary session spending on social care by a quarter, and we are ahead of trajectory on that.
We continue to work with partners to address the pressures that they face and to take forward reform to deliver improved and sustainable services.
On social care workers’ pay, those who deliver direct care and commissioned services will see their pay increase to a minimum of £12 an hour from April next year. That is up from the £10.90 minimum rate that was introduced this year.
The creation of a national care service will help to provide consistency in further improved pay and conditions and access to training and development, and ensure that a career in social care is attractive and rewarding. We are beginning to make those improvements now.
Scottish Ambulance Service (Recruitment and Retention)
To ask the Scottish Government whether it will provide an update on what steps are being taken to increase recruitment and retention of staff in the Scottish Ambulance Service this winter. (S6O-02690)
The Scottish Government has provided £50 million above baseline funding to support the Scottish Ambulance Service this year. That investment supports on-going work to recruit 317 front-line staff, to help to increase capacity to respond to emergencies. That includes 18 additional clinicians in the integrated clinical hub who, through additional triage, can offer patients alternative treatment routes, and thereby reduce the number of hospital admissions.
To support the retention of staff, the Scottish Government invested £568 million in the national health service agenda for change 2023-24 pay deal, to ensure that NHS Scotland agenda for change staff remain the best paid in the United Kingdom.
The £50 million in funding that was announced in October to support recruitment in the Scottish Ambulance Service is very welcome. That will play an important role in ensuring that the service is prepared for the winter months ahead. Will the cabinet secretary join me in recognising the incredible efforts of our ambulance service, particularly during the busy winter period? Can he say any more about how that investment will help to support increased demand?
I join Jackie Dunbar in paying tribute to the incredible work that is carried out by our ambulance staff throughout the year, and particularly during the winter months, when we see demand at its peak.
The £50 million in funding that I announced last month will assist the Scottish Ambulance Service to further develop its demand and capacity work, which will help it to continue to build on the additional staff whom it has been recruiting over the past couple of years. As a result of our investment over the past few years, the service has been able to recruit 1,388 additional staff since 2020.
I advise Jackie Dunbar that the Scottish Ambulance Service is working to recruit staff in its ambulance control centres as well as clinicians to work in its integrated clinical hubs, which help to guide patients to the most appropriate community pathway, where that is applicable. That will reduce unnecessary admissions to hospitals and—
Thank you, cabinet secretary. I need to move on to the supplementary question.
The £50 million is welcome. However, a freedom of information request revealed that more than 850,000 hours of overtime was worked by SAS staff between April 2022 and July 2023 at a cost of £24.4 million. Recruiting and onboarding ambulance service staff takes time. Can the cabinet secretary promise our overworked ambulance staff that they will receive better support this winter than they did last winter?
That is why we are providing the ambulance service with additional funding so that it can recruit more staff and provide additional clinical staff in its clinical hubs, who can support paramedics on the ground when they are dealing with patients. The purpose of that funding is to provide additional staff capacity.
High Blood Pressure (Detection and Treatment)
To ask the Scottish Government what it is doing to improve the detection and treatment of high blood pressure, in light of reports that an estimated 1.3 million people in Scotland are living with this condition. (S6O-02691)
Our heart disease action plan and stroke improvement plan include the aim of minimising preventable cardiovascular disease by improving detection, diagnosis and management of risk factor conditions such as hypertension and high blood pressure. The connect me programme delivers a national pathway for high blood pressure diagnosis and management. The pathway is already used in every health board and by most general practitioner practices in Scotland. Evaluation has shown that it is having a positive impact on reducing blood pressure. It has enabled more than 85,000 people in Scotland to remotely monitor their blood pressure, and it has contributed to improved blood pressure control.
Data from the Scottish national health service suggests that only a quarter of the people who have high blood pressure are treated to target. With high blood pressure being associated with around 50 per cent of heart attacks and strokes, will the minister commit to prioritising action on high blood pressure in order to reduce the burden of ill health that it causes for people in Scotland?
I recognise the importance of taking action to tackle risk factors such as high blood pressure in order to minimise preventable cardiovascular disease. That is why, as I said in my initial response, we have already prioritised that by including actions to improve the diagnosis and management of high blood pressure in our heart disease action plan and stroke improvement plan. For example, our heart disease action plan supports community models of detection, although it is important to note that such efforts should be aligned with clear referral pathways for further investigation and clinical advice.
Covid-19 Vaccination Programme
To ask the Scottish Government whether it will provide an update on the winter Covid-19 vaccination programme. (S6O-02692)
The winter flu and Covid-19 vaccination programme began on 4 September and will run until 31 March 2024; the majority of vaccinations will be completed by 11 December to ensure that there is maximum protection over the festive period.
At the midway point of the programme, uptake is strong. As of 29 October, more than 810,000 Covid-19 vaccinations, along with more than 1.2 million flu vaccinations, have been administered. Getting vaccinated is the safest and most effective way for people to protect themselves and the national health service this winter, so if anyone who is eligible has yet to book an appointment, I encourage them to do so.
That is an encouraging answer in terms of uptake numbers. However, I asked my question because I have had representations from quite a few constituents that they are not being sent information on the time when they will be eligible for vaccination. Will the minister have discussions with the NHS to ensure that that information is as clear as possible?
I agree that the information that is sent has to be absolutely clear. I am happy to speak to my officials about that.
Mental Health Law Review (Legal Status of Autistic People)
To ask the Scottish Government what assessment it has made of the impact of the Scottish mental health law review on the legal status of autistic people in relation to treatment and involuntary detention. (S6O-02693)
The Scottish mental health law review recommended making changes to the Mental Health (Care and Treatment) (Scotland) Act 2003 while retaining provisions that cover non-consensual care and treatment. As part of our mental health and capacity reform programme, we will work with partners to consider those proposals, and, in particular, the definition of mental disorder, to reach a position on who should be within the scope of the 2003 act. That work will be undertaken alongside the development of the proposed learning disability, autism and neurodivergence bill, which would enhance and protect the rights of people with learning disabilities, autistic people and neurodivergent people.
The minister will be aware that the current definition of mental disorder that is outlined in the 2003 act incorporates autistic people. Although the Scottish Government’s commitment to work with partners on definitions in this space is welcome, the Scottish mental health law review’s recommendation that autistic people should continue to fall within the scope of the 2003 act is not.
Given that autism is a lifelong neurodevelopmental difference, and not a mental health condition, does the minister agree that autism must be removed from the scope of the 2003 act as part of the promised reforms? Will she commit to working with partners to deliver that much-needed change?
The issue of the definition of mental disorder under the 2003 act is complex and sensitive. I absolutely recognise the concerns of many people with a learning disability, autistic people and organisations that advocate for them or on behalf of them.
I can confirm that scoping work has already started in the mental health and capacity reform programme to consider that issue, and that includes plans to engage with stakeholders. It is too early in the programme to establish whether autism should remain in the scope of the definition. Significant work is needed to inform that position.
Children in Temporary Accommodation (Access to Mental Health Services)
To ask the Scottish Government what assessment it has made of the ability of children living in temporary accommodation to access health services, in particular in relation to current levels of treatment from mental health services. (S6O-02694)
Everyone should receive the best possible care and treatment from our health services, including mental health services, regardless of whether they are living in temporary accommodation. Children who are living in temporary accommodation can access local general practice and mental health services, including referrals to child and adolescent mental health services if that is appropriate.
CAMHS is available for all children and young people who meet the agreed referral criteria. For others, community-based mental health support might be the most appropriate form of support. We are providing local authorities with £15 million per year to fund community-based mental health supports and services for children and young people.
A total of 2,265 children are living in temporary accommodation here in the capital, so it is little wonder that, last week, City of Edinburgh Council declared a housing emergency. I have been supporting and working with a number of families living in temporary accommodation who have been unable to register with general practitioners in the capital. Many GPs are operating closed lists and are therefore telling families to go to accident and emergency to access health services.
What review has been undertaken to look at the health services that are available to children who are living in temporary accommodation? If there has not been such a review, will ministers agree to urgently undertake one?
I am not aware of a review having been done—my portfolio area is mental health, and I can assure Miles Briggs that children are able to access CAMHS even when they are staying in temporary accommodation.
Local authorities have statutory obligations to assess the needs of the household—not the needs of children in particular—and that encompasses assessing people’s health needs. If there is difficulty in registering with a GP, as Miles Briggs narrates, the health board has a role in ensuring that everybody can access general practice services. Should he have examples of where that has not been the case, I would be more than happy to take that up with him outside the chamber, if he writes to furnish me with the details.
An important strand of ensuring that mental health services are accessible to young people involves ensuring a high standard of community-based mental health support, which the minister referred to. Will she provide an update on the steps that the Scottish Government is taking to support community-based mental health services?
The £15 million of annual funding that I referred to has enabled local authorities to put in place more than 300 community services across the country for children, young people and their families. Local authorities report that more than 45,000 people accessed those supports in the second half of 2022. The services focus on prevention and early intervention, and they provide support for positive mental health and wellbeing, as well as with emotional distress. Easy accessibility is a core principle of community services, and many of the supports are accessed through self-referral.
Members across the chamber will be familiar with young people who have struggled to access mental health support. The Government made a commitment that 10 per cent of NHS expenditure would be dedicated to improving mental health, but that target is still not being met—in fact, funding is currently £180 million adrift in cash terms. How does the minister justify that? How will she ensure that people can access mental health services, given that the Government is so far off meeting the target?
The focus of question 7 is, of course, children who are living in temporary accommodation.
I am happy to address the question. We have made a commitment, in this session of Parliament, to ensure that 10 per cent of the entire health budget is spent on improving mental health and that 1 per cent of that is spent on CAMHS.
Although challenges undoubtedly remain, we see positive signs of improvement in CAMHS as a result of the Government’s action. The waiting list for first-time appointments has been reduced by almost a third in the past year, and the number of children who waited more than 18 weeks decreased by two thirds in the same period. National performance against the 18-week CAMHS standard is at the third-highest level to have been achieved since the quarter that ended in June 2017. The median wait time for CAMHS is 11 weeks, which means that way more than half of children who are referred for CAMHS appointments see a CAMHS specialist within the 18-week target.
Waiting Times
To ask the Scottish Government what progress it has made on eliminating long waiting times for national health service patients. (S6O-02695)
We are working closely with NHS boards to reduce long waits and to deliver the commitments in our £1 billion NHS recovery plan to increase in-patient, day-case and out-patient activity. In each of the next three years, we plan to provide NHS boards with £100 million to help to reduce in-patient and day-case waiting lists by an estimated 100,000 patients and to deliver year-on-year reductions. We will work closely with NHS boards and stakeholders on a number of key actions that will result in patients being treated as quickly as possible.
In addition, 2023 is a milestone year for the national treatment centre programme. NTC Fife and NTC Highland opened in the spring and, later this winter, NTC Forth Valley will open and the extension of NHS Golden Jubilee will be completed.
Patients are waiting years for NHS treatment. One patient who lives in the NHS Grampian area has waited six years for surgery. Another constituent, who was hospitalised with gallstones in March 2020, is still waiting for his gall bladder to be removed. He is in significant pain, suffers regular attacks that result in hospitalisation and vomits for up to 12 hours at a time. He has had to take a significant amount of time off work, which has caused financial difficulty for his family.
The backlog is having devastating impacts on people across Scotland. In addition to what the cabinet secretary set out, what concrete plans does the Scottish Government have to ensure that health boards are able to reduce waiting lists and that my constituent will receive his operation?
I recognise the concern that the member has raised on behalf of his constituent. I deeply regret that someone has had to wait an extended period for treatment that they clearly require.
Decisions about priorities are for clinicians to make, but the member will recognise that a significant backlog of elective work has developed as a result of the pandemic. We can see the impact that the pandemic has had on healthcare systems not just in Scotland but across the United Kingdom and globally.
The member challenged me to set out the specific action that we are taking to address the issue. As I outlined, we will invest an additional £100 million in each of the next three years to ensure that there are sustained reductions in waiting lists across all specialty areas. We have made that a funding priority because we want to ensure that waiting times reduce for individuals such as the member’s constituent. That investment over the next three years will allow us to treat an extra 100,000 people through the NHS.
I have received requests for three supplementaries. If we have brief questions and answers, I will squeeze in all three.
Technology has a key role in increasing capacity to clear NHS waiting lists. How many NHS operations were carried out last year, and how many were carried out using robotic surgery? How does the Scottish Government plan to increase that number?
We have provided in the region of £20 million to support the introduction of robots, and we now have 16 in operation across NHS Scotland. Data provided by Public Health Scotland shows that, last year, there were 230,000 NHS operations and that, of those, some 3,180 were undertaken by robot-assisted surgery. We have 90 surgeons trained in a variety of techniques who are operating across the system to help to maximise the potential benefits for clinical outcomes for patients from new technologies such as robot-assisted surgery.
For children who are on waiting lists for clinical operations, waiting for months can feel like years. What is the Scottish Government doing to reduce child waiting lists?
I recognise that a wait for anyone for an extended period is not acceptable, which is why we are investing an additional £100 million in each of the next three years to see sustained reductions in waiting lists across all specialties, including where children are waiting for procedures. That will allow us to increase the number of procedures by 100,000, and it will result in sustained reductions in waiting times across all the specialty groups.
I have been advised that reduced access to community health facilities and the increased pressure on and workload for community midwifery teams have led, in relation to in-person appointments in Ayrshire and Arran, to a situation in which
“many women do not ‘meet’ their named midwife until 22 weeks of pregnancy”.
That wait is far too long and is of significant concern.
Will the cabinet secretary outline how the Government is working with health boards to eliminate long waits for pregnant women who are looking to meet their named midwife in person? Has the Government explored asking health boards to formally record the length of those waits per case?
I do not want expectant mothers to wait unduly long periods to meet their named midwife. If there are specific issues in Ayrshire and Arran that the member wants to provide me with the details of, I will be more than happy to look into that and to try to identify where actions can be taken to address the concerns that she has raised.
I have a late entrant—Craig Hoy has a supplementary question.
In September, only six in 10 accident and emergency patients in NHS Lothian were seen within four hours. What does the cabinet secretary have to say to the four in 10 patients who are often waiting in pain for many hours or for more than a day? Surely it has to be more than sorry.
It is more than sorry. It is about the actions that we are taking to address the issues. As I mentioned earlier—I am sure that the member was here for the earlier part of portfolio questions—we are expanding hospital at home, with an extra £12 million being invested in that, on top of the £3.6 million that we announced earlier this year, to see an even more rapid expansion of the service. We are also providing an extra £50 million to the Scottish Ambulance Service to increase its capacity to see and treat, as part of our winter resilience programme.
That concludes portfolio questions on NHS recovery, health and social care. There will be a short pause to allow front-bench teams to change position, should they wish to do so.