Rural Affairs and Islands
Good afternoon. The first item of business is portfolio question time, and the first portfolio is rural affairs and islands. If a member wishes to request a supplementary question, they should press their request-to-speak button or enter the letters “RTS” in the chat function during the relevant question. I call for succinct questions and answers in order to get in as many members as possible.
Meat Exports (United Kingdom Regulations)
To ask the Scottish Government what assessment it has made of the potential impact on Scotland’s agricultural sector of the United Kingdom Government’s upcoming new regulations regarding meat exports. (S6O-01508)
The Scottish Government’s assessment is that the European Union’s requirement for meat to come from farms that are subject to regular veterinary visits will affect mainly the non-farm-assured livestock sectors. However, it will create bureaucracy across the industry that would have been unnecessary had the UK Government chosen a closer relationship with the EU based on shared standards. The vast majority of cattle, sheep and pigs produced in Scotland are farm assured.
The Scottish Government is working with the Department for Environment, Food and Rural Affairs to try to find a pragmatic solution that will allow farmers and the meat industry to continue exporting and minimise trade barriers. I have raised the issue with the UK Secretary of State for Environment, Food and Rural Affairs, Thérèse Coffey, to urge a speedy solution.
The results of Quality Meat Scotland’s annual export survey underline the importance of European markets to those who produce Scotland’s world-class meat, and the Scottish Association of Meat Wholesalers has been clear about its concerns that businesses
“stand to lose millions of pounds of export business unless DEFRA relents”.
The UK Government has already forced Brexit on Scotland’s farmers and producers; it should be looking to make things easier, not harder. In the cabinet secretary’s engagement with the secretary of state, has she received any other information as to whether DEFRA is likely to amend this problematic set of regulations?
I am absolutely aware of the industry’s concerns. It has contacted me directly about the situation to highlight just how stark it is. I fully agree with the member that it is the UK Government’s approach to the issue and to withdrawal from the EU that has caused these burdens for Scottish farmers and Scottish businesses. As I said in my initial response, I raised the issue with the secretary of state, Thérèse Coffey—I did so at the interministerial group meeting that we had just at the start of this week. Officials, led by the chief veterinary officer, are working with DEFRA to develop a workable solution, and I hope that such a solution is still possible.
However, it is also important to highlight just how proud we can be of our Scottish producers, because the vast majority of Scottish farms belong to an assurance scheme such as the one from QMS, which the member referred to. It is quite right that we celebrate that.
We are right in the middle of the store lamb and calf sale season right now, with prices linked to what fat producers believe the longer-term values will be. The timing of the decision could be hugely damaging to hill and upland farmers—the very farmers who need more support than others—and I know first hand the stresses that the situation will be causing and the impact that it could have.
Was the cabinet secretary given any notification of the change by DEFRA or the UK Government? If not, does she agree that, on issues of such grave importance to our livestock and meat sector, they both have a duty to consult the devolved legislatures?
In relation to the member’s question about consultation, from what I understand, DEFRA said that it had engaged with stakeholders. However, we were certainly not involved in any formal consultation in relation to the issue until the most recent discussions with the chief veterinary officer. Given the impact of such decisions, we should of course be involved in the decision making and we should be consulted as early as possible.
Farm Payments (Convicted Criminals)
To ask the Scottish Government for an update on what action it is taking to withhold farming payments from convicted criminals. (S6O-01509)
There is no provision within the current legislation governing the basic payment scheme to recover or withhold payments to an individual business if it is meeting the scheme requirements. We are, however, considering whether future changes to legislation could introduce provisions to withhold payments to those who may not be fit and proper persons.
The cabinet secretary will probably be aware that the reason why I ask is that, in July, we learned that a farmer who was jailed for the sexual abuse of three children had been awarded almost £50,000 in subsidies by the Scottish National Party Government. At the time, a Government spokesperson indicated that it was considering whether the law could be changed in order to block such payments in future, as the cabinet secretary has just repeated. Weeks later, however, the Daily Record revealed that the same individual was given another £36,000. Can the cabinet secretary give any indication as to when that loophole might be closed?
The member raises an important point. It is critical to highlight that, although the powers over the basic payment scheme are devolved and we have the powers to change eligibility, we can do that only when it would simplify or improve the existing rules. At the moment, within the current powers and the legislation that we have in place, it is not possible for us to do that. As he will no doubt be aware, a consultation is open right now on legislation that we are looking to introduce in the Parliament, and I very much hope that he will take part in that consultation and make his views on the issue known. We will give that consideration when that legislation is brought forward.
Pet-owning Households
To ask the Scottish Government what information it has on whether there are households that took on a pet during the Covid-19 pandemic and are now struggling to look after them, in the light of the cost of living crisis. (S6O-01510)
The Scottish Government does not hold data relating to pets that were purchased during the pandemic and whose owners may now face difficulties with providing adequate care for them as result of the crisis.
The Scottish Society for the Prevention of Cruelty to Animals reports that the number of calls received from concerned pet owners has increased by 218 per cent compared with last year. Concerned owners looking for help and advice can contact the Scottish SPCA, in confidence, via its helpline. It is really important that, if people feel that they need help, they do that. The helpline number is 03000 999 999, and people can also visit the Scottish SPCA’s website to find out more about its pet aid scheme, which can help pet owners with essential food supplies.
I thank the cabinet secretary for her detailed answer. As she says, some of the figures are stark. The Scottish SPCA has reported that, in the whole of last year, 194 dogs were taken into care, and in the first six months of this year, the number was around 700. Can the cabinet secretary advise pet owners about where else they can get food for their animals—food banks, for example? Clearly, it is better if they do not have to hand over their animals to charities.
It is really distressing to hear the figures that the member has highlighted. It is upsetting when anyone feels as though they have no option other than to give up their pet, which is, of course, part of their family. I absolutely would encourage anyone who is experiencing difficulties, who thinks that they cannot cope or who thinks that they cannot keep their animal to reach out for support, because there are people who can help.
I specifically highlight the Scottish SPCA’s pet aid initiative, which supports people, and their pets, who are struggling. Recently, I met the Scottish SPCA in my constituency to hear more about the initiative. Through pet aid, the organisation supplies pet supplies and food through food banks and community larders. That initiative is in a number of locations throughout Scotland, and the Scottish SPCA is looking to expand the network further.
The Scottish SPCA does not want people to be separated from their pets. It was really awful to hear from the organisation about some instances in which people have been effectively starving themselves to try to feed their animals. I do not think that that should be a choice that anyone has to make.
The Scottish SPCA provides invaluable support and assistance. As I highlighted in my initial response, it can be contacted by phone or via its website. If anyone is struggling, I would encourage them to reach out and ask for help and support.
I highlight the work that the Edinburgh Dog and Cat Home does to provide support. During lockdown, increased demand for dogs saw increased prices, resulting in dog abductions surging a staggering 170 per cent, according to one charity. The current law does not do a good job of tackling the problem: the data is poor, the maximum punishment does not fit the crime, and dogs are treated as objects instead of living beings. Does the cabinet secretary agree that we need much better options if we are to tackle that heartless crime, such as those in my new proposed dog abduction bill?
I appreciate that the member is bringing forward that bill and I am, of course, more than happy to discuss it with him in more detail.
We know that, when they are sentencing, the courts will take into account the circumstances of any theft, including whether a loved family pet has been stolen. However, dogs and other pets are not the same as inanimate objects and I know that, when a theft of a pet occurs, it can cause significant upset.
We know that microchipping is an effective method of identifying animals, which can help to reunite lost or stolen dogs with their owners. The Scottish Government made it compulsory for all dogs to be microchipped and for contact details to be kept up to date. I encourage all dog owners to ensure that their dogs are microchipped.
I appreciate what the member is looking to do and, as I said, I am more than happy to consider his proposals when they come forward, and to discuss the matter further.
Food and Drink Sector (Impact of Brexit)
To ask the Scottish Government what its latest assessment is of the impact of Brexit on Scotland’s food and drink sector. (S6O-01511)
As a result of the United Kingdom Government’s reckless approach to European Union negotiations, Scotland’s food and drink sector lost many of the benefits that it once had when trading with the EU. The full economic consequences of exiting the EU are still to be realised. However, businesses now face additional expense when trading, and some food producers have found that their goods can no longer be exported to the EU. Many of Scotland’s food industries are still suffering from lower exports to the EU. There has been, for example, a 52 per cent fall in exports of fruit and vegetables and a 25 per cent fall in exports of dairy and eggs in the first months of 2022 compared to the same period in 2019.
Dr Liz Cameron of Scottish Chambers of Commerce recently stated:
“Scottish exporters are telling us that they continue to face growing challenges trading with countries in the EU post Brexit.”
Given the absence of any meaningful effort to alleviate the impacts on Scottish businesses of the UK Government’s economically inept and ideologically driven Brexit policy, does the cabinet secretary think that it is issues of competence or a thinly veiled contempt for Scotland that drives UK Government decision making on these issues?
It is disappointing to look at the series of decisions that have been taken and the catastrophic impact that they continue to have on Scotland and on our businesses. We can see that in the export figures that I have outlined, but we also continue to see the damage in the labour shortages that we see across our food and drink industry and many other sectors in Scotland.
Snaring
To ask the Scottish Government when it will publish the outcome of both the statutory review of snaring and its additional review, which was considering a potential ban on snaring in Scotland. (S6O-01512)
We published the outcome of the statutory review of snaring earlier this year on 1 April, and it can be found on the Scottish Government website. As Mr Smyth mentioned, I commissioned a review on the animal welfare aspects of snaring and also the implications of a ban on snaring on land management activities in Scotland. I expect to be able to publish the findings of that review soon, including any decisions made regarding the future of snaring in Scotland.
I note that the recommendations of the review that were published in April seem to implement the recommendations of the previous review in 2017, which have not yet been implemented. I hope that they will be delivered this time.
Can the minister give a clear assurance that, should there be any proposed legislative changes arising from the wider review of snaring—which, of course, I hope will involve a full ban—the timescale for publishing the review and any necessary consultation will allow any proposed changes to be incorporated in the proposed wildlife management (grouse) bill, which is the obvious place for them, rather than having to wait for separate legislation in the future?
I am happy to confirm my view that, should my view be that legislative change is needed as a result of the review, that will correlate with that bill and be included therein.
NatureScot predicts that the capercaillie will become extinct in the next two to three decades, and the British Trust for Ornithology notes that curlew populations have been rapidly declining over the past two decades. Predation by species such as fox is one of the foremost challenges that are faced by these rare birds, so how does the minister intend to confront biodiversity loss and protect species such as the capercaillie and curlew while her Government systematically dismantles the tools for ethical predator control, such as snaring?
On the one hand, I understand why many people instinctively feel that snaring is cruel but, on the other hand, I understand that land managers require access to control methods for legitimate purposes, including conservation, as Rachael Hamilton said. It was for exactly those considerations that I commissioned a review and, as I said to Mr Smyth, I will consider its outcome and publish it shortly.
On 25 November 2021, in answer to my colleague Colin Smyth, you indicated in your ministerial role that the Scottish Government would extend the scope of the snaring review to include a potential outright ban on snaring in Scotland. Is that still on the cards?
Yes, it is. The statutory review is, I think, required to take place every five years, although I might be getting the number of years wrong. I commissioned the separate review that Christine Grahame referred to, which went beyond the terms of the statutory review and looked at the potential and impacts of banning snaring in Scotland. That is the review that I hope to publish soon.
Question 6 was not lodged.
Argyll and Bute (Depopulation)
To ask the Scottish Government what further financial support it will provide to Argyll and Bute to help tackle depopulation of rural areas and islands. (S6O-01514)
Despite our capital allocations being significantly restrained as a result of the United Kingdom Government’s spending review, we continue to invest in our rural and island communities. That investment is provided through a range of programmes, such as the affordable housing supply programme, our rural and islands communities ideas into action fund and the Argyll and Bute rural growth deal. However, it is crucial that we acknowledge that the Scottish Government alone cannot tackle the critical challenge of depopulation. National and local government and the third, community and private sectors all have a role to play if we are to tackle depopulation collectively.
The cabinet secretary will be aware that Argyll and Bute is the second largest local authority by area in Scotland, but it is suffering from significant depopulation. At the same time as the population increased across Scotland, it decreased in Argyll and Bute, most notably by 34 per cent in the 25 to 44 age group. There are two infrastructure constraints: the first is the lack of a reliable ferry service and the second is the on-going problem on the A83 at the Rest and Be Thankful. In the latter case, can the cabinet secretary tell me when medium and long-term solutions will be found for the A83? Has the funding for that been identified in the budget?
Of course, if the member has not already done so directly, I am happy to raise those questions with the transport minister.
I come back to the initial part of my response to the member, which was that we alone cannot fix the challenges of depopulation. It takes work on a variety of fronts to tackle the sheer scale of the challenges that we have, whether that is transport or digital infrastructure, or housing.
I also emphasise that I am part of a ministerial task force that is looking at this. We will also bring forward a depopulation action plan; alongside my ministerial colleagues, I am leading on elements of that. We are intent on tackling the issues in and around all these problems and doing what we can across the piece, as well as across other parts of Government.
Beatrice Wishart has a supplementary question. I flag up to Ms Wishart that the question is about what further financial support the Government would provide to Argyll and Bute to help tackle depopulation in rural areas and islands.
In addition to Argyll and Bute, other areas are experiencing population decline. [Laughter.] In Shetland, infrastructure such as fixed links has proved positive in reversing depopulation. What additional financial support can the Scottish Government provide to island areas for tunnel or fixed-link infrastructure to help tackle depopulation?
Thank you, Ms Wishart; that was very deftly done. I feel that it is always important to bring supplementary questions back to the question that is in the Business Bulletin.
Again, I highlight my first response to Jackie Baillie’s question, in which I mentioned the significant capital restraints that we face in relation to our budget. It is important to work across Government, the third sector and local government to tackle the issues that communities on our islands face.
I represent Argyll and Bute, and it is important to recognise that Highlands and Islands Enterprise’s business panel survey noted that 53 per cent of businesses feel that workforce challenges are a perceived risk to their viability. Migration has a critical role to play in tackling population workforce challenges and, sadly, Labour is now actively engaging in a race to the bottom on immigration. Does the cabinet secretary agree that the need has never been clearer for Scotland to have its own immigration system to meet the needs of rural and island communities, including Argyll and Bute, to reflect our values and to repair the damage of Brexit?
Absolutely. Migration is a crucial part of the required approach to addressing our population challenges. We know that the United Kingdom Government’s immigration policy does not reflect the needs of Scotland’s rural communities, and that is exactly why we made the rural visa pilot proposal. It is a bespoke approach, and it not something that we have developed and delivered ourselves—we have worked on it with, and it has been supported by, a range of partners, including our local authorities. I know that Shetland Islands Council has previously commented that it considers the scheme to be an extremely important step when it comes to addressing the demographic challenges and skills shortages, which simply must be counted among the most serious issues that our economy is facing.
Members in the chamber will be aware that, during the debate on the rural visa pilot proposal in September, it was endorsed by a clear majority in the Scottish Parliament. I strongly encourage the UK Government to be more receptive to the democratic will of this Parliament and to allow the proposal to go ahead.
Proposed Agriculture Bill
I refer members to my entry in the register of members’ interests. Having attended the chamber for yesterday’s statement, I think that I know the answer to this question.
To ask the Scottish Government whether its proposed new agriculture bill will be introduced before 2024. (S6O-01515)
Yes.
That was predictable. Let us see whether we can get a yes or no answer to this question.
Yesterday, the cabinet secretary failed miserably to answer my question on whether farmers will be any more aware of the conditionality of future farm support. Forever the optimist, I will try again. Will the cabinet secretary confirm that all farmers will have access to all the agri support schemes that replace the single farm payment and that they will not be excluded by their location or land type? A yes or no answer would suit me.
My initial response was only predictable because the member was here for yesterday’s parliamentary statement. I had already committed to introducing the agriculture bill to Parliament next year.
As I outlined yesterday, what we are introducing in 2025 is a rollover of the schemes that we have at the moment. To be crystal clear, when the enhanced payment is introduced—it is the first element of the new framework that we will be looking to introduce—we want it to be available for everyone, which is why we are working with stakeholders to produce the appropriate measures for that payment through our national test programme, testing actions for sustainable farming.
We know that many farmers and crofters have been leading the way, and it is only right and fair that their work is recognised, as I outlined yesterday. The enhanced payment will not only seek to recognise and award those people who have been pioneering that work but aim to support and incentivise the continued efforts of others, too. Therefore, I strongly encourage all farmers and crofters to join the national test programme, which is testing the actions that could form part of that enhanced payment, to ensure that it is developed in a way that is accessible for everyone.
The cabinet secretary will be aware of the importance of livestock farming in Orkney and of the growing concern about the fall in suckler cow number in the islands. What assurances can she offer that the agriculture bill will actively support retaining the critical mass of the Orkney beef herd and will help to build desperately needed confidence in the wider farming sector in our islands?
The proposals in the bill, which are currently out for consultation, include powers to enable us to continue to support beef and sheep farmers. That includes those who farm in our most marginal land. We know that grazing livestock is vital for food production, and we also know that it is vital for our biodiversity and for various habitats and species. That is why we are committed to providing that support.
I also take the opportunity to mention the agriculture bill consultation, which we will be extending by another couple of weeks. The consultation had been due to run until 21 November, but it will now run until 5 December. That is specifically because we will be holding an in-person consultation event in Kirkwall on, I believe, 28 November. Of course, I would be happy to circulate further information about those events.
That concludes portfolio questions on rural affairs and islands. We will move to the next portfolio after a short pause to allow front-bench teams to change position.
Health and Social Care
The next portfolio is health and social care. If a member wishes to ask a supplementary question, they should press their request-to-speak button during the relevant question or enter “RTS” in the chat function during the relevant question.
I ask for succinct questions and answers, so that we can get in as many members as possible.
Advanced Clinical Practitioners (Training)
To ask the Scottish Government how it is supporting the training of advanced clinical practitioners. (S6O-01516)
In its broadest sense, the term “advanced clinical practitioner” can be applied to a range of healthcare professionals. Such practitioners are able to take on expanded roles as a consequence of advanced educational achievement, which is reflected in the scope of their practice.
In Scotland, we have an established advanced nursing practice education and training network, and we committed to training 500 additional advanced nurse practitioners by 2021. That target was exceeded, which was made possible with £4 million of Scottish Government funding to all regional national health service boards for trainee advanced nurse practitioners across all nursing fields and settings, including acute, community, care homes and prisons.
The cabinet secretary has largely answered my supplementary question. However, I will highlight that an ACP working in an accident and emergency department told me that, with the training of more ACPs, the burden on consultants would be significantly reduced and A and E waiting times improved. Is the cabinet secretary minded to look at developing that strand of training and recruitment with those things in mind?
We are absolutely committed to continuing to invest in our advanced nurse practitioners and other advanced clinical practitioners. Today, I was at Wishaw general hospital’s A and E department, where I spoke to an advanced nurse practitioner. It was very clear that that person, from the excellent work that he was doing, freed up some of the time of, for example, consultants, medical staff and other nursing staff to look at other cases. They are worth their weight in gold—and more, I would suggest. Therefore, we will continue to invest in ANPs and ACPs.
Carol Mochan, who joins us online, has a supplementary question.
Training advanced clinical professionals is vital to ensuring that the NHS develops and improves the level of care that it provides. Allied health professionals from across Scotland, including many of those who were in this Parliament last month—there were nearly 100 of them—are seeing the pressures that specialised NHS staff face daily.
AHPs are our third-largest workforce, and their skills can and will improve patient outcomes. Will the minister commit to listening to and working with AHPs to ensure that they are supported and adequately resourced, so that NHS service planning includes pathways for AHPs to further develop advanced clinical roles, ensuring clinical leadership from them across health and social care?
I agree with almost all of that. Our AHPs play a tremendous role, whether in acute settings or in the community. I am committed to continuing to work with the professional bodies that represent our allied health professionals, continuing to invest in them and, where appropriate, making sure that we invest in their further education and training. As is the case with the point that Gillian Martin rightly made, we know that, given the demands on the health service, the wider and broader that we can spread the workload, the better it is for everybody involved.
I agree very much with Carol Mochan, and I am very happy to discuss the matter further with her offline if she wishes to do so.
Excessive Alcohol Consumption (Impact on National Health Service)
To ask the Scottish Government what additional strain excessive alcohol consumption is having on the national health service. (S6O-01517)
Excess alcohol consumption is an important public health challenge in Scotland. It contributes to an increasing risk of developing a number of conditions, including cancers, heart disease and stroke. In 2020-21, there were 35,124 alcohol-related hospital admissions in Scotland. That was a decrease from the previous year, although Covid-19 and lockdown measures are likely to have contributed to that.
I thank the minister for the statistical update. After I wrote an article recently in Holyrood magazine about my own, very personal family experience of alcohol, a constituent wrote to me with some on-the-ground feedback about what is happening with alcohol services. She said:
“The lack of societal responsibility for our national shame is clearly demonstrated through a lack of coordination of services. When there is no coordination, there is no responsibility. We should never have to beg to be cared for. It is humiliating.”
I simply ask: why are so many people being let down at the moment by alcohol treatment services? Why are so many people not being treated? Why are so many people not being listened to? I am sure that the experience of my constituent is shared by thousands of people across Scotland. It is simply not good enough.
Alcohol and drug-related harms are vitally important public health issues in Scotland. That is why we established a national mission to improve and save lives. At the core of that mission is ensuring that every individual is able to access the treatment and the recovery that they choose.
We are working to ensure that people with alcohol use disorder continue to receive the same quality of care as those with problematic drug use. The forthcoming alcohol treatment guidelines, on which we are working with the United Kingdom Government and which have been delayed multiple times, will provide support for alcohol treatment similar to the medication-assisted treatment standards for drugs. We are also developing alcohol treatment targets alongside stage 2 of the drug’s target implementation in 2024.
We are absolutely aware of the challenges that the community faces in accessing care. We are investing in residential rehabilitation, which will benefit the people who are experiencing challenges with alcohol as well as those with drug addiction.
Alcohol absolutely remains a priority for the Scottish Government. Our alcohol and drug teams work very closely together on these issues, sharing our knowledge about what works and ways to reduce the impact of addiction, as well as routes through treatment.
Paul O’Kane has a supplementary question.
In the summer recess, I visited Moving On Inverclyde, which is a community-based service supporting people who are in recovery from addiction and supporting families who have lost a loved one to alcohol or drugs. Crucially, such services contribute to the reduction of strain on our national health service.
Inverclyde is one five local authorities in which alcohol-specific death rates have remained above the Scottish average consistently for the past five years. In response to those figures, Dr Alastair MacGilchrist, the chair of Scottish Health Action on Alcohol Problems, has called on the Scottish Government to increase funding and resources for alcohol services.
What additional support will be made available to ensure that people have access to life-changing and life-saving support, which is so often delivered by the third sector, particularly given the challenges that many charities are facing just to keep the lights on and the doors open because of the cost of energy and resources?
The first thing to say is that every death from alcohol is an absolute tragedy. At the moment, in Scotland, we lose 24 people a week to directly alcohol-related causes, and that is simply the tip of the iceberg. Behind those statistics of directly alcohol-related deaths, there are also a number of deaths in which alcohol is a factor, including some cardiac deaths, accidents and all sorts of other deaths. Cancer is also a big issue.
We are—absolutely—investing in addiction services as a whole, because of the national drugs mission. We are determined to improve the situation for people who are facing alcohol-related harms. As I said in my answer to the previous questioner, we are awaiting national treatment guidelines, which are being worked out on a four-nations basis. Once they are in place, we will be able to develop targets and scrutinise what is happening on the ground and to invest impactfully in areas where there are gaps in order to ensure that the situation improves.
As well as our work to directly improve access to addiction care, we are working on a whole-population basis to ensure that the long-standing and challenging relationship that we have with alcohol in Scotland is altered in the future. The whole Parliament will be asked whether we should continue one of our flagship policies in that effort—the minimum unit pricing of alcohol—and, if so, whether we should review the price at which it is set. A number of other policies are also in the pipeline, including an alcohol advertising policy and a whole suite of policies that we are determined to use to tackle this long-standing blight on our national landscape.
Long Covid (Support)
To ask the Scottish Government what support is in place for people with long Covid. (S6O-01518)
All national health service boards are providing support for people with long Covid, across local primary care teams, community-based rehabilitation services and referrals for further investigation in secondary care settings, where that is clinically appropriate.
For example, in September, I was pleased to meet the multidisciplinary team that is responsible for NHS Lanarkshire’s long Covid rehabilitation pathway, which covers the member’s constituency. That is delivering a single point of access for assessment and co-ordinated support from services, including physiotherapy, occupational therapy, psychology and speech and language therapy, depending on what is most appropriate for the individual’s needs.
I thank the cabinet secretary for that response and for his response to my recent written question on the matter. I welcome the development of the centre in Lanarkshire.
Over the past few months, I have been dealing with a constituent, Tracy McMullen, who has been in touch about her son Jonathan. I know that Tracy has also been in touch with the cabinet secretary directly. Jonathan is in his third year of suffering from long Covid and has been bed-bound for more than a year. It is truly a tragic set of circumstances, as he should be attending sixth year at high school, applying for university and having fun, but, instead, he cannot get out of bed most of the time.
Jonathan’s parents have found it extremely difficult to get any support through the NHS or to get him a diagnosis. They have found that primary care givers have no one to refer him to, and the family have had to turn to private providers, where he has recently been diagnosed with mast cell activation syndrome, which is common in long Covid. Hopefully, the symptoms can be treated, but that will be at considerable cost.
Is the Government undertaking any meaningful research into long Covid? When will multidisciplinary teams of knowledgeable healthcare professionals be established to help people such as Jonathan with diagnosis and medical intervention?
I thank Fulton MacGregor for raising Jonathan’s case in Parliament. I met his constituent Tracy in June, and I know from speaking to her just how challenging the symptoms are and what a detrimental impact they are having on her son, Jonathan. I have also written to Jonathan, and my understanding is that he has now been offered NHS support through the pathway that I referred to in my previous answer.
On the specific question on mast cell activation syndrome and research, the Scottish Government has worked with a range of specialists, including immunologists, to develop an implementation support note that provides practical information for clinicians on the identification, assessment and management of the long-term effects of Covid-19. That includes information on mast cell activation syndrome.
We have funded nine Scottish-led research projects on the long-term effects of Covid-19, with a total funding commitment of £2.5 million. Those studies aim to improve our understanding of the long-term effects of Covid-19 on physical and mental health in Scotland, and to inform clinical interventions to support recovery and rehabilitation. Although none of the projects focuses specifically on mast cell activation syndrome, our chief scientist office research funding schemes are open, and applications relating to the syndrome are welcome. Applications would go through the CSO standard independent expert review process to allow funding decisions to be made.
In October 2021, 90,000 Scots were suffering with long Covid. In May 2022, the Scottish Government announced that £3 million from its long Covid fund will be allocated in 2022. The number of Scots with long Covid is now 200,000, which is more than the population of Aberdeen. How much of the £3 million has been allocated and for what purposes? Does the cabinet secretary accept that the number of long Covid cases in Scotland will continue to boom, as has been the case over the previous 12 months?
I will write to Dr Sandesh Gulhane with the details not only of how much has been allocated but of how much has been allocated per health board, if he would find that useful. We can also give him some detail of each of the projects. As he will know, there is a £10 million commitment over three financial years.
The important point to make is that there is no doubt that there has been a rise in the number of those who are suffering from the long-term effects of Covid—we have seen that in the Scottish health survey and in Office for National Statistics data—so I expect health boards to readjust their spending in the light of the additional demands. The member will know that there is exceptional pressure on our health budget—in fact, my health budget is worth £650 million less than when it was set in December, as a result of inflationary pressures alone. We are in difficult financial circumstances, but, where we have an increase in demand, as we have seen with long Covid, I expect health boards to adjust spending appropriately.
Last week, Long Covid Scotland published a harrowing report that revealed that only one person out of the hundreds who replied had fully recovered and that relapses were common in four out of five people experiencing symptoms. Those are not just statistics; we are talking about our friends, our families and our neighbours.
Let me come back to the point about money. When the £3 million for long Covid services was announced, 79,000 people had been diagnosed with long Covid. According to the ONS, a year later, the number had increased to 202,000 people, which represents a staggering 155 per cent increase. Rather than leave cash-strapped health boards to pick up the slack, will the cabinet secretary increase the budget to meet that significant additional demand?
As I said to Dr Sandesh Gulhane in my previous answer, whenever there are increases in demand, we expect health boards to adjust their spending accordingly. As, I think, Jackie Baillie is quite aware, I have had to reprofile £400 million of funding in order to deal with the inflationary pressures that have impacted on our budget and to ensure that our NHS staff get a fair pay deal. She has stood up in the chamber and publicly criticised some of the reprofiling relating to mental health services, social care and primary care. Those were all really difficult decisions, and I took no pleasure in making them, but I had to make them because we live within a finite budget. If Jackie Baillie has any ideas about how else we should reprofile money and put it into, for example, long Covid support, I would be more than happy to have that discussion with her.
National Treatment Centres (Staffing)
To ask the Scottish Government, in light of the reported present staffing crisis, how it will ensure adequate staffing for the proposed national treatment centres. (S6O-01519)
We are committed to recruiting 1,500 additional staff during this parliamentary session to work across our national treatment centres. The Scottish Government is providing a range of recruitment support, training and development activity to assist health boards in securing the right mix of new and experienced staff. That includes additional funding to support international recruitment; providing additional postgraduate specialty training places in medicine; funding training opportunities through the NHS Scotland Academy, including training for new perioperative staff; and actively considering future staffing needs as part of on-going workforce planning activity. We have also taken action to support the retention of experienced staff and to develop new pathways into NHS Scotland careers.
The cabinet secretary says that he is committed to providing 1,500 additional staff. He might want to say how that is going. Will he set out a timetable for it? In recent weeks and months, I have met local staff and trade unions in Fife and across the region, and they ask that question.
Is there not also a need for greater transparency? Although people acknowledge the difficulties that the NHS faces, they must have confidence that the Government is on top of the issue. If staff who work on the front line do not have that confidence, how can the cabinet secretary expect anyone else to have it?
I speak to staff regularly. In fact, I did so today during a visit to Wishaw general hospital’s accident and emergency department, in Lanarkshire.
The Government has a proud record on NHS staffing and on growing staffing levels—NHS staffing is at record levels. We have committed to publishing next year, in our regular statistics, details of how the recruitment is going for the NTCs. I state, again, our commitment to provide 1,500 additional staff for those centres. From the information that I have to hand and from my discussions with the local health board, I know that the recruitment for the Fife national treatment centre is going well and that things are very much on track for its opening next year.
The 10 national treatment centres should deliver at least 40,000 additional elective surgeries and procedures a year by 2026. Luke Farrow, an orthopaedic surgeon and research fellow at the University of Aberdeen, told BBC Scotland that getting the treatment centres online is an absolute priority and that, every week, the backlog gets worse. Mr Farrow also stated that there must be planning to ensure that the 1,500 staff for the national treatment centres are not taken from elsewhere in the NHS, which would merely serve to worsen wider recruitment issues.
The NHS Lothian treatment centre in Livingston will need 400 staff, but NHS Lothian has warned that significant risks and challenges exist around that level of hiring. Can the cabinet secretary confirm that none of the 1,500 staff that are required for the national treatment centres will be taken from the current NHS staff?
I reiterate what I said to Alex Rowley: we expect the 1,500 staff to be additional. It is worth noting that the commitment to recruit 1,500 additional staff equates to recruiting less than 1 per cent of the total NHS workforce, so the risks of destabilisation are slim, although we will of course engage with boards—like we would do with NHS Lothian—in order to monitor any local challenges.
When we look at the recruitment of staff, we are aware that significant challenges exist, not just in urban settings such as our NTC in Edinburgh, but also, in particular, in our rural and remote communities. We will engage with boards regularly, but I give a firm commitment that we are talking about additional staff and add that the risk of destabilisation is very slim.
Boasting about recruitment track records and talking about the current crisis as being a “challenge” underestimates the real crisis that we have in our NHS. Just this week, we have heard about the astonishing waits at accident and emergency and about the crisis in our mental health services, yet the cabinet secretary talks as if he is managing the system well. When will he get real about the crisis in the NHS, and when will he sort it out?
That was yet another Willie Rennie intervention, full of constructive ideas, solutions and suggestions. I say to him that nobody—not I nor anyone in the Government—underestimates the challenge that the NHS faces. That is why I spend every waking moment trying to do our best to resolve some of the issues that we are facing, not just in the NHS but in social care. That is why the Government has invested record funding in our NHS and social care, and why we have record staffing in our NHS. That is not a boast; it is simply to demonstrate that we are taking action to help our NHS in a period of difficulty and challenge, which will only increase over the course of the winter.
If Willie Rennie has any constructive suggestions—he is shaking his head to show that he does not—I am more than happy to sit with him and have that discussion off table.
In light of Keir Starmer’s truly irresponsible comments on reducing the number of migrant workers in the NHS, how can the Scottish Government ensure that Scotland attracts the finest talents from overseas to address the immediate staffing shortages in our health service?
I agree with Stephanie Callaghan—Keir Starmer’s comment on overseas workers was inflammatory and such comments have no place in Scotland. Our NHS family should be proud of the fact that it is diverse. People from across the world choose to work in our NHS; they come here and provide excellent care to people in need. Whether you are a nurse, doctor, cleaner, member of admin staff, porter or anybody in between—whatever your role is and whether you have been in Scotland for 20 years or for just a couple of weeks—not only is Scotland your home but we are proud to have you as part of the NHS family.
The Labour Party, instead of chuntering from the sidelines, should care less about the front pages of certain right-wing newspapers and do what we do in the Scottish Government: care more about the front line of our NHS.
Rural General Practices
To ask the Scottish Government whether it can provide an update on the steps it is taking to encourage more general practitioners to work in rural practices. (S6O-01523)
We are fully committed to ensuring that all communities in Scotland receive safe, reliable and sustainable healthcare services, including in general practice.
The Scottish Government offers a wide range of initiatives specifically to attract GPs to rural areas, which includes golden hellos and bursaries for newly qualified GPs to take up posts in hard-to-fill rural locations. I add that our new Scottish graduate entry medicine programme—ScotGEM—which focuses on general practice and rural working, is proving very popular, with the first cohort of 44 students graduating in June of this year from the University of Dundee and the University of St Andrews.
Current recruitment strategies are clearly not working. In the rural area that I represent, GP practices have had to close as they were unable to recruit more GPs.
Other practices have stepped in, but they, too, are struggling due to recruitment issues and have to rely on expensive locum GPs. That situation is replicated across rural areas throughout Scotland. I ask the cabinet secretary not to repeat previous answers as we need something different. What more is the Scottish Government doing now to address rural GP recruitment issues? What incentives are there for doctors to specialise in general practice? How many additional places will be made available at Scottish universities to help fill future vacancies?
We have a manifesto commitment to increase medical graduate places by 100 per year, and we are fulfilling that commitment, so that is something very tangible. However, it is important that we are also able to ensure that a percentage of those graduates end up in general practice. Our GP specialty trainee bursary has been a phenomenal success that is contributing to our target of having 800 more GPs in Scotland between 2017 and 2027. In an effort to make GP training a more attractive career option, Scotland offers a one-off taxable bursary of £20,000 for GP STs. The scheme’s criteria are about posts that are historically hard to fill.
Notwithstanding that and what I have said already about what we are doing, I recognise the points that Sharon Dowey and others have made. We are proactively looking to recruit from other parts of the UK. Sharon Dowey might have seen our campaign marketing Scotland as an attractive destination for GPs and other medical staff to come to in order to set up a life and work.
As part of the latest round of that marketing campaign, our team attended the joint Royal College of General Practitioners and Wonca Europe event held in the ExCel arena in London, where it made more than 80 contacts with delegates who shared a desire to come to Scotland to work, either now or in the future.
We are straining every sinew possible in that regard, and we have a number of incentivisation programmes in place. It will be hard graft, but it is work that I am convinced that we can continue to do to ensure that we have as many GPs as possible coming here to train, work and build a family. If any members wish me to look at specific situations, I am happy to do that.
I can squeeze in two supplementary questions, if both questions and answers are brief.
It is not only rural areas that struggle to fill vacancies; the same situation exists for island posts. What can the cabinet secretary say to a local doctor promoting a GP role in the community of Hillswick, when a British Medical Association Scotland survey found that nearly 50 per cent of junior doctors are considering leaving the profession? How can that be squared with the 2007 SNP manifesto commitment to encourage people to train in rural medicine and commit to working in rural areas?
I am afraid that it is important that we do not lose sight of the impact of interventions such as Brexit. That is particularly relevant to islands such as Shetland, where a considerable number of doctors and medical staff were from Europe. Notwithstanding that fact—Brexit has been taken forward at full scale by the UK Government—I will not repeat what I have said about the incentivisation schemes. However, I am happy to discuss the issue with Beatrice Wishart if she thinks that there is more that we can do, particularly for island communities. I continue to have regular dialogue with Shetland, Orkney and our colleagues in the Western Isles and the Highlands and Islands.
I welcome the steps that have been taken so far, but can the cabinet secretary expand on the challenges of recruiting GPs from overseas, which, if overcome, could help with the GP numbers in rural areas and the Highlands and Islands?
That is an important question. It is a source of constant frustration for most Government ministers that the UK Government’s immigration system does not meet the needs of those living in Scotland. I suspect that it is also doing damage to the profession in England and the UK more widely. I have raised the issue of the Home Office immigration rules, and I intend to raise it again. There are particular issues with regard to tier 2 visas, impacting on international medical graduates who work in the UK after training in Great Britain. They are often left in the position of potentially being in the country illegally if they cannot find a sponsor within a few weeks of completing their training and they are unable to apply for indefinite leave to remain. Something has to change.
I will again write to the Home Office to intervene on that important issue, and I will seek a meeting on the matter. The Scottish Government will continue to press the UK Government on those issues at every available opportunity, and my officials are working with stakeholders to pull together best practice guidance to assist GP practices that wish to become sponsors to enable such highly skilled professionals to continue careers in the NHS in Scotland.
Thank you, cabinet secretary. That concludes portfolio questions on health and social care. There will be a short pause before the next item of business.