Meeting of the Parliament [Draft]

Meeting date: Tuesday, June 11, 2024

Official Report 922KB pdf

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Topical Question Time

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Bowel Cancer Screening

To ask the Scottish Government what its position is on whether bowel cancer screening is being carried out to detect cancer at the earliest possible stage or whether it is being determined by NHS capacity for colonoscopies and treatment. (S6T-02037)

Scotland is the only United Kingdom nation to fully adopt the United Kingdom National Screening Committee’s recommendation to screen all individuals aged between 50 and 74. The UK National Screening Committee has not recommended a specific threshold at which individuals should be referred for colonoscopy, but Scotland has the lowest referral threshold in the UK.

Professor Farhat Din has made it clear to the Health, Social Care and Sport Committee that she has seen bowel cancer patients who had been falsely reassured after sending off their stool samples. I accept that Scotland leads the way on the sensitivity of screening for bowel cancer, but that is not sufficient.

The minister has told me that the test cannot be made more sensitive because NHS Scotland does not have the capacity to carry out further investigations and primary colonoscopies. Can the minister quantify the estimated number of additional colonoscopies that would be required, and their cost, if the sensitivity of the test was increased by 75 per cent, as has been called for by Bowel Cancer UK?

I note the comments that were made by Professor Din in her statement and evidence.

Colonoscopy capacity in the national health service is continuously monitored and the bowel programme board will continue considering lowering the FIT—faecal immunochemical test—threshold. In the meantime, patients who are, via the Scottish bowel screening programme, referred with an urgent suspicion of cancer will continue to be prioritised for scope-based diagnostic tests, based on their level of clinical need.

That does not answer the question. Answers to freedom of information requests that I submitted to health boards across Scotland suggest that the cost of a colonoscopy is in the region of £800, or up to £2,500 if one is forced to go private. Does the minister really believe that saving that small sum of money is an adequate excuse for not detecting bowel cancer as early as possible, thereby making it treatable and preventing the potential horrors of bowel cancer, including chemotherapy, radiotherapy, surgery—which I know all about—or, worse still, death?

I recognise the work that Edward Mountain has done to raise awareness of the importance of bowel cancer testing. From my experience of having a father who was diagnosed with bowel cancer, I recognise the importance of carrying out the test.

Mr Mountain and I have had a number of conversations about the matter. The advice is that we should work towards a lower test threshold. However, that threshold would subject more people to potentially unnecessary diagnostic tests, while impacting on waiting times for symptomatic patients.

I am content to continue our conversations to see whether we can move things on.

It is vital that cancer is detected at the earliest possible stage to ensure the best chance of survival for patients. Our rapid diagnostic services, including the service that has been established in Dumfries and Galloway NHS, play a crucial role in that. Will the minister provide an update on the Scottish Government’s assessment of the impact to date of Scotland’s rapid cancer diagnostic services?

The Scottish Government has invested additional money to reduce colonoscopy waiting lists. We have also ensured that we will have mobile units available for allocation around the country, as necessary, for another year.

The latest data from Public Health Scotland shows a shocking 21 per cent gap in the uptake of bowel cancer screening between the most-deprived areas and the least-deprived areas. Does the minister accept that health inequalities are a blight on Scotland and does she also accept that this Scottish National Party Government is not doing enough to close that divisive health inequality gap?

I absolutely recognise that there are inequalities in the uptake of bowel screening. The Scottish Government has been investing to try to reduce those inequalities and ensure that more people from the diversity of people in Scotland take part in the bowel cancer screening.

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International Students (Immigration Rules)

To ask the Scottish Government what assessment it has made of reports that Scottish universities’ budgets have been impacted by £100 million due to a 20 per cent drop in applications from international students in the last academic year as a result of new United Kingdom Government immigration rules. (S6T-02044)

International students play a crucial role socially, culturally and economically in Scotland, and it is important that we continue to do everything that we can to welcome them to live, study and work in Scotland.

Instead, however, UK immigration policies are attempting to turn them away, which is hurting our higher education sector and demonstrating once again that those policies simply do not address Scotland’s distinct demographic and economic needs. The Scottish Government will continue to push the UK Government for a migration policy that meets Scotland’s needs, and for the decisions to be made in Scotland in order for Scotland to ensure that we can support our world-class universities.

Does the cabinet secretary agree with the recent statement by Sir Anton Muscatelli of the University of Glasgow, who said that

“By restricting student visas, the UK is endangering its world-class university sector”?

It is time to stop the senseless self-harm to our economy and to focus on our national assets. To have a discriminatory visa system that is designed to satisfy the extreme prejudice of the anti-immigration lobby is an act of colossal self-harm. Surely what we need is to encourage more undergraduate and graduate students by removing all visa impediments.

I completely agree with Sir Anton. Not only do international students enrich our culture and our cities, but they support our universities through their contribution to our world-leading research and they support this vital area of the economy more broadly. Sir Anton leads one of our world-class universities—I declare an interest as a graduate of the University of Glasgow—and people there can see every day the damage that is being done to our higher education sector by right-wing immigration policy at Westminster and by a Brexit that Scotland did not vote for.

The Scottish Government has recently set out, in our “Building a New Scotland” series of proposals, a Scottish connections visa that would allow graduates to work in Scotland in order to become eligible for Scottish citizenship. That is what independence can offer, unlike the status quo, which is continuing to damage our higher education sector. It could not be clearer that leaving such decisions to the UK Government, whether it be led by Labour or the Tories, is just not in Scotland’s interests.

Not only have we witnessed a drop in the number of international students who come to study here, but, as the cabinet secretary correctly notes, Brexit has brutally removed opportunities for Scotland’s universities to build international relationships. Does she share my concern that Scotland’s further and higher education sectors are suffering under a refusal from Westminster—from the Tory and Labour parties alike—to acknowledge, own and address the damage of Brexit, and that the best way to address that damage is to return to membership of the European Union?

I absolutely agree with Michelle Thomson’s points. Brexit has caused incredible damage—not just to Scotland’s further and higher education sectors, but to our wider economy and society. It has meant staff losing the ability to move freely and share ideas and—of course—it has meant students losing the ability to experience new cultures. The UK Government’s decision not to participate in or associate with Erasmus+ is a particularly damaging example of that. It robs our young people of the opportunities that previous generations, including mine, took for granted.

With both Labour and the Conservatives being committed to that extreme form of Brexit, which Scotland rejected, this Government will continue to make the case for Scotland to rejoin the European Union as an independent country, which would see our universities playing a full, positive and constructive role with our neighbours in Europe and ensuring that our world-class researchers remain at the forefront of international collaboration.

Dr Conlon of London Economics told the Education, Children and Young People Committee last week:

“Higher education institutions here are underfunded: they have 27 per cent less funding than institutions in England”—[Official Report, Education, Children and Young People Committee, 5 June 2024; c 36.]

In a submission that was received today, Robert Gordon University says:

“the under-funding of Scottish HE means ... a conscious Scottish Government policy where fee income from international students is expected to cross-subsidise universities’ activities.”

Conlon later said that

“Ultimately, an institution is going to fall over ... If you are happy to let an institution collapse, then it”—

“it” being funding—

“is sustainable, but it might not be ideal.”—[Official Report, Education, Children and Young People Committee, 5 June 2024; c 38.]

Is the cabinet secretary happy to let an institution collapse due to Scottish Government policy?

Liam Kerr will recognise that, as a result of a funding cut to this Government’s budget from his party in Westminster, this Government has faced one of the most challenging financial situations since devolution.

However, despite that challenging fiscal position, the 2024-25 budget allocates nearly £2 billion to colleges and universities to support their delivery of high-quality education, training and research. We have also invested £1 billion in Scotland’s university sector every year since 2012-13. This year, in addition, we have protected an increase to the research budget of 4.75 per cent in cash terms—which, I note, was welcomed by Universities Scotland in its briefing to the Education, Children and Young People Committee.

I heard the cabinet secretary, but she will also be aware that Scottish Government funding to universities has fallen by £2,325 per student between 2014-15 and 2021-22. At the weekend, Sir Paul Grice said that

“over the last decade, government has just not been able to meet its part of the deal.”

Universities Scotland said that, as a result, institutions face closures. The National Union of Students and the University and College Union say that there is concern about retention of poorer students and that university job losses are looming. With that in mind, does the cabinet secretary believe that the Scottish Government is properly funding universities? If so, what does she say to those, including Sir Paul Grice, who say otherwise?

I thank Pam Duncan-Glancy for her question and for her interest in the matter.

The Labour Party seems to have been adhering to the Conservatives’ spending ideas in relation to public services, including on funding for our universities. If the member would like additionality for our university sector, I am sure that she will be having a word with her bosses in London about Labour’s proposals for allocation of funding to the sector.

I am very content with the funding that this Government provides to the university sector, in the context of there being a funding cut from the UK Government. If Pam Duncan-Glancy’s party will seek to reverse that funding cut, I am sure that we can have a conversation about the sustainability of Scotland’s university sector, but until the Labour Party takes such a decision—I have not yet heard it do so—I do not think that we will have an honest conversation about sustainability.

More broadly, on the member’s point about funding for our universities, one really important thing that my party believes in is the policy of free tuition. I think that Pam Duncan-Glancy’s party does not now support that policy. It would be helpful to hear from Scottish Labour whether it would support it. I see Pam Duncan-Glancy nodding. The last time that the Labour Party was in power in the Scottish Parliament, people such as I had to pay the graduate endowment, so we well remember the impact that its decisions on tuition fees had on people from low-income families. Just now, this Government is helping students in Scotland to avoid accruing debt of up to £27,750 each. The Labour Party should think again about its policy on free tuition.

That concludes topical question time. There will be a momentary pause, to allow the front benches to organise.